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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Bonnie on May 2, 2000, at 23:23:32
i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
Posted by JohnL on May 3, 2000, at 4:11:43
In reply to no medicine works for me, help!, posted by Bonnie on May 2, 2000, at 23:23:32
> i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
Bonnie,
I'm so sorry you're having such a battle. I can sure relate. I feel for you very strongly, as do I'm sure many others here. I know it doesn't help enough, but at least know you are in good company. You are among other folks who know exactly what you're experiencing.In cases like yours I find the greatest advantage in embracing an approach pioneered by Dr Jensen. That is, try about three drugs from each of several drug classes for one week each. The idea is to stumble upon the right drug. How will we know the right drug? It will show definite response within a week, often the first day or two. Side effects will be minimal. These are characteristics of a drug molecule that your unique body chemistry likes, and a molecule that corrects whatever chemical imbalance is causing the symptoms. Drug molecules not liked by your body are characterized by what you have already experienced...poor, slow, or no response, and sometimes worsening of symptoms.
It is unlikely you'll find a local phsycian practicing this approach. That's too bad, because this approach is specifically geared for sufferers just like you. And it's primary goal is to get you well FAST. While traditional psychiatry preaches 6 week trials, you could spend the rest of your life trying to find the right drug that works. There's no need to wait that long. In my opinion, your condition is not just uncomfortable and painful, it is a medical emergency. That's just how I view it. And it warrants aggressive treatment.
You may want to at least visit www.drjensen.com to get a better overview of these things I've mentioned. And if you can afford the cost of a psychiatrist, then you can afford to set up a consultation with Dr Jensen by phone. He'll work with your current physician in recommending what drugs to try, how to try them, and why. You will still need longer 6 six week trials, but only AFTER superior meds have been identified, and AFTER inferior ones have been weeded out. It doesn't take 6 weeks to do that.
Assuming you continue down the same path you've been on, what's next? The choices are staggering. There are other SSRIs, like Zoloft, Paxil, Luvox. There are TCAs like Nortriptyline or Desipramine. Mood stabilizers like Lithium, Depakote, Lamictal, Neurontin. Stimulants like Ritalin or Adderall. APs like Zyprexa, Risperdal, Stelazine. All of these have the potential to target whatever chemistry is causing your depression. But where to go next? This question highlights the need for a real good doctor who has a real talent with depression chemistry. The run-of-the-mill doctor is going to take a LONG time to find the right drug for you, unless by huge luck you happen to stumble onto it earlier.
On a different tact, I've noticed over the years that people who do not do well with 'natural' remedies go on to find a presciption they like. And vice versa. People who have been frustrated with many prescrips often go on to find a 'natural' remedy works better. If you can afford $20 to $40 a week, it would certainly be worth trying NatureMade SAMe from Wal*Mart. In my experience, a minimum effective dose is about 4 pills a day...2 in midmorning, 2 in midafternoon, all on an empty stomach. But the max is 8 pills a day. Anecdotal evidence as well as scientific evidence suggest SAMe really does work, especially at these higher doses. But it is expensive. I've tried it several times. Each time it kicked in by day 3 and provided significant improvement (4 pills per day). If not for the expense, I would have continued with it at higher doses. It usually does work fast, so that is important in your case. A 'natural' remedy for you might be SAMe in the short run, and St Johnswort in the longrun. Start both at the same time. While SAMe should work fast, it will carry you a few weeks until the SJW kicks in. For SJW, stick with these scientific-formula brands...Movana, Kira, Perika, Ricola. And be aware that the best results have been shown in clinical trials to be 2 to 3 times higher than the usual dose of 3 per day. Nine a day is the maximum and most effective. For me, 5 a day works best.
I'm sorry you're feeling so bad. And I'm sorry there's no easy answer. But for the quickest success, I would suggest one of the following:
1. go to www.drjensen.com
2. start a new AD, but start a stimulant with it (they work fast, 24 to 72 hours when they work)
3. start SJW and SAMeHope this helps more than it confuses. :-)
JohnL
Posted by Bonnie on May 3, 2000, at 7:29:14
In reply to Re: no medicine works for me, help!, posted by JohnL on May 3, 2000, at 4:11:43
> > i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
> > Bonnie,
> I'm so sorry you're having such a battle. I can sure relate. I feel for you very strongly, as do I'm sure many others here. I know it doesn't help enough, but at least know you are in good company. You are among other folks who know exactly what you're experiencing.
>
> In cases like yours I find the greatest advantage in embracing an approach pioneered by Dr Jensen. That is, try about three drugs from each of several drug classes for one week each. The idea is to stumble upon the right drug. How will we know the right drug? It will show definite response within a week, often the first day or two. Side effects will be minimal. These are characteristics of a drug molecule that your unique body chemistry likes, and a molecule that corrects whatever chemical imbalance is causing the symptoms. Drug molecules not liked by your body are characterized by what you have already experienced...poor, slow, or no response, and sometimes worsening of symptoms.
