Posted by 3 Beer Effect on June 7, 2002, at 2:14:28
In reply to What do I do now? Just want to cry., posted by rainbowlight on June 6, 2002, at 15:08:40
Rainbowlight- Your case sounds very complex- you might need to find a very good psychiatrist & I think I know will you will be able to find the best. For example where I live there is an esteemed medical school called the University of Texas Southwestern Medical Center. Most of the Medical School Professors, who are all M.D. psychiatrists (many of whom are famous for their research studies, books etc), also maintain their own private office of psychiatry or have one at the medical school where they take difficult-to-treat/challenging patients. These Medical School Professors of Psychiatry are actually doctors too, they don't just teach & do research. I contacted several & could have made appointments for myself but unfortunately at the time I had Cigna insurance which none of them took (Cigna has a reputation of being a hassle to deal with-most Doctors seem to hate Cigna insurance).
You can probably find most of the necessary info & also doctors names, phone #s on the website of the Medical School in your area or by calling the Department of Psychiatry at that Medical School. Just be sure the doctor you pick takes your health insurance (check the provider directory for your insurance or call). I would make a list of the top three psychiatrists you want to see who also teach classes at a good Medical School in your area. These psychiatrists can be harder to get appointments with so be patient, but if you can't make an appointment with one, just move on down the list.
Also, are you happy with taking Remeron? It personally turned me into a lethargic zombie who slept 14 hours a day even at 45 mg, & at 60 mg it was no longer sedating but made me hostile & angry/sharp with others. Perhaps the Remeron is why you had lethargy with some of the other antidepressants (Paxil, Luvox etc). Remeron changes the way an SSRI works by blocking some of their (mostly negative) effects at certain Serotonin receptors. But it also has norepinephrine boosting (NE is more often implicated in anxiety than serotonin or dopamine) & alpha-2 NE antagonism (which can cause hostility in some patients).Perhaps Zoloft w/ Klonopin (a 2nd line anti-manic & anti-anxiety agent) or Paxil w/ Klonopin BOTH WITHOUT REMERON but with Ambien 10-20 mg to sleep at night might work. With SSRIs, sexual side effects are an effect you just have to live with, not much way around that besides Viagra for women.
Sometimes when the new drugs don't work, people have to turn to the old ones.
Have you ever considered the MAOI Nardil? The MAOIs have less side effects than the TCAs (The TCAs were more popular because they didn't figure out the tyramine/cheese effect until 10 years after MAOIs came out- Several deaths occured & MAOIs were withdrawn for a few years, & when they were reintroduced they never got over their 'bad' reputation (kind of like how Wellbutrin is still struggling to overcome its seizure causing stigma). Nardil does have sexual side effects & other side effects at first, but i've heard, unlike SSRIs, your body gets used to these side effects and they go away after 4-6 months or so.Hope this helps & good luck- I don't think you will find the correct treatment combination by talking on this board. You might need the assistance of the best psychiatrists in your area. Also regularly see a good psychotherapist- people have a tendency to discount them, but my psychiatrist told me i'm never going to solve all my problems/achieve happiness by adjusting the amounts of various neurotransmitters in my head. You have to go out & do stuff, have hobbies, exercise, & basically live life (TV & the Internet do not constitute real life)! Do you ever go to the movies & out on dinner dates with your husband? After seeing a good movie, I always leave the movie theatre feeling more optimistic about the future & life in general.
3 Beers..........
poster:3 Beer Effect
thread:108970
URL: http://www.dr-bob.org/babble/20020602/msgs/109029.html