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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 jujube on October 26, 2004, at 16:35:25
My problem with medication is probably insignificant and petty compared to most, but I am struggling and need some medication advice nonetheless.
Since last fall, I have been on four ADs (Paxil, which I had been on before for a number of years, but didn't seem to help second time around; Prozac, which made me crazy for two weeks; Effexor, which wasn't too bad, but left me extremely apathetic and apprehensive and gave me really bad night sweats; and now Celexa for the past seven weeks). Nothing seems to be helping, and I am starting to get discouraged and even more depressed. This, in turn, is making me even more anxious than I already am. I don't even want to go out, see people or do anything. I was only ever like this once before (when I quit drinking), and even then I still cared about things. Nothing seems to matter now. The past few weeks, I just keep thinking it would be so nice if I just had a heart attack or a massive stroke or something to put me out of my misery.
Anyways, I have an appointment with the pdoc that is taking take of my medication next Monday and I wanted to be able to discuss medication options with him. Since I live in Canada, Lexapro and Cymbalta are out (not yet available here). Can anybody give me some suggestions that would be good for both depression and GAD?
Another question. I had heard that Paxil and other SSRIs are not as effective or effective at all the second time around. Is this true? I had been on Paxil for a number of years (the last of which was at a very small maintenance dose), and it had worked extremely well for me. When I tried it again in the fall, it didn't work (but I was also severely iron deficient, so maybe no AD would have helped).
Sorry to sound like such a whiner. Any advice would be greatly appreciated. Thanks so much.
Tamara
Posted by jboud24 on October 26, 2004, at 22:27:16
In reply to Can anybody help me please - need advice, posted by jujube on October 26, 2004, at 16:35:25
Have you tried an NRI like desipramine or Reboxetine(if ya'll have reboxetine, we don't)? Perhaps Parnate or Nardil could also help. Also you could combine desipramine or reboxetine with l-deprenyl if it's available up there.
I know what its like searching for a new med regimen. I'm there myself right now. Hopefully when I see my new pdoc next Tuesday, he'll agree to trial me on Nardil or Parnate for my anxiety/depression problem.
Best wishes,
Justin
Posted by TheOutsider on October 27, 2004, at 6:02:12
In reply to Re: Can anybody help me please - need advice, posted by jboud24 on October 26, 2004, at 22:27:16
High there, sorry your suffering from such horrible anxiety.
I haven't had a lot of experience with anxiety but one suggestion I would make is that perhapse you should consider Clomipramine, I am currently taking it, and it does seem to have obliterated my general anxiety it has also helped my depression somewhat.
Side effects are quite sevear to start with but they do get better, I am on 150mg which I find relativly tolerable. Just a thought
Posted by jujube on October 27, 2004, at 7:39:59
In reply to Re: Can anybody help me please - need advice, posted by jboud24 on October 26, 2004, at 22:27:16
Thanks for the suggestions. I will add them to my list of options to discuss with the pdoc. I wish you luck at your appointment with your own pdoc. I hope you find a med that works for you. Take care.
Tamara
> Have you tried an NRI like desipramine or Reboxetine(if ya'll have reboxetine, we don't)? Perhaps Parnate or Nardil could also help. Also you could combine desipramine or reboxetine with l-deprenyl if it's available up there.
>
> I know what its like searching for a new med regimen. I'm there myself right now. Hopefully when I see my new pdoc next Tuesday, he'll agree to trial me on Nardil or Parnate for my anxiety/depression problem.
>
> Best wishes,
> Justin
Posted by jujube on October 27, 2004, at 7:51:00
In reply to Re: Can anybody help me please - need advice, posted by TheOutsider on October 27, 2004, at 6:02:12
Thanks. I will add that to my list. I was actually thinking of Imipramine, another TCA, which is supposed to be very good for GAD. I am a little afraid to try a TCA because of the side effects, particularly the postural hypotension. My blood pressure already tends to be on the low side, and I frequently get dizzy when I stand up. All I know is that I have to find something before I go stark raving looney. In the meantime, I have to hang on to the hope that things will get better. Hope the Clomipramine continues to work for you. Take care.
Tamara
> High there, sorry your suffering from such horrible anxiety.
>
> I haven't had a lot of experience with anxiety but one suggestion I would make is that perhapse you should consider Clomipramine, I am currently taking it, and it does seem to have obliterated my general anxiety it has also helped my depression somewhat.
>
> Side effects are quite sevear to start with but they do get better, I am on 150mg which I find relativly tolerable. Just a thought
Posted by ravenstorm on October 28, 2004, at 18:03:59
In reply to Re: Can anybody help me please - need advice » TheOutsider, posted by jujube on October 27, 2004, at 7:51:00
Let us know what you try and how you do on it. Sounds like you don't get too bad going on and off these drugs so that is a big plus in your favor and should make the searching at least not as bad as it could be. I am also trying to find a med so I feel for you.
Posted by jujube on October 28, 2004, at 18:36:04
In reply to Re: Can anybody help me please - need advice, posted by ravenstorm on October 28, 2004, at 18:03:59
Thanks. I've spent a lot of time today researching meds, so I think I am relatively prepared to have a good discussion with the pdoc next week. After 7 weeks, I don't believe Celexa is working for me, particularly for the debilitating anxiety, so that's the first topic of discussion. I did so well in terms of anxiety and mood when I was on Paxil (wish I had just continued on the small maintenance dose I was taking). Perhaps the Paxil CR might work where the regular Paxil didn't the second time around. I am also going to ask about augmenting to try to alleviate the adhedonia I am experiencing, which is frightening in and of itself. The things I have identified as possible augmenters are: Adrafinil; Provigil; Gabapentin and Lyrica. The problem I face is that the pdoc I see, although he is extremely knowledgable and experienced, is, I think, somewhat conservative, and may not be too keen on augmenting or prescribing anything that might be considered off-label use. Oh well, it can't hurt to try. As for going off the drugs, I didn't have a problem stopping Paxil (at least I didn't notice any withdrawals). Stopping Effexor was a different story, but I am over that now. Anyway, sorry to ramble.
Take care, and good luck to you in finding a med that works.
Tamara
> Let us know what you try and how you do on it. Sounds like you don't get too bad going on and off these drugs so that is a big plus in your favor and should make the searching at least not as bad as it could be. I am also trying to find a med so I feel for you.
This is the end of the thread.
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