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Dr. Bob is Robert Hsiung, MD,
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Posted by morgan miller on February 8, 2011, at 22:53:06
In reply to Re: What should I be aiming for? Medications...., posted by bleauberry on February 8, 2011, at 18:28:06
I wouldn't forget the other ones. I personally believe Zoloft to be a superior antidepressant to Prozac. There are several reasons for this beyond it just being a better antidepressant. Zoloft is not anticholinergic in the way that Prozac is. Zoloft is less likely to raise prolactic levels than Prozac. Zoloft inhibits mTOR which may actually help prevent some cancers. Zoloft is also more of a feel good drug that is less likely numb emotions.
Long term SSRI use does not permanently alters or impairs everyone. I'm not even sure it permanently does anything to anyone. The problem is people probably don't have the time, money or knowledge(I'm not saying I know, none of us really do, we can only do some research, experiment and guess) to do what they need to do in order to heal from the use of these drugs. I was on Zoloft for 7 years and came off it cold turkey without any problems. Before Zoloft I had been on Prozac two times for a year. My 2 week experiment with Paxil was a total nightmare. My 2 month experiment with Luvox was not that great either.
I did have a major mixed episode 6 months after I stopped Zoloft but that had nothing to do with permanent brain alterations. I had a mixed episode at 22 before I was ever on medication. And up until the major mixed episode after stopping Zoloft, I felt normal and functioned at a high level. I believe it may have had something to do with the fact that I exercised religously, took fish oil, and ate well. I'm sure it also had something to do with my brain biology and how it responds to medications.
Lexapro or Zoloft would be my picks. Superior drugs to Prozac both in the short and long run. I believe Lexapro hardly inhibits acetylcholine or not at all. Not sure though. Maybe Linkage knows. I'll have to look it up. I just think the efficacy, side effect profile, and pharmacology of both of these drugs are better suited for many people than prozac.
Posted by morgan miller on February 8, 2011, at 22:54:35
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 8, 2011, at 20:03:51
> Thanks BB for your honesty. What about other classes of meds?
>
> I'm rather pissed about the whole thing. I didn't have a "depression problem" back when I took this crap and now I seem to have a chronic problem.But you probably had underlying depression.
Why did you start taking Paxil to begin with?
Posted by Phillipa on February 8, 2011, at 23:29:13
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 8, 2011, at 22:54:35
Laney just read your thread. I must say I agree with Morgan. And was head pressure why you were put on paxil? Or anxiety that felt like head pressure? Love Phillipa
Posted by morgan miller on February 8, 2011, at 23:54:21
In reply to What should I be aiming for? Medications...., posted by Laney on February 8, 2011, at 17:52:36
I agree with BB about not getting off something that has been working for so long without ill effects. Unfortunately we have this idea that we are prisoners of medication and want to be free, but in reality it is the medication that is freeing us.
Posted by sigismund on February 8, 2011, at 23:59:50
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 8, 2011, at 22:54:35
>But you probably had underlying depression.
How do you know?
Posted by morgan miller on February 9, 2011, at 0:43:22
In reply to Re: What should I be aiming for? Medications...., posted by sigismund on February 8, 2011, at 23:59:50
>>But you probably had underlying depression.
>How do you know?
Well if anxiety was the reason for the issues that lead to using Paxil, then depression was likely present. Anxiety and depression go hand in hand. Often times anxiety is a manifestation of depression and is used as a coping mechanism, yes, I said coping mechanism. If you study psychology enough, and have enough conversations wtih experienced psychologists, you begin to realize some amount of underlying depression/sadness is very very common amongst all people. Thing is, we just have ways of suppressing it and distracting ourselves enough not to ever really really feel the depth of it.
Posted by Laney on February 9, 2011, at 10:52:45
In reply to Re: What should I be aiming for? Medications.... » sigismund, posted by morgan miller on February 9, 2011, at 0:43:22
Thanks for all your replies.
I took paxil for head pressure/squeezing. Not for depression. I was already on .5mg. clonazepam per day for anxiety. I definitely know what depression is now so no, I believe I was a pretty happy camper.
But does it really matter why I went on paxil? The point is that it doesn't do anything for me anymore except keep me from withdrawl.
My brain doesn't like life without it and it isn't effective at returning me to my previous state.
