![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by linkadge on May 4, 2004, at 18:17:24
For the past 4 years I have been on almost every drug, save the tryciclics, and have just plain not been getting any better. I am scared to try a tricyclic because of the cardiovascular effects. I had bad cardiovascular reactions on Effexor.
Linkadge
Posted by SLS on May 4, 2004, at 20:27:40
In reply to just plain not getting any better, posted by linkadge on May 4, 2004, at 18:17:24
> For the past 4 years I have been on almost every drug, save the tryciclics, and have just plain not been getting any better. I am scared to try a tricyclic because of the cardiovascular effects. I had bad cardiovascular reactions on Effexor.
That totally sucks.
I'm sure you posted the answer to this question before, but what exactly is wrong with you?
- Scott
Posted by fraulein1456 on May 4, 2004, at 22:21:19
In reply to just plain not getting any better, posted by linkadge on May 4, 2004, at 18:17:24
The drug parade is no fun. I've been on quite a few myself - probably 12. Here's a stupid question - but have you tried different doctors? I had to "shop around" before I found one that could help me. That's no fun either. Sorry for your pain.
Posted by linkadge on May 5, 2004, at 8:42:44
In reply to Re: just plain not getting any better, posted by fraulein1456 on May 4, 2004, at 22:21:19
Basically I've been depressed since I was 17 (now 21). There were a few brief periods where I want to live, but the rest I really don't care much about living. The drugs seemed to work at first but now seemed to have stopped working. I am scared about dose increases after I saw a lady in the psychward who came off 80mg of paxil, and didn't even know her children's names anymore.
Linkadge
Posted by SLS on May 5, 2004, at 9:00:06
In reply to Re: just plain not getting any better, posted by linkadge on May 5, 2004, at 8:42:44
Hi Linkadge.
I'm in a bit of a rush right now, so I can only drop you a few lines.
My depression became abruptly severe when I was seventeen too. I'm 44 now. At age 21, you have so many years ahead of you yet to unfold. The odds are with you that you won't have to wait until you are 44. If I were to get well tomorrow, I would say that life was well worth the wait.
> There were a few brief periods where I want to live...
Hold on to those memories as tightly as you can. Let them offer a taste of the wonderful things that are to come for you if you persist. You (and perhaps a doctor) will find the means to get you well. The odds are in your favor.
> but the rest I really don't care much about living.
Even if your mind were convinced that you had everything to live for, your brain would tell you otherwise. It is the depression talking, not you.
Hang in there. You'll get there.
- Scott
Posted by griswald on May 5, 2004, at 19:59:22
In reply to just plain not getting any better, posted by linkadge on May 4, 2004, at 18:17:24
I sympathize with you. I've tried everything and I'm not getting better either. I hope you find something that works.
Posted by Bill LL on May 6, 2004, at 9:13:52
In reply to Re: just plain not getting any better, posted by linkadge on May 5, 2004, at 8:42:44
Linkage- You MUST go with a dose increase. That's the way these drugs work. The starting dose is just that- it's only a starting dose. To get to your maintenance dose- you have to increase the starting dose. Don't go by what happened to the women in the hospital.
The starting dose of Lexapro for example is 10 mg. I am doing fine on 30 mg and some people take 40. Prozac's starting dose is 20 mg, but a lot of people take 40 or 80 or more.
Be aggresssive with your treatment.
Posted by harryp on May 6, 2004, at 22:38:17
In reply to just plain not getting any better, posted by linkadge on May 4, 2004, at 18:17:24
Based on what I have read, I think you need to try a different family of drugs. If you get no response to one SSRI, usually trying other SSRI's is not useful (if you get a partial response, or a side effect problem, then trying another SSRI could be worthwhile).
I strongly recommend trying some TCA's. They are totally different from Effexor, and actually quite a varied group in terms of SE's. You might not have any trouble with any of them, and if you do, quitting is a simple matter (unlike with Effexor!).
Since serotonergic drugs haven't worked well for you I would suggest trying Desipramine. It has the best SE profile of the TCA's and is a norepinephine reuptake inhibitor.
If it doesn't work, I'd try Imipramine (inhibits both serotonin and norepinephrine reuptake--but more SE's) or else go to a MAOI (true "industrial strength" AD's with surprisingly good SE profile--particularly Parnate--as long as you are careful with diet/drugs, etc.).
If a MAOI is not working well enough, add lithium.
Just be creative and aggressive, and don't give up. Unless you find an unusually good, determined, and empathic doctor, it's an unfortunate fact that people with our kinds of problems are pretty much on our own--drug wise.
Posted by greywolf on May 6, 2004, at 22:53:39
In reply to Re: just plain not getting any better, posted by linkadge on May 5, 2004, at 8:42:44
I understand exactly what you're going through. But you cannot stop trying to find something that works for you, whether it's pharmacological or otherwise.I have been through every SSRI that's been on the market in the last 7 years, then add in the SNRIs, NDRIs, TCAs, and a few I'm sure I'm forgetting--all without success. I've just ended a trial of Wellbutrin, after Lexapro, after Effexor, after . . . you get the drift. So what to do now? Well, I haven't tried Remeron, so I'm off to that.
It's not easy. It's not fun. It's very frustrating. But you don't give up. Simple as that.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.