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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by SometimesBlue on August 27, 2007, at 16:06:53
Hi all, need some advice on medications. Here's the following information on myself (i've actually kept a journal which shows just what i've been feeling and going thru, i tend to leave out info at my doc's office..always overwhelmed)
Currently on Lexapro 20mg once a day in the a.m. usually, and i take an ephedrine based energy pill (24mg ephedrine based alkoids(?).
Symptoms:
Depressed, especially at night/evenings
Tired (physically, my body feels heavy? but i'm not overweight)
Sleep (or try to) a lot
Anxiety all the time
Panic attacks, (3 in the past month)
Aorgasmia (that one really sucks!)FYI: i'm female
Not apathetic, but sometimes i feel like i can't cry (can't let out whatever is making me sad even though i want to)
Dysthmia, frequently, I don't thinks it's everyday
Depersonalization during panic attacks
Lack of Focus
Lack of Motivation
Lack of Organization
Can't seem to get things done without writing a list to keep me organized, or just so i can check it off and feel good that i accomplished something(?)make sense
I always feel like when i try to do things like chores, i can't get started, my mind starts racing and i always feel like i have to do this first, or that, and then something else, so nothing ever gets done...i don't know if there's a term, but it's frustrating and isn't a mind over matter thing.
I'm also smoking and drinking a lot recently, which is weird but i feel like it's somehow tied into everything else.My take on me is that I am obviously suffering from depression, this past month has been eextremely worse, i don't know why. But i also think I have some ADD symptoms, not sure if it's ADD though.
Anyway from what I've read on babble, i compiled (in my journal) a list of stuff to ask my doctor about, but any info you can give me would be very helpful:
Wellbutrin: smoking, anorgasmia, depression
Paxil or Prozac: for anxiety, i hear it also doesn't make you tired
Ritalin, Adderall, Celexa or Focalin: for the ADD-like symtomsWhat do you guys think? Any negative side affects i should know about?
please help...
Thanks in advance,
BluePS: sorry for the lengthy post, i just really want to get this problem resolved oince and for all, i hate this up and down rollercoater everyday, and lately i'm in sucha hole, i have 2 kids, i dont want them to suffer because i'm a mess.
Posted by Phillipa on August 27, 2007, at 16:29:51
In reply to If you have TIME...Need ADVICE on MEDS..., posted by SometimesBlue on August 27, 2007, at 16:06:53
Doc ever bipolar before or is ADD a big problem for you as I see you are those med. I'm sure others with more knowledge will join in . Good luck to you. Phillipa
Posted by LlurpsieNoodle on August 27, 2007, at 17:48:59
In reply to If you have TIME...Need ADVICE on MEDS..., posted by SometimesBlue on August 27, 2007, at 16:06:53
hi blue,
sorry that you're having such a hard time. I think that a lot of the cognitive problems you're having could be chalked up to depression that is not being treated. Perhaps it's time to switch anti-depressants, since you're having too many depressive symptoms.You take an ephedrine based energy pill, which may contribute a lot to "anxiety all the time" and "panic attacks". Try to wean yourself off of these and maybe use coffee in moderation?
The organization problems can really happen because depression uses up a lot of brain power. Once your depression is properly treated, your mental powers will return. Remember- depression is not just a mood disorder, it affects all kinds of functioning.
the smoking and drinking is probably an attempt at self-medicating. You know that already. Dunno about nicotine, but alcohol give an initial antidepressant feeling. nice, but the long-term consequences are deeper depression, despair, etc. probably not worth it.
A benzodiazepine like klonopin or xanax could help with the anxiety (anxiety could be causing the cognitive symptoms too), and has far fewer side effects than smoking and drinking.
good luck, sounds like you're in for a med overhaul. let us know what happens...
-Ll (who was recently overhauled herself to great success)
Posted by Justherself54 on August 27, 2007, at 18:00:41
In reply to Re: If you have TIME...Need ADVICE on MEDS... » SometimesBlue, posted by LlurpsieNoodle on August 27, 2007, at 17:48:59
How long have you been on Lexapro..perhaps it has "pooped out" on you?