I did go on zoloft for a while. It was added to my paxil. It didn't seem to do anything to improve my mood either way. I figured if it didn't help my mood along with paxil then why decrease the paxil? That would have certainly made things worse it seems.
But I don't remember if I was on Nort. at the time or for long enough though.
By the way, what is a better med to replace Nort. without the weight gaining properties. This is a big problem as well.
Thank you,
Laney
Posted by Zyprexa on February 9, 2011, at 11:58:24
In reply to What should I be aiming for? Medications...., posted by Laney on February 8, 2011, at 17:52:36
Maybe you should try a higher dose?
Posted by morgan miller on February 9, 2011, at 12:56:10
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 9, 2011, at 10:52:45
>I took paxil for head pressure/squeezing. Not for depression. I was already on .5mg. clonazepam per day for anxiety. I definitely know what depression is now so no, I believe I was a pretty happy camper.
When there is an anxiety issue, depression is almost certainly present under the surface. I think it's difficult for people the grasp the idea of being a "happy cammper" or "happy go luck" but still having underlying depression, just never feeling depressed. This phenomenon happens all the time. And then there is denial, which is so powerful it helps us keep the sadness and depression in check to the point of never knowing it is there.
Posted by morgan miller on February 9, 2011, at 13:14:52
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 9, 2011, at 10:52:45
>But does it really matter why I went on paxil? The point is that it doesn't do anything for me anymore except keep me from withdrawl.
I think it does matter. But I do understand your point. I gave you my suggestions.
I don't do as well on Zoloft anymore and it appears that Lexapro may be something that helps me tremendously, in the way Zoloft once did. So there is hope for you. I gave you my suggestions. I'm not saying BB is wrong, I just think Lexapro and Zoloft are better drugs than Prozac.
>I did go on zoloft for a while. It was added to my paxil. It didn't seem to do anything to improve my mood either way. I figured if it didn't help my mood along with paxil then why decrease the paxil? That would have certainly made things worse it seems.
How much Zoloft were you on? I bet the dose was pretty low if it was combined with Paxil. Responses to Zoloft can be very dose dependent. Also, what you experienced with Zoloft may have been damped by still being on Paxil.
The positive in all this is that you don't seem to have complaints about major side effects with medications while on them, other than the withdrawal and lack of efficacy when reintroducing Paxil.
Again, I want to reiterate that I'm not sure if a drug not working anymore is necessarily a sign of a permanent brain alteration or damage. It is very possible, given the right amount of time and other factors, that eventually that drug that does not work again now, would work again sometime down the road. I believe in the brain's power to heal from many things. I have to believe it is possible, again given time and maybe other healing contributors, that someone who feels their brain is altered permanently by SSRI use can recover. I also think that periods of severe chronic depression, anxiety, and bipolar episodes can alter brain chemistry in ways that impact the brain's response to drugs. In addition, the current psychological state of someone may impact one's response to a medication. There are many things to consider here before we start jumping to the conclusion that drugs like SSRIs are PERMANENTLY changing our brains. Aging permanently changes our brains.
Morgan
Posted by morgan miller on February 9, 2011, at 13:18:00
In reply to Re: What should I be aiming for? Medications...., posted by Zyprexa on February 9, 2011, at 11:58:24
>Maybe you should try a higher dose?
Not bad advice. Unfortunately doses over time may have to be modified in order to get a similar response. This happens with people that never stopped a drug, instead the drug just stopped working as well. They raise the dose and find that they the old response returns. I'm not sure if this would work with Paxil though.
Posted by morgan miller on February 9, 2011, at 13:49:59
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 9, 2011, at 13:18:00
Sorry for all the posts. One more thing I wanted to add was that at this point, I believe Zoloft my have given me more relief than it did the two times I tried it again after being on it for 7 years. I chose Lexapro partly because I decided it might be a better suited SSRI for me than Lexapro, I probably should have been on it instead of Zoloft. Zoloft can make people less inhibited in their behavior, that's something I don't need as it comes naturally. Too much of this type of behavior can be very counterproductive for many reasons. Zoloft is also typically more stimulating and may not be the best SSRI for people that fall in the bipolar spectrum. I really needed to target my anxiety and Lexapro seemed like the most sensible choice. I admit I did want to introduce a new drug to my brain in hopes that my response would be stronger.