>
> It is unlikely you'll find a local phsycian practicing this approach. That's too bad, because this approach is specifically geared for sufferers just like you. And it's primary goal is to get you well FAST. While traditional psychiatry preaches 6 week trials, you could spend the rest of your life trying to find the right drug that works. There's no need to wait that long. In my opinion, your condition is not just uncomfortable and painful, it is a medical emergency. That's just how I view it. And it warrants aggressive treatment.
>
> You may want to at least visit www.drjensen.com to get a better overview of these things I've mentioned. And if you can afford the cost of a psychiatrist, then you can afford to set up a consultation with Dr Jensen by phone. He'll work with your current physician in recommending what drugs to try, how to try them, and why. You will still need longer 6 six week trials, but only AFTER superior meds have been identified, and AFTER inferior ones have been weeded out. It doesn't take 6 weeks to do that.
>
> Assuming you continue down the same path you've been on, what's next? The choices are staggering. There are other SSRIs, like Zoloft, Paxil, Luvox. There are TCAs like Nortriptyline or Desipramine. Mood stabilizers like Lithium, Depakote, Lamictal, Neurontin. Stimulants like Ritalin or Adderall. APs like Zyprexa, Risperdal, Stelazine. All of these have the potential to target whatever chemistry is causing your depression. But where to go next? This question highlights the need for a real good doctor who has a real talent with depression chemistry. The run-of-the-mill doctor is going to take a LONG time to find the right drug for you, unless by huge luck you happen to stumble onto it earlier.
>
> On a different tact, I've noticed over the years that people who do not do well with 'natural' remedies go on to find a presciption they like. And vice versa. People who have been frustrated with many prescrips often go on to find a 'natural' remedy works better. If you can afford $20 to $40 a week, it would certainly be worth trying NatureMade SAMe from Wal*Mart. In my experience, a minimum effective dose is about 4 pills a day...2 in midmorning, 2 in midafternoon, all on an empty stomach. But the max is 8 pills a day. Anecdotal evidence as well as scientific evidence suggest SAMe really does work, especially at these higher doses. But it is expensive. I've tried it several times. Each time it kicked in by day 3 and provided significant improvement (4 pills per day). If not for the expense, I would have continued with it at higher doses. It usually does work fast, so that is important in your case. A 'natural' remedy for you might be SAMe in the short run, and St Johnswort in the longrun. Start both at the same time. While SAMe should work fast, it will carry you a few weeks until the SJW kicks in. For SJW, stick with these scientific-formula brands...Movana, Kira, Perika, Ricola. And be aware that the best results have been shown in clinical trials to be 2 to 3 times higher than the usual dose of 3 per day. Nine a day is the maximum and most effective. For me, 5 a day works best.
>
> I'm sorry you're feeling so bad. And I'm sorry there's no easy answer. But for the quickest success, I would suggest one of the following:
> 1. go to www.drjensen.com
> 2. start a new AD, but start a stimulant with it (they work fast, 24 to 72 hours when they work)
> 3. start SJW and SAMe
>
> Hope this helps more than it confuses. :-)
> JohnL
hey JohnL, thank you very much for this advice. I will go to dr.jensen and consult my doc about this. i would like to try SAM-e, but i think it would br to expensive, and I hate taking pills. That is the problem, and why I stopped taking my meds a week ago. I once took 40 tyenols in dec 99 an now taking pills makes me sick. Thanks, BOnnie
Posted by Noa on May 3, 2000, at 8:48:49
In reply to Re: no medicine works for me, help! , posted by Bonnie on May 3, 2000, at 7:29:14
Bonnie, I know how demoralizing it can be to struggle to find a medication that works. I have been going through this, too.
While you search for a good med, are you in any kind of therapy? Therapy has helped me so much, and it sounds like you could use the support.
Also, who prescribes your meds, and are you comfortable talking to that person? Do you get enough time with this doc to discuss what is going on with you? How much time did you give each med to see if it helped? Has your doc mentioned the idea of combining two or more meds to achieve a better effect? Were you consistent in taking your meds at the right times?
What do your parents say about all of this? Is there a family history of depression? Do you know if there was something that triggered the depression 9 months ago? What was it?
I won't say hang in there, but I will say that you are not alone.