Posted by SometimesBlue on August 27, 2007, at 18:28:02
In reply to Re: If you have TIME...Need ADVICE on MEDS..., posted by Justherself54 on August 27, 2007, at 18:00:41
i was on lex a couple of years ago, when i had my first son, and it worked great. But i stopped because i got pregnant again. This time, it just doesn't have the same affect. I've been on it for about 1 months, right after i had my second child i got on zoloft, but that didn't work so i switched to lexapro thinking it would work like the first time.
I guess it's possible i have some post-partum issues/depression, being as my son is only 3 1/2 months old. But, i just feel like this time i'm spiralling downward so fast i can't even catch my breath.
I'm having suicidal thoughts, i think, not that i would do it, really...i could never leave my kids. But, i sometimes think that if i weren't here, i wouldnt be going thru this. Or that someone more capable could raise my kids.
i feel like i'm broken, ya know? like i'm just no good. I feel like i'm faking thru life, like i try to smile just so no one asks me what's wrong. It's easier to type my problems because i don't have to see anyone's face, judgmental eyes, ya know? But i can never talk about it.
Posted by tecknohed on August 27, 2007, at 19:07:37
In reply to If you have TIME...Need ADVICE on MEDS..., posted by SometimesBlue on August 27, 2007, at 16:06:53
Hello again.
> Currently on Lexapro 20mg once a day in the a.m. usually, and i take an ephedrine based energy pill (24mg ephedrine based alkoids(?).
Firstly, get off the ephedrine. No wander you're always anxious! I know of no place for it in mental health (theraputic) treatment. There are better & FAR more effective meds if you're lethargic & tired, etc. You will also build tolorance to it in terms of the energy it gives. You'll know what I mean if you've ever abused amphetamines before, long-term (like I have).
> Symptoms:
>
> Depressed, especially at night/eveningsEphedrine sounds like its contributing to your evening blues, especially as Lex should be actually helping this (I've been on escitalopram & found evenings to be the best part of the day & falling to sleep was easy).
> Tired (physically, my body feels heavy? but i'm not overweight)
> Sleep (or try to) a lotStims, like ephedrine can 'burn you out'. Though I also found both citalopram & escitalopram 'stole' my energy from me.
> Anxiety all the time
> Panic attacks, (3 in the past month)
> Depersonalization during panic attacksLike I say, it may be the eph. Or have you only just started Lex (anxiety may increase with Lex during the first few weeks).
> Anorgasmia (that one really sucks!)FYI: i'm female
Male or female, SSRIs are of course renound for this. A few addon meds can help. Your pdoc should know some.
> Not apathetic, but sometimes i feel like i can't cry (can't let out whatever is making me sad even though i want to)
> Dysthmia, frequently, I don't thinks it's everyday
> Lack of Focus
> Lack of Motivation
> Lack of Organization
> I always feel like when i try to do things like chores, i can't get started, my mind starts racing and i always feel like i have to do this first, or that, and then something else, so nothing ever gets done...i don't know if there's a term, but it's frustrating and isn't a mind over matter thing.All these might be 'numbness' caused by, you guessed it, daily stim use. Same goes for the indecisiveness.
> Can't seem to get things done without writing a list to keep me organized, or just so i can check it off and feel good that i accomplished something(?)make sense
Yes it makes sense and actually sounds like a good idea at the moment. Its good to have some way of feeling a sense of accomplishment. I wish I wrote things down more, then maybe things wouldn't get so 'forgotton' about!
> I'm also smoking and drinking a lot recently, which is weird but i feel like it's somehow tied into everything else.
No wonder when you're so stressed!
> My take on me is that I am obviously suffering from depression, this past month has been eextremely worse, i don't know why. But i also think I have some ADD symptoms, not sure if it's ADD though.
>
> Anyway from what I've read on babble, i compiled (in my journal) a list of stuff to ask my doctor about, but any info you can give me would be very helpful:
>
> Wellbutrin: smoking, anorgasmia, depressionI added it to Nardil & clonazepam. Actually caused some stress, but maybe thats more to do with my personality as I'm very short tempered anyway. Definitely helps with smoking - even though I still had the occasional cigarette (I'm a 'part-time' smoker now) the enjoyment was much less. When I stopped the bupropion I spewed my gets up the first smoke I had!
