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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by Mr. Scott on September 19, 2001, at 21:55:03
Hi,
I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.If given the choice which would you try first?
1)Effexor XR
2)Serzone
3)RemeronIf none of these.. what then?
Posted by paxvox on September 20, 2001, at 7:31:49
In reply to AD question 4 you, posted by Mr. Scott on September 19, 2001, at 21:55:03
There ARE other types of ADs than SSRI, such as the original tricyclics and MAOIs. HOWEVER, many people have trouble using these particular types because of certain side effects. There are also AD like Wellbutrin, which I take, that works differently to achieve its effect. You may also go with a combo or cocktail of meds, which may include a reduced amount of SSRI.
PAX
Posted by ChrisK on September 20, 2001, at 8:20:39
In reply to AD question 4 you, posted by Mr. Scott on September 19, 2001, at 21:55:03
Try a Tricyclic! They are still around for a reason- they work. I think that the side effects are overplayed. Look into the standards that everything gets compared to: amitriptyline, imiprimine, nortriptyline.
Don't rule tham out just because they are the "old" school of meds. I never reacted to an SSRI or Remeron nor Effexor but I did have withdrawl problems with those. The TCA's have worked better than anything else for me.
Good Luck,
Chris
Posted by JohnL on September 21, 2001, at 17:53:43
In reply to AD question 4 you, posted by Mr. Scott on September 19, 2001, at 21:55:03
> Hi,
>
> I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
> Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.
>
> If given the choice which would you try first?
>
> 1)Effexor XR
> 2)Serzone
> 3)Remeron
>
> If none of these.. what then?My vote is for none of the above. Instead, I will place my bet on Zyprexa. Without going into an explanation of why, I personally think Zyprexa would be a strong bet. I have many reasons for feeling that way. I would favor it over the other three choices. In my opinion it would be a good strategy to try Zyprexa 5mg to 10mg, and then after 4 weeks decide if you like it or not. If not, then you can go back and try the others. To do it in the reverse order I think would lead to more frustration and more time. The quickest and surest bet I can think of is Zyprexa. No guarantees, but a real good bet.
John
Posted by Kristi on September 22, 2001, at 19:10:11
In reply to AD question 4 you, posted by Mr. Scott on September 19, 2001, at 21:55:03
Oh.... definately don't start with effexor. There are so many side effects and it's just awful to come off of. Even doctors and pharmacists are finally admitting this now. My doctor won't even prescribe it.... and a friend of mines husband is a pharmacist, and he says he cringes everytime he receives a script for it. You know yourself best tho, do what you think is right for yourself. Good luck, Kristi
> Hi,
>
> I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
> Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.
>
> If given the choice which would you try first?
>
> 1)Effexor XR
> 2)Serzone
> 3)Remeron
>
> If none of these.. what then?
Posted by galtin on September 22, 2001, at 19:34:26
In reply to Re: AD question 4 you, posted by Kristi on September 22, 2001, at 19:10:11
> Oh.... definately don't start with effexor. There are so many side effects and it's just awful to come off of. Even doctors and pharmacists are finally admitting this now. My doctor won't even prescribe it.... and a friend of mines husband is a pharmacist, and he says he cringes everytime he receives a script for it. You know yourself best tho, do what you think is right for yourself. Good luck, Kristi
For some people, yes. For others, like myself, there are no side effects. Some of the problems people associate with Effexor are due to underdosing. Low doses can equal a high level of side effects, not to mention leaving the depression untouched.
>
> galtin
>
>
>
>
> > Hi,
> >
> > I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
> > Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.
> >
> > If given the choice which would you try first?
> >
> > 1)Effexor XR
> > 2)Serzone
> > 3)Remeron
> >
> > If none of these.. what then?
Posted by Cindylou on September 22, 2001, at 21:50:30
In reply to Re: AD question 4 you, posted by galtin on September 22, 2001, at 19:34:26
I have to second Kristi's point here -- I have a horrible time with SSRI side effects, and I had an even WORSE time with Effexor.
