![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Joan O. on May 27, 2013, at 18:53:19
Diagnosed with depression in 1980s. Nardil helped but rough side effects. On and off Prozac for 10 yrs. till it didn't work. On and off Paxil for 12 yrs till it didn't work. In between tried Wellbutrin didn't work, Effexor made me suicidal, Cymbalta did nothing, kept going back to Paxil. Currently off Paxil since January. I wake every day to waves of terror and doom. Feelings dissipate till I feel normal by evening. Doc had me try clonazepam. Does nothing. The only thing that seems to counter the "morning terror/doom" is when I take a little zolpidem (which was prescribed a couple yrs. ago for sleep)along with caffeine to counter-act sleepiness. Seems illogical, but helps.
Is Paxil withdrawal causing "morning terror"?
Is taking zolpidem at night bringing on terror when it wears off in the morning?
Anyone have a situation like mine?
Posted by Phillipa on May 27, 2013, at 23:00:59
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
Yes I feel the terror in the morning. On low dose Lexapro & luvox & benzo for sleep. Wake and immediately feel terror. I try and make myself get up and go through my normal routine. And same as you when evening comes feel better. Take no meds during the day. Am as perplexed as you are. And shouldn't happen as valium is still in system in am. Phillipa
Posted by Zyprexa on May 27, 2013, at 23:07:23
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
I think it the paxil. You should go back on that. Its because paxil is a sedative. Which is the effect you seem to be looking for.
Posted by Zyprexa on May 27, 2013, at 23:11:09
In reply to Re: Morning terror » Joan O., posted by Phillipa on May 27, 2013, at 23:00:59
There may not be as much valium in your system by morning. And evening is when you take it, so you don't have that problem then. Have you tried a smaller dose in morning to help out?
Posted by SLS on May 28, 2013, at 7:12:51
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
Continually going on and off antidepressants is a recipe for treatment-resistance. A recurrent course of depressive illness indicates continued treatment. When you find something that works, you should probably take it indefinitely or until new ways of treating depression become available.
You might be right about the zolpidem (Ambien). Zolpidem has a short half-life (2 - 3 hours). The appearance of anxiety might be a rebound effect.
Have you ever tried a tricyclic (TCA)? They sometimes work for people whose depression and agitation are at their worst in the morning.
- Scott
Posted by lillabella on May 28, 2013, at 14:59:52
In reply to Re: Morning terror » Joan O., posted by SLS on May 28, 2013, at 7:12:51
Scott I believe you are right. Changing meds regularly seems to me to be a cause for a medication to cease working. I was on Parnate and doing just great. Then a new p-doc insisted I stop the Parnate and take an old anti-psychotic called Doxepin, I think that was what it was called. Had full on panic and lots of tardive dyskensia on this med but he made me stay on it until after a week when I refused. Went back to Parnate, my magic bullet, and nothing. No effect. I stayed on the Parnate for weeks hoping for it to finally give me the relief I once felt. I know it was this powerful drug that altered my brain chemistry somehow as I had such a strong reaction. I think p-docs should listen to patients when they say a med is working but some feel they have to make changes. A lot work on a formula like if you have bi-polar you have to take an ant-psychotic even tho you tell them that for you as an individual with a different brain chemistry even tho you have bi-polar you can't tolerate that class of drug. It was forced on me because at the time I was in a psych ward and the resident p-doc, who dealt with a new crop of patients every day, refused to listen to me and applied his basic formula. I know my brain chemistry is extremely sensitive and has been messed with from too many meds over the years. I wish I had a good doctor but I don't. My current p-doc gets frustrated with me when I tell him that the meds he has me on aren't working. He refuses to believe I am depressed. I live in Toronto and all medical treatment is free as well as my scripts. Trying to find a good shrink is next to impossible here. None of them are taking on new patients. I would pay out of pocket to have an open minded savvy doctor who would listen to me but that isn't happening. All I can say is if you are on something that is working for you stay with it. There are probably a lot of people out there who are doing well on their meds and so for the most part they no longer need this board because they are busy and functioning. God bless them but God bless all of us who are still out in the wilderness of mental anguish searching for the med or combo of meds to get them well again. How are you doing Scott?? You and Phillipa and a few others are constants on this board and your knowledge, compassion and understanding really do so much for those of us struggling in the dark. Peace and love to all..........lillabella
Posted by Roslynn on May 28, 2013, at 15:08:44
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
Dear Joan, I am sorry you have to experience this.
