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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Elizashae on April 19, 2001, at 15:41:23
Hello all. I'm new to this board and am in need of advice.
I have major depression and Panic. I'm currently taking 15mgs of Remeron(just started), .5 to .75 of klonopin(weaning off) and just finished Paxil at 40 mgs and am jumping over to prozac at 20mgs.
I guess the advice I'm looking for is I've tried all the SSRI's and they don't do much for me. I've also been on Wellburtrin, Serezone, Effexor XR, trazadone, etc....to much to name.
I do have problems with eating and sleeping to much when depressed and when on anti-depressants.
Please....what route do I take now?
Posted by SalArmy4me on April 19, 2001, at 17:03:45
In reply to What to do, posted by Elizashae on April 19, 2001, at 15:41:23
Write down all the medications you have taken, and I guarantee that I will be able to find 10 more good options for you.
> Hello all. I'm new to this board and am in need of advice.
> I have major depression and Panic. I'm currently taking 15mgs of Remeron(just started), .5 to .75 of klonopin(weaning off) and just finished Paxil at 40 mgs and am jumping over to prozac at 20mgs.
> I guess the advice I'm looking for is I've tried all the SSRI's and they don't do much for me. I've also been on Wellburtrin, Serezone, Effexor XR, trazadone, etc....to much to name.
> I do have problems with eating and sleeping to much when depressed and when on anti-depressants.
> Please....what route do I take now?
Posted by ShelliR on April 19, 2001, at 18:29:30
In reply to What to do, posted by Elizashae on April 19, 2001, at 15:41:23
Elizashae, Given your history with trying all sorts of ssri +, I'd be inclined to try an MAOI. There are some dietary restrictions, but eventually you learn what you can eat on the list without affecting you. I see them as life-saving drugs for depression, since I believe they saved mine. Unfortunately, they may take up to six weeks to kick in, and your choice of combining other meds with them is more limited.Shelli
Posted by Fred Potter on April 19, 2001, at 20:48:31
In reply to What to do, posted by Elizashae on April 19, 2001, at 15:41:23
I got Prozac to work again by adding 25mg Naltrexone daily. See the TIPS section. It doesn't work for everyone though. The fact that you're sleeping more, rather than less, I think points to "atypical depression". Which is what I have, along with unremitting anxiety.
Good luck
Fred
Posted by Elizashae on April 19, 2001, at 22:58:27
In reply to Re: What to do, posted by SalArmy4me on April 19, 2001, at 17:03:45
Ok, I'll try and remember all meds, but I don't think I can remember exactly how much or why I stopped. I've had depression since I was thirteen and I'm 27 now.....
Paxil
Prozac
Zoloft
Celexa
Wellbutrin SR
Effexor XR
Remeron(just started)
Trazadone
Klonopin
Valium
Tofranil
Serezone
Hmmmmm...I thinks that's it. I guess what I want out of a medication is less anxiety, my energy back, more motivation, hopefully no weight gain and I really hate my sex drive being gone.....I have no idea what it's like to feel normal or even if there is such a thing.
Maybe I haven't tried the right combo...or the right drug. Who knows.> Write down all the medications you have taken, and I guarantee that I will be able to find 10 more good options for you.
>
> > Hello all. I'm new to this board and am in need of advice.
> > I have major depression and Panic. I'm currently taking 15mgs of Remeron(just started), .5 to .75 of klonopin(weaning off) and just finished Paxil at 40 mgs and am jumping over to prozac at 20mgs.
> > I guess the advice I'm looking for is I've tried all the SSRI's and they don't do much for me. I've also been on Wellburtrin, Serezone, Effexor XR, trazadone, etc....to much to name.
> > I do have problems with eating and sleeping to much when depressed and when on anti-depressants.
> > Please....what route do I take now?
Posted by SalArmy4me on April 19, 2001, at 23:41:38
In reply to Re: What to do » SalArmy4me, posted by Elizashae on April 19, 2001, at 22:58:27
Lamotrigine - good side-effect profile; most antidepressant properties of the anticonvulsants.
Carbamazepine XR- less side effects than Lithium or divalproex sodium.
Topiramate - the newest mood-stabilizer; it promotes weight loss.
Buspirone - an effective antidepressant and anxiolytic at high doses.
Maprotiline - a tetracyclic that came out around the time as Prozac did but has no hype; it has fewer side-effects than tricyclics; it is unique because it works on noradrenaline.
Moclobemide (RIMA) - requires none of the dietary restrictions as traditional MAOIs; it is very stimulating and is a dream to take compared to phenelzine.
Pramipexole - proven effective in depressive illnesses by two studies on Medline.
Augmentation of anything you have tried before with Lithium, Pindolol, or buspirone (I take pindolol). http://www.med.nyu.edu/Psych/aug/
Augmentation of anything you have tried with stimulants such as methylphenidate, dexedrine, or pemoline.
Atypical Neuroleptics/Antipsychotics with antidepressant properties: Risperidone, Olanzapine, Quetiapine, Ziprasidone (newest).