I'd say don't waste your time going with Effexor -- at least not until you've given some others a try.
good luck,
cindy> > Oh.... definately don't start with effexor. There are so many side effects and it's just awful to come off of. Even doctors and pharmacists are finally admitting this now. My doctor won't even prescribe it.... and a friend of mines husband is a pharmacist, and he says he cringes everytime he receives a script for it. You know yourself best tho, do what you think is right for yourself. Good luck, Kristi
>
> For some people, yes. For others, like myself, there are no side effects. Some of the problems people associate with Effexor are due to underdosing. Low doses can equal a high level of side effects, not to mention leaving the depression untouched.
> >
> > galtin
> >
> >
> >
> >
> > > Hi,
> > >
> > > I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
> > > Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.
> > >
> > > If given the choice which would you try first?
> > >
> > > 1)Effexor XR
> > > 2)Serzone
> > > 3)Remeron
> > >
> > > If none of these.. what then?
Posted by Kristi on September 22, 2001, at 22:49:29
In reply to Re: AD question 4 you » galtin, posted by Cindylou on September 22, 2001, at 21:50:30
Thanks for the support. Bottom line..... use as a last resort. There are so many out their to use. Just look here and the archives.. their is so much posted about effexor. That's not good. Again..... don't use it as a first time AD
> I have to second Kristi's point here -- I have a horrible time with SSRI side effects, and I had an even WORSE time with Effexor.
>
> I'd say don't waste your time going with Effexor -- at least not until you've given some others a try.
>
> good luck,
> cindy
>
> > > Oh.... definately don't start with effexor. There are so many side effects and it's just awful to come off of. Even doctors and pharmacists are finally admitting this now. My doctor won't even prescribe it.... and a friend of mines husband is a pharmacist, and he says he cringes everytime he receives a script for it. You know yourself best tho, do what you think is right for yourself. Good luck, Kristi
> >
> > For some people, yes. For others, like myself, there are no side effects. Some of the problems people associate with Effexor are due to underdosing. Low doses can equal a high level of side effects, not to mention leaving the depression untouched.
> > >
> > > galtin
> > >
> > >
> > >
> > >
> > > > Hi,
> > > >
> > > > I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
> > > > Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.
> > > >
> > > > If given the choice which would you try first?
> > > >
> > > > 1)Effexor XR
> > > > 2)Serzone
> > > > 3)Remeron
> > > >
> > > > If none of these.. what then?
Posted by galtin on September 24, 2001, at 22:42:56
In reply to Re: AD question 4 you » Cindylou, posted by Kristi on September 22, 2001, at 22:49:29
>
>
> Thanks for the support. Bottom line..... use as a last resort. There are so many out their to use. Just look here and the archives.. their is so much posted about effexor. That's not good. Again..... don't use it as a first time AD
>
>
>
>
>
>
>
>
> > I have to second Kristi's point here -- I have a horrible time with SSRI side effects, and I had an even WORSE time with Effexor.
> >
> > I'd say don't waste your time going with Effexor -- at least not until you've given some others a try.
> >
> > good luck,
> > cindy
> >
> > > > Oh.... definately don't start with effexor. There are so many side effects and it's just awful to come off of. Even doctors and pharmacists are finally admitting this now. My doctor won't even prescribe it.... and a friend of mines husband is a pharmacist, and he says he cringes everytime he receives a script for it. You know yourself best tho, do what you think is right for yourself. Good luck, Kristi
> > >
> > > For some people, yes. For others, like myself, there are no side effects. Some of the problems people associate with Effexor are due to underdosing. Low doses can equal a high level of side effects, not to mention leaving the depression untouched.
> > > >
> > > > galtin
> > > >
> > > >
> > > >
> > > >
> > > > > Hi,
> > > > >
> > > > > I can't tolerate SSRI's...At All..Hate them..I find SSRI's make me obnoxious, irritable, anxious, agitated, cause my face to swell, I gain weight, want to sleep all the time, sexual problems, no emotions, and muscle pains.
> > > > > Have chronic depression w/ lots of severe anxiety frequent double depression that is severe (frequent suicidal thoughts). More of the fatigued overeater type though.
> > > > >
> > > > > If given the choice which would you try first?
> > > > >
> > > > > 1)Effexor XR
> > > > > 2)Serzone
> > > > > 3)Remeron
> > > > >
> > > > > If none of these.. what then?After this post I will try to keep out of the Effexor wars, othewise I'll get blocked for being tedious.
