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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by HyperFocus on January 29, 2009, at 18:16:08
I've read too many tragic stories on this board about people who respond to a particular line of treatment, discontinue it for any number of reasons, and then attempt to return to it only to find that it no longer works at all for them. It may not seem logical, but there are too many cases of this happening to make these some random ocurrences
If you are responding to your meds, stay on them - there is no reason to discontinue unless there is a major problem with side effects. If your doctor wants you to stop because "you've been on them long enough" or "you're better now" or he/she wants to experiment with the latest pharmaceutical concoction, consider carefully what could happen when you stop and get a second opinion at least. Don't reduce the dosage or substitute one for another, no matter how logical and straightforward the adjustment might seem. No doctor can peer into your brain and understand what is going on. Nobody is concerned more about your welfare than you. Understand that if you adjust, switch or stop then there's a good chance you well not get the same good response again, and let your doctor know that
If you have minor to moderate SEs consider carefully if it would be worth staying on the meds and looking for another med that can manage the SEs, rather than discontinuing. Understand that if you stop there is a significant chance the meds will longer work for you. If you have severe and life-threatning SEs then you may not have a choice, but at least find out all the options available for treating them and maybe weigh the risks to your health - always mindful than quitting this particular med might mean permanent lack of response from this line of treatment.
Get well and stay well.
Posted by yxibow on January 29, 2009, at 19:25:30
In reply to If you are feeling better STAY ON YOUR MEDS, posted by HyperFocus on January 29, 2009, at 18:16:08
> I've read too many tragic stories on this board about people who respond to a particular line of treatment, discontinue it for any number of reasons, and then attempt to return to it only to find that it no longer works at all for them. It may not seem logical, but there are too many cases of this happening to make these some random ocurrences
Yes, I don't quite know why but I'm rather annoyed that a medication I take that I'd rather not take isn't working at its original 100% or even 80%.
> If you are responding to your meds, stay on them - there is no reason to discontinue unless there is a major problem with side effects. If your doctor wants you to stop because "you've been on them long enough" or "you're better now" or he/she wants to experiment with the latest pharmaceutical concoction, consider carefully what could happen when you stop and get a second opinion at least. Don't reduce the dosage or substitute one for another, no matter how logical and straightforward the adjustment might seem. No doctor can peer into your brain and understand what is going on. Nobody is concerned more about your welfare than you. Understand that if you adjust, switch or stop then there's a good chance you well not get the same good response again, and let your doctor know that
>
> If you have minor to moderate SEs consider carefully if it would be worth staying on the meds and looking for another med that can manage the SEs, rather than discontinuing. Understand that if you stop there is a significant chance the meds will longer work for you. If you have severe and life-threatning SEs then you may not have a choice, but at least find out all the options available for treating them and maybe weigh the risks to your health - always mindful than quitting this particular med might mean permanent lack of response from this line of treatment.
>
> Get well and stay well.
I do agree though. I mean if you and your doctor are confident that anxiety or depression or whatever ails you has gone way down, and you are on polypharmacy (many medications), there is one counter to this in that the least number of medications is always the best, because the more you have, the more interactions and even the best psychopharmacologist can't predict everything.
Still, if you're on a MED (minimum effective dose) of things you take, which reduces side effects -- I would agree, if the benefits outweigh any strong side effects you might be having, medications are largely palliatives -- that is, when you are on them, the transmitters that they are occupying, raising, lowering, etc, are at a state they should be if they are working for you.But if you go off them, one may discover -- and this is common for example with SSRIs, that a person was better off on it than off.
I agree -- something to ponder
-- tidings
Jay
Posted by Phillipa on January 29, 2009, at 20:32:52
In reply to Re: If you are feeling better STAY ON YOUR MEDS » HyperFocus, posted by yxibow on January 29, 2009, at 19:25:30
Yup l0mg of paxil went off with doc's permission with xanax stayed on it never worked again and it was working fine. Why go off the pdoc wanted me to try a new med. Idiot that I am I agreed. Phillipa
Posted by sam K on January 29, 2009, at 22:21:00
In reply to Re: If you are feeling better STAY ON YOUR MEDS » yxibow, posted by Phillipa on January 29, 2009, at 20:32:52
so crazy.. How do medicines work and then don't work again? hard to understand.
