Psycho-Babble Medication Thread 394822

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

what is wrong with me???????

Posted by woolav on September 25, 2004, at 7:54:31

I am so confused about my dx. I feel like i dont know whats really wrong with me. My pdoc says i have panic disorder. Ive been taking prozac, lamictal and now ativan. (very low dose) grrrr..But I dont feel happy. I kind of feel nothing. Its like things work for me for a week or 2, then stop. I have changed meds so many times this year I feel crazy when i see my pdoc. I wonder if i am mis-diagnosed? I just want to feel happy...
S

 

Re: what is wrong with me???????

Posted by SLS on September 25, 2004, at 8:23:21

In reply to what is wrong with me???????, posted by woolav on September 25, 2004, at 7:54:31

What exactly do you experience that makes you feel uncomfortable or unhappy?


- Scott

 

Re: what is wrong with me???????

Posted by woolav on September 25, 2004, at 9:04:13

In reply to Re: what is wrong with me???????, posted by SLS on September 25, 2004, at 8:23:21

Well, I havent been happy in a long time, even though there is no "see-able" reason. I have anxiety all the time. I have social phobia. Which makes me not like myself. I feel worthless most of the time. I remember about a year ago, being very happy because I was dating my now husband. But I havent been happy like that since and I do love my hubby-so its not that. I dont know what my problem is..In switching from paxil to prozac I almost severed my ties completely from my mom. I was filled with rage for some reason. And there are days I just want to crawl into a hole somewhere and not have to face life. My pdoc is no help. She just tries meds, but we dont talk.
Anyway, that about sums it up.....
:( Sandy

 

Re: what is wrong with me???????

Posted by SLS on September 25, 2004, at 10:59:14

In reply to Re: what is wrong with me???????, posted by woolav on September 25, 2004, at 9:04:13

Hi Sandy.

I'm no diagnostician, of course, but what you are describing sounds like a pretty common depression with some social anxiety that probably doesn't rise up to meet the requirements for an anxiety disorder. You haven't described anything that sounds like panic disorder.

http://www.mentalhealth.com/dis1/p21-an01.html

If it were me, I would want to continue looking for an effective antidepressant medication and go for some psychotherapy from someone who specializes in that type of treatment. It sounds like the combination of the two would be productive.

As far as which medications to choose, that is almost always a trial-and-error process. It doesn't sound like what you are taking is working. Has your depression ever been worse than it is right now? Do you think the medication is providing a partial improvement? It is likely that the anxiety will improve as the depression improves.

Prozac can produce irritability and hostility - more so than the other SSRIs. It might not be the right drug for you.

What medications have you tried already? Do you have the resources to see a psychotherapist?


- Scott

 

Re: what is wrong with me???????

Posted by woolav on September 25, 2004, at 13:42:44

In reply to Re: what is wrong with me???????, posted by SLS on September 25, 2004, at 10:59:14

Scott, Thanks for taking the time to write me. I also appreciate your understanding, and the link to the website. I have felt more depressed before in my life. Without meds I would prob. get to low points where suicide crosses my mind. I have tried so many ssri's though. paxil, effexor, zoloft, serzone, celexa and now prozac. The serzone got me out of a really dark time, but then my pdoc wanted me off it bc of the liver issue. I take lamictal also. 200mg. my doc wants me to stay on that for some reason. I did recently switch from xanax to klon, then to ativan. I wonder if any of this new depressive feelings has to do with xanax withdrawl? I really dont know. The klonopin made me very sleepy and more depressed so she switched me to ativan, but took me from 3mg klon to 1.5 ativan? So, I am anxious again, a little fearful etc..I plan to see a therapist who specializes in dep/anxiety disorders, but i have to wait until my insurance kicks in...I am wondering if I can mix klon and ativan? perhaps, take the klon at night, bc i cant sleep anymore due to missing the xanax. Any thoughts on that?
thanks scott!!!
Sandy

 

Re: what is wrong with me???????