My morning problems involve screaming and crying in self-hatred. It happens immediately after waking. It can last until noon (not continuously but in waves).
I wish I had an answer for both of us.
Roslynn
Posted by SLS on May 28, 2013, at 19:03:37
In reply to Re: Morning terror, posted by Roslynn on May 28, 2013, at 15:08:44
> My morning problems involve screaming and crying in self-hatred. It happens immediately after waking. It can last until noon
:-(
- Scott
Posted by SLS on May 28, 2013, at 19:10:18
In reply to I agree with you Scott!, posted by lillabella on May 28, 2013, at 14:59:52
Peace and Love to you too, Lillabella.
I am feeling and functioning significantly better. Thanks for asking.
:-)
There is still a great deal of ground to cover, though, and I don't feel that I am ready to go back to work yet. I sleep too much during the day. It might be due to the prazosin I am taking. Fortunately, I do not get sleepy when I am engaged in an activity.
- Scott
Posted by SLS on May 28, 2013, at 19:28:55
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
Just a thought:
I am currently taking a combination nortriptyline (TCA) and prazosin (NE alpha-1a/b/d antagonist) along with a few other drugs.
TCA often works in cases of melancholic depression where depression is at worst in the morning. Prazosin has been found to be effective in treating PTSD with disrupted sleep and nightmares. It also works to treat daytime depression and anxiety. Prazosin feels like a very "clean" antidepressant to me. It doesn't make me feel apathetic or spacey. If your life history includes chronic trauma (particularly in childhood), prazosin might be very helpful. Perhaps combining nortriptyline + prazosin is a treatment that would be effective in treating melancholic depression with a history of chronic trauma or PTSD.
- Scott
Posted by Phillipa on May 28, 2013, at 20:02:17
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
Joan now reading your original post this evening and read it in a different way. Seems like paxil for you is like luvox for me. I've managed to get it down to 25mg not even therapeutic. But this was really hard to do. Seems I can do whatever with Lexapro. No difference. By the way do you have thyroid issues. I ask as this is what caused me to need an ad. Before then a small dose of benzo worked very well. But what works for me the best is getting up, dressing, eating, washing hair, make up and getting out of the house and engaging with other people. Seems this is what changes my mood the very best. Phillipa
Posted by alchemy on May 28, 2013, at 21:16:10
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
When I went through a phase of extreme anxiety the mornings were the worst. I would wake up at 5:30 am sharp no matter what. I've also gone through phases where my depression is worse in the mornings and phases when it was worst in the afternoon. Who knows why, it is frustrating though!
As far as my anxiety stretch, I think it may have been from a long emsam withdrawal. Xanax for me. I wish I had an answer for you. And for me :)
Posted by Joan O. on May 30, 2013, at 18:41:09
In reply to Re: I agree with you Scott! » lillabella, posted by SLS on May 28, 2013, at 19:10:18
Thanks to all who have responded. I've taken notes. I see doc again tomorrow to discuss it. Thanks for helping me feel I'm not alone. God bless you all.
Posted by Joan O. on May 30, 2013, at 18:59:44
In reply to Re: Morning terror, posted by alchemy on May 28, 2013, at 21:16:10
This is scary. Terrors woke me at 5:30 am too. Last month Doc gave me a scrip for alprazolam (generic xanax). He said I could take it 3 times a day but one pill knocked me out for a day and a half. Been biting off tiniest possible pieces of pill and it seems to help. I wish there were answers for all of us. :)
Posted by Joan O. on May 30, 2013, at 19:13:22
In reply to Re: Morning terror » Joan O., posted by Phillipa on May 28, 2013, at 20:02:17
Had thyroid checked a few years ago. No problem but blood tests showed anemia. Engaging with people does seem to help. I've been helping out a widow neighbor past three mornings. She thanks me but I tell her she is probably helping me more than I am her. I get scared to leave bed, praying to fall back for a little more sleep. Then it's time to face another day and pray for evening. I hear conflicting things about Lexapro. Scared to try something new, but scared to stay where I am. Thanks, Phillipa, and everyone who responded, for listening.
