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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by zzz7 on December 6, 2008, at 13:51:54
From 1997 to 2006 I was on large amounts of SRI drugs. At various points, I was on 400mg clomipramine with 100mg Luvox, 110mg Prozac, 100mg Prozac and 400mg ProVigil, and the like.
in 2006 I entered a deep depression after a sporting injury that caused me to go from a high level of physical activity to none at all for several months. To get out of it, I pushed serotonin levels even higher than I had before. I assumed that drugs were pooping out on me. I even added small amounts of 5HTP. All of this seemed to make things even worse. I backed way off when I developed signs of serotonin syndrome. As I backed off, I felt better. The lower I went, the better I felt. I went down to 1mg Lexapro for a while. I felt better, but still slightly depressed. Then, all the way down to two sand-sized grains of Lexapro. Finally relief. I experimented some more by going off SRIs altogether (in this case Lexapro). The depression came back. So, apparently I'm hyper-sensitive to serotonin (and the same turns out to be case for DA; I found this out by decreasing doses of amatadine to lower serotonin levels when I had taken too much of the SRI).
The problem is that something like exercising will increase DA levels such that I get depressed. One grain too much on Lexapro, I get depressed. I sit on this knife's edge between DA and 5HT, and it's tough not to fall off one side.
Advice?
Posted by bleauberry on December 6, 2008, at 17:00:23
In reply to Strange shift in 5HT tolerances, posted by zzz7 on December 6, 2008, at 13:51:54
Me too. I wish I had some explanation or suggestion for you.
I never went to real high doses like you did, but I was on regular doses for a decade. Then after strange developments, paradoxical reactions, poopout, and failed ECT, I am super sensitive as you are. Even a mere 2mg lexapro had me on my knees in uncontrollable tears within 3 days. Anything DA helps a slight bit, but then again, just tiny amounts. Any more and things get worse.
Very strange phenomenon.I suspect somewhere along the line receptors just got reconditioned in sensitivity from their artificial environment, or genes got reprogrammed, or something weird.
Interesting about sand sized grains of lexapro. I could try that. :-)
The only med I have been able to tolerate is low dose Milnacipran. Starting dose is 25mg, therapeutic dose is 50mg to 100mg, max is 200mg, but I felt it extremely strong at just 12.5mg.
While 5HT and DA seem messed up somehow, NE seems in better shape. Maybe all those meds didn't mess with NE too much?
Anyway, you aren't alone in this weird thing.
Posted by zzz7 on December 6, 2008, at 18:54:03
In reply to Re: Strange shift in 5HT tolerances, posted by bleauberry on December 6, 2008, at 17:00:23
Thanks for the reply. I wish I were alone in this. It's no fun.
I've tried Strattera and crashed with it. I suspect it's because NE will affect DA and 5HT levels.
I take tiny bits of Lexapro and put them in capsules I buy from the health foods store. The same goes for the small amounts of amatadine I take.
No Milnacipran here in the US. So that won't work for me.
> Me too. I wish I had some explanation or suggestion for you.
>
> I never went to real high doses like you did, but I was on regular doses for a decade. Then after strange developments, paradoxical reactions, poopout, and failed ECT, I am super sensitive as you are. Even a mere 2mg lexapro had me on my knees in uncontrollable tears within 3 days. Anything DA helps a slight bit, but then again, just tiny amounts. Any more and things get worse.
> Very strange phenomenon.
>
> I suspect somewhere along the line receptors just got reconditioned in sensitivity from their artificial environment, or genes got reprogrammed, or something weird.
>
> Interesting about sand sized grains of lexapro. I could try that. :-)
>
> The only med I have been able to tolerate is low dose Milnacipran. Starting dose is 25mg, therapeutic dose is 50mg to 100mg, max is 200mg, but I felt it extremely strong at just 12.5mg.
>
> While 5HT and DA seem messed up somehow, NE seems in better shape. Maybe all those meds didn't mess with NE too much?
>
> Anyway, you aren't alone in this weird thing.
Posted by azalea on December 6, 2008, at 21:20:03
In reply to Re: Strange shift in 5HT tolerances, posted by zzz7 on December 6, 2008, at 18:54:03
Have you tried Wellbutrin (bupropion)?
> Thanks for the reply. I wish I were alone in this. It's no fun.
>
> I've tried Strattera and crashed with it. I suspect it's because NE will affect DA and 5HT levels.
>
> I take tiny bits of Lexapro and put them in capsules I buy from the health foods store. The same goes for the small amounts of amatadine I take.
>
> No Milnacipran here in the US. So that won't work for me.
>
> > Me too. I wish I had some explanation or suggestion for you.
> >
> > I never went to real high doses like you did, but I was on regular doses for a decade. Then after strange developments, paradoxical reactions, poopout, and failed ECT, I am super sensitive as you are. Even a mere 2mg lexapro had me on my knees in uncontrollable tears within 3 days. Anything DA helps a slight bit, but then again, just tiny amounts. Any more and things get worse.
> > Very strange phenomenon.
