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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 poser938 on March 18, 2011, at 22:22:07
so i've been wondering something. well.. i've had a bit of experience with antidepressant meds (SSRI and SNRI) they make me numb after about 2 weeks of taking them. well now im seeing a new psychiatrist and she is telling me that if i were to keep taking them after they make me numb then that side effect would go away. ive had other side effects go away but never the numbness. should i really taking them even if they make me numb to emotion. i wouldnt be so worried about it but side effects ALWAYS stay with me after i stop taking a med. and i dont want to be stuck extremely numb.
Posted by bleauberry on March 19, 2011, at 5:51:48
In reply to antidepressant side effects!, posted by poser938 on March 18, 2011, at 22:22:07
Well, no offense intended to the doctor, my opinion differs from that of your doctor. The numbness is not a side effect. It is a direct effect. Some have called antidepressants emotional anesthetizers. Sure they can get rid of the lows, but goodbye highs also.
That is not always the case. But we see it I think more frequently than not.
The numbness is thought to be the squashing down of the excitatory neurotransmitters (dopamine/norepinephrine) by one of the inhibitory neurotransmitters....serotonin. There has even been some speculation that the excess serotonin caused by antidepressants is taken up into dopamine and/or norepinephrine receptors. True or not I don't know.
Some doctors, such as at psychotropical.com, attest to best results with antidepressants that balance the neurotransmitters. The only way to do that is with combinations, such as SSRI plus TCA. As in Zoloft + Nortriptyline. While it is claimed that effexor and cymbalta are SNRIs, they really aren't. They are predominantly serotonin with very little respective action at norepinephrine. Balancing reduces or eliminates the numbness.
Stimulants are sometimes used to reverse the numbness. That follows the same theory as above....the stimulants add more norepinephrine and dopamine to the excess serotonin.
The only two balanced antidepressants are clomipramine and milnacipran.
Numbness can also be helped by lowering the dose. Lower doses can work. They just take longer.
I suspect that one reason a doctor might think that the numbness is a side effect that goes away, is because over time...months...as the patient becomes acclimated to the numbness they don't notice it any more. It's still there, but they've just gradually become accustomed to it so it is a part of them. Then maybe they take a little interest in a new hobby or something....not the same kind of gusto they would have had otherwise....but nevertheless it could "appear" the numbness is gone. I think with some detailed deep questioning, it would become obvious the numbness is still there and is a major handicap to enjoying life abundantly.
During years of prozac my doctor had me fill out the depression diagnostic survey questionnaire each visit. I scored very well...no depression on any of the topics except one....the question about "interest in activities and hobbies"...which I always scored the worst possible. All the others....sleep, appetite, pain, fatigue, mood, etc...were all real good. He claimed the lack of interest was not a concern since my test showed I did not have depression any more. He couldn't have been more wrong. i was not depressed during my prozac years, but those years were completely lifeless. Numbness impacts everything....productivity at work, interest in hobbies, interest in friends, interest in God, normal chores, getting projects done, deadlines, love relationships, sexual attraction, sexual ability, everything. So in my view, it is a huge concern. It's hard for me to decide which is worse....depression or numbness. The numbness is obviously gentler to handle, but nonetheless just as debilitating in every day life as depression is.
My own hunch is that if someone gets numbness on a SSRI or so=called SNRI, then serotonin is not their primary problem and serotonin should not be the main target. Some people become fully alive and motivated on SSRIs. They indeed probably need the serotonin. But when numbness happens, it is just the body's way of saying, "hey, too much serotonin!". In that case, the meds should be other than ssris, or other meds of norepinephrine/dopamine focus added to lower doses of ssris.
Posted by Phillipa on March 19, 2011, at 13:04:42
In reply to Re: antidepressant side effects!, posted by bleauberry on March 19, 2011, at 5:51:48
Seriously what if you now just don't respond either way either bad or good no side effects no nothing. Phillipa
Posted by poser938 on March 19, 2011, at 14:28:55
In reply to Re: antidepressant side effects!, posted by bleauberry on March 19, 2011, at 5:51:48
thanks for the very iinformative post. thats what i believed also, that emotional numbness is a direct effect of SSRI's. when i took effexor i did have side effects from it that went away but never the numbness, but i had quit it as soon as i had become numb.. and my doc was trying to tell me if i had kept on taking it that side effect could go away. i just dont see how some doctors cn be so ignorant about the meds they prescribe and work with everyday. makes it very hard to get some actual help from them.