Posted by SLS on September 25, 2004, at 14:36:18

In reply to Re: what is wrong with me???????, posted by woolav on September 25, 2004, at 13:42:44

Hi Sandy.

There are a couple of things worth mentioning. First of all, you might be right about Xanax and depression. Xanax has demonstrated some antidepressant properties, so it might have been somewhat helpful while you were taking it. Secondly, Klonopin can produce worsening of depression in some people. It did with me. I don't know the exact reasons, but it does have some poorly understood effects on serotonin. Serzone is still available in generic form as nefazodone. Serious liver reactions are *extremely* rare with nefazodone. If your liver tests are clean, there is no reason why you can't take it. It would probably help you sleep. 1.5mg of Ativan a day isn't really that much. I used to take 2.0mg at night for sleep. Given your reaction to Klonopin, I would think that it makes more sense to take more Ativan if that were an option. If sleep continues to be a problem, perhaps using a small dose of Remeron would solve the problem. If going back to nefazodone is not your top choice, perhaps it would be worth trying a tricyclic. Nortriptyline might be a good choice. I think if I were in your position, though, I would give consideration to trying Cymbalta, the new SNRI antidepressant. It seems to handle depression and the anxiety that goes along with depression equally well. You do have options.


- Scott

 

Re: what is wrong with me??????? » SLS

Posted by yznhymer on September 25, 2004, at 14:46:15

In reply to Re: what is wrong with me???????, posted by SLS on September 25, 2004, at 14:36:18

Hey Scott,

Speaking of Cymbalta, what's the latest word on the sexual side effects, if any?

Mark


> Hi Sandy.
>
> There are a couple of things worth mentioning. First of all, you might be right about Xanax and depression. Xanax has demonstrated some antidepressant properties, so it might have been somewhat helpful while you were taking it. Secondly, Klonopin can produce worsening of depression in some people. It did with me. I don't know the exact reasons, but it does have some poorly understood effects on serotonin. Serzone is still available in generic form as nefazodone. Serious liver reactions are *extremely* rare with nefazodone. If your liver tests are clean, there is no reason why you can't take it. It would probably help you sleep. 1.5mg of Ativan a day isn't really that much. I used to take 2.0mg at night for sleep. Given your reaction to Klonopin, I would think that it makes more sense to take more Ativan if that were an option. If sleep continues to be a problem, perhaps using a small dose of Remeron would solve the problem. If going back to nefazodone is not your top choice, perhaps it would be worth trying a tricyclic. Nortriptyline might be a good choice. I think if I were in your position, though, I would give consideration to trying Cymbalta, the new SNRI antidepressant. It seems to handle depression and the anxiety that goes along with depression equally well. You do have options.
>
>
> - Scott

 

Re: Thank You. Thank You! (nm)

Posted by woolav on September 25, 2004, at 14:47:04

In reply to Re: what is wrong with me???????, posted by SLS on September 25, 2004, at 14:36:18

 

Re: what is wrong with me??????? » yznhymer

Posted by SLS on September 25, 2004, at 15:05:19

In reply to Re: what is wrong with me??????? » SLS, posted by yznhymer on September 25, 2004, at 14:46:15

Hi Mark.

> Speaking of Cymbalta, what's the latest word on the sexual side effects, if any?

I've noticed a small decrease in libido, but no problems reaching orgasm. I just wish it were doing more for my depression right now. Improvements seem to come in waves. I'm still somewhat improved, but not experiencing the more robust response that I did early last week.

:-(

Still optimistic, though.


- Scott

 

Re: what is wrong with me???????

Posted by ChicagoPete on September 25, 2004, at 15:53:57

In reply to Re: what is wrong with me??????? » SLS, posted by yznhymer on September 25, 2004, at 14:46:15

I've discontinued Cymbalta after about 11 days due to the sexual side effects.

It seemed to work well at helping me stop obsessive thoughts, however it does nothing to help me with general and social anxieties, and the sexual and sleep side effects are just not worth it.

