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Dr. Bob is Robert Hsiung, MD,
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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.
Posted by Laney on February 10, 2011, at 23:22:09
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 10, 2011, at 22:55:37
Thanks for your input guys. Phillipa, why would you avoid MAOI's? Just curious.
MM, I will probably ask to try Lexapro and do a cross taper.
You guys are great. I'm glad to have people on here that seem to really care.
Thanks,
Laney
Laney
Posted by floatingbridge on February 11, 2011, at 11:56:47
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 10, 2011, at 23:22:09
Laney,
Just a p.s. Lexapro was alright for me. Might really be helpful for you and do the trick.
I wish you the very best results :)
Hugs (if alright)
fbPlease keep us up to date!
Posted by Conundrum on February 11, 2011, at 12:24:50
In reply to What should I be aiming for? Medications...., posted by Laney on February 8, 2011, at 17:52:36
Laney,
What are the negative side effects you are still suffering from? Pessimism, crying and stuff like that? or like a zombie feeling?You probably have tried this, but what about increasing the dose and seeing if a higher dose is more effective.
I wish we were informed about how bad stopping these drugs could be before we started taking them. :(
Posted by Phillipa on February 11, 2011, at 19:35:26
In reply to Re: What should I be aiming for? Medications...., posted by Laney on February 10, 2011, at 23:22:09
Hi Laney just on to me they are the big guns when nothing else works. Emsam is different I feel can customize sizes per my pdoc. Love Phillipa
Posted by morgan miller on February 11, 2011, at 23:55:24
In reply to Re: What should I be aiming for? Medications.... » Laney, posted by Conundrum on February 11, 2011, at 12:24:50
> Laney,
> What are the negative side effects you are still suffering from? Pessimism, crying and stuff like that? or like a zombie feeling?
>
> You probably have tried this, but what about increasing the dose and seeing if a higher dose is more effective.
>
> I wish we were informed about how bad stopping these drugs could be before we started taking them. :(Or, maybe we could be more informed and experienced so that we knew if we stopped taking something that was working well without side effects that impaired normal function, our lives may be miserable and finding a medication that works may be more difficult. There's always a trade off. What were we going to do in this world of needing to function better and feel better without the medication in the first place? Continue to suffer until we maybe get better several years later? Go on disability? I think the lesson to be learned is, if you find a medication that works, and it's been working for a long time, don't stop! A real good sign for not stopping medication is if you find yourself say, "I feel good and normal on this medication without side effects, but I just don't want to have to rely on medication." I did this, and it is one of a few reasons why my life has been such a complete nightmare the last 3 years.
Conundrum, I think there is a way to heal with time, supplements, diet, exercise, and YES, medication. There is hopefully a medication out there that will help us again if our old medication no longer does. We may need to be patient and take good care of ourselves in the meantime, but it will happen for many of us. Some of us unfortunately may have a very very difficult time finding relief from medication for a painfully long time. I have experienced a taste of what this must be like so I feel very badly for those of us that are imprisoned by this long term suffering.
Posted by morgan miller on February 12, 2011, at 0:04:40
In reply to Re: What should I be aiming for? Medications.... » Laney, posted by Phillipa on February 11, 2011, at 19:35:26
Laney, it seems to be a popular thing these days to start with a super low dose of Lexapro. If you end up trying it, talk to your doctor about starting at 2.5 mg. Lexapro is a very powerful medication and you may not need much to get back to feeling better. Some people stick with the 2.5 mg dose. Others go up to 5 or 10 mg. For me, 10 mg may be what I need. So far it is helping with anxiety and depression. I think it's going to be a full 3 months on Lexapro before I really am close to feeling normal again. Some depression relief can come as soon as 1 to 2 weeks, and symptoms will continue to improve as time goes by. Same goes for anxiety, but anxiety symptoms take much longer to resolve, usually taking up to 3 months before people finally report feeling "normal" again.
Posted by Conundrum on February 12, 2011, at 11:36:59
In reply to Re: What should I be aiming for? Medications...., posted by morgan miller on February 11, 2011, at 23:55:24
> > Laney,
> > What are the negative side effects you are still suffering from? Pessimism, crying and stuff like that? or like a zombie feeling?
> >
> > You probably have tried this, but what about increasing the dose and seeing if a higher dose is more effective.
> >
> > I wish we were informed about how bad stopping these drugs could be before we started taking them. :(
>
> Or, maybe we could be more informed and experienced so that we knew if we stopped taking something that was working well without side effects that impaired normal function, our lives may be miserable and finding a medication that works may be more difficult. There's always a trade off. What were we going to do in this world of needing to function better and feel better without the medication in the first place? Continue to suffer until we maybe get better several years later? Go on disability? I think the lesson to be learned is, if you find a medication that works, and it's been working for a long time, don't stop! A real good sign for not stopping medication is if you find yourself say, "I feel good and normal on this medication without side effects, but I just don't want to have to rely on medication." I did this, and it is one of a few reasons why my life has been such a complete nightmare the last 3 years.