Posted by sigismund on February 9, 2011, at 14:29:50
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 9, 2011, at 12:56:10
It is fortunate we have modern psychology to explain this for us and clear it all up.
Posted by morgan miller on February 9, 2011, at 17:58:25
In reply to Re: What should I be aiming for? Medications...., posted by sigismund on February 9, 2011, at 14:29:50
>It is fortunate we have modern psychology to explain this for us and clear it all up.
I'm not sure exactly what you mean. Is it that we all know this already? Or that modern psychology does not know anything about how the human psyche works and responds to the environment it's exposed to.
I think denying psychology will keep us from progressing. I'm not saying you are doing this.
Posted by sigismund on February 9, 2011, at 19:54:29
In reply to Re: What should I be aiming for? Medications.... » sigismund, posted by morgan miller on February 9, 2011, at 17:58:25
I'm not sure you should listen to me.
I might have an underlying psychosis.
Posted by floatingbridge on February 9, 2011, at 20:00:26
In reply to What should I be aiming for? Medications...., posted by Laney on February 8, 2011, at 17:52:36
Hi Laney,
I agree with you Laney, that depression was not a prior, underlying problem. Anxiety can be a precursor to some depressions, and I claim no authority other than some reading and my idiosyncratic personal experience, but many endure bouts of anxiety and anxiety-induced headaches and are not
nor ever become depressed.I also agree you are not here to debate that. You want peer advice for some
ideas about how to proceed. (I'm just a little angry you were given Paxil for an anxiety headache!)My lord. The choices. What meds are
you currently taking? (Paxil, nortriptyline, clonazapam.) On the old scale of 1-10,
where is your current level of depression? And anxiety? Any other symptoms?Was the nortrip added for depression?
I wish conundrum would weigh in--he had/has a discontinuous response similar enough, I believe, to yours.
I cannot suggest any particular AD. I don't have the knowledge. It might come down to trial and error; I don't know, and you are absolutely right to info gather as much as possible.
What type of doctor is treating you now?
What type of taper did you last try? Some suggest going back up to dose and
beginning again excruciatingly slow.Laney, I don't know what happened 13
years ago. I have a serious problem with male doctors that give women ssri's for all types of ailments without disclosing. There's a sexist misuse of medical authority there. Laney, if this isn't at all what happened, just tell me. If anyone wants to take issue with me on
this, please start another thread --unless, of course, it's you, Laney :) And please
forgive me for getting so ticked when all you asked for was advice.(Hey, have you tried Wellbutrin? It's very easy to start and stop....)
Very kindest regards,
fb
Posted by floatingbridge on February 9, 2011, at 20:08:13
In reply to Re: What should I be aiming for? Medications.... » sigismund, posted by morgan miller on February 9, 2011, at 17:58:25
Hi Morgan,
Sigi can publish some very Sphinx-like posts. FYI. I'd need a degree in philosophy. Or Beckett.
How have you been doing? Send me a babblemail if you want so I don't hijack Laney's thread.
Hugs.
Posted by sigismund on February 9, 2011, at 21:32:30
In reply to Re: What should I be aiming for? Medications.... » morgan miller, posted by floatingbridge on February 9, 2011, at 20:08:13
>Or Beckett.
Now you're talking.
Eliot comes to mind: 'Streets that follow like a tedious argument of insidious intent'.
Posted by morgan miller on February 10, 2011, at 0:05:59
In reply to Re: What should I be aiming for? Medications.... » morgan miller, posted by sigismund on February 9, 2011, at 19:54:29
> I'm not sure you should listen to me.
>
> I might have an underlying psychosis.That's pretty damn funny. You made me laugh. Yeah I get your point. You have a great sense of humor Sigismund.
Posted by sigismund on February 10, 2011, at 1:42:32
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 10, 2011, at 0:05:59
It just struck me as being an example of psychiatric totalitarianism. If you say someone has an underlying whatever they can not prove you wrong because they are, by definition, unaware of it. Psychiatry and psychoanalysis did that all the time. Here you can't kill yourself without being labelled as depressed. You might have been on dialysis for years, it might be anything, and along comes some private school boy wet behind the ears and he is prepared to commit you because you suffer from depression. It just seems kind of ignorant and invasive.