> Paxil or Prozac: for anxiety, i hear it also doesn't make you tired
Prozac commonly causes less tiredness, you're right, but may instead increase anxiety. Paxil made me sleep loads but is often very good for anxiety (after the start-up that is).
> Ritalin, Adderall, Celexa or Focalin: for the ADD-like symtoms
Wouldn't know about that one, though Celexa sounds a bit odd for ADD(?). Correct me if I'm wrong, someone.
Sorry if I've not sounded at all helpfull but I really wanted you to be especially aware of the possible consequences with regards to your ephedrine use, despite you using seemingly lowish doses. I myself was once a chronic amphetamine user/abuser though I wasn't on a particularly high dose either, maybe 150-200mg/day pure base which isn't alot for a long term user really. I had all the symptoms you describe above. I cant even tolorate caffein any more, none at all!
I have to say, I salute you for managing to take care of 2 young kids along with all your struggles. I'm sure they pay a large part in helping you keep striving on.
Posted by SometimesBlue on August 27, 2007, at 20:17:06
In reply to Re: If you have TIME...Need ADVICE on MEDS... » SometimesBlue, posted by tecknohed on August 27, 2007, at 19:07:37
The Citalopram made my anxiety worse, i had a panic attack on this...it was within the first week, but i couldn't take the idea of having another one.
I just started using the ephedrine and while, yes, in tooo much of a high dose it makes my anxiety worse, even when not taken, i feel like crap...anxiety anxiety anxiety! And since the anxiety seems never ending, i still feel better having some kind of focus and energy since i have to work full-time. But you are right, i'm sure there are beter things out there...i just havent come across them.
You have been very helpful, techno...any advice is welcomed right now, i just wanna feel better, ya know...normal?
Posted by Phillipa on August 27, 2007, at 21:11:34
In reply to Re: If you have TIME...Need ADVICE on MEDS... » tecknohed, posted by SometimesBlue on August 27, 2007, at 20:17:06
A few thoughts. First something to calm you down SSRI's even after start-up never did lessen the anxiety. I was very tired on only l0mg of paxil but attributed this to the lopressor 25mg the doc gave me first but in thinking back the low dose xanax and l0mg may have just taken me longer than most to adjust to. At night I confess to 4-6 beers or seriously I'd have never made it. But the beer never depressed me or left me hung over. Maybe hops or something that is unique to the brain of me, my deceased parents, sister, her kids and mine as we are all the same in reguards to beer. Phillipa ps no longer drink ll years and I feel horrible hence why I say something in the beer agrees with me and my family. Good luck
Posted by tecknohed on August 28, 2007, at 7:54:06
In reply to Re: If you have TIME...Need ADVICE on MEDS... » SometimesBlue, posted by Phillipa on August 27, 2007, at 21:11:34
Hi Phillipa.
Just a quick point about the hops in beer. Hops is supposed to be contraindicated in depression. Can cause melancholy by itself. When looking for natural 'calming' remedies from health food shops I have always checked they dont contain hops (which most formulas do!).
http://www.healthtouch.com/bin/EContent_HT/altCareMedShowLfts.asp?fname=00096&title=HOPS+&cid=HTALT
Posted by tecknohed on August 28, 2007, at 11:50:03
In reply to Re: If you have TIME...Need ADVICE on MEDS... » tecknohed, posted by SometimesBlue on August 27, 2007, at 20:17:06
Perhapse Provigil would be a good 'get up & go' pill for you. Shouldn't cause much anxiety, if any, niether will it make you feel excessively active or high, unlike many typical stims. Commonly clears the head increasing focus, concentration & mental energy. It can also be taken 'as needed' as well as every day. Interactions with other meds like SSRIs are low & it may even enhance them too. All this without addiction!
Posted by SometimesBlue on August 28, 2007, at 12:34:48
In reply to Re: If you have TIME...Need ADVICE on MEDS... » SometimesBlue, posted by tecknohed on August 28, 2007, at 11:50:03
Yeah, i was on Provigil when i was on Zoloft, and it made it worse (the anxiety & depression...actually i think it was more like Dysthmia), so i was switched to Lexapro and it helped a lot. I had to stop taking it though because my insurance company that covered scripts was cancelled and Provigil is very expensive.