>
> Conundrum, I think there is a way to heal with time, supplements, diet, exercise, and YES, medication. There is hopefully a medication out there that will help us again if our old medication no longer does. We may need to be patient and take good care of ourselves in the meantime, but it will happen for many of us. Some of us unfortunately may have a very very difficult time finding relief from medication for a painfully long time. I have experienced a taste of what this must be like so I feel very badly for those of us that are imprisoned by this long term suffering.Obviously we aren't as bright as we need to be to realize that we must stay on these meds indefinitely. Now had my pdoc said to me, "Many people feel worse after stopping the drug and in fact suffer irreversible changes when discontinuing a drug, especially abruptly, so don't stop it if it is working," I would have either a) decided not to take it, and I was 16 at the time, so I may have gotten better on my own or b) made damn sure I got my script refilled. Instead I was told it has a long half life so there are no discontinuation symptoms. Now does that mean I should have stopped it on my own? No, but even when I went back on and then stopped it later under my doctor's supervision I still suffered massive cognitive problems afterwords for 7 years until this very day.
The problem I have with psychiatry is that no one is admitting that there are long term effects of SSRIs. There is some evidence of post ssri sexual dysfunction but nothing about emotional blunting or cognitive problems when stopping the drug. I know doctors are probably worried about being sued. That is why I've been thinking that patients should have to sign a waiver before taking psychotropic meds. The gist of the waiver would be. "This drug won't stop your heart, or your breathing or kill you, but since the brain is possibly the most complex system in the universe, there is no knowing what side effects it can cause, nor has this drug been studied for longer than 6 months (or year) so the long term effect on the brain are not known" This way everyone would know the true risks, and pdocs could be honest about what happens to patients and their cognitive/neurological/sexual complaints and actually report them to the FDA so we have a more comprehensive collection of side effects. It would also help us see that there is still a long way to go in understanding the brain.
On the pharmaceutical company side more could be done. Like when they give a rat an SSRI and it stops wanting to mate they should report that. They should also see what the rats do after long term use and after stopping the drug and let the patient know all of these things.
I think that would allow us to make more informed decisions. Now you might say, that would scare people away from psych meds altogether. It would certainly make some think twice and try other avenues first, but some who need the drugs will still take them. I'm not against psychiatry, but if they're gonna tell us some side effects of the drug, they should tell all of them, and let the patients know that some things could happen that are unpredictable.
Posted by floatingbridge on February 12, 2011, at 12:38:29
In reply to Re: What should I be aiming for? Medications.... » morgan miller, posted by Conundrum on February 12, 2011, at 11:36:59
Conundrum, are you so young? I had no idea.... :(
Laney, little did you know what your question would provoke. Hope that's o.k. with you.
Imho, one does not need to be near genius levels to become a gp. Aren't gp's the main prescribers of medications? Some do not do much thinking past what
a drug rep says. They studied very little neuroscience in school.Just about three weeks ago, the guy who used (!) to manage my pain meds told me, in all (frickin) sincerity, to just stop my Cymbalta. When I protested that I had been on some form of ssri, snri for at least 12 years, he would repeatedly counter, 'yes, but you've only been on the Cymbalta for little over a month. That isn't enough time to develop a
dependency.' I felt like I was back in the 90's. (If only! I'd be running my half marathons, before the yucky meds. I could have been placed on a simple benzo, given a sleep aide, started real
therapy for anxiety, which is what I
believe, caused my breakdown--unrelenting, escalating anxiety, and horrible anxiety about insomnia. But I could be wrong.)The next time I see this guy, he's telling me, all earnestly, that he believes my
discontinuation symptoms are real, and it's like he's interviewing me, like, 'tell me about this. I've never heard of this.' This guy is supposed to manage PAIN meds. He's got a state license for crying out loud.Oh, I think I've said enough.
Best to you all on this thread. Laney, I do like Morgan's advice of low dose Lexapro. Whatever you decide, maybe, fingers crossed, this will be your ticket :)
fb
Posted by floatingbridge on February 12, 2011, at 16:36:10
In reply to Re: What should I be aiming for? Medications.... » floatingbridge, posted by sigismund on February 9, 2011, at 21:32:30
Beckett for the humor. Eliot seems so dreary.
Of course, there is 'April is the cruellest month, breeding Lilacs out of dead land, mixing Memory with Desire, stirring dull roots with Spring rain....'
My springtime mantra when I lived on the east coast. My depression and overall health usually at it's worst in spring.
And I have measured out my life in coffee spoons.
My son and I are reading suitable Tintin comics together. Lately, that's what I've adopted. If you are familiar with them, I'm the Thomson/Thompson's.
Cheers, Sigi :)
> >Or Beckett.
>
> Now you're talking.
>
> Eliot comes to mind: 'Streets that follow like a tedious argument of insidious intent'.
Posted by sigismund on February 12, 2011, at 16:48:18
In reply to Re: What should I be aiming for? Medications...., posted by floatingbridge on February 12, 2011, at 16:36:10
>Eliot seems so dreary.
Years ago I said to an elderly aunt that I loved Eliot. She said 'He's so gloomy'.
'Oh no', I said 'He's not gloomy at all.'When he was suffering from emphysema he was told to go to the Caribean for the English winter.
He hated the sight of all that sand and said it reminded him of snake worship.
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