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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Anna Laura on April 9, 2001, at 14:37:47
Hi Everybody!
Please forgive me for my bad english, but it's not my mother tongue: i studied english in high-school and a little bit in College, ( hopefully well enough to make myself understood).
I live in Europe, in the not-always-sunny Northern Italy.
Here's my brief story : hope it won't sound pathetic or self indulgent.
I got depressed when i was twenty-one after two horrible years of severe stress. That was more then ten years ago. Unfortunately, my depression was misdiagnosed and i was prescribed for tranquillizers instead of AD plus i was adviced to follow a psychoanalitic-oriented therapy. The result was that i got worse year by year, until i went psychotic in 1993. I still wonder how i managed to survive that horror. I recovered from the major episode, with the aid of tofranil, (imipramine) but since then I have a pretty invalidating kind of dhystimia. My formal pdoc, a cognitive therapy fanatic, was saying i didn't need medications and that ijust had to be more "positive" : he went on telling me that i was sticking to depression for psychological reasons (I was "protecting myself" from the stress of the outside world with my anhedonia). So my anedhonia/dysthimia went untreated because i trusted him so much (he was the guy who got me out of the psychotic episode), that i didn't even mind questioning his opinions. Needless to say i didn't try any medication.
I just went on blaming myself, kept on telling myself that i could get out of it if i really wanted, or that i was just plain lazy. The situation got even worse in the last three years (not going out, not seeing friends, no joy at all, no sex).
The paradox is that i felt better when i was worse. In 1993 i was psychotic and the horror was always there, but still, i could enjoy simple things like listening to music, or having sex, seeing friends, even go shopping for clothes etc., i was much more indipendent than now and my personality traits were still there on the "surface" (now i barely know who i am) .
The last bout, due to severe, prolonged stress, was six months ago. I never felt so apathetic in my whole life. I couldn't move from the couch, i din't eat anymore. I felt like i was dead.
Thanks god the tofranil started working and i got better but still low-functioning (just managing to do the house-work plus little jobs at home via computer, still anhedonia). The pdoc i was seeing until a few weeks ago suggested to switch the medications, so i went on prozac.I 'm currently taking prozac (started ten days ago with 20 mg. then 40 mg. after a few days) and i lowered the tofranil dose (from 150 mg. down to 50 mg.).The result is that I'm getting worse day by day. I feel like i'm slipping in to that horrible state of mind again. What should i do? Should i go back to the old tofranil dose, or just wait for prozac to start working? Do i need a psychotherapy or should i try medications until i find the one that works for me?
Do i have any hope of recovering and feeling lively again?
Thanks for listening
Anna Laura
Posted by Shirley2 on April 9, 2001, at 18:59:53
In reply to Long term depression :Any advice?, posted by Anna Laura on April 9, 2001, at 14:37:47
Anna Laura,
Your English is fine so not to worry. I am so sorry you had to experience all that garbage before appropriate medical treatment.
I am not a physician so please keep that in mind when reading my post. First of all, I assume you have told your doctor about what is happening with the Prozac. If not, it sounds like you need to as soon as possible.
When you say you're slipping into that horrible state of mind, what do you mean? If your mood is worsening to the point of feeling suicidal or being more psychotic, I would definately not stay on Prozac as I believe it is know to do things like that on the odd occasion. But please check with your doctor or if you already have, what did he/she say? I think what I am saying is I'm concerned but I don't want to do anything irresponsible and tell you to get off the drug when I may be missing a piece of the puzzle.
If your worsening state of mind means you have nasty side effects but they aren't life threatening, that's more of a personal decision.
When I was on Celexa at 5mg, I had severe agiatation but my psychiatrist felt safe continuing me on the drug. I said "No thank you."
See what I am saying?It sounds like to me Tofranil hasn't worked that great and maybe you need additional or new medicine. That is if you switch from Prozac. But again, check with your doctor.
I hope that helps and welcome to the board.
Shirley
Posted by SalArmy4me on April 9, 2001, at 19:59:26
In reply to Long term depression :Any advice?, posted by Anna Laura on April 9, 2001, at 14:37:47
Pardon me, but why do you have to lower the Tofranil dose?
Posted by phillybob on April 9, 2001, at 23:48:52
In reply to Long term depression :Any advice?, posted by Anna Laura on April 9, 2001, at 14:37:47
> Please forgive me for my bad english, but it's not my mother tongue:
Hi, Anna Laura! As Shirley posted, your English is just fine (and, in fact, better than some of the other native speakers posting on this board!) :)
> Here's my brief story : hope it won't sound pathetic or self indulgent.
It sounds neither pathetic nor self-indulgent. We all have similar stories ... unfortunately.
> My formal pdoc, a cognitive therapy fanatic, was saying i didn't need medications and that i just had to be more "positive"
It sounds like you don't quite have the same opinion as your formal pdoc. That's good!
Nothing is worse than getting a "guilt trip" from one's pdoc about how our illnesses are under our control. I certainly believe that talk therapy has its place in helping us to understand and react better to our situations, but some things, like many of our illnesses, are no more going to be cured by talking than would a fractured bone.
> I just went on blaming myself, kept on telling myself that i could get out of it if i really wanted, or that i was just plain lazy.
It seems like you understand now that this is not the case. You are not lazy. You do not choose to be sick. How silly for a pdoc (an individual of medicine and reason, supposedly) think that!
