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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by allisonm on May 7, 2002, at 10:36:58
My pdoc wants to change my cocktail again. I have been on Zoloft, Effexor XR, Remeron, lithium, Wellbutrin, Neurontin, Celexa, and Serzone in various combinations. Currently on Wellbutrin and Serzone (each 150mg 2X/day).
In the past few months when under stress, my emotions have been rather unstable and anxiety has been very very high. I start weeping at the drop of a hat -- anywhere and often in public. Some people have noticed this, which makes me all the more anxious. Pdoc more than a month ago urged me to take the Ativan he's prescribed more often and whenever I feel this anxiety coming on. It is only a stop-gap.
So now he wants to wean me off the Serzone and try an SSRI again (Zoloft, Prozac, Paxil, Celexa). I haven't tolerated SSRI's in the past and have always had to get off them. It feels as though he is running out of drugs to try.
Would anyone have a throry as to why he would want to try SSRIs again after previous intolerable side effects? Is there really any chance that an SSRI could help now? Has anyone had this happen?
Thanks for listening.
Allison
Posted by judy1 on May 7, 2002, at 11:46:20
In reply to OK, here's a new question for ya, posted by allisonm on May 7, 2002, at 10:36:58
Well if you've had 'intolerable' side-effects on a class of drugs, it makes absolutely no sense to go that direction again- and remember you have the right to say 'no'. You make no reference to addressing your source of stress- are you going to therapy? meditating? exercising? Benzos are fine to take, you shouldn't feel like they are a 'stop-gap', they're a drug like any other and many people take them long term. Another thought- I don't know your age, but many women go through hormonal changes that induce adrenaline that causes symptoms of stress- post-partum (me), peri-menopause, menopause, etc- even changing birth control pills. The point I'm getting at here is not to ignore medical causes either. I hope you feel better soon- Judy
Posted by allisonm on May 7, 2002, at 23:25:45
In reply to Re: OK, here's a new question for ya » allisonm, posted by judy1 on May 7, 2002, at 11:46:20
Judy,
Thanks for writing. I try not to go into my situation because I don't want to bore people or solicit sympathy. I started seeing a psychiatrist more than 4 years ago. I see him once a week. He is my therapist and prescribes my ADs. I have had chronic refractory depression for many years, stretching way back into childhood. It just wasn't recognized. Things really blew up in 1998 when my marriage started to fail (I didn't see it coming) and my alcoholic mother's health continued to decline. My ex moved out and my mom died unexpectedly within 10 days of each other. I think my divorce reminded her of her own and pretty much put her over the edge. She increased her drinking and her body just quit. I had been married 13 years; he ran off with another woman. I am now 40. It took a few years to get through that, getting divorced, selling my mom's house, etc. Last summer I decided since I had nothing holding me back (no siblings, no children), I would go back to school. I am a grad student working on my master's in horticulture. I am a journalist by trade, so this is quite a change. It has been very stressful not having been in school for 20 years. And it is a tough school. I am a perfectionist, obsessive (I've learned), so it's hard for me to try to get all of this work done when I'm trying to do it all perfectly. I work and study among some professors who are pretty famous in their field, so it's daunting being a student of theirs knowing their accomplishments.
I don't really have time to meditate. I used to swim when I had a career, but school takes up a lot more time than any job I've had. It is the end of the semester. Finals start friday. I just spent three full days working on a 25 page paper that I just turned in today. Lots of pressure right now.
With Zoloft, I had tremor, felt as though I was racing in my own body. It was the first thing I tried and it felt awful. Effexor did the same thing but worse. I tried Celexa a year ago last winter. It slowed me down to the point where I had no energy and could get nothing done. I lost interest in everything, stopped going to rehearsals, meetings, classes for the "hobby" "special interest" things I used to do. The house became a pit. I had trouble getting the energy together to get to work and to get work done. I didn't care about anything AND I had tremor too. For a while I thought I just had a very longterm case of flu. Finally got off of it. My pdoc has mentioned on more than one occasion that I seem to be extremely sensitive to serotonin. I think he is trying to get back to it to help with the obsessive worry I have been experiencing.
Thanks for the comment on benzos. I don't like taking drugs but have given up the idea of ever getting off them. It's just that I guess I have an image of myself that I shouldn't have to need or depend upon a tranquilizer to get through life. That's all.
It could be possible that hormones are doing things. I know I get a lot worse before my periods start. I am on no birth control.
Thanks for your input!
Allison
Posted by judy1 on May 7, 2002, at 23:43:13
In reply to Re: OK, here's a new question for ya » judy1, posted by allisonm on May 7, 2002, at 23:25:45
And it sounds like a lot of 'situational' type of stressors. Maybe your pdoc (is it a full 50 minute session?), could concentrate on teaching you coping skills for times like this- although personally I've found psychologists more skilled in this area. The SSRI's DO cause tremors in some people just like AP's do- I had TD from zyprexa, even though people claim there's almost no chance of getting it from the atypical AP's- bs. If your symptoms worsen before your period, then you definitely should have a work-up, preferably by an ob/gyn/endocrinologist- usually fertility docs. They will probably do FSH, E2 (estradiol) levels, thyroid- all of which influence symptoms of stress and depression. Psychiatrists tend not to think outside the box, which is why I feel the client needs to do the work for themselves and demand the proper tests and medication if necessary. I wish you all the best and congrats on finishing your paper! Take care, Judy
Posted by noa on May 16, 2002, at 15:24:52
In reply to Wow, you have a lot on your plate!! » allisonm, posted by judy1 on May 7, 2002, at 23:43:13
Have you asked him this question? It is a good question. Plus, it couldn't hurt to go for a second opinion consult since your depression has been not as responsive to meds as you hoped. Especially since this doc does therapy and meds--you could just get a consult from a pdoc who does a lot more medication work, ie has more medication experience. In any event, even with a really experienced pdoc, a second set of eyes can help sometimes.
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