Posted by mtdewcmu on March 23, 2011, at 0:01:08
In reply to Re: antidepressant side effects!, posted by bleauberry on March 19, 2011, at 5:51:48
> Well, no offense intended to the doctor, my opinion differs from that of your doctor. The numbness is not a side effect. It is a direct effect. Some have called antidepressants emotional anesthetizers. Sure they can get rid of the lows, but goodbye highs also.
>It would be nice if your theory could be formulated in a way that could be tested scientifically, and then have studies done. It seems like there is no rational theory for what antidepressants do, aside from cause a statistically tiny improvement in depression scores. It would be a big advance, IMO, if psychiatry could establish that SSRIs are emotional numbing agents. When I have tried to lower my dose of SSRI past a certain point, I notice feeling more present, but then this terrible depression returns and I have to stop the experiment.
Posted by desolationrower on March 23, 2011, at 5:13:23
In reply to Re: antidepressant side effects!, posted by mtdewcmu on March 23, 2011, at 0:01:08
It is extremely hard to 'experiment' on actual humans, especially when psyches are at stake.
-d/r
Posted by mtdewcmu on March 23, 2011, at 12:32:18
In reply to Re: antidepressant side effects!, posted by desolationrower on March 23, 2011, at 5:13:23
> It is extremely hard to 'experiment' on actual humans, especially when psyches are at stake.
>
> -d/rI disagree. It might be unethical to use depressed people, but you could ask normal people to take SSRIs and determine if they are numbed. SSRIs are considered pretty safe.
Posted by Phillipa on March 23, 2011, at 20:17:51
In reply to Re: antidepressant side effects!, posted by mtdewcmu on March 23, 2011, at 12:32:18
Seriously thanks for confirming this. Always thought SSRI's pretty safe also. Phillipa
Posted by mtdewcmu on March 23, 2011, at 21:16:59
In reply to Re: antidepressant side effects! » mtdewcmu, posted by Phillipa on March 23, 2011, at 20:17:51
> Seriously thanks for confirming this. Always thought SSRI's pretty safe also. Phillipa
Yeah. Generally people don't die from overdosing on them, and they are believed to not cause any long-term damage to your body.
Posted by desolationrower on March 25, 2011, at 4:50:03
In reply to Re: antidepressant side effects!, posted by mtdewcmu on March 23, 2011, at 12:32:18
> > It is extremely hard to 'experiment' on actual humans, especially when psyches are at stake.
> >
> > -d/r
>
> I disagree. It might be unethical to use depressed people, but you could ask normal people to take SSRIs and determine if they are numbed. SSRIs are considered pretty safe.Not if there is an institutional review board involved.
-d/r
Posted by BetweenDreams81 on March 25, 2011, at 8:19:26
In reply to antidepressant side effects!, posted by poser938 on March 18, 2011, at 22:22:07
Have you tried Lamictal? I mourn that I had a bad adverse reaction to it and was unable to continue taking it...finally was feeling alive again. Depression was subsiding, and for the first time in ages felt what 'happy' was like. Still haven't experienced that feeling since...like what bleauberry said, not depressed, but certainly not alive and pursuing the things I really enjoy, and could be perfectly content not leaving the house.
Just a thought. Hope you find a compatible answer soon!
Posted by hopefullynow on March 27, 2011, at 0:40:30
In reply to Re: antidepressant side effects! » poser938, posted by BetweenDreams81 on March 25, 2011, at 8:19:26
> Have you tried Lamictal? I mourn that I had a bad adverse reaction to it and was unable to continue taking it...finally was feeling alive again. Depression was subsiding, and for the first time in ages felt what 'happy' was like. Still haven't experienced that feeling since...like what bleauberry said, not depressed, but certainly not alive and pursuing the things I really enjoy, and could be perfectly content not leaving the house.
>
> Just a thought. Hope you find a compatible answer soon!You were only on Lamictal?What dosage if you don't mind?