> >
> > I suspect somewhere along the line receptors just got reconditioned in sensitivity from their artificial environment, or genes got reprogrammed, or something weird.
> >
> > Interesting about sand sized grains of lexapro. I could try that. :-)
> >
> > The only med I have been able to tolerate is low dose Milnacipran. Starting dose is 25mg, therapeutic dose is 50mg to 100mg, max is 200mg, but I felt it extremely strong at just 12.5mg.
> >
> > While 5HT and DA seem messed up somehow, NE seems in better shape. Maybe all those meds didn't mess with NE too much?
> >
> > Anyway, you aren't alone in this weird thing.
>
>
Posted by bleauberry on December 7, 2008, at 10:24:56
In reply to Re: Strange shift in 5HT tolerances, posted by zzz7 on December 6, 2008, at 18:54:03
I live in the US. You are correct, Milnacipran is not sold in the US. But it is easily available from overseas mailorder. Anyone can order it and receive it within about 2 to 3 weeks.
While Strattera is real strong on NE, it cannot be used a comparison to Milnacipran. Milnacipran is also strong on NE, but in a very different way that I cannot put into words. The meds are only similar when talking about them in general terms on paper. That has zero accuracy in how they are actually dramatically different in how they feel. Strattera to me felt like absolute poison. Milnacipran actually felt kind of good. If someone reacted badly to Strattera and said too much NE, too much DA, whatever, and then said well Milnacipran is like that too so it won't work, they would likely be way wrong.
> Thanks for the reply. I wish I were alone in this. It's no fun.
>
> I've tried Strattera and crashed with it. I suspect it's because NE will affect DA and 5HT levels.
>
> I take tiny bits of Lexapro and put them in capsules I buy from the health foods store. The same goes for the small amounts of amatadine I take.
>
> No Milnacipran here in the US. So that won't work for me.
>
> > Me too. I wish I had some explanation or suggestion for you.
> >
> > I never went to real high doses like you did, but I was on regular doses for a decade. Then after strange developments, paradoxical reactions, poopout, and failed ECT, I am super sensitive as you are. Even a mere 2mg lexapro had me on my knees in uncontrollable tears within 3 days. Anything DA helps a slight bit, but then again, just tiny amounts. Any more and things get worse.
> > Very strange phenomenon.
> >
> > I suspect somewhere along the line receptors just got reconditioned in sensitivity from their artificial environment, or genes got reprogrammed, or something weird.
> >
> > Interesting about sand sized grains of lexapro. I could try that. :-)
> >
> > The only med I have been able to tolerate is low dose Milnacipran. Starting dose is 25mg, therapeutic dose is 50mg to 100mg, max is 200mg, but I felt it extremely strong at just 12.5mg.
> >
> > While 5HT and DA seem messed up somehow, NE seems in better shape. Maybe all those meds didn't mess with NE too much?
> >
> > Anyway, you aren't alone in this weird thing.
>
>
Posted by zzz7 on December 7, 2008, at 15:31:50
In reply to Re: Strange shift in 5HT tolerances » zzz7, posted by bleauberry on December 7, 2008, at 10:24:56
That an interesting idea. I'll talk to my pdoc and ask him if he'll go for it (I suspect he'd be fine with it).
Thanks!
Posted by zzz7 on December 7, 2008, at 15:37:10
In reply to Re: Strange shift in 5HT tolerances » zzz7, posted by bleauberry on December 7, 2008, at 10:24:56
I just googled the drug and got hits from all sorts of questionable-looking pharmacies. Do you have any suggestions for good overseas pharmacies? Thanks.
Posted by Deputy Racer on December 7, 2008, at 17:47:29
In reply to Re: Strange shift in 5HT tolerances, posted by zzz7 on December 7, 2008, at 15:37:10
> Do you have any suggestions for good overseas pharmacies?
Please follow the guidelines for this site, which prohibit sharing information about obtaining medications without a doctor's prescription. Additionally, please do not ask anyone to use the BabbleMail feature to send you such information, as doing so also violates the site guidelines.
If you have any questions regarding the posting policies on this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#illegal Follow ups to this action should be directed to the Administration board and should themselves be civil.
Dr Bob has ultimate authority over all administrative issues on this site, and may choose at any time to revise or reverse any action taken by a deputy.
Deputy Racer
Posted by zzz7 on December 7, 2008, at 18:23:59
In reply to Please follow site guidelines » zzz7, posted by Deputy Racer on December 7, 2008, at 17:47:29
I wasn't looking for information as to how to get medications without a prescription at all. In fact, I want one that will take prescriptions from my doctor.
But now that I see the FAQ link that you sent me, it looks pretty clear that getting the medication would be illegal.
