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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 PaulW on April 15, 2001, at 13:33:25
Feeling the black dog creeping upon me again, last August/September, I decided to embalk on the 'natural option'and swallowed St Johns Wort for a good 8 weeks. It did nothing to stem the momentum of depression.
I switched immediately to Paxil w/ no respite, starting at 15mg and moving up to 20 and then 30mg increasing every fortnight. No joy, despite previous success.
Doc switches me immediately to Lofepramine (UK TCA), no taper, and I give this 4 weeks at 2*70mg and then another 4 weeks at 3*70mg. Still no joy and depression worsening.
Read about Effexor XR on this site and counter the negatives thrown at it with the knowledge that it's 'unique' structure may assist to shift this thing.
Ask my Doc for some and he responds, by putting me on 75mg first 4 weeks and now 150mg(last three).Again with no wash out of the TCA
I am still waiting and if anything i have felt worse in the last two days.
I swear I have already experienced some of the withdrawal symptoms so vividly described on these pages.
I just feel so disconnected, i cannot believe this is happening
I know that the depression is battering me, but are the various dabblings in classes of med.screwing with my head even further?
Perhaps I should give the Effexor just a little longer to settle down? Or get the hell off now? Trouble is, how do I taper when all I have are 150mg to hand?
Any thoughts welcomed to silence me, because i've been polluting this board with too much rubbish of late
Cheers
Paul
Posted by Michele on April 15, 2001, at 14:18:32
In reply to Multi Med Changes w/ no wash outs. Consequences???, posted by PaulW on April 15, 2001, at 13:33:25
Hi Paul,
Sorry to hear about your discomfort. :-( I was hoping this would work for you.
I wish I can offer you some advice about going from one med to another.... but I don't have enough experience there. But if there are not an MAOI's involved.... your probably ok on that front. But like I said, I am no expert on this.Can I ask what you are presently feeling from the Effexor? I'm wondering how close it is to mine. How long have you been on it? Again.... I think you started it when I did... so you would have had ample time to know if it is going to work. When I talked to my pdoc on friday... I admitted I went off cold Turkey.... and he just said to give him a call if I start to get some of the withdrawal effects I told him about. On my 5th day.... so far feeling great. I guess it's that everybody is different thing.
I have heard many people opening up the capsules and seperate the doses..... when I tried this I got too frustred..... too many different sizes and whatnot. But there are many threads on here on how to do it. Many you can check em out. It is possible to taper with only the 150 on hand... follow the advice.
Hoping great things for ya kiddo..... Michele
Posted by SalArmy4me on April 15, 2001, at 23:42:55
In reply to Multi Med Changes w/ no wash outs. Consequences???, posted by PaulW on April 15, 2001, at 13:33:25
Give the Effexor at least a 6 week trial; it is a good medication that is effective for a lot of people and perhaps you too.
Taking more and different medications will not affect your brain negatively--there is no evidence to suggest this.
Go out and get 75 mg capsules any way you can for the purpose of tapering off. Otherwise, your well-being will be affected negatively.
--The Salvation Army In Your Community: Changing the World One Life At A Time
Posted by JohnL on April 16, 2001, at 6:04:45
In reply to Multi Med Changes w/ no wash outs. Consequences???, posted by PaulW on April 15, 2001, at 13:33:25
Paul,
I've tried dozens of drugs to arrive at my current very effective cocktail. Only once did I do a washout. I do not believe multiple med changes screw anything up. In contrast, I think multiple med changes are good because it is the only way to pinpoint which drug is a superior match for you. Excluding MAOIs, a one day washout is fine.In your shoes, with the benefit of hindsight, I would stay on Effexor but add Zyprexa to it. If you don't like Zyprexa after two weeks, then switch to Risperdal. I preach these drugs all the time, but for good reason. Clinical and anecdotal evidence is very encouraging, not to mention my own success after years of failure with other common and other exotic approaches.
