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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 Jay_OriginalOne on September 25, 2015, at 13:26:42
I am sorry I can't reference them, but I came across a few pubmed studies indicating highdose Cipralex/Lexapro is the best ssri for aggravated grief symptoms. I am up to 40 mg of the stuff, which the articles say is the best max dose. It, well, works 60-80 percent of the time. I also have to use a once a day high dose benzo of 4mg of clonazepam, and 2mg lorazepam prn. Just started the Cipralex about 3 months ago, and sorta seems to be working. I am much more socializing, a bit more hopeful about the future. I still have that bit of fear, though, as my money has been super tight, that I am gonna end up on the street. (Which I am not. I have a brother and a friend who would take me in.) Is their something I can add on for the grief? I had a buddy who was going through a real rough time and a couple of doses of Extasy help him through it. Pot doesn't do much for me. Maybe some ketamine? Where can you legally get that?
Posted by Tomatheus on September 25, 2015, at 17:15:08
In reply to High dose Lexapro/Cipralex for grief, etc..help!!!, posted by Jay_OriginalOne on September 25, 2015, at 13:26:42
Jay,
It sounds like you're going through a difficult time, and I'm sorry that the treatments that you're utilizing for the grief that you're experiencing don't seem to be helping you quite as much as you'd like for them to be. The only suggestion that I can make medication wise is to maybe consider trying another antidepressant, if you think that switching might be a good idea. While it may be true that escitalopram (Lexapro/Cirpalex) is the best SSRI for aggravated grief symptoms, individual responses can vary, and so switching antidepressants might be one thing to consider if you're looking for a more robust response. Another thing you might want to look at if you're utilizing psychotherapy (which I would definitely recommend for grief if you're not already utilizing it) is whether you feel the methods your therapist is using are giving you the most benefit. Although it does take time for the benefits of psychotherapy to become apparent, I think that it can be helpful to evaluate from time to time whether your therapist (if you have one) and his or her methods are the best fit for your situation. So, although I think that medications are one thing to look at as you go through the grieving process, I think it's also important to make sure you're maximizing the benefits that you could be getting from psychological treatments.
I wish you the best of luck as you move through what sounds to be a trying time for you.
Tomatheus
Posted by Tomatheus on September 25, 2015, at 17:33:29
In reply to Re: High dose Lexapro/Cipralex for grief, etc..help!!! » Jay_OriginalOne, posted by Tomatheus on September 25, 2015, at 17:15:08
To give you a more direct answer to the question that you posed about add-on options, there are several add-on options for depression that might be worth asking your prescribing health professional about. Such options include Buspar (burpirone), atypical antipsychotics such as Abilify (aripiprazole) and Seroquel (quetiapine), and Deplin (l-methylfolate). Of course, affordability might be an issue, especially when it comes to the antipsychotics. And I'm not sure exactly how helpful any of the options that I mentioned might be for aggravated grief, but I can say that they're options that doctors commonly use for depression (and, as antidepressants tend to be helpful for those who are grieving, these options might be worth looking into).
Tomatheus
Posted by Tomatheus on September 25, 2015, at 17:34:42
In reply to Re: High dose Lexapro/Cipralex for grief, etc..help!!! » Tomatheus, posted by Tomatheus on September 25, 2015, at 17:33:29
Posted by Jay_OriginalOne on September 26, 2015, at 9:40:16
In reply to Re: High dose Lexapro/Cipralex for grief, etc..help!!! » Jay_OriginalOne, posted by Tomatheus on September 25, 2015, at 17:15:08
> Jay,
>
> It sounds like you're going through a difficult time, and I'm sorry that the treatments that you're utilizing for the grief that you're experiencing don't seem to be helping you quite as much as you'd like for them to be. The only suggestion that I can make medication wise is to maybe consider trying another antidepressant, if you think that switching might be a good idea. While it may be true that escitalopram (Lexapro/Cirpalex) is the best SSRI for aggravated grief symptoms, individual responses can vary, and so switching antidepressants might be one thing to consider if you're looking for a more robust response. Another thing you might want to look at if you're utilizing psychotherapy (which I would definitely recommend for grief if you're not already utilizing it) is whether you feel the methods your therapist is using are giving you the most benefit. Although it does take time for the benefits of psychotherapy to become apparent, I think that it can be helpful to evaluate from time to time whether your therapist (if you have one) and his or her methods are the best fit for your situation. So, although I think that medications are one thing to look at as you go through the grieving process, I think it's also important to make sure you're maximizing the benefits that you could be getting from psychological treatments.
>
> I wish you the best of luck as you move through what sounds to be a trying time for you.
>
> TomatheusHi Tomatheus:
Thanks so much for your wonderful response. Like many, I have done the rounds of pretty much every antidepressant out there. Although lexapro/cipralex has it's flaws too, it seems to provide this emotional distance between 'triggers', and I don't fall apart. It also doesn't seem to create the anxiety/spacey/numb/dumb feeling that many other ad's do esp at very high does. The literature actually somewhat confirms this to, at doses up to 40 mg's. Also saying this could be the 'one' for many with PTSD. Still, lots of experimentation to do.I def have to try and get some talk therapy in there. I am surprised at the Cipralex/lexapro though. Now I can work out my grief in my way. It has been a year since mt Dad passed and about 2 and a half since my Mum passed. "4:37 am 'Sunrise in the mirror, lightens that invisible load'" -Neil Peart, Ghostrider.
Posted by bleauberry on October 2, 2015, at 14:07:37
In reply to High dose Lexapro/Cipralex for grief, etc..help!!!, posted by Jay_OriginalOne on September 25, 2015, at 13:26:42
I don't understand giving an SSRI which takes 6 to 12 weeks to work for grief? That is more of a psychological or counselor thing than it is a drug thing. Opinion.
MDs don't usually admit that SSRIs often cause an emotional numbing effect. But in this situation, where numbing is a good thing, they seem to take advantage of that side effect.
That is what the drug will do, given a few weeks at high doses....sadness will go away....but happiness goes away too....everything is just sort of flat. At that time, the patient usually begins to complain of lack of motivation, lack of pleasure, and apathy. But at least the sadness is gone. To me to numbness was just as much of a degrading of life quality as the original symptoms were.
Posted by phidippus on October 13, 2015, at 22:43:49
In reply to High dose Lexapro/Cipralex for grief, etc..help!!!, posted by Jay_OriginalOne on September 25, 2015, at 13:26:42
There is no treatment for grief. You just have to go through it.
This is the end of the thread.
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