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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Sheilac on May 9, 2008, at 15:45:19
Ugh, I'm depressed and can't sleep and have anxiety. I have xanax to take (which helps). I have been taking seroquel 50mg at night to sleep, but I worry about prolactin levels - plus I'm depressed during the day.
I don't have good luck with ssris or snris (they hurt my bladder).
I've also aggravated my depression by taking diet pills to try and lose weight.
I tried taking a small dose of geodon but it gave me muscle spasms and eye twitches.
Are there any meds that I could try? I feel so depressed.
Posted by SLS on May 9, 2008, at 16:31:32
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
Many doctors ignore the older drugs that are more potent than SSRIs as antidepressants. If you haven't tried a tricyclic yet, I would consider desipramine or nortriptyline. These two have milder side effects.
- Scott
Posted by 4WD on May 9, 2008, at 16:34:10
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
Hi. Sounds like you're having a really rough time. What meds are you on? It's hard to know what to suggest without knowing what you are currently on. If you can't take SSRIs or SNRIs there is always the possibility of a triclyclic like imipramine or nortriptyline. They have their own set of side effects - harsher than SSRIs but they work well for some people.
You might also consider an MAOI. It won't help with your sleep, though. I take Trazadone at night to sleep and it helps a lot. I don't need it to fall asleep but it keeps me from waking up way too early. And it had an unexpected side effect. Once I started taking it, I quit waking up from a jolt of fear. I still have to take anxiety meds but at least I wake up okay now.
Yeah, diet pills are probably not a good idea. When they wear off, I would guess your depression gets worse than before you took them. And they can't be helping with your sleep. If you go off Seroquel, the weight issue will probably resolve itself.
Geodon helped me a lot with no side effects. But there are many other drugs in the same class you could try - Abilify, Risperdal are two. I think Risperdal is supposed to help with anxiety.
Hope this helps a bit
Marsha
> Ugh, I'm depressed and can't sleep and have anxiety. I have xanax to take (which helps). I have been taking seroquel 50mg at night to sleep, but I worry about prolactin levels - plus I'm depressed during the day.
>
> I don't have good luck with ssris or snris (they hurt my bladder).
>
> I've also aggravated my depression by taking diet pills to try and lose weight.
>
> I tried taking a small dose of geodon but it gave me muscle spasms and eye twitches.
>
>
> Are there any meds that I could try? I feel so depressed.
Posted by bulldog2 on May 9, 2008, at 16:41:25
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
> Ugh, I'm depressed and can't sleep and have anxiety. I have xanax to take (which helps). I have been taking seroquel 50mg at night to sleep, but I worry about prolactin levels - plus I'm depressed during the day.
>
> I don't have good luck with ssris or snris (they hurt my bladder).
>
> I've also aggravated my depression by taking diet pills to try and lose weight.
>
> I tried taking a small dose of geodon but it gave me muscle spasms and eye twitches.
>
>
> Are there any meds that I could try? I feel so depressed.The tca imipramine used to be the gold standard of ADs. It effects both ne and se. I saw one article on the internet that says also dopamine reuptake but I'm not sure about that.
Posted by Maxime on May 9, 2008, at 19:35:37
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
Seroquel can help depression. It's also the only anti-psychotic I don't lactate on, so I don't know how much it affects prolactin levels.
Posted by Phillipa on May 9, 2008, at 20:50:17
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
Seroquel but it can cause weight gain and if you've been on diet pills sounds like that wouldn't be an option. No benzos? Love Phillipa
Posted by Jay_Bravest_Face on May 9, 2008, at 22:12:30
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
Despite all of the negativity towards antidepressants, and yes I have had my share of bad times with them, when you find the right combo and dose, they can work wonders.
Id echo what Scott said about tricyclics, and also add to consider starting with VERY low doses of some newer meds. Eg. 5-10 mg of Paxil, 10 mg Prozac, half a 37.5 mg capsule of Effexor XR.30 mg of Cymbalta. Have some good benzos at your side to fight any start-up anxiety. Using this very slow titration, your body isnt put into shock by the much larger doses usually used. Also, there are many pdocs combining different antidepressants too, to get the best use from a few angles.Best,
Jay
Posted by Sheilac on May 10, 2008, at 7:59:21
In reply to Re: Feel like I've tried everything... » Sheilac, posted by Jay_Bravest_Face on May 9, 2008, at 22:12:30
Thank you all. I know I have to stop the diet pills. The xanax does help with anxiety. I've also been having thyroid problems, which makes the depression worse.
The Geodon makes me nervous. I thought 10 - 20mg of Geodon might be good. I've heard good and bad things about it though.
Seroquel has been a life saver for sleep. I have a total hysterectomy 2 years ago and since then I don't sleep.