As of 9/1/07 i switch to another ins. co. that covers scripts, so i may ask for it again.
I did find i wanted to use it daily because it was fast acting, and did enhance the lex.
Thanks for your help :0)
Posted by Phillipa on August 28, 2007, at 20:10:53
In reply to Re: If you have TIME...Need ADVICE on MEDS... » Phillipa, posted by tecknohed on August 28, 2007, at 7:54:06
Thanks tech but my biggest problem is anxiety and had permission from the pdoc for the beer. It was after stopping it that anxiety got worse and maybe getting depressed. Interesting article. No never drink hard alchohol. Phillipa
Posted by Phillipa on August 28, 2007, at 20:13:41
In reply to Re: If you have TIME...Need ADVICE on MEDS... » SometimesBlue, posted by tecknohed on August 28, 2007, at 11:50:03
Providgil can be taken as needed didn't know that. Thanks Phillipa
Posted by tecknohed on August 28, 2007, at 20:21:13
In reply to Re: If you have TIME...Need ADVICE on MEDS... » tecknohed, posted by Phillipa on August 28, 2007, at 20:13:41
> Providgil can be taken as needed didn't know that. Thanks Phillipa
I only say that as the 1st pill usually works strait away (it did with me) & so I'd say it could be a good (& better) substitute for caffein or other less helpfull & tolerance building stims.
Not sure how many doctors would prescribe it for 'as needed' use, though I don't see the problem with it.
I'm sure I've read of others on here using it 'as needed' too.
Posted by curiousfish on August 29, 2007, at 4:04:35
In reply to If you have TIME...Need ADVICE on MEDS..., posted by SometimesBlue on August 27, 2007, at 16:06:53
huh... that all sounds quite familiar to me.
im going to recopy your post and put an 'x' next to symptoms ive hadX Depressed, especially at night/evenings
X Tired (physically, my body feels heavy? but i'm not overweight)
X Sleep (or try to) a lot
X Anxiety all the time
X Panic attacks, (3 in the past month)
X Aorgasmia (thats the lex talking..i hate ssris)
Dysthmia, frequently, I don't thinks it's everyday
Depersonalization during panic attacks
X Lack of Focus
X Lack of Motivation
X Lack of Organization
X Can't seem to get things done without writing a list to keep me organized, or just so i can check it off and feel good that i accomplished something(?)make sense
X YES YES. I always feel like when i try to do things like chores, i can't get started, my mind starts racing and i always feel like i have to do this first, or that, and then something else, so nothing ever gets done...i don't know if there's a term, but it's frustrating and isn't a mind over matter thing.
I'm also smoking and drinking a lot recently, which is weird but i feel like it's somehow tied into everything else.pretty compelling.. ive been diagnosed with bipolar spectrum disorder. My hypomania is much like ADHD (which i dont usually have). my hypomania is hyper, restless, slightly grandiose, impatient, ADHD, edgy, nervous. It can be panicky, depressed as well. and all that energy tires me out and im more tired..while being wired at the same time. lots of energy..but cant focus enough to get anything useful done..depression at night if im alone and not stimulated
im not a doc and everyone's experience is drastically different. Research bipolar spectrum.. ie. bipolar 2 and see how much you relate or dont and talk to your doc about it.
im having issues with meds right now..but ADs had a very bad poop out rate for me or made me worse (ie wellbutrin).i tried an ADHD amphetamine blend med for morning energy because lamictal gave me insomnia.. i just felt jittery and nasty on it..like too much caffeine.. definitely a message to me that im not ADD =P
good luck!!!
Posted by SometimesBlue on August 29, 2007, at 14:10:31
In reply to Re: If you have TIME...Need ADVICE on MEDS..., posted by curiousfish on August 29, 2007, at 4:04:35
I googled what you advised and I found a lot in common with the symtoms of BPII. I have a family history of Bipolar Disorder, primarily my mother's side, as well.
But I'm not sure I've ever had a manic-hypomanic episode? I've had people tell me "wow, you're hyper today" since I'm usually a very low energy person...or they'll say, when we're engaged in a conversation, "ok, i'm right here, lower your voice"....
What are they like, from your experiences?
-SB
This is the end of the thread.
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