Suggestion: Update the FAQ link to include more of the text from the .gov website:
"The Federal Food, Drug, and Cosmetic Act (the Act) prohibits persons from importing into the United States any prescription drug that has not been approved for sale by the United States Food and Drug Administration (FDA)"
fromhttp://www.cbp.gov/xp/cgov/travel/clearing/restricted/medication_drugs.xml
Posted by Deputy Racer on December 8, 2008, at 8:49:22
In reply to Re: Please follow site guidelines, posted by zzz7 on December 7, 2008, at 18:23:59
Posted by NewQuestions on December 8, 2008, at 11:29:01
In reply to Strange shift in 5HT tolerances, posted by zzz7 on December 6, 2008, at 13:51:54
I can totally relate to this! I was on a relatively high dose of Zoloft for years, then experienced new side effects (mental fog, confusion, lethargy, muscle ache, apathy). The other SSRI's didn't work either--some made me more anxious, some made me more depressed! I tried many other drugs too (cymbalta, effexor, wellbutrin, TCA, MAOI) and they all had devastating side effects. Like you, I became hypersensitive to the drugs.
You may want to try lamictal, which does not work on the big three neurotransmitters (it helped me a little but affected my cognition too much), or stablon, which works on serotonin but in a different way. I have not tried Milnacipram.
I have been getting my hormones checked out, and researching various theories like adrenal fatique syndrome. I am considering trying Ablify or Nefazone as well. Ultimately, I don't know what happened. My doctor says it is atypical. I have only found a small handful of people on the internet who have similar experiences.
Of course, if you can do it, a "drug holiday" is probably best.
Posted by zzz7 on December 8, 2008, at 14:49:37
In reply to Re: Strange shift in 5HT tolerances, posted by NewQuestions on December 8, 2008, at 11:29:01
Well, there are three of us, at least. I had thought about Lamictal, as well. But I'm a researcher and need my brain to work well. So I'm hesitant about Lamictal, too.
Abilify makes me depressed. The EPS it brings on suggests it antagonizes the D2 receptor more than one might think at first.
With me, no drugs=major depression. The problem is not going over optimal dose by even ~.01mg
Posted by NewQuestions on December 8, 2008, at 16:48:41
In reply to Re: Strange shift in 5HT tolerances, posted by zzz7 on December 8, 2008, at 14:49:37
Do you experience other side effects too? What are they?
Posted by NewQuestions on December 9, 2008, at 15:29:32
In reply to Strange shift in 5HT tolerances, posted by zzz7 on December 6, 2008, at 13:51:54
I read this in an article about SSRI's and the thyroid:
"Theoretically, an excess serotonin may lead to the opposite reaction. For example, excess serotonin leads to reduction in dopamine production, which then leads to increased norepinephrine production, leading to an increased stress response and cortisol production."
Could this be what is happening? Take an SSRI, it increases serotonin, which decreases dopamine (leading to depression/lethargy) and/or increases norepinephrine (increasing anxiety)? If so, it would seem one would need to take multiple drugs that specifically target these effects by increasing the dopamine and/or decreasing the norepinephrine? My understanding is that the new drug Abilify works with SSRI's and increases dopamine, but I am no expert.
Posted by zzz7 on December 12, 2008, at 2:57:09
In reply to Re: Strange shift in 5HT tolerances, posted by NewQuestions on December 9, 2008, at 15:29:32
I think that is what is happening. I am taking Abilify now (though I'm taking literally .05mg or so because any more makes me depressed) to see if it can stabilize the balance.
Posted by crittercuddler on December 15, 2008, at 22:36:54
In reply to Strange shift in 5HT tolerances, posted by zzz7 on December 6, 2008, at 13:51:54
Hello there. :-)
I just wanted to say that there are five of us for sure. I too am having very bad sensitivity issues. I was not on my anti-depressant as long as you (I was on mine for four years), but nevertheless, I am having a very difficult time getting stablized again. Check out my thread on the Medication Board to see what people have suggested to me. My posting name is crittercuddler. It will be in the December posts.
I am hesitant to offer advice myself as I am just starting to research this more myself. Others on this site though have been very helpful in enlightening me, especially desolationrower.
A good book to consult on this subject in general would be Essential Psychopharmacolgy by Steven Stahl. You can view parts of the book online. It is also of course available for purchase.
Posted by zzz7 on December 15, 2008, at 23:11:43
In reply to Re: Strange shift in 5HT tolerances, posted by crittercuddler on December 15, 2008, at 22:36:54
Thank you very much for this!
Lamictal helped me hugely, though anything more than 12.5 mg makes me depressed :)
Fingers crossed it keeps up.
Posted by NewQuestions on December 23, 2008, at 13:42:47
In reply to Re: Strange shift in 5HT tolerances, posted by zzz7 on December 15, 2008, at 23:11:43
For people in our boat, has anyone tried Nefazodone? Apparently, it works by blocking post-synaptic receptors. From what I understand, this is different from SSRIs/TCAs, which affect pre-synaptic receptors and reuptake, and MAOIs, which release stored serotonin. Its the only mechanism for raising serotonin I have not tried!
Posted by zzz7 on February 28, 2009, at 5:25:33
In reply to Re: Strange shift in 5HT tolerances, posted by crittercuddler on December 15, 2008, at 22:36:54
Thanks for this. I have a copy of Stahl and have found it to be very helpful (though for this it's more a case of adding something and seeing how I react to it).
This is the end of the thread.
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