If not for personal experience, the posters here would convince me to test the anti-depressant properties of strychnine before considering Effexor. Maybe satisfied Effexor customers don't write in. It is not that Effexor is a unique wonder-med, but there are people who have done well on it. Me, for example. It eradicated a killer depression. And at fairly high doses I have had only a couple mild side effects and have suffered no side effects at all the several times I have stopped taking it.
I know several other people who, like myself, were rescued by Effexor at that point of desperation when all else has failed. I have no idea what medication any given person should take. Maybe Effexor should be a second or third option. But I hope that people who have not been helped by other meds won't rule it out based on the bad experiences some have had with it.
galtin
Posted by Cindylou on September 25, 2001, at 12:53:19
In reply to Re: AD question 4 you- Kristi, Cindylou, posted by galtin on September 24, 2001, at 22:42:56
Hi Galtin,
I understand your point, and agree that Effexor has helped many people ... my concern here is that Scott has had such a hard time with SSRIs ... Effexor does have some SSRI properties, and I believe that if someone has difficulty with SSRIs they most likely will have trouble with Effexor.Maybe I'm wrong here, though -- have you tried other SSRIs and had bad side effects with them? I would happily stand corrected if I knew that others who had bad experiences with SSRIs could have positive experiences with Effexor.
Thanks for your input,
cindy.
>
> After this post I will try to keep out of the Effexor wars, othewise I'll get blocked for being tedious.
>
> If not for personal experience, the posters here would convince me to test the anti-depressant properties of strychnine before considering Effexor. Maybe satisfied Effexor customers don't write in. It is not that Effexor is a unique wonder-med, but there are people who have done well on it. Me, for example. It eradicated a killer depression. And at fairly high doses I have had only a couple mild side effects and have suffered no side effects at all the several times I have stopped taking it.
>
> I know several other people who, like myself, were rescued by Effexor at that point of desperation when all else has failed. I have no idea what medication any given person should take. Maybe Effexor should be a second or third option. But I hope that people who have not been helped by other meds won't rule it out based on the bad experiences some have had with it.
>
> galtin
Posted by Kristi on September 25, 2001, at 21:35:22
In reply to Re: AD question 4 you- Kristi, Cindylou » galtin, posted by Cindylou on September 25, 2001, at 12:53:19
>
My only point is that maybe you can try something else FIRST. They are just too many things popping up about effexor.... why go there if you don't have to.
Hi Galtin,
> I understand your point, and agree that Effexor has helped many people ... my concern here is that Scott has had such a hard time with SSRIs ... Effexor does have some SSRI properties, and I believe that if someone has difficulty with SSRIs they most likely will have trouble with Effexor.
>
> Maybe I'm wrong here, though -- have you tried other SSRIs and had bad side effects with them? I would happily stand corrected if I knew that others who had bad experiences with SSRIs could have positive experiences with Effexor.
>
> Thanks for your input,
> cindy.
>
> >
> > After this post I will try to keep out of the Effexor wars, othewise I'll get blocked for being tedious.
> >
> > If not for personal experience, the posters here would convince me to test the anti-depressant properties of strychnine before considering Effexor. Maybe satisfied Effexor customers don't write in. It is not that Effexor is a unique wonder-med, but there are people who have done well on it. Me, for example. It eradicated a killer depression. And at fairly high doses I have had only a couple mild side effects and have suffered no side effects at all the several times I have stopped taking it.
> >
> > I know several other people who, like myself, were rescued by Effexor at that point of desperation when all else has failed. I have no idea what medication any given person should take. Maybe Effexor should be a second or third option. But I hope that people who have not been helped by other meds won't rule it out based on the bad experiences some have had with it.
> >
> > galtin
Posted by Mr. Scott on September 26, 2001, at 20:30:44
In reply to Re: AD question 4 you- Kristi, Cindylou, posted by Kristi on September 25, 2001, at 21:35:22
I think I'm going to try Serzone and then Effexor. My doctor thinks I have it in for myself and that is why I cannot tolerate the SSRI's. I don't know that I buy that. It effectively makes treatment my failure instead of his.
Scott
Posted by Cindylou on September 26, 2001, at 21:52:42
In reply to Thanks, posted by Mr. Scott on September 26, 2001, at 20:30:44
Hi Scott,
I definitely don't buy your doctor's thinking. It's not your fault you can't tolerate the SSRIs! A lot of people can't tolerate them ... we all have different chemical make-ups ...Anyway, I could go on ranting and raving here. Just trust yourself and how you feel. I truly hope things go well for you with the Serzone or Effexor.