Posted by Laney on February 10, 2011, at 12:22:01
In reply to Re: What should I be aiming for? Medications...., posted by sigismund on February 10, 2011, at 1:42:32
Hey guys,
Thanks for all your responses. My doctor back then (13 or 14 years ago) was a male. At that time I didn't know anything about meds for depression. I knew about anxiety because I have always had some of that and started taking a med (klonopin) about 4 years before the paxil. I have the crappiest memory unfortunately and just remember complaining about this head pressure to my regular doctor. I trusted him and I'm not sure why but took his advice on the paxil. Again, I never thought twice about depression. I just wanted relief from the head pressure. If it were depression don't you think that once I took the medication I would have said, "wow - I can't believe how well this works! It's made me feel so much happier or upbeat as well as taking the head stuff away". Well that didn't happen. The head stuff went away and on with life. :)
Anyway, I can't remember how much zoloft I took. I would have to look up old posts here. Someone asked about the severity of my depression. I'm not sure how to answer that. I am an outgoing person and it keeps me away from friends, etc. It's hard to explain. I just don't care a lot of the time about much.
I'm trying to remember what some of you asked. I tried Wellbutrin. Didn't like it. Didn't do anything except give me much more anxiety on top of my depression.
I've tried Lamictal. Nothing. But the Nortriptyline seemed to get me out of it some but it feels like that's not quite doing it either anymore even at a higher dose. I don't really want to go much higher because it make me anxious and talk a lot (motor mouth) LOL! Sorry if I'm doing that now.
If I did try Lexapro, what would you suggest as far as a crossover. I'm asking you guys because you guys have experience with these meds.
What about MAOI's? Do you think I should try the SSRI's again first?
Thanks everyone.
Laney
Posted by Phillipa on February 10, 2011, at 19:14:22
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 10, 2011, at 12:22:01
Laney sounds a bit like my past history on low dose benzos for so many years felt happy and great then menopause and thyroid issues for l0mg of paxil felt horrible for three months then I guess my brain adjusted and felt good again. You could wait til the new ago is released second quarter of years supposed to be mild and lacks a lot of side effects. Vibrdd or some name like that will be called. I'm now taking both luvox small dose and low dose of lexapro with low dose benzos. Personally I wouldn't try maois myself. Love Phillipa
Posted by floatingbridge on February 10, 2011, at 20:56:38
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 10, 2011, at 12:22:01
Hi Laney,
Sorry to hear that depression is keeping you from seeing or enjoying your friends. And not caring much about things... :(
Do you someone overseeing your meds? If you aren't seeing a psychiatrist, maybe consider seeing a good one to guide you. There are some med savvy folks her, but
I wouldn't want any advice unsupported by a doctor in your life. You know what I mean? And taking another ssri on a personal recommendation has little guarantee.So, if you are only on nortriptyline, you
could try an maoi. I have never taken one, though contemplating Emsam, though it's reputation is mainly trash around here.So a good nortriptyline response is valuable
information.Anybody take it from here?
fb
Posted by Phillipa on February 10, 2011, at 22:00:49
In reply to Re: What should I be aiming for? Medications.... » Laney, posted by floatingbridge on February 10, 2011, at 20:56:38
FB I really wanted to do EMSAM 6mg no dietary restrictions. Some did well. I think the expense kept more from trying. Robert David in archieves should be long thread when EMSAM new. Love Phillipa
Posted by morgan miller on February 10, 2011, at 22:55:37
In reply to Re: What should I be aiming for? Medications.... » Laney, posted by floatingbridge on February 10, 2011, at 20:56:38
Sigismund, I should not have said "probably have underlying depression", I should have said "may have underlying depression". I understand your point. My point was that it may not have been just the use of Paxil to cause the depression. If anxiety was always present, and especially since it was such a young age, depression could have come to the surface and manifested to some extent later in early adulthood regardless of Laney's experience with Paxil.
FB, thanks for asking about me. Will babblemail you. Hope you are doing o.k.
Laney, I would go with another SSRI first, JMHO. As far as a cross-taper, you would want to see a good psychiatrist about that. Or, someone here may have some good advice to give you. Some doctors just have you stop the SSRI your currently on and start you on the new SSRI the next day. Other doctors will take up to a month to cross-taper.
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