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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by zeugma on April 11, 2004, at 12:58:23
I had a terrible series of responses to seronergetic drugs in the past (Prozac- rapid weight loss, aggravated insomnia; Zoloft- some kind of CNS-toxic reaction, possibly allergic) so I have steered clear of them since returning to meds two years ago. I currently take nortriptyline, 75 mg, Strattera, 80 mg, buspirone, 30 mg, and clonazepam .5 mg. These drugs are strong on NE but not so much on 5-HT. The symptoms I currently have are the following:
1) a severe lack of energy;
2)a strong desire to isolate, due in part to the lack of energy (I just want to lay around) but also due to self-consciousness, feeling improperly connected to my body (Body Dysmorphic Disorder?) and still experiencing visceral feelings of fear when in the company of others. Basically, I feel so weak that I want to stay by myself so as not to be overwhelmed by another's presence. I feel inferior to everyone I meet, and can be highly suggestible, passive, and fearful.
Do you think Anafranil would be a better choice of TCA than nortriptyline? I've also considered Effexor, but I need a sedating AD in order to sleep. TIA for any opinions.
Posted by Sad Panda on April 11, 2004, at 13:43:51
In reply to serotonin and body image, sociability, self-esteem, posted by zeugma on April 11, 2004, at 12:58:23
> I had a terrible series of responses to seronergetic drugs in the past (Prozac- rapid weight loss, aggravated insomnia; Zoloft- some kind of CNS-toxic reaction, possibly allergic) so I have steered clear of them since returning to meds two years ago. I currently take nortriptyline, 75 mg, Strattera, 80 mg, buspirone, 30 mg, and clonazepam .5 mg. These drugs are strong on NE but not so much on 5-HT. The symptoms I currently have are the following:
>
> 1) a severe lack of energy;
>
> 2)a strong desire to isolate, due in part to the lack of energy (I just want to lay around) but also due to self-consciousness, feeling improperly connected to my body (Body Dysmorphic Disorder?) and still experiencing visceral feelings of fear when in the company of others. Basically, I feel so weak that I want to stay by myself so as not to be overwhelmed by another's presence. I feel inferior to everyone I meet, and can be highly suggestible, passive, and fearful.
>
> Do you think Anafranil would be a better choice of TCA than nortriptyline? I've also considered Effexor, but I need a sedating AD in order to sleep. TIA for any opinions.
>
>I go for Anafranil as it wouldn't be hard to switch to from Nort & it wouldn't be hard to switch back. One downside is it will have more side effects mostly because you will have to take twice as much of it. An advantage to Anafranil is it one of the few drugs that is actually above average, rather than below average.
You never know until you try it.
Effexor... well it works for me & it's great combined with Remeron. The first drug I got given was Prozac & I know what you mean about 'aggravated insomnia' as I had that + agitation in the daytime + it drastically worsened my social anxiety to near paranoia. When sleep did come I had my first ever dream of killing somebody & a reoccurring nightmare from my childhood.
Back to my Effexor + Remeron, it has fixed alot of my problems, but it hasn't given me the energy/motivation I need, but I strongly suspect I am hypothyroid & I will be trying to get some thyroxine from my doc this week.
Cheers,
Panda.
Posted by zeugma on April 11, 2004, at 14:11:36
In reply to Re: serotonin and body image, sociability, self-esteem » zeugma, posted by Sad Panda on April 11, 2004, at 13:43:51
Thanks panda for the feedback. I was thinking that maybe my dr. would let me substitute a capsule/pill for clomipramine for one of my NOR capsules (25 mg) and slowly taper that way, if no adverse effect presents itself (that I can't deal with, that is). I am learning about these meds and neurotransmitters all the time, and it does seem that serotonin is crucially involved in bodily self-perception (hence a study in which clomipramine was more effective than desipramine in Depersonalization Disorder, albeit it was a small study and neither was tremendously impressive).
Plus, anecdotally, a lot of people have commented that clomipramine was the most powerful AD they ever took.
Posted by Sad Panda on April 11, 2004, at 14:42:03
In reply to Re: serotonin and body image, sociability, self-esteem » Sad Panda, posted by zeugma on April 11, 2004, at 14:11:36
I imagine that Clomipramine would be a wonder drug except for the side effects :) It's funny how it took nearly 20 years for Clomipramine to get from France to the Anglo countries.....
Re: serotonin and body image, sociability, self-esteem: Effexor hasn't fixed my body image problem, I am still a fat pig(which I actually am), but I care a lot less than I use too & I now don't feel like everyone is pointing at me. It did improve my self-esteem alot, it has made me a lot more sociable, I now go out of the house & see people, It also has allowed me to enjoy things again, ie: I now enjoy watching movies & listening to music again. Before Effexor I could not sit through an entire movie as it was just so uninteresting. Another good thing is it has given me the ability to talk about my problems with close family, friends & doctors. Before Effexor I was silently planning my demise on a daily basis, I am glad I never did anything stupid. :)
Cheers,
Panda.