Take care, and keep posting to let us know how it goes,
cindy.
> I think I'm going to try Serzone and then Effexor. My doctor thinks I have it in for myself and that is why I cannot tolerate the SSRI's. I don't know that I buy that. It effectively makes treatment my failure instead of his.
>
> Scott> I think I'm going to try Serzone and then Effexor. My doctor thinks I have it in for myself and that is why I cannot tolerate the SSRI's. I don't know that I buy that. It effectively makes treatment my failure instead of his.
>
> Scott
Posted by Zo on September 29, 2001, at 2:50:48
In reply to Thanks, posted by Mr. Scott on September 26, 2001, at 20:30:44
> My doctor thinks I have it in for myself and that is why I >cannot tolerate the SSRI's. I don't know that I buy that. >It effectively makes treatment my failure instead of his.
You got it. God I hate to see the doctor blame the patient. . .laziness combined with ignorance is truly a nasty little weapon. Isn't there some kind of. . .oath. . they take?
Zo
Posted by Mr. Scott on September 30, 2001, at 17:54:01
In reply to Thanks, posted by Mr. Scott on September 26, 2001, at 20:30:44
Okay so I found another doctor who gave me enough free Serzone to kill a small horse. I'm Currently at 150mg and headed for 400mg. All I notice so far is constipation and fatigue/confusion, but the body seems to adapt after a few days at each dose, at least mostly. It's been 1 week at subtherapeutic doses so I don't expect much yet.
I'm trying to stay put on this drug and not jump ship. Otherwise I'll never know if it could have worked. Don't appreciate the side effects though.
>
> Scott
Posted by Cindylou on September 30, 2001, at 23:12:02
In reply to Trying Serzone, posted by Mr. Scott on September 30, 2001, at 17:54:01
Love those samples! Good luck to you -- I hope the side effects subside soon!
-cindy
> Okay so I found another doctor who gave me enough free Serzone to kill a small horse. I'm Currently at 150mg and headed for 400mg. All I notice so far is constipation and fatigue/confusion, but the body seems to adapt after a few days at each dose, at least mostly. It's been 1 week at subtherapeutic doses so I don't expect much yet.
>
> I'm trying to stay put on this drug and not jump ship. Otherwise I'll never know if it could have worked. Don't appreciate the side effects though.
>
>
> >
> > Scott
Posted by Denise528 on October 1, 2001, at 5:54:14
In reply to Re: Trying Serzone » Mr. Scott, posted by Cindylou on September 30, 2001, at 23:12:02
> Scott,
How's it going with the Serzone?
Posted by Mr. Scott on October 1, 2001, at 21:12:25
In reply to Re: Trying Serzone, posted by Denise528 on October 1, 2001, at 5:54:14
Hi Denise,
Well... I feel more tired, digestive process seems disturbed, I have some mild facial swelling, dizziness, and lightheadedness. I also feel like my body has lead balloons attached to it, but some of my anxiety has diminished. I'm at 100mg having backed down from 150mg for a few more days, so my depression, irritability is still rampant. I have to say though that I haven't thought of suicide as much.
I really hope some of the side effects diminish, and I can stick it out for a full trial. I can't believe that when i was a teenager I was able to tolerate Sinequan (a tricyclic). I am so sensitive to side effects now...
Thanks for asking!
Scott
Posted by Denise528 on October 2, 2001, at 4:08:56
In reply to Re: Trying Serzone » Denise528, posted by Mr. Scott on October 1, 2001, at 21:12:25
> Scott,
Yes I know what you mean about tolerating side effects. I'm really cheesed off. I used to take seroxat about 4 years ago and was fine on it but came off it simply because I didn't want to develop a tolerance to them. Anyway this year around about Feb started getting depressed again, tried going back on Seroxat and couldn't felt more depressed and anxious than ever. So I've now got to start all over again. It's really disappointing. Have you tried Orlanzapine?
Denise
Posted by Mr. Scott on October 2, 2001, at 23:43:16
In reply to Re: Trying Serzone, posted by Denise528 on October 2, 2001, at 4:08:56
No..Why? I've always avoided Antipsychotics for fear of gaining too much weight.. I am too vane for my own good perhaps..
