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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by porkpiehat on June 21, 2012, at 11:02:57
recently switched from Celexa to Zoloft. Great for concentration and less frantic raciness. Not so good for actual depression and now I'm having precipitous suicidal thoughts.
They seem to come about the time that Klonopin reaches its half life. They tend to go away with another klonopin or a beer or three. Some of the suicidal ideations started BEFORE I switched to Zoloft they are just worse now. I wonder if there is some kind of backlash or withdrawl/early addiction indicators happening with the Klonopin.
Of course if I have BPII then Zoloft could be contributing to the bad feelings.
thoughts?
Posted by ron1953 on June 21, 2012, at 12:25:06
In reply to Zoloft or Klonopin: suicidal thoughts, posted by porkpiehat on June 21, 2012, at 11:02:57
I can only speak of my personal experience with Klonopin but not Zoloft. I never thought of, or attempted suicide except while on Klonopin.
Posted by Phillipa on June 21, 2012, at 12:31:58
In reply to Zoloft or Klonopin: suicidal thoughts, posted by porkpiehat on June 21, 2012, at 11:02:57
So you do well on klonopin? And you find the symptoms worse when the half life occurrs. Could it be klonopin. Since it works from what you have written how often do you dose? What would happen with doses taken more often? I found celexa very very sedating. And the short period on zoloft it was tolerable. And you don't have a diagnosis for bipolar II. Why then do you feel you might have it? Phillipa
Posted by porkpiehat on June 21, 2012, at 14:30:26
In reply to Re: Zoloft or Klonopin: suicidal thoughts » porkpiehat, posted by Phillipa on June 21, 2012, at 12:31:58
> So you do well on klonopin? And you find the symptoms worse when the half life occurrs. Could it be klonopin. Since it works from what you have written how often do you dose? What would happen with doses taken more often? I found celexa very very sedating. And the short period on zoloft it was tolerable. And you don't have a diagnosis for bipolar II. Why then do you feel you might have it? Phillipa
There is a lot of overlap between BPII that my pdoc (current) is inclined to believe and the PTSD quasi-borderline tendencies that my therapist sees. Therein lies the mystery. Celexa ramps up my urge to drink and drug and spend and act out, but never to the extent that I've been awake for days or chased the soccer ball around with a Chevy (my dad's trick when he's manic. Oh yeah, there's the strong family history of BP.
I think the concern is how well I DON'T do when the klonopin wears off. It's not anxiety, rather oppressive sadness/suicide. Can't really be sure, that's just my current theory.
It is my strong inclination to take a holiday from everything and see where my head is REALLY at, but that is a big gamble owning my own business and all.
Posted by Phillipa on June 21, 2012, at 20:54:51
In reply to Re: Zoloft or Klonopin: suicidal thoughts, posted by porkpiehat on June 21, 2012, at 14:30:26
Family history means a good indicator that you also may have bipolar. I'd call your doc and run it by him. Usually a mood stabalizer first. I did read an article on bipolar II before responding and seems lithium is the best mood stabalizer. No owning your own business doesn't sound like a great idea to ditch your meds. Phillipa
Posted by Emily Elizabeth on June 21, 2012, at 20:57:06
In reply to Re: Zoloft or Klonopin: suicidal thoughts, posted by porkpiehat on June 21, 2012, at 14:30:26
From your short post, it sounds like the possibility of BP II needs to be taken seriously. Have you ever been on a mood stabilizer? If it is indeed BP II, zoloft could be making your situation worse.
I have been doing a lot of reading on this lately and found a lot of good info on psycheducation.org. The doc who runs the site also wrote a really good book on BP II. His name is Phelps and the book is called something like "why am I still depressed..."
Best,
EE
Posted by porkpiehat on June 22, 2012, at 17:20:28
In reply to Re: Zoloft or Klonopin: suicidal thoughts, posted by Emily Elizabeth on June 21, 2012, at 20:57:06
I see my current options as this:
-Go up yet again on the Zoloft above 75mgs to see if the sadness and ideations abate. Use Klonopin in emergency
-Try adding some SAM-e for the sadness and decrease the Zoloft.
-Try adding a little seroquel or abilify to help with the edgy and sadness. Hopefully lower the Zoloft.
I'm already at the point that my sex drive is gone and I've lost interest in my hobbies and spontaneity (some might say slight impulsivity) that bugs me about SSRI's, so not a fan of going up on Zoloft.
Ditching the Klonopin would probably help in the long run too.
I think I forgot to mention I'm taking 200 mgs of Lamictal also.
and I think "dystonic mania" is the concern with Zoloft that results in anger and suicidal sh*t.
Posted by bleauberry on June 23, 2012, at 14:02:19
In reply to Zoloft or Klonopin: suicidal thoughts, posted by porkpiehat on June 21, 2012, at 11:02:57
Either of those meds could be causing your symptoms. It sounds like there was already something going on under surface, either your own body or the klonopin, and the switch just highlighted it more. Maybe?
No matter, let's not lose sight of the real message here....these meds aren''t exactly doing what was hoped. That's the real focus.
A switch to Xanax maybe? It is less depression prone. I think I am one of the few that feels this way, and I got confirmation of my feelings when I read all the stuff of Dr Gillman, but I think one of the biggest mistakes made in treating depression is the lack of attention to balancing serotonin AND norepinephrine...not just one or the other. Your meds have no effect on norepinephrine at all. A very low dose addition of either nortriptyline, desipramine, or savella could fix that. For a really quick test just to get a hint of whether that might be the right direction to go or not, ask for a prescription....just 2 or 3 pills....of Ritalin, and 2 or 3 of Adderall. A rapid positive response to Ritalin points the way to Nortriptyline. Adderall points to Desipramine. These probing experiments are helpful because it only takes a day or two to find out. And the doctor should not be hesitant or disagreeable about writing a prescription for such a small amount where there is zero risk of overdose, zero risk of addiction, extremely low risk of anything going wrong. The risks are lower than starting a new med trial. Personally I favor Savella over either. In Japan Savella is added to SSRIs.
Anyway, the instant results of probing experiments with the stimulants can tell you a lot. With anxiety as an ongoing issue already, those experiments will probably make that worse, but sometimes paradoxically make it better. Either way, it's only for a few hours (do not get extended release). Or maybe you try that and neither of them feels good in any way to you. Ok fine. Then at least you know, maybe the norepinephrine angle is not the way to go.....not for sure, but at least you know more than did before, and that helps to make the next decision a good one.
Posted by porkpiehat on June 28, 2012, at 19:00:50
In reply to Re: Zoloft or Klonopin: suicidal thoughts, posted by bleauberry on June 23, 2012, at 14:02:19
my understanding was that stimulants like ritalin and adderal work on dopamine.
Anyhow, I have dropped the zoloft down to 50 mgs and I'm supplementing it with a tiny dose of Sam-e. Day 4 and it's working good.
Thanks everyone!
Posted by Phillipa on June 29, 2012, at 19:56:08
In reply to Re: Zoloft or Klonopin: suicidal thoughts » bleauberry, posted by porkpiehat on June 28, 2012, at 19:00:50
You like Sammee? What does it feel like? Like an SSRI or different? Phillipa
This is the end of the thread.
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