There are actually doctors who specialize in rapid fire drug trials with patients. Drugs are tried for only 5 days to 2 weeks each. I've had two doctors that treated me this way. I was able to weed out a lot of dud drugs and stumble onto really good ones, in a relatively short amount of time. Without this approach, I would still be suffering and would still probably be stuck back in the SSRI arena, flooded with confusion and frustration of what to do next.
When a superior drug match is encountered, it is often obvious within days. Once superior matches have been identified, then longer trials can be committed to. This is not at all a common way to treat patients, and it is often controversial, but I can say from personal experience it works. You have already weeded out some dud inferior matches for you. Though it doesn't feel like, you have made progress by narrowing down the list. At this point, to stack the odds in your favor, I would consider adding Zyprexa and then Risperdal to your ongoing Effexor. And on the back burner I would keep Prozac in mind. It is a time tested proven workhorse and is still the most unique of all the SSRIs. It could not have stood the test of time without good reason. As a sidenote, clinical trials as well as anecdotal evidence show there is some kind of real special synergy between Prozac and Zyprexa when they are combined. Try it! And don't worry about the washout thing.(MAOIs excluded)
John
Posted by PaulW on April 16, 2001, at 13:06:24
In reply to Re: Multi Med Changes w/ no wash outs. Consequences???, posted by JohnL on April 16, 2001, at 6:04:45
> Paul,
> I've tried dozens of drugs to arrive at my current very effective cocktail. Only once did I do a washout. I do not believe multiple med changes screw anything up. In contrast, I think multiple med changes are good because it is the only way to pinpoint which drug is a superior match for you. Excluding MAOIs, a one day washout is fine.
>
> In your shoes, with the benefit of hindsight, I would stay on Effexor but add Zyprexa to it. If you don't like Zyprexa after two weeks, then switch to Risperdal. I preach these drugs all the time, but for good reason. Clinical and anecdotal evidence is very encouraging, not to mention my own success after years of failure with other common and other exotic approaches.
>
> There are actually doctors who specialize in rapid fire drug trials with patients. Drugs are tried for only 5 days to 2 weeks each. I've had two doctors that treated me this way. I was able to weed out a lot of dud drugs and stumble onto really good ones, in a relatively short amount of time. Without this approach, I would still be suffering and would still probably be stuck back in the SSRI arena, flooded with confusion and frustration of what to do next.
>
> When a superior drug match is encountered, it is often obvious within days. Once superior matches have been identified, then longer trials can be committed to. This is not at all a common way to treat patients, and it is often controversial, but I can say from personal experience it works. You have already weeded out some dud inferior matches for you. Though it doesn't feel like, you have made progress by narrowing down the list. At this point, to stack the odds in your favor, I would consider adding Zyprexa and then Risperdal to your ongoing Effexor. And on the back burner I would keep Prozac in mind. It is a time tested proven workhorse and is still the most unique of all the SSRIs. It could not have stood the test of time without good reason. As a sidenote, clinical trials as well as anecdotal evidence show there is some kind of real special synergy between Prozac and Zyprexa when they are combined. Try it! And don't worry about the washout thing.(MAOIs excluded)
> JohnThanks for the suggestions, which I'll mention to my doc, but that's another story... i'm not convinced his knowledge is any greater than mine. However,finding a decent doc, who has the knowledge and/or willignes to prescribe different drugs, in my part of England is proving to be very difficult, despite having many friends who work in the mental health field.
As an example, he will not raise FXR above 150mg. There's people who post here on 600mg!I keep flagging up Paxil, because it has worked wonders for me before, only this time not so.
I'm really tempted to go cold on the FXR and start this again. A real gamble and, I bet, if i listen hard, I can hear your wince from here?Are you suggesting prozac with the FXR? Starting at 10/20mg? Decreasing FXR down from 150mg to 75mg or keeping the same.
Yeah, I'm confused...
CheersPaul
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