Posted by Greg on May 3, 2000, at 9:16:51
In reply to Re: no medicine works for me, help! , posted by Noa on May 3, 2000, at 8:48:49
Bonnie,
My first thought when I read your post was "she's too young to have to deal with this crap". Being an older fart (44) I guess I tend to assume that everyone out here is around my age. Depression doesn't have an age limit.Noa beat me to the punch on most of my questions and comments for you about med combos and therapy, but I still have a few. Is your doctor taking an aggressive approach to the fact that your not responding to the meds, what type of a gameplan does he/she have for you? Have you given the meds that you have tried long enough time to do their job? I've read so many posts here where a person was not responding to a med right away, but when they gave it some extra time it started working great.
God bless you for having the courage to share with us what's going on with you. This is a great place with great people. Please continue to let us know how you're doing.
Hugs,
Greg
Posted by Bonnie on May 3, 2000, at 14:29:39
In reply to no medicine works for me, help!, posted by Bonnie on May 2, 2000, at 23:23:32
> i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
My doctor really hasn't done anything besides hand me medicine and tell me to take them. There hasn't been any tests or anything. I appreciate all the responses i am getting back, thanks. it does help me
Posted by Greg on May 3, 2000, at 14:53:24
In reply to Re: no medicine works for me, help!, posted by Bonnie on May 3, 2000, at 14:29:39
Bonnie,
Too many doctors say "Take two of these and call me in the morning". I've been down that road many times. If your doc isn't being pro-active and trying to get to the root of the problem, then it sounds like time to make a change. Don't let a doc with Revolving Door Syndrome (get 'em in, get 'em out) keep you from getting the help you need!In the mean time keep talking to us, we're not doctors, but we'll do everything we can to help. If you ever want to talk offline, feel free to e-mail me.
Big Hugs,
Greg> > i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
> My doctor really hasn't done anything besides hand me medicine and tell me to take them. There hasn't been any tests or anything. I appreciate all the responses i am getting back, thanks. it does help me
Posted by Kimberly on May 3, 2000, at 16:18:26
In reply to no medicine works for me, help!, posted by Bonnie on May 2, 2000, at 23:23:32
Bonnie,
I too have had severe difficulty finding a med to work for me with side effects that are not worse than the depression. I also had no luck with prozac, celexa, and effexor. It sounds to me like you have tried very similar meds. Both celexa and prozac are SSRIs. While effexor is not officially an SSRI, it acts in a very similar way. Also wellbutrin can be very stimulating which may be a problem for you. Maybe you could look into some completely different types of depression drugs such as a tricyclic (ex. elavil) or serzone (which is sort of in a class by itself) or there are several others. However, I would highly recommend therapy in addition to the drugs if you are not already in it.
> i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
Posted by SD on May 3, 2000, at 19:32:31
In reply to no medicine works for me, help!, posted by Bonnie on May 2, 2000, at 23:23:32
http://www.mhc.com/Algorithms/Depression/index.htm
It starts at the above URL.
It is by David N. Osser, M.D.Associate Professor of Psychiatry
Harvard Medical SchoolBasically it shows a recommended decision process for determining the order of meds to try for treating a depressed person. My experience is that the advice of most shrinks/psychopharmacologists will closely mirror this algorithm, including a rather limited use of combinations of meds and relegation of MAO inhibitors to 'third class' status.
I can't help thinking the under-use of combinations is wrong-headed because when I read on the web or a usenet newsgroup a personal account of someone finding a 90%+ cure after no luck with the first two or three meds, it is almost two or more meds together.On the other hand, the value of combinations may be particularly common in the case of multiple disorders (comorbidity) or a single disorder other than a depressive one, neither of which this algorithm covers.
peace and health,
SD
Posted by Racer on May 3, 2000, at 20:47:37
In reply to Re: no medicine works for me, help!, posted by Bonnie on May 3, 2000, at 14:29:39
Dear Bonnie:
I'm so sorry you're going through all this. I've written so much to you below, I thought I'd stop back up here and tell you that even if you don't read it all it's all written with hope that you feel better very soon, and that your doctor responds to your concerns.
Here's one piece of advice, though, before my marathon: write down all that you can, neatly, in some sort of order, and take it to your doctor. List the reactions you had to all the drugs, the symptoms of depression you've experienced, any good effects of the drugs, etc. If you have it in writing, the doctor may take it more seriously. Especially, write any specific events. If you say, 'gee, I feel lousy all the time', that's easy to ignore or brush off. If you can say, 'gee, I felt really lousy on Monday. I couldn't even get out of bed without crying, and the thought of school was like a black cloud. Tuesday, though, I felt pretty good around 4PM when I took the dog for a walk.' That's specific about symptoms and relief. That sort of thing carries more weight.
> > i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it.
Well, even if we can't offer anything else, we can at least offer company in wanting relief. Most of us here have experienced a good deal of trial and error in finding the right drug or combination of drugs to help us. There's little worse than trying a bunch of different drugs with different side effects, and no guarantees that at the end of the time we'll feel better.
