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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Jim Bob on August 31, 2002, at 19:16:26
Hey people,
I'm just really frustrated tonight and in need of support regarding my treatment. I've been on Prozac 20 mg. for 4 weeks, and my pdoc has just increased it to 30 mg. on my 5th week, with plans to increase to 40 mg. on my 7th. I'm also on Risperdal 0.5 mg PRN for agitation and anxiety.
I'm upset because the treatment isn't helping. I've noticed no difference whatsoever since starting the Prozac, and the Risperdal really doesn't do much of anything for my anxiety. Part of the problem is that I've been labeled a drug-abuser, and so my pdoc is being very cautious with what he prescribes. Also, I've been on Prozac, Wellbutrin, Elavil, and Paxil all in the past, with none of them helping. The problem is that the depression has been so bad that I've switched meds. around alot, so my pdoc isn't sure that anything's been given a fair chance. My symptoms are major depression with lethargy, difficulty concentrating or focusing, and anxiety with irritability and agitation.
So my question is: what is a fair chance? I'm almost to the point that I want to switch pdocs, but I'm afraid to, and don't even know how -- e.g. I don't want to have to wait a month to get in with someone else, etc. It's just that every time I see my doctor I tell him that I'm not feeling any better, and all he does is up the dose on my prozac. I've read about things like augmenting SSRI therapy with Pindolol, and when I mentioned this to my doctor, he looked at me like I was crazy (imagine that), and said, "well, I don't think that will be necessary."
I'm feeling so terrible that I'm looking for something drastic to be done, and I guess my question is, short of hospitalization (which I've done in the past with no success) and ECT, what drastic medical treatment is there that *can* be done? What experience have you all had with failed treatments - i.e. how many meds. and how many months did it take to get something that worked?
Thanks,
Jim Bob
Posted by BrittPark on August 31, 2002, at 20:28:14
In reply to frustrated, treatment not working, posted by Jim Bob on August 31, 2002, at 19:16:26
First off, you almost certainly will get better, if not on the current set of meds then on something after that. Second 4 weeks is not long enough of a trial to know whether the prozac is going to work. You'll need to wait at least 8 weeks to see if it really works. That doesn't mean that you'll have to suffer all that time. Your pdoc should be considering ameliorative measures. I don't know what your symptoms are but I'm assuming among them is anxiety. Risperdal is not a first choice for an anxiolytic (though it sometimes speeds up antidepressant response). Klonopin or Xanax or both are a better choice.
Post again, and let the psycho-babble people know in what ways you are suffering. They have a lot of experience and may be able to suggest things to try.
Keep plugging and you will feel better.
Britt
Posted by Jim Bob on August 31, 2002, at 20:36:38
In reply to RE: Treatment not working » Jim Bob, posted by BrittPark on August 31, 2002, at 20:28:14
Thanks Britt,
I appreciate the optimism. I'll go ahead and give the 8 weeks a shot, at least so I can say I've given it a good shot. As far as the "ameliorative measures," my doc. is very wary of prescribing benzos both because of my drug abuse history, and his fear of addiction. I really feel that the anxiety is preventing me from getting schoolwork done (I'm a college student), although some might be undiagnosed ADD. He's ruled out prescribing pstims too though, because of the abuse factor, and because of the anxiety. From what I've read on this list, this is a rather antiquated way of thinking. Is it worth changing pdocs over? I feel bad "bugging" my doc. all the time, especially calling between appointments. Any advice?
Jim
> First off, you almost certainly will get better, if not on the current set of meds then on something after that. Second 4 weeks is not long enough of a trial to know whether the prozac is going to work. You'll need to wait at least 8 weeks to see if it really works. That doesn't mean that you'll have to suffer all that time. Your pdoc should be considering ameliorative measures. I don't know what your symptoms are but I'm assuming among them is anxiety. Risperdal is not a first choice for an anxiolytic (though it sometimes speeds up antidepressant response). Klonopin or Xanax or both are a better choice.
>
> Post again, and let the psycho-babble people know in what ways you are suffering. They have a lot of experience and may be able to suggest things to try.
>
> Keep plugging and you will feel better.
>
> Britt
>
Posted by Arthur Gibson on September 1, 2002, at 2:39:51
In reply to RE: Treatment not working, posted by Jim Bob on August 31, 2002, at 20:36:38
4 weeks is nothing with PROZAC. It could be six before you get any relief.
However you should have had some slight relief by now.
Hang on till 6 or 7 weeks and reasess your improvement.
Don't change your doctor.
Keep writing here for support.
Don't take alchohol or any other drugs or herbs.
PROZAC sometimes make you worse before it makes you better, but the final effect can be good.
How is your sleep pattern?
Posted by denise528 on September 2, 2002, at 12:06:59
In reply to frustrated, treatment not working, posted by Jim Bob on August 31, 2002, at 19:16:26
Hi Jim Bob,
I can't really advise but I just wanted to say your situation is so very much like mine. It could have been me writing it. I too feel really frustrated and have been messing around with my drugs and dosages out of desperation to the point where my psychiatrist has now told my Mum (I'm 36 years old) to look after all of my medication). I'm always pestering my psychiatrist between appointments, he doestn't even bother to ring me back any more and he gets £200 per appointment. I firmly believe (based on past experience) that if a drug is going to work that you will notice some positive effects within the first 2 weeks, Dr Martin Jenson reaffirms this in his book but there are others who say that it can take up to 10 weeks (I'm not so sure about this) but I suppose you need to stick it out just so that you can satisfy your Doctor. Then perhaps he might start being a bit more radical in his treatment.
All my psychiatrist keeps doing is upping the dose too. I've even got to the stage of asking for ECT.
The only thing that has helped me this time round is Zyprexa (some people do not agree with taking this because of the possibility of EPS) however, if I take 10mg of this it lifts me out of the depression and the effects last for about 6 days) I've tried asking my psychiatrist for stimulants and benzos but they won't prescribe me them.
I'd give my left arm (literally) for the drugs to work again. If somebody said we can make the drugs work but we'll have to chop off your left hand I would agree to it.
I'd really hope that you find something that works and if you do be sure to let everyone know about it. It's great to hear success stories.
Denise
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