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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Lindsay Rae on March 21, 2004, at 13:44:31
I started to write a post about my history of self medicating my depression with alcohol and opiate analgesics (only in small amounts, like two Vicodin a day), but the long post was somehow lost when I passed out from being so tired. I'm frustrated about it, but maybe it was TMI anyway. Basically, I know for a fact that opiate receptors are not working properly in some people, and I am one of them. I have to supplement with small doses of opioids to feel "normal," and I have to have Xanax on standby to ease daily panic attacks. The depression and anxiety started when I was ten, then exploded when puberty hit. That's why I question the role hormones play in my overall mental health picture (and everyone else's for that matter).
What is so damned frustrating for me is the guessing game with the different anti-depressants. With opiates, it is clear what the medicine is doing: filling those receptors that fire neurons to the brain that ease pain and gives you an enhanced sense of wellbeing. The debate over addiction vs. dependence, and who is an addict and who is self medicating for depression, is not the topic of this thread, but it's a lingering question nonetheless.
I work in a mental health facility that consists of several p-docs and therapists. I participate in conversations daily about mental health, medications, and various topics of interest, and I still come to the same conclusions about psychotropics as I did when I was 18, taking my first prescription of Paxil off to college across the country with me and never bothering to take it.
It seems that the newest, latest drugs on the market (and I'm not narrowing them down to p-drugs), for the purpose of this conversation, are the ones prescribed. How could one know if the infamous Prozac is better than, equal to, or obsolete in proportion with Lexapro, its shiny new opponent? Sure, these SSRI meds have different compositions, but aren't they all the same? Wellbutrin is different; that much I know. And different meds work well for different people. But since we can't study the brain and measure one's Seratonin, Dopamine, and other chemical levels, aren't we limited to trial and error? Circumstance plays a part, as do hormone levels, so how do we know whether to shell out a ton of money for Lexapro when Prozac is only around $8.
Obviously, I'm speaking from personal experience. But I watch patients day in and day out who are diagnosed with depression and medicated accordingly. It bugs me that Lexapro tissue boxes and Zyprexa pens litter the waiting room and office. Reps come and go almost as often as do patients. And you never hear the word "Prozac" or "Paxil" uttered anymore simply because they are not hot on the market.
Any thoughts on this? Does anyone else have experience with taking different types of meds, which ones made you gain weight (Zoloft?) and which make you lose (Prozac?)? Is it safe to flip-flop from Lexapro to Zoloft while the pharmacy mails you the correct antidepressant?
Any answers would be appreciated. I'm taking an online survey, if you will, since I'm not in a position to talk to patients outright about these medications and their effects. One patient who was being treated with antipsychotics swallowed a dozen razor blades over the weekend, so they are now considering hormones to be at fault. The guessing game is really scary, is it not?
Thanks Much!
L. Rae
Posted by Dinah on March 21, 2004, at 15:14:34
In reply to Treatment with Meds...Legit or Lazy?, posted by Lindsay Rae on March 21, 2004, at 13:44:31
This is the end of the thread.
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