Posted by Joan O. on May 31, 2013, at 15:26:35
In reply to Re: Morning terror, posted by Roslynn on May 28, 2013, at 15:08:44
Roslynn, as I cry at my keyboard I just want to reach out and put my arms around you and tell you, "one breath, one hour, one day at a time." As for screaming, I'm not there yet, though I visited haunted houses last Halloween for the sheer pleasure of screaming my head off (and still being socially acceptable).
Posted by Joan O. on June 1, 2013, at 15:39:15
In reply to I agree with you Scott!, posted by lillabella on May 28, 2013, at 14:59:52
Thankfully I have a doctor who listens, who believes when I say a med is working or not. I've been with him 12 yrs now and, even though he's on the clock, I feel respected. I saw him yesterday and got a perscription for something else to try. Haven't tried Lexapro yet, so I'll see. lillibella I hope you get some competent help. That's a big part of the battle right there. Bless you.
Posted by Joan O. on June 1, 2013, at 15:51:39
In reply to Re: Morning terror » Joan O., posted by SLS on May 28, 2013, at 7:12:51
Thanks, Scott. The problem with the Paxil is that a couple years ago (after 10 yrs of Paxil use) it just stopped working. Serious doom and dread mainly started over a year ago as I tried to wean off it, in between trying new things. Completely off Paxil 5 months ago when terrors started dominating mornings and day.
I discussed your post with doc and we considered your suggestions. I'm so blessed to have a doc who talks 'with' me, not 'at' me.
Posted by Joan O. on June 1, 2013, at 15:56:50
In reply to Re: Morning terror, posted by SLS on May 28, 2013, at 19:28:55
Scott, I can only think that from your insights and knowledge, you have been fighting battles for a long time. Thanks for your help. Sending good wishes your way.
-Joan
Posted by SLS on June 1, 2013, at 16:44:12
In reply to Re: Morning terror » SLS, posted by Joan O. on June 1, 2013, at 15:56:50
> Scott, I can only think that from your insights and knowledge, you have been fighting battles for a long time. Thanks for your help. Sending good wishes your way.
> -JoanThanks, Joan. That means a lot to me.
Yes, my war has been going on for about 35 years. With the exception of a 9-month remission, I have been chronically and severely depressed. Not fun.
Here's another idea. Prazosin. It is an old antihypertensive that shows efficacy in treating PTSD, anxiety, and depression where chronic childhood trauma, abuse, or neglect has taken place. This drug has acted as a potent antidepressant for me in combination with the other drugs I take.
http://clinicaltrials.gov/show/NCT00532493
One more. Minocycline. It has been shown that this antibiotic also acts as an antidepressant for some people. It is supposed to be helpful in combination with a tricyclic, but it can work well without one. Right now, the two people I know who are having success with minocycline both take Abilify along with it.
http://clinicaltrials.gov/ct2/show/NCT01514422
http://www.ncbi.nlm.nih.gov/pubmed/18267354
- Scott
Posted by rovers95 on June 2, 2013, at 18:31:13
In reply to Morning terror, posted by Joan O. on May 27, 2013, at 18:53:19
> Diagnosed with depression in 1980s. Nardil helped but rough side effects. On and off Prozac for 10 yrs. till it didn't work. On and off Paxil for 12 yrs till it didn't work. In between tried Wellbutrin didn't work, Effexor made me suicidal, Cymbalta did nothing, kept going back to Paxil. Currently off Paxil since January. I wake every day to waves of terror and doom. Feelings dissipate till I feel normal by evening. Doc had me try clonazepam. Does nothing. The only thing that seems to counter the "morning terror/doom" is when I take a little zolpidem (which was prescribed a couple yrs. ago for sleep)along with caffeine to counter-act sleepiness. Seems illogical, but helps.
> Is Paxil withdrawal causing "morning terror"?
> Is taking zolpidem at night bringing on terror when it wears off in the morning?
> Anyone have a situation like mine?Hi
I've had similar issues in the past, for me it seems to be blood sugar related (hypoglycemia). Could it be that once you eat or have some caffeine this then boosts your blood sugar levels back up? Just a thought.
Rover
Posted by Joan O. on June 3, 2013, at 14:51:57
In reply to Re: Morning terror, posted by rovers95 on June 2, 2013, at 18:31:13
It's worth a thought, Rover. Thanks, Joan
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.