Posted by Zyprexa on January 30, 2009, at 19:46:30
In reply to Re: If you are feeling better STAY ON YOUR MEDS, posted by sam K on January 29, 2009, at 22:21:00
Is it possible the doctor perscribes placebo when you go back on. Or has the new med changed your brain chemistry so much that the old med does not work the same right away.
Thats what I think has happened with my zyprexa. I went off it to try abilify. and that didn't work so went back on zyprexa. Well the zyprexa didn't work at first. Seemed that it wasn't working at all for the longest while. Taking higher doses for a long time for some relife. Well now its been almost 2 years since stoping abilify. And the zyprexa is finaly working as good as it did, before the abilify.
So yah, what happened?????
I'm at my origional dose of zyprexa again! 10mg. Had gone as high as 50mg at some times, belive it or not, and just for a little relife.
Posted by Phillipa on January 30, 2009, at 21:28:04
In reply to Re: If you are feeling better STAY ON YOUR MEDS, posted by Zyprexa on January 30, 2009, at 19:46:30
Sam good question I'd like to know the answer myself. Love Phillipa
Posted by 49er on January 31, 2009, at 10:35:58
In reply to If you are feeling better STAY ON YOUR MEDS, posted by HyperFocus on January 29, 2009, at 18:16:08
Hi,
<<If you are responding to your meds, stay on them - there is no reason to discontinue unless there is a major problem with side effects.>>
What about side effects that may develop down the road? If a person waits until side effects develop, it might be too late to reverse them. They can be just devastating emotionally as the depression the meds are suppose to be preventing.
Maybe the person has learned good coping techniques and is at a stable place in their life. Really, it is their decision.
<<If your doctor wants you to stop because "you've been on them long enough" or "you're better now" or he/she wants to experiment with the latest pharmaceutical concoction, consider carefully what could happen when you stop and get a second opinion at least. >>
I agree that if the doctor wants to experiment with the latest pharmaceutical toy, that is a lousy reason.
However, keeping people on meds for life in psychiatry as a routine matter defies logic.
You don't keep a cast on a broken leg because it might get broken again.
Also, I feel that keeping someone on meds because they might relapse doesn't seriously take into account withdrawal issues that are confused with relapse.
People also can learn new coping techniques. Please don't take as saying that I feel you can pull yourself out of your bootstrap.
But I just feel that this argument "once or twice depressed" always depressed is simply lunacy. I was one of those who supposedly came under this category and I haven't relapsed in spite of dealing with my mother's death and job instability. I have simply learned not to go down the trail of negative thoughts that I know lead to a bad path.
<<Understand that if you adjust, switch or stop then there's a good chance you well not get the same good response again, and let your doctor know that>>
Fair point. However, many people like me have no intention of ever taking psych meds again.
>
<<If you have minor to moderate SEs consider carefully if it would be worth staying on the meds and looking for another med that can manage the SEs, rather than discontinuing.>>And what happens when you get a side effect from the med you added to manage the 1st side effect? When does it stop? No wonder we have people on so many meds that had nothing to do with their original condition.
Please understand that I realize this not an easy issue. Even though I have tapered very slowly, withdrawal is no fun so believe me, I understand. But I also think people need to realize what it means to keep adding meds.
<<If you have severe and life-threatning SEs then you may not have a choice, but at least find out all the options available for treating them and maybe weigh the risks to your health - always mindful than quitting this particular med might mean permanent lack of response from this line of treatment.>>
I made the decision to taper off of meds when I developed a hearing loss from Remeron. I shudder to think what my emotional heath would have been like if I had stay on the med and lost my hearing completely. On top of having a learning disability, that would have been devastating.
Initially, I was going to stay on the other meds but I felt they were all causing a worsening of LD issues and I have been proven right. I also had a tremor that I feel was a potential sign of neurological difficulties down the road.
Anyway, knowing what I now know, I wish to god I had tapered off the meds when I became stable initially. Actually, I wish I had never touched psych meds but that is another post for another day.
>
> Get well and stay well.We can all agree on that no matter what our position is on meds.
49er
This is the end of the thread.
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