Provigil - a stimulant that is a possible mood-brightener according to studies done on mammals.
Selegiline (MAOI-B), an antidepressant that at 20 mg TID is almost comparable to 30 mg Phenelzine.
> Paxil
> Prozac
> Zoloft
> Celexa
> Wellbutrin SR
> Effexor XR
> Remeron(just started)
> Trazadone
> Klonopin
> Valium
> Tofranil
> Serzone
Posted by JohnL on April 20, 2001, at 4:40:52
In reply to What to do, posted by Elizashae on April 19, 2001, at 15:41:23
> Hello all. I'm new to this board and am in need of advice.
> I have major depression and Panic. I'm currently taking 15mgs of Remeron(just started), .5 to .75 of klonopin(weaning off) and just finished Paxil at 40 mgs and am jumping over to prozac at 20mgs.
> I guess the advice I'm looking for is I've tried all the SSRI's and they don't do much for me. I've also been on Wellburtrin, Serezone, Effexor XR, trazadone, etc....to much to name.
> I do have problems with eating and sleeping to much when depressed and when on anti-depressants.
> Please....what route do I take now?It sounds to me like you could do well with either a stimulant, an antipsychotic, or both. My personal preference would be to add Zyprexa to your favorite SSRI so far. Give it two weeks. If needed, then try Risperdal for two weeks as a comparison. On the back burner could be Ritalin and Adderall for future trials if needed.
I mention these two classes of meds because we happen to see a good amount of success stories with them, most especially in patients who have not done well with a variety of antidepressants.
John
Posted by ShelliR on April 20, 2001, at 9:27:57
In reply to Re: What to do » SalArmy4me, posted by Elizashae on April 19, 2001, at 22:58:27
Elizashae. I would think it would be confusing to have so many different antidepressants/antipsychotics/mood stablizers suggested to you at the same time. You might want to look over the suggestions then go to:
www.psycom.net/depression.central.drugs.htmlwhere the drugs are broken down into categories and there is much more information about each. Good luck. Shelli
Posted by PaulB on April 20, 2001, at 13:56:43
In reply to Re: What to do » Elizashae, posted by ShelliR on April 20, 2001, at 9:27:57
> Elizashae. I would think it would be confusing to have so many different antidepressants/antipsychotics/mood stablizers suggested to you at the same time. You might want to look over the suggestions then go to:
> www.psycom.net/depression.central.drugs.html
>
> where the drugs are broken down into categories and there is much more information about each. Good luck. ShelliAs an alternative to the many prescription drugs being offered you may like to try a natural alternative. I dont mean St johns wort. If Prozac or another SSRI has stopped working for you that wont help. Id suggest you try either 5-HTP which is the natural precursor to serotonin or/and L-Tyrosine which is the natural precursor to dopamine and noradrenaline. Tips-take these supplements on an empty stomach, take a B-Complex and if you can afford it take SAM-E too.
Over here in the UK we have L-Tryptophan available still(precursor to 5-HTP) but ONLY for severe depressives who have not responded to anything else. On a positive note these supplements have both helped me.
Posted by Elizashae on April 20, 2001, at 14:39:21
In reply to Re: What to do , posted by PaulB on April 20, 2001, at 13:56:43
Thanks to all who responded. I'm taking these ideas with me to my therapist. I'm much more hopeful now:)
Posted by kate9999 on April 20, 2001, at 21:16:36
In reply to Re: What to do » SalArmy4me, posted by Elizashae on April 19, 2001, at 22:58:27
All that and you've never tried an MAOI inhibitor? Especially if you have oversleeping and overeating you should consider it.
> Ok, I'll try and remember all meds, but I don't think I can remember exactly how much or why I stopped. I've had depression since I was thirteen and I'm 27 now.....
> Paxil
> Prozac
> Zoloft
> Celexa
> Wellbutrin SR
> Effexor XR
> Remeron(just started)
> Trazadone
> Klonopin
> Valium
> Tofranil
> Serezone
> Hmmmmm...I thinks that's it. I guess what I want out of a medication is less anxiety, my energy back, more motivation, hopefully no weight gain and I really hate my sex drive being gone.....I have no idea what it's like to feel normal or even if there is such a thing.
> Maybe I haven't tried the right combo...or the right drug. Who knows.
>
> > Write down all the medications you have taken, and I guarantee that I will be able to find 10 more good options for you.
> >
> > > Hello all. I'm new to this board and am in need of advice.
> > > I have major depression and Panic. I'm currently taking 15mgs of Remeron(just started), .5 to .75 of klonopin(weaning off) and just finished Paxil at 40 mgs and am jumping over to prozac at 20mgs.
> > > I guess the advice I'm looking for is I've tried all the SSRI's and they don't do much for me. I've also been on Wellburtrin, Serezone, Effexor XR, trazadone, etc....to much to name.
> > > I do have problems with eating and sleeping to much when depressed and when on anti-depressants.
> > > Please....what route do I take now?
This is the end of the thread.
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