I was unable to give it a real trial due to side effects.I wonder, after how time the side effect subsided?
Posted by BetweenDreams81 on March 27, 2011, at 9:00:56
In reply to Re: antidepressant side effects!, posted by hopefullynow on March 27, 2011, at 0:40:30
I am new to all this...Lamictal was the first thing doc tried, and I was (still am) on alprazolam for anxiety, and ambien for sleep. Since the Lamictal didn't agree with my system, I am on a low dose of lithium and the others, (I augment with supplements and am now starting to use homeopathics as well).
I was on the starter pack and into the 3rd week (50 mg) when I had a very bad systemic reaction to it. I know I was only on it for a VERY short time, and maybe it isn't fair to even say that it was helping me, but the moment I was on 50 mg of it, I was waking up at 7:30 AM on my own, felt fully rested, clear headed, inspired to go out and do things...the colors I swear were brighter and just overall felt at ease. The goal when I was started on Lamictal was to get up to 100mg and add low dose of lithium.
Unfortunately, my entire body ached like I had been run over by a train, then developed flu symptoms with a fever, my lymphnodes were visibly inflammed, and then a rash started to form. So, I was pulled off it. Currently I'm on alprazolam 0.5 mg, 2x/day, 150 mg lithium 2x/day, and 10 mg ambien. It's a bandaid for the moment. I can't see my doc until late april b/c I've been out of state for the past 2 1/2 months...so I'm guessing managing a brand new client from long distance is a bit tricky and you have to go safe route first. I am mostly stable at the moment...no deep depressions and I haven't been going on shopping sprees, but I also haven't felt that clearheaded happiness that I was starting to feel with Lamictal. (though have regained a bit more energy using homeopathics)
Current "routine":
150 mg Litium AM/PM0.5 mg Alprazolam
AM/when needed during the day (though, I have split them in half. Learned through trial and error that I have to start the day with 0.5 mg)10 mg Zolpidem (Ambien)
PM for sleep...trying to use just the Hyland's formula right now b/c I wake up feeling better than with the ambien...hard for me to wake up if I've taken ambien (even if I split it in half)Hylands Bioplasma Cell Salts
8 pellets under tongue 3-4x/dayHylands Insomnia
3 tabs 30min before sleep, then another 2-3 15 min after taking the first dose. Also taking 2 if I feel anxious before taking alprazolam to see if I can manage w/o alpraz.Hylands Arnica 30x
5 pellets taken same time as cell salts and as needed throughout the day (it's most common use is for pain/inflammation/bruising)Neem Leaf
2 caps 2x/day for general health/wellness it also has contraceptive propertiesOmega 3 Mood by Country Life high EPA formula 2 caps 2x/day
Simply One Multi vit.
Posted by Phillipa on March 27, 2011, at 19:03:35
In reply to Re: antidepressant side effects! » hopefullynow, posted by BetweenDreams81 on March 27, 2011, at 9:00:56
I've used arnica montana for pre and post op surgery no bruising at all. It's great and inespensive!!!! Phillipa
Posted by BetweenDreams81 on March 27, 2011, at 19:53:33
In reply to Re: antidepressant side effects! » BetweenDreams81, posted by Phillipa on March 27, 2011, at 19:03:35
We use arnica extensively in horses as well for joint pain/muscle pain.
Phillipa, was it you who mentioned that after taking an ibuprophen you had a mood lift? and then wondered about possibly some mental illness being related to inflammation of some sort? If that is true arnica may have its merits for helping more than pain and inflammation. I do think lately I have more energy in part from the arnica.
Posted by Phillipa on March 27, 2011, at 21:44:12
In reply to Re: antidepressant side effects!, posted by BetweenDreams81 on March 27, 2011, at 19:53:33
Yes it was me took 600mg of motrin for 24 hours and next day had a good day best I'd had in a while. So what and how can arnica help joint pain? I have horrible back pain oa with bone spurs, narrowing of spinal cannal due to see a back neurosurgeon end of April. I bite my lip as after riding bike pain horrible. Also osteoporosis but don't take any meds. Please answer send link I thought was only for bruising? And they have different strengths of arnica mine the lowest concentration I think. Thanks Phillipa
Posted by hopefullynow on March 28, 2011, at 12:16:09
In reply to Re: antidepressant side effects! » hopefullynow, posted by BetweenDreams81 on March 27, 2011, at 9:00:56
> I am new to all this...Lamictal was the first thing doc tried, and I was (still am) on alprazolam for anxiety, and ambien for sleep. Since the Lamictal didn't agree with my system, I am on a low dose of lithium and the others, (I augment with supplements and am now starting to use homeopathics as well).