My illness certainly did not progress to be as severe as yours, but I have finally realized that I am not lazy by choice and that I am not sick by choice, etc., etc. As a matter of fact, I consider myself to be quite fine except for some missing ingredients to my neuro-chemistry (or something like that). I would venture to guess that you, too, are a great gal in need of a small amount of medical correction. I am currently searching for the right cure for myself and feel that I am hot on its trail (though I go up and down in thinking that ... but I know that I MUST find something).
> Thank god the tofranil started working and i got better but still low-functioning (just managing to do the house-work plus little jobs at home via computer, still anhedonia). The pdoc i was seeing until a few weeks ago suggested to switch the medications, so i went on prozac.I 'm currently taking prozac (started ten days ago with 20 mg. then 40 mg. after a few days) and i lowered the tofranil dose (from 150 mg. down to 50 mg.).The result is that I'm getting worse day by day. I feel like i'm slipping in to that horrible state of mind again. What should i do?
As Shirley posted, talk to your pdoc. If the tofranil does not interact poorly with Prozac, you might want to continue on the 150 mg dosage as you wait for Prozac to "kick" in. I'm not sure. The best advice I can really offer you is to research, research, research (i.e. read websites such as this one) so that you are a part of your cure and thus, in some way, in control of your life!
> Do i have any hope of recovering and feeling lively again?
I hope so. :) Be well.-Bob
Posted by JohnL on April 10, 2001, at 4:21:51
In reply to Long term depression :Any advice?, posted by Anna Laura on April 9, 2001, at 14:37:47
You have some wonderful meds in Europe that we don't have here. It just so happens that one of them is quite promising for the symptoms you have described. It is Amisulpride. I order mine from a pharmacy in Italy and they ship it to me. I have tried just about every antidepressant and other psychiatric drugs you can think of, but nothing has ever worked as well as the antipsychotics for my symptoms. Amisulpride, Sulpiride, or Zyprexa would be excellent options for you. I just get the sense that taking an antidepressant alone will not do the trick for you. Either stay on Prozac, or return to Tofranil, but consider adding Amisulpride or Zyprexa to it. That's what I would do in your shoes, with the benefit of hindsight.
John
Posted by Anna Laura on April 10, 2001, at 4:28:00
In reply to Long term depression :Any advice?, posted by Anna Laura on April 9, 2001, at 14:37:47
I'will try to answer to each one of you writing a single mail, hoping to cover the missing pieces of the puzzle.
My pdoc told me that prozac interact with imipramine by elevating the blood levels of imipramine, thus creating an "additive effect". i.e. : if i i'm taking 100 mg. of Tofranil while taking prozac at the same time, the amount of imipramine, because of the interaction with fluoxetine, would "pile up", sometimes even doubling. The result it would be as if i were taking 200 mg. instead of 100 mg.
As a matter of fact, i was scared of lowering the tofranil dose so abruptly before the prozac could kick in, thus ending up feeling "uncovered". But my pdoc assured me that it wasn't going to be like that. The problem is that i i feel like imipramine ceased working. I lost my appetite, feel more apathetic and insecure and i 'm kind of scared of things again.
I don't feel suicidal, but i don't feel my body anymore : i feel like a ghost again, plus I can't concentrate: right now i have difficulties writing this mail: i hope it won't sound odd or confusing.
I 'm afraid that the so-called "additive effect" might vary a lot between individuals because each one of us has a different metabolism. I probabilly need to augment the imipramine dose, but my pdoc is always too cautious about it. I tried to talk with him yesterday but i couldn't find him. Sometimes i can't contact him for days.
I'm fed up with this. I 'm quite reluctant about seeing others pdoc because some of them tend to suggest hospitalization for medicine testing. I don't see the point because i'm not suicidal (i've never been) nor i'm psychotic (not now).
So why should i hand the stress of hospitalization?
On the other hand my current pdoc is too much "dégagé" and careless. He's always like : "don't worry about it, everything it's fine". Or : "You know, depression is a part of the life process". I need to find "somebody-in-between" these two extremes.
I have got an appointment today with another pdoc, kind of scared, but i'll go anyway.
Perhaps i've just to try and try until i find somebody suitable for me.
Thank you all for answering me.Blesses,
Anna Laura
Posted by Anna Laura on April 10, 2001, at 5:11:00
In reply to Re: Long term depression :Any advice?, posted by JohnL on April 10, 2001, at 4:21:51
> You have some wonderful meds in Europe that we don't have here. It just so happens that one of them is quite promising for the symptoms you have described. It is Amisulpride. I order mine from a pharmacy in Italy and they ship it to me. I have tried just about every antidepressant and other psychiatric drugs you can think of, but nothing has ever worked as well as the antipsychotics for my symptoms. Amisulpride, Sulpiride, or Zyprexa would be excellent options for you. I just get the sense that taking an antidepressant alone will not do the trick for you. Either stay on Prozac, or return to Tofranil, but consider adding Amisulpride or Zyprexa to it. That's what I would do in your shoes, with the benefit of hindsight.
> JohnI didn't try amisulpride. I took a medication called "impromen", a butyropherone derivate ( i think the chemical compound is named something like "bromperidol") and made me feel like a zombie. I felt totally numb and almost catatonic. Does amisulpride resemble that, being an antypsicotic agent? Moreover, i'm concerned about TD.
Anna Laura
This is the end of the thread.
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