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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by AVR on August 1, 2001, at 23:50:51
Hi, I am a 17(almost 18) year old male from Canada and I have been on Paxil for almost 2 years now for my dysthymia (depression and being down most of the time) and for my anxiety and panic attacks. I have been coming off this AD now for around a month. I went from 20 mg/day to 5mg/day in 3 weeks and then quit completely and now I am off Paxil for 1 week and notice my mental illnesses are returning. I am feeling anxiety and the shyness that the anxiety made me have before. When I was on Paxil it made me feel less bad but The problem was that I felt less bad when I was angry at someone as well. And if I dwelled on negative thoughts such as revenge I did not get the guilty feelings associated with these thoughts that would normally be there, and should be there. I was able to "go-off" on someone that angered me and do it with little guilt. And I made comebacks when people made fun of me which I normally didn't have the strenth to doo when not on an AD. I had dreams about killing friends and people that angered me and after the dream I felt absolutely no remorse whatsoever. I was only slightly angry. This scared me because I was not in the right state of mind and reality was far away from me. I'm off this awful AD now and have the strength to write about my experience with Paxil. My point is that the drug seemed to suppress bad feelings whether they were warrented or not , such as when they should be present when doing or thinking cruel thoughts, such as shame, or horror for one's indecent thoughts or actions. My experience is similar to a news story I saw someone write about. This was around the time Prozac first came out. This woman was on Prozac and killed her mother with a steak knife. She blamed it on Prozac. There is a connection. Before going on Paxil People knew that I had weird problems and didn't know what was wrong with me and just thought I was a screwed up person (ex. I had a panic attack after spilling water on this guy I hardly knew. I couldn't say I was sorry instead my face got bright red and my heart started beating fast.) I couldn't even tell my friends what was wrong with me cause I knew they wouldnt understand that I was having a "panic attack". This is a major problem with people now. Has this "cold-blooded" side effect ever been noticed about antidepressants??
IS THERE ANY WAY OUT OF THIS??? I AM THINKING OF TRYING A NEW SSRI (celexa) BUT I KNOW THERE IS A GOOD POSSIBLITY OF THIS AWFUL SIDE AFFECT COMING BACK.
Also, Marijuana gives me panic attacks so I usualy just smoke with a friend that knows I get like that and them I'm usualy fine and enjoying the high.
What should I do now? I could Stay off the AD's and deal with my dysthymia which I don't want to do.
Does anyone have any advice or replys on this thread because I would like to hear anything! Thanks!
Posted by MM on August 2, 2001, at 2:11:29
In reply to I never had a panic attack for 2 years until now!, posted by AVR on August 1, 2001, at 23:50:51
Well some people get an "I don't care" or apathetic reaction to SSRI's. I don't know exactly what type of reaction you had (hopefully someone else will) but it sounds like you may have gotten psychotic on paxil. I don't know exactly how that could have happend (unless you were manic, but I don't know if many manic people think about killing people). I don't doubt that paxil could be the cause, as I have had my share of problems with SSRI's, and there seems to be some credible evidence that this reaction can happen.
I'm not quite sure what brain chemical causes panic attacks (I thought it was serotonin but I guess I am mistaken. Marijuana is a serotonergic drug BTW, and I get panicky on it too). I have tried many SSRI's and both the SNRI's, and I think if one doesn't work, the others most likely won't either, but I don't know for sure. Celexa might be quite different than paxil. Someone who knows will probably be able to answer that for you. I don't know much about dysthymia, but I'm sure there's other types of meds you can try. Sorry I didn't know anything :).
BTW did you tell your pdoc about the dreams and anger etc.?? You really should if you haven't because if that's the reaction you got, I don't know if he would prescribe another SSRI if he knew, and if he would after knowing that, I don't know if you have the best pdoc. I don't see why you should try ALL the SSRI/SNRI's before it's clear that you don't tolerate them well, just because they're trendy. JUST MY OPINON THOUGH.
Posted by grapebubblegum on August 2, 2001, at 9:08:48
In reply to I never had a panic attack for 2 years until now!, posted by AVR on August 1, 2001, at 23:50:51
Now, wait a minute and let's not throw around the word "psychotic" just because he is honest enough to say that he had some angry feelings that were not accompanied with guilt. I think everyone has angry feelings and here is my theory:
SSRIs can liberate you enough that you do not feel shy or inhibited socially; the bad side is that your anger is liberated such that you don't necessarily hurt people but you can "tell off" people like you couldn't before (this parallels the previous inability to just make social conversation; see the continuum here?) and that you can consciously experience thoughts of anger toward people that previously you may have suppressed WAY down deep, such that you weren't even aware of these thoughts in your dream life or couldn't recall these dreams.
In other words, it is true that SSRIs can bring on a degree of apathy. My opinion is that they reduce anxiety to the degree that sometimes you are not as careful as you should be. Or that you have less of a conscience than you previously did. Which is good if your conscience was turned up to warp speed, but not so good if you're doing things that are out of character and unpleasant...
Maybe a different dose or a different SSRI could be tried, or maybe a different medication altogether. But I would advise AVR to keep the doctor informed of any disturbing thoughts; you don't have to go into complete detail but you could tell him/her that you are experiencing unaccustomed and uncomfortable revenge or anger feelings and dreams accompanied with a notable lack of remorse. I'm sure there is a way your medication could be tweaked to put you in a comfort zone.
Posted by MM on August 2, 2001, at 18:54:01
In reply to Re: I never had a panic attack for 2 years until now!, posted by grapebubblegum on August 2, 2001, at 9:08:48
I'm sorry I implied that you were psychotic AVR. I didn't mean to scare you or anything. I would be concerned if Paxil caused these feelings etc. is all, and I think your pdoc needs to know if he doesn't already. I agree with grape, that you don't need to go into details, but if you don't tell him something, he might just keep prescribing the same class of meds, and that could do more harm than good (if it's not JUST the paxil and is SSRI's in general causing this).
grapebubblegum
Is psychosis only hearing or seeing things? I thought there were degrees of it? I don't think the thoughts are completely uncommon. It's the urge to act on it right? That's what would be considered psychotic? Bagh I dunno. I'm sorry I threw that word around.
Posted by grapebubblegum on August 3, 2001, at 8:43:31
In reply to Re: I never had a panic attack for 2 years until now!, posted by MM on August 2, 2001, at 18:54:01
Sorry, MM - I didn't catch that part until I re-read it, the part about "I was out of my normal mind." So it doesn't really matter what word was used, anyway. If someone is worried that they are not feeling like or acting like themselves, I'm sure it is a reason for concern. I don't know anything about definitions; I guess my Freudian slip was showing because I am a little sensitive now because I have been going through stuff just a tad similar to what AVR described, although not similar down to the last detail, of course.
Check back in with us, AVR. It would be good to know how you are doing.
Posted by AVR on August 3, 2001, at 13:38:04
In reply to Re: I never had a panic attack for 2 years until now!, posted by grapebubblegum on August 2, 2001, at 9:08:48
Thanks for the help mm and grape. I went to my doc yesterday and I told him I got like that on Paxil and I said maybe I should try a new SSRI like Celexa, an SSRI that is supposed to have fewer side effects than the other SSRