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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 Medusa on August 2, 2002, at 12:30:23
I've been on and off various antidepressants, mostly SSRIs, for almost 10 years. Invariably, the effect wanes after a few months to a year.
I went off fluoxetine in April. I went through a few weeks of feeling kind of hung over and zomby-ish, and then it was back to "normal" depression.
Now I'm starting a job hunt, and my energy and motivation and hope are all so low, my partner is nudging me to take medicine again.
I've started on 20 mg/day of fluoxetine. My intention is to take this for ten days, then to begin supplementing with 25 mg/day venlafaxine, a combination that has worked before.
I *hate* venlafaxine - my temperature goes up, I get a dry throat, and the levels are so bloody unstable, I start feeling icky an hour or so before it's time for a dose. Terrible stuff.
BUT I discovered the effects of combination a few years ago when I accidentally packed an old bottle of venlafaxine (which, by itself, gave me pure side effects and no relief from depression) instead of sertraline. When I discovered my mistake, I thought I'd better take +something+ and ... for ten days I could barely remember ever being depressed, and I wondered what had been wrong with me.
Then I ran out of venlafaxine, and didn't know about the terrors of cold turkey, and tripped the worst depressive episode of my life.
So I hate playing with the stuff, but I'm in search of that ten-day charm again. That's about how long I get on the combination dose I'm starting with ... and then I have to increase the doses.
I have not found doctors to be helpful with these issues. For much of my first seven years on and off meds, I saw doctors in and affiliated with a hot-shot U.S. east coast university & teaching hospital. One of them, at the university health services, told me to go to church. Another insisted on doing talk therapy - he was just a meds consult guy - yet consistently fell asleep during our sessions. Another told me, "your family is really f--d up!" (heh, ya think?)
I'd rather not go on anything at all, but I have to show my partner I'm doing something for this. I'm a mess. I'm scared of myself these days - I don't know if a little burst of energy will combine with the lifelong idea of suicide and I'll just do it without thinking about it. I really don't think that mixing venlafaxine into this is the greatest idea, long term, but the job search is short term, and then work helps me to get beyond all this in some ways.
Any constructive input is welcome.
Posted by Shawn. T. on August 3, 2002, at 1:23:49
In reply to going back on meds - sorry, long, posted by Medusa on August 2, 2002, at 12:30:23
Why don't you try Wellbutrin? If SSRI's and venlafaxine are out, then it may be the next thing to try. Energy and motivation are Wellbutrin's strong points because it has mild dopamine reuptake inhibiting properties.
The following site has some fair information:
http://www.fpnotebook.com/PSY168.htmShawn
Posted by Medusa on August 3, 2002, at 16:19:18
In reply to Re: going back on meds - sorry, long, posted by Shawn. T. on August 3, 2002, at 1:23:49
Thanks Shawn. I'll check it out.
IIRC, a pdoc thought about this one, then decided against it because of risk of convulsions. Epilepsy in the family. I don't know what the risk is.
> Why don't you try Wellbutrin? If SSRI's and venlafaxine are out, then it may be the next thing to try. Energy and motivation are Wellbutrin's strong points because it has mild dopamine reuptake inhibiting properties.
> The following site has some fair information:
> http://www.fpnotebook.com/PSY168.htm
>
> Shawn
>
>
Posted by Shawn. T. on August 5, 2002, at 4:24:53
In reply to Re: going back on meds - sorry, long, posted by Medusa on August 3, 2002, at 16:19:18
Wellbutrin SR has a 1/1000 risk of seizures, which is the same risk that some of the SSRI's have. The standard release form is four times more likely to cause seizures. Most pdocs don't hesitate to prescribe drugs with 1/1000 risk of seizures; I certainly doubt that many know that Zoloft has 4/1000 chance of seizures.
Shawn
Posted by Medusa on August 5, 2002, at 13:18:09
In reply to Re: going back on meds - sorry, long, posted by Shawn. T. on August 5, 2002, at 4:24:53
I had no idea about Zoloft.
Why does Wellbutrin have a reputation (and big warning labels) for increasing seizures, if it's no worse than the others?
This is the end of the thread.
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