>
> I was on the starter pack and into the 3rd week (50 mg) when I had a very bad systemic reaction to it. I know I was only on it for a VERY short time, and maybe it isn't fair to even say that it was helping me, but the moment I was on 50 mg of it, I was waking up at 7:30 AM on my own, felt fully rested, clear headed, inspired to go out and do things...the colors I swear were brighter and just overall felt at ease. The goal when I was started on Lamictal was to get up to 100mg and add low dose of lithium.
>
> Unfortunately, my entire body ached like I had been run over by a train, then developed flu symptoms with a fever, my lymphnodes were visibly inflammed, and then a rash started to form. So, I was pulled off it. Currently I'm on alprazolam 0.5 mg, 2x/day, 150 mg lithium 2x/day, and 10 mg ambien. It's a bandaid for the moment. I can't see my doc until late april b/c I've been out of state for the past 2 1/2 months...so I'm guessing managing a brand new client from long distance is a bit tricky and you have to go safe route first. I am mostly stable at the moment...no deep depressions and I haven't been going on shopping sprees, but I also haven't felt that clearheaded happiness that I was starting to feel with Lamictal. (though have regained a bit more energy using homeopathics)
>
> Current "routine":
> 150 mg Litium AM/PM
>
> 0.5 mg Alprazolam
> AM/when needed during the day (though, I have split them in half. Learned through trial and error that I have to start the day with 0.5 mg)
>
> 10 mg Zolpidem (Ambien)
> PM for sleep...trying to use just the Hyland's formula right now b/c I wake up feeling better than with the ambien...hard for me to wake up if I've taken ambien (even if I split it in half)
>
> Hylands Bioplasma Cell Salts
> 8 pellets under tongue 3-4x/day
>
> Hylands Insomnia
> 3 tabs 30min before sleep, then another 2-3 15 min after taking the first dose. Also taking 2 if I feel anxious before taking alprazolam to see if I can manage w/o alpraz.
>
> Hylands Arnica 30x
> 5 pellets taken same time as cell salts and as needed throughout the day (it's most common use is for pain/inflammation/bruising)
>
> Neem Leaf
> 2 caps 2x/day for general health/wellness it also has contraceptive properties
>
> Omega 3 Mood by Country Life high EPA formula 2 caps 2x/day
>
>
>
>BetweenDreams, thank you for your detailed explanation!!!
Be well !
Posted by BetweenDreams81 on March 28, 2011, at 13:24:20
In reply to Re: antidepressant side effects! » BetweenDreams81, posted by Phillipa on March 27, 2011, at 21:44:12
Traumeel is the brand that we've always used in the horse industry...but Hyland's also makes arinca montana. Here's a really interesting link I came across!
http://abchomeopathy.com/r.php/Arn
Enzymatic Therapy brand makes a product called Flex Agility Max http://www.enzymatictherapy.com/Products/Weight-Management-and-Fitness/Pain-and-Inflammation-due-to-Exercise-and-Overused/01686-FlexAgility-MAX.aspx
It used to be called End Pain, and it worked really well for me when OTC pain killers just didn't do it for me.
I've been using Hyland's Arnica Montana 30x lately...4-5 pellets under tongue 4x/day. I started off 4 pellets every 15-20 min for the first 2 hours and then tapered to 4-5 pellets every 4-6 hrs. Did the same thing with their Bioplasma Cell Salts, and now about 3-4x/day, 6-8 pellets/dose.
Posted by Phillipa on March 28, 2011, at 20:14:48
In reply to Re: antidepressant side effects! » Phillipa, posted by BetweenDreams81 on March 28, 2011, at 13:24:20
Thanks for the links. I was under the impression could only use arnica for a few days? Seems like it does everything. Might want to post a thread about these homeopathic remedies. Phillipa
This is the end of the thread.
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