I will say, though, that if you can find the magic bullet, you WILL feel better. Don't 'just hang in there', but do know that there IS help, even if it doesn't always feel that way.
I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked.
This is a long enough list that it must be overwhelming for you right about now. Ask the old timers around here, they'll tell you that it took about two years to find the combination of drugs to help me. Of course, this was largely because of a totally wretched excuse for a doctor prescribing them! It won't take that long for you, with any luck at all.
I am working my hardest and think I am making people around me depressed.
This is the worst part of depression. It really does rob you of many social contacts. I won't call them friends: friends stick it out! Remember that: anyone who walks away because you're depressed is worse off than you are.
I just want it to go away,I would appreciate any advice.
Here's a piece of advice: Stick with it! Get help now, fight for it with everything you have. All the research I've read says that the sooner you get effective treatment, the less chance you have of going through it again!
I was morbidly depressed at 15, with a home life like something out of a horror novel. It went on, and on, and on. It took until I was almost 30 to find a doctor willing to try meds on me, and even then it took until I was 35 to find a truly effective combination. The best part of it is this: it's long been said that a drug that is effective once will likely be effective again. That means that if/when the depression comes back, I can probably go back on the same combination of drugs.
Again, your story is very different from mine. For one thing, when I was 15, the only drugs out there had so many side effects and were effective in such a relatively small percentage of cases that they simply were not prescribed for young people. You WILL get help now, and it WILL help you through the next critical years of your life. I believe that, and I believe that this is a great place for you to come for understanding, advice, support, and a safe place to vent your fears and frustrations with this process.
Just don;t say "hang in there". Thanks
> My doctor really hasn't done anything besides hand me medicine and tell me to take them. There hasn't been any tests or anything. I appreciate all the responses i am getting back, thanks. it does help me
Posted by Racer on May 3, 2000, at 20:56:29
In reply to Re: no medicine works for me, help!, posted by Racer on May 3, 2000, at 20:47:37
Ack! Nearly forgot the most important thing:
Have your doctor check your thyroid function!
If he starts in on that sort of 'gee, you must be a hypochondriac' line, just tell him you went to a support group which recommends its members all be checked for thyroid disorders, since it can be a cause of depression.
Why suffer through all the trials of drugs if it's as simple as that, huh?
Good luck!
Posted by JohnB on May 3, 2000, at 22:00:44
In reply to no medicine works for me, help!, posted by Bonnie on May 2, 2000, at 23:23:32
Bonnie- Suggestions; 1. Keep posting and reading other posts on this board.
2. Your parents should take your situation as Priority No. 1 in their lives as well as yours. 3. If this doctor isn't able to help you (is this your parent's HMO doc or what?), get your parents to find the best psychiatrist in your area, (give more info about where you live and people on this board might be a able to help). If the your parents' medical plan doesn't cover the cost, they should consider a loan to cover the cost - it's that important. 4. If you try some of the things suggested to you in previous posts, that's fine, but it's also important to have a real person, (we call 'em pdocs here) who is knowledgeable and who you trust and can talk to, in your corner.
Posted by Noa on May 5, 2000, at 16:14:10
In reply to Important PS to Bonnie, posted by Racer on May 3, 2000, at 20:56:29
> Ack! Nearly forgot the most important thing:
>
> Have your doctor check your thyroid function!
YES!!! Absolutely!! And when you get the test results, ask for a copy of the actual results, not just whether they were "normal" or not. Many doctors do not know how to interpret low-grade hypothyroidism test results.I recommend the book, The Thyroid Solution.
Posted by Kimberly on May 7, 2000, at 6:30:39
In reply to no medicine works for me, help!, posted by Bonnie on May 2, 2000, at 23:23:32
Hi Bonnie, I wrote you before but I just wanted to send a little more. I too had no luck at all with the exact 4 (effexor, celexa, wellbutrin, prozac). I just found out Friday that it is most likely because my body is hypersensitive to dopamine and all those four effect dopamine in some way. If you found that they revved you up too much, gave you insomnia, and maybe more anxiety, that could be the case. It is worth looking into with your doc/a doc. Serzone does not effect dopamine at all. I have been on it before and it helped and i just started back on it 2 days ago, so far with no side effects at all. There are others that do not touch dopamine too, so maybe ask your doc. This is just a thought! Whatever you do I wish you the best of luck and don't give up, you will find the right one and you will feel so much better ! Kimberly
> i am 15 years old and have been suffering from depression for about 9 months and i am so sick of it and want it to be over it. I have tried Prozac, wellbutrin, Celexa, and Effexor. None of these meds have worked. I am working my hardest and think I am making people around me depressed. I just want it to go away,I would appreciate any advice. Just don;t say "hang in there". Thanks
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