Posted by francesco on April 11, 2004, at 16:38:28
In reply to Re: serotonin and body image, sociability, self-esteem » zeugma, posted by Sad Panda on April 11, 2004, at 14:42:03
Hi Zeugma, I have tried Anafranil, and yes, it's the most powerful med I have ever tried. But it didn't help me in the social area. Just the opposite. I had the tendency to isolate myself too. I avoided people and liked to stay at home watching film and reading books. I have a theory regarding this. Antidepressants make you feel different emotions, emotions that the other doesn't feel. This make us more difficult to communicate. Ok, it maybe a stupid theory and it's not very encouraging but this is what I've experienced. Anyway, I have tried four different SSRIa and Anafranil didn't make me feel so detached from my feelings as SSRIa did. Not so much. If you want to stay on antidepressants Anafranil may be your best choice. I've on it for 7 years. Best wishes
Posted by zeugma on April 11, 2004, at 16:50:44
In reply to Re: serotonin and body image, sociability, self-esteem » Sad Panda, posted by francesco on April 11, 2004, at 16:38:28
> Hi Zeugma, I have tried Anafranil, and yes, it's the most powerful med I have ever tried. But it didn't help me in the social area. Just the opposite. I had the tendency to isolate myself too. I avoided people and liked to stay at home watching film and reading books. I have a theory regarding this. Antidepressants make you feel different emotions, emotions that the other doesn't feel. This make us more difficult to communicate. Ok, it maybe a stupid theory and it's not very encouraging but this is what I've experienced. Anyway, I have tried four different SSRIa and Anafranil didn't make me feel so detached from my feelings as SSRIa did. Not so much. If you want to stay on antidepressants Anafranil may be your best choice. I've on it for 7 years. Best wishes
>Hi francesco,
I am definitely planning on staying on AD's, as I don't have much success with anything when not on them. A difference between us might be that you isolate when on antidepressants, but that that is not your natural tendency (?), but I isolate whether on an antidepressant or not. I suppose the isolating, for me, becomes more troubling because the other symptoms of depression lift.
it is encouraging to hear that Anafranil was powerful for you and also that it didn't cause as much detachment as SSRI's. We have discussed this before and my theory is that Anafranil inhibits norepinephrine reuptake also which actually makes certain feelings stronger. How is yourr current cocktail of meds helping you?
Posted by francesco on April 11, 2004, at 17:45:08
In reply to Re: serotonin and body image, sociability, self-esteem » francesco, posted by zeugma on April 11, 2004, at 16:50:44
> > Hi Zeugma, I have tried Anafranil, and yes, it's the most powerful med I have ever tried. But it didn't help me in the social area. Just the opposite. I had the tendency to isolate myself too. I avoided people and liked to stay at home watching film and reading books. I have a theory regarding this. Antidepressants make you feel different emotions, emotions that the other doesn't feel. This make us more difficult to communicate. Ok, it maybe a stupid theory and it's not very encouraging but this is what I've experienced. Anyway, I have tried four different SSRIa and Anafranil didn't make me feel so detached from my feelings as SSRIa did. Not so much. If you want to stay on antidepressants Anafranil may be your best choice. I've on it for 7 years. Best wishes
> >
>
> Hi francesco,
>
> I am definitely planning on staying on AD's, as I don't have much success with anything when not on them. A difference between us might be that you isolate when on antidepressants, but that that is not your natural tendency (?), but I isolate whether on an antidepressant or not. I suppose the isolating, for me, becomes more troubling because the other symptoms of depression lift.
>
> it is encouraging to hear that Anafranil was powerful for you and also that it didn't cause as much detachment as SSRI's. We have discussed this before and my theory is that Anafranil inhibits norepinephrine reuptake also which actually makes certain feelings stronger. How is yourr current cocktail of meds helping you?Hi Zeugma, yes, we have discussed this before but my memory is poor and quite selective !!! Today I have been so depressed that I forgot your interesting NE-reuptake theory about emotions. Now I'm on Zoloft 50mg (God only knows why) and Lamictal 25mg (to counteract severe cycling induced by Zoloft). The picture is complicated by the fact that I'm drinking over my meds, so, I don't know what they're doing and what alcohol is doing. I'm abusing also caffeine in this period.
All this sucks but I hope to manage to quit alcohol because I think I'm self-sabotating. The problem is that I use alcohol to counteract numbness from Zoloft and coffee to counteract sleepiness from Lamictal. what a mess !!! So, so far the meds are just ruining my life, as I written in another post I have a girl who leaves every fuc**in time I come back to meds because she feels (and she's right) that I'm less interested in her. Sorry for ranting. I have decided that tomorrow I'll diminish Zoloft to 25 mg (where has my sex desire gone ?) and add 10mg of Imipramine, as my psychiatrist suggested (unfortunately Imipramine has also SE-reuptake properties). Lamictal gave me very good feelings on the first two days but I have experienced a severe down in the evening.About Anafranil ... I'm a big fan of it. It gave me mental clarity even if the first period can be difficult (sleepiness was the main problem for me). If weight gain is not a problem for you go for it, my experience is that also sexual dysfunctions of Anafranil are nothing compared to the ones of SSRI's. And it didn't make me apathetic at all !!! Why didn't I come back to Anafranil ? It made me a misantropist but this could be dued to untreated bipolar II. So, if you want to try it, I'll strongly suggest it. Best wishes
Posted by zeugma on April 11, 2004, at 21:54:13
In reply to Re: serotonin and body image, sociability, self-esteem » zeugma, posted by francesco on April 11, 2004, at 17:45:08
Ouch, that sounds bad. I too use coffee to counteract the exhaustion from meds. It sounds like a good idea to discontinue the Zoloft. Imipramine will probably be much better... maybe imipramine plus lamictal could wind up being a more tolerable combination. Of course, you will still probably be drinking caffeine to stay awake (I just read an article on the 'abuse' of caffeine), but then you and i are in exactly the same position, because I'm a caffeine addict, if that's any consolation.
Maybe if you see the drug changes through and are able to substitute imipramine for Zoloft your emotions might return. Alcohol is seductive but it has always made me depressed the next day.
I've got a month to think about Anafranil, because I just had an appointment with my doctor on Friday. I also have a therapist that i can discuss meds with. 25 mg of lamictal is a low dose, I've seen posts that say that benefits aren't reached until 200-300 mg. There are always dilemmas when contemplating meds, and sometimes I feel like I've sacrificed energy for concentration. But then i remember how I was before meds, and most of the time I couldn't get out of bed. Good luck!
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