Posted by circusboy on May 27, 2006, at 21:48:34
In reply to Cymbalta vs imipramine, posted by Robert35 on May 21, 2006, at 17:09:49
> I have had a lot of trouble with the Prozac I was on till about 10 weeks ago: trouble concentrating (at my job; at home not being able to read), emotionally feeling flat (like I am "ok" with almost everything), feeling exhausted, not adequately reacting e.g. at my job or too slow to react, sexual trouble.
> (It would take (and still does) me 80 minutes to write this.)After I'd been on Prozac again for a while (~1 year) I experienced the very same thing. Writing was especially excruciating, as was any sort of task that required sustained attention (following recipes, pushing data around at work). My head was constantly buzzing with incoherent half-thoughts as well, and I was perpetually anxious. This was odd to me, as I'd taken the drug several times before without this happening. At least not to the same degree -- in retrospect, it might've contributed to the circumstances that made me drop out of college. My psychiatrist prescribed Ritalin (methylphenidate), which helped *tremendously*. If you decide to stick with Prozac, I strongly recommend a stimulant (doctor willing, of course).
However, I don't think you should stick with Prozac. Early this year I tapered off Prozac (for, as it turns out, probably specious reasons: I blamed the drug for sexual issues when it was probably just anxiety in a new relationship) and on to, as it were, desipramine. Over the course of several weeks my anxiety almost disappeared and my concentration improved dramatically. I was amazed. Unfortunately, it turned out I couldn't sleep on a theraputic (for me: ~50mg) dose of desipramine and had to stop. I tried nortriptyline next. Couldn't tolerate that, either: I slept very well and my mood was starting to improve, but it caused some serious memory and cognitive disturbances.
I quit antidepressants altogether, and just stuck with Ritalin at 25-30mg/day. *The anxeity and cognitive problems I had on Prozac did not return!* I truly thought it was the desipramine conferring all those benefits, but it turns out a lot of it came just from *stopping Prozac*.
Now, I'm not anti-Prozac. In fact, it was one of only two SSRIs that actually worked for me (the other was sertraline), and I thought I'd be on it for the rest of my life. It had helped me quite a bit in the past. My guess is that Prozac, over the long term, supresses dopamanergic neurotransmission and causes anxeity through direct agonism at the 5HT2C receptor, as well as by simply increasing extracellular serotonin. (Please correct and/or add to my hypothesis if you've got any ideas). This would at least help explain the cognitive issues.
What were/are the primary symptoms of your depression? Not that the dots are easily connected, but it's at least a place to start.
-cb
poster:circusboy
thread:646652
URL: http://www.dr-bob.org/babble/20060525/msgs/649525.html