Scott
Posted by dove on October 3, 2001, at 14:57:21
In reply to Re: Trying Serzone » Denise528, posted by Mr. Scott on October 2, 2001, at 23:43:16
Here's what my top strategies would be:
1) Serzone. "Start low and go Slow", as they say. 400 mgs. per day being the normal ramping goal.
2) Amitriptyline. Quite sedating for some, I've found that it fluctuates. However, I take my Amitriptyline before bed w/ 100 mgs. of Serzone.
3) Combining the above and/or adding Neurontin. Neurontin has been a very smooth med for me, and I've been staying within the 1,800 mgs per day range. Although, I have to space it into 4 individual doses throughout the day to get the desired effect (i.e. less anxiety, fewer panic attacks, and a slight lifting of my deepest depression; bringing a more stable depression.
I've never tried Effexor and would be curious to give it a go, and have even asked my p-doc for it. He isn't comfortable with some of Effexor's side-effects and discontinuation problems and has said "no" for the time being.
I'm taking Serzone at 400 mgs. per day, divided into four separate doses, and initially suffered from fatigue, light-headedness (is that a word?), brain-drain, ect... Once I reached the 400 mgs per day and stayed there for 3 weeks or so, I noticed a significant change in the side-effects. It improved my libido after having nil while taking Prozac at 20 mgs. per day. It stole the harsh edge of my anxiety problems, and just kind of smoothed things out.
Currently, I'm taking 6 different psychoactive meds, and Serzone is still on the list at 400 mgs per day. One very negative side-effect I've discovered is accidental withdrawal symptoms from hell! I miss my dose by one hour and I'm as sick as a dog and feel like my skull is caving in. I have spoken with my p-doc regarding this and he says it's probably not the Serzone but the synergistic effect going on between the different meds and the missed Serzone might be lessening the amount of my other med's active availability.
And that whole idea of going back to a med that worked previously after discontinuation is bang on! One of my current six med-cocktail is the Prozac that killed my marital relations first time around. It has a completely different feeling this time around. In fact I've moved up to 25 mgs. per day and am still not seeing the positive effects it gave me before. I wish there was some concrete evidence to explain these supposed apparitions (at least in my p-doc's view)!
I know you're still not convinced of Serzone's effectiveness, and no wonder! I would not ever rely on Serzone alone to handle my major depression or anxiety baggage, not ever!!!
dove
Posted by SLS on October 3, 2001, at 19:21:15
In reply to Re: Trying Serzone, posted by dove on October 3, 2001, at 14:57:21
Posted by Mr. Scott on October 3, 2001, at 20:56:46
In reply to Re: Trying Serzone, posted by dove on October 3, 2001, at 14:57:21
May I ask what other meds you are on? Also, how much do you drink if at all? What is your Diagnosis? Just trying to see how everything fits together. I have 4 psychiatrists...none of them agree on anything.
Scott
Posted by SLS on October 3, 2001, at 21:54:15
In reply to Re: Trying Serzone » Denise528, posted by Mr. Scott on October 2, 2001, at 23:43:16
> No..Why? I've always avoided Antipsychotics for fear of gaining too much weight.. I am too vane for my own good perhaps..
>
> Scott
Hi Scott.It seems that ziprasidone (Geodon), an atypical antipsychotic with antidepressant potential, really is free of the side effect of weight-gain. I'm taking 40mg now, a relatively low dosage. So far, I haven't noticed any increase in my appetite. I did, however, with as little as 2.5mg of Zyprexa. Many people have reported a significant antidepressant effect from it. I give you kudos for hanging in there with Serzone. Like you, I have found myself to be far less tolerant of side effects now than I was 20 years ago. It's a bit ironic, because I can afford far less to give up on a medication so quickly. I'm ready to begin a trial of Remeron. I am sure that I'm going to hate it. I don't tolerate sedating or soporific drugs very well, and I'll be pissed as hell if I gain weight. Unfortunately I don't have the luxury of picking and choosing. I guess you know the feeling.
Good luck.
- Scott
Posted by Mr. Scott on October 3, 2001, at 22:29:33
In reply to Re: Trying Serzone » Mr. Scott, posted by SLS on October 3, 2001, at 21:54:15
I couldn't agree more! I used to tolerate all kinds of stuff with little or no effect, now I take advil and can notice side effects!
Scott
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