Posted by Forerunner on May 10, 2008, at 14:00:17
In reply to Re: Feel like I've tried everything..., posted by SLS on May 9, 2008, at 16:31:32
TCA's and MAOI's.
Posted by llurpsienoodle on May 10, 2008, at 18:45:54
In reply to Re: Feel like I've tried everything..., posted by Forerunner on May 10, 2008, at 14:00:17
lamictal (lamotrigine) is a mood stabilizer that is used as an antidepressant. For a few months it was my only antidepressant. the only downside to lamictal is that you have to titrate up fairly slowly to avoid side effect (a nasty skin rash)
I think it's a good drug though.
Sorry you're hurting, I hope this helps, a tiny eensy weensy bit
Ll
Posted by Phillipa on May 10, 2008, at 19:43:18
In reply to Re: Feel like I've tried everything..., posted by Sheilac on May 10, 2008, at 7:59:21
Welcome to the thyroid club it definitely can mess with how you feel. Don't know age or anything but are you on supplemental hormones. As a total can be a huge shock to your system. I also thought geodon was a good antianxiletic?? Love Phillipa
Posted by elanor roosevelt on May 10, 2008, at 22:52:46
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
The only med I ever lost weight on was Parnate
Posted by undopaminergic on May 11, 2008, at 13:16:00
In reply to Re: Feel like I've tried everything..., posted by elanor roosevelt on May 10, 2008, at 22:52:46
I lost weight on sertraline initially, and also on methylphenidate until tolerance developed to its appetite-suppressant effects.
Posted by Racer on May 11, 2008, at 19:35:45
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
Obviously, you haven't tried everything, so I won't repeat what others have said so much better than I could... ;-)
I'm wondering what your doctor has had to say about the bladder irritation you say SSRIs and SNRIs give you? That's ringing some sort of bell in my brain that I can't quite recognize, so I'm wondering if what your doctor has to say might trigger recognition for me... It does sound like a side effect which might be go away over time or be manageable if the medications work for you -- have you been able to tolerate one long enough to find out? If not, due to the side effects involved with the other classes of drugs, it might be worth trying to stay on one until you can find out if it would work for you.
It's hard when you have trouble finding a medication with a good balance between effectiveness and tolerability. I'm feeling stuck right now myself, because the best I've found so far isn't all that effective -- but that's the trade off I've made at this point in my life. Maybe at another time in my life, I'll make a different choice.
Good luck.
Posted by Racer on May 11, 2008, at 19:37:42
In reply to Feel like I've tried everything..., posted by Sheilac on May 9, 2008, at 15:45:19
By the way, I have probably asked you this before, but I'm going to ask it again since I don't remember the answer: do you have an eating disorder? Distorted body image? Is that why the diet pills and concern regarding weight gain?
Remember -- I have an eating disorder, and won't be judging you about it if the answer is yes. I'm asking because it's relevant to the questions you're asking, and to how the medications may affect you.
Good luck.
Posted by Sheilac on May 12, 2008, at 7:12:48
In reply to PS » Sheilac, posted by Racer on May 11, 2008, at 19:37:42
No I don't have an eating disorder. About 5 years ago I packed on 35 lbs with Celexa and have not taken it off. SSRIs made me very happy for many, many years until they started bothering my bladder (frequent urination, and bladder irritation). Lexapro was the worst as far as bladder pain and irritation. I went to a urologist and she said she does see this a lot and didn't know if it was due to filler ingrediants or receptors in the bladder, etc.
But, when I don't take the SSRIs or SNRIs I don't have any bladder problems. So something about the drugs that effect those serotonin receptors physically hurts me.
I've had pretty good luck with Seroquel 50mg for sleep. It also helps a little with my depression. But it would be great to get a little more help with my depression.
After a few days on Geodon, I don't like it. It made my heart do weird things - very scary.
My pdoc did mention parnate - but isn't parnate an MAOI? Doesn't that mean I will have to watch what I eat and drink?
I know I shouldn't take the phentermine diet pills because after a few days they really depress me.
It would be nice to get and AD that could help me with appetite and mood.
Posted by undopaminergic on May 15, 2008, at 22:35:36
In reply to Re: PS, posted by Sheilac on May 12, 2008, at 7:12:48
>
> My pdoc did mention parnate - but isn't parnate an MAOI? Doesn't that mean I will have to watch what I eat and drink?
>Yes, Parnate (tranylcypromine) is a MAOI, and it does require the avoidance of certain foods that may trigger hypertensive reactions, but the dietary restrictions are often exaggerated, and those who really enjoy the antidepressive effects of Parnate rarely find the restrictions to be much of a sacrifice. Some people find Parnate to cause weight loss, so it may be a good choice in your situation.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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