![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Laney on March 16, 2010, at 16:34:40
With a change in meds, etc.? Something you might have added that reversed it? Getting off of SSRI's and onto something else that doesn't do this?
I know this is Serotonin based. It's got to be. I never had this before.
Thanks!
Laney
Posted by bleauberry on March 16, 2010, at 17:08:11
In reply to Anyone exp. emotional flatness that turned around?, posted by Laney on March 16, 2010, at 16:34:40
I added 5mg zyprexa and 300mg adrafinil to get rid of the flatness of 20mg prozac and it worked pretty well, about 80%-90%.
Overall I feel the key is to add something that is specific for norepinephrine, dopamine, or both, in order to balance out the serotonin's dominance. Unfortunately the exact med and the exact mechanism is subject to personal trial and error. It could be ritalin, nortriptyline, savella, wellbutrin, desipramine, adderall, adrafinil, modafinil, etc.
For me the two meds on the planet that have worked best overall on depression and reversed the flatness thing, both as monotherapy by themselves, were either savella or amisulpride.
Posted by Laney on March 16, 2010, at 17:44:01
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by bleauberry on March 16, 2010, at 17:08:11
Thanks Bleauberry! Do you know exactly what I mean by emotional flatness. Feelings of love, passion for things you liked/loved before, etc. gone. Did that reverse for you?
Laney
Posted by Phillipa on March 16, 2010, at 22:10:26
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by Laney on March 16, 2010, at 17:44:01
Laney is it depression or anxiety? Love Phillipa ps what SSRI did you chose?
Posted by conundrum on March 16, 2010, at 22:46:55
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by Laney on March 16, 2010, at 17:44:01
I'm notice pristiq is adding some slight color back into my life. Definetly feels better than a pure serotonergic drug.
Posted by SLS on March 17, 2010, at 11:53:28
In reply to Re: Anyone exp. emotional flatness that turned around? » Laney, posted by conundrum on March 16, 2010, at 22:46:55
> I'm notice pristiq is adding some slight color back into my life. Definetly feels better than a pure serotonergic drug.
This has been my experience as well. I did not feel emotionally blunted or apathetic on Effexor.
- Scott
Posted by Laney on March 17, 2010, at 12:54:25
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by SLS on March 17, 2010, at 11:53:28
Thanks guys! Phillipa, I'm on 10mg. paxil and also prozac trying to W/D the paxil. Not sure this is what I should be doing. I'm thinking of augmenting the paxil with something.
Thanks!
Laney
Posted by bleauberry on March 17, 2010, at 17:21:25
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by Laney on March 16, 2010, at 17:44:01
> Thanks Bleauberry! Do you know exactly what I mean by emotional flatness. Feelings of love, passion for things you liked/loved before, etc. gone. Did that reverse for you?
>
> LaneyWell Laney, how about this. All my life, starting at age 6, I was a guitarist and loved it. Was one of the best in town. My passion. On the ADs, my guitar went into the closet for 5 years. All that passion vanished. With meds that reversed the flatness...adrafinil primarily...I regained interest...except it was in other stuff. I got into plants, gardening, painting, talk radio, other stuff but not music.
It wasn't until I was totally off all meds for a few months that the long lost friend of music came knocking at my door. The passion was back bigtime. Since then, the only meds that have not hurt that passion, and actually helped fuel it, have been Savella or Amisulpride. Pretty much all other meds are passion killers for me.
Posted by Phillipa on March 17, 2010, at 20:37:01
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by Laney on March 17, 2010, at 12:54:25
Laney I usually ask what does your pdoc say or suggest? Phillipa
Posted by conundrum on March 17, 2010, at 21:14:43
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by bleauberry on March 17, 2010, at 17:21:25
Ah I remember your old post. While my guitar gently rusts, or something like that. I have the same problem. It seems we are similar in that regard. I play guitar too but haven't really been into it for 7 years since stopping prozac. I was fine while on prozac, but starting it again hasn't worked as well and only helps at a smaller dose. I also am finding I seem to respond to norepinephrine better than SNRIs. I actually had to leave Berklee College of Music because of all this. Hope to find something that helps soon. I know I stilll want to play music, but I just can't feel it or create.
Posted by Brainbeard on March 18, 2010, at 10:41:20
In reply to Re: Anyone exp. emotional flatness that turned around? » bleauberry, posted by conundrum on March 17, 2010, at 21:14:43
I'm a guitarist too, and a singer-songwriter.
Paradoxically perhaps, my first AD, which was prescribed for severe OCD, was Paxil ('Seroxat' actually, in Holland, which is of course paroxetine), and while initially it flattened my mood, it eventually (on the higher dose of 40mg) made me kind of hypomanic and gave me relentless enthusiasm for setting up my life, diving into my study of theology, enjoy friendships and mutual interests, and... It likewise fuelled my passion for writing songs! I was never without inspiration during this phase, which lasted perhaps for about one and a half or two years. I was fat, sweaty and had bouts of morning drowsiness, but - 'never a dull moment'! (To make the picture complete, my love for my girlfriend WAS dampened, whereas romantic and erotic interest in other women was greatly increased.)
Perhaps it should be mentioned that Paxil, on higher doses, touches both noradrenaline and dopamine, however lightly. It may have made the difference.
When I entered Paxil's withdrawal hell, I kept making and recording songs, but this time frustration and life's absurdity were my inspiration. I used to have a tape with fourtrack recordings dubbed 'The Seroxat Sessions'.
I don't think I ever fully regained the enthusiasm I used to have both before and during my Paxil use. Making music has been highly problematic for me ever since. The creative process is ever being highjacked by perfectionism, a lack of self-trust, obsessive fears etc.
I should add that years before I started taking Paxil, I had been a marihuana addict for three years, and during this time, I was never without musical inspiration either.
Well, I'm taking Lexapro (escitalopram) now, I'm currently on 5mg and are hesitating with going further up precisely because of impending emotional flatness. In fact, I think I experience the emotional flatness already. I try to counter it by taking amitriptyline, 25-50mg, but I'm not sure how well it works. I also experiment with taking imipramine (aka Tofranil), 25mg, but that increases anxiety.
I would love to try milnacipran (Savella) - sadly however, it's not available here in Holland, and from what I can see on the web it's fairly expensive.
Posted by conundrum on March 18, 2010, at 23:03:35
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by Brainbeard on March 18, 2010, at 10:41:20
40 mg paxil. Yikes! That drug scares the crap out of me, I've read so many horror stories about it and the withdrawals.
Personally I think seroxat is a terrible name for a drug. I don't know why they didn't marktet it as paxil in Europe.
You could substitute 5 mg prozac every other day for lexapro. I find that it can increase motivation and some pleasure at that dose.
Posted by Brainbeard on March 19, 2010, at 16:39:38
In reply to Re: Anyone exp. emotional flatness that turned around? » Brainbeard, posted by conundrum on March 18, 2010, at 23:03:35
> You could substitute 5 mg prozac every other day for lexapro. I find that it can increase motivation and some pleasure at that dose.
I know, but low dose Prozac doesn't do anything for (my) OCD.
Posted by meltingpot on March 25, 2010, at 8:34:40
In reply to Re: Anyone exp. emotional flatness that turned around?, posted by bleauberry on March 17, 2010, at 17:21:25
Hi Bleauberry,
Did you find amilsupride better than Zyprexa for removing flatness? Also have you ever tried Abilify or Edronex (Reboxetine)?
Denise
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.