 

Re: what is wrong with me??????? » ChicagoPete

Posted by yznhymer on September 25, 2004, at 16:13:18

In reply to Re: what is wrong with me???????, posted by ChicagoPete on September 25, 2004, at 15:53:57

> I've discontinued Cymbalta after about 11 days due to the sexual side effects.
>
> It seemed to work well at helping me stop obsessive thoughts, however it does nothing to help me with general and social anxieties, and the sexual and sleep side effects are just not worth it.
>
>

Bummer, that. Sorry it didn't work for you. I'm afraid of the same experience. Still, I wonder if you gave it a long enough trial? Conventional wisdom seems to be that several weeks are needed for most ADs to kick in, and for side effects to subside. Though, that hasn't been my experience. Usually, I find the side effects don't get better, and I get a quick response followed by a quick fizzle. That said, I'd still go at least 6 weeks before giving up, just in case. What did your doc say about you quitting after 11 days?

Mark

 

Re: what is wrong with me??????? » SLS

Posted by yznhymer on September 25, 2004, at 16:58:09

In reply to Re: what is wrong with me??????? » yznhymer, posted by SLS on September 25, 2004, at 15:05:19

> Hi Mark.
>
> > Speaking of Cymbalta, what's the latest word on the sexual side effects, if any?
>
> I've noticed a small decrease in libido, but no problems reaching orgasm. I just wish it were doing more for my depression right now. Improvements seem to come in waves. I'm still somewhat improved, but not experiencing the more robust response that I did early last week.
>
> :-(
>
> Still optimistic, though.
>
>
> - Scott

Hey Scott...

Thanks for the update. Mixed news is better than bad news, but I'm still keeping fingers crossed for your full remission with Cymbalta. The fact that your still optimistic and not hopeless is a good sign :-)

I'll probably be trying cymbalta next, followed by the EMSAM (if it ever is released and the Cymbalta doesn't work). Still, as I get closer to my pdoc appt Monday, I'm less and less sure I want to go back down the road of new drug trials.

It would be nice if there were a solution in a pill, but after 30 years of this I'm rewondering if there isn't more of a psychological basis for my depression than I've been willing to admit in recent years. I cleaned up most of the external issues a long time ago. Now I'm wondering if I simply do not have the courage to embrace life, for example. Or perhaps I'm letting a fear of failure shortcircuit the willingness to even "try". That and the physiological aspects of aging may account for my current depression. I dunno, but if that's true, the remedies prolly lie in my kitchen, the gym, the shrinks office or a group therapy situation, and the proper supplements.

In one respect... the opportunity to take an unmedicated look at myself... not being on any medication has been worthwhile. Anyway, whether through meds or some profound psychological epiphany, or major lifestyle changes, I too am hopeful that Imna shake this thing.

Hang in there,
Mark

 

Re: what is wrong with me??????? » ChicagoPete

Posted by Racer on September 25, 2004, at 17:12:12

In reply to Re: what is wrong with me???????, posted by ChicagoPete on September 25, 2004, at 15:53:57

11 days isn't very long. I've been on Cymbalta for almost as long as SLS now, and a lot of the adjustment phase effects have gone away. The first few days, I had trouble sleeping, but now I fall asleep easily. GI stuff for a week or so, but that's mostly gone. Sexual side effects have varied -- some anorgasmia, but then again, not a lot of interest, either.

Have you considered trying a separate med to manage the anxiety? Or therapy? Both can be good solutions.

 

Re: what is wrong with me???????

Posted by ChicagoPete on September 25, 2004, at 22:35:11

In reply to Re: what is wrong with me??????? » ChicagoPete, posted by Racer on September 25, 2004, at 17:12:12

I am noticing the same side effects with Cymbalta as with Paxil, Zoloft, etc - all of which I have tried for a few months and the sexual side effects never seemed to subside, not to mention the benefits weren't very substantial.

Yes, it hasn't been very long, but so far it's just the same old bull all over again. My doc says to keep taking it, especially since it seems to be helping slightly.

What is a good med for managing anxiety? It's pretty bad for me, and I'm nervous to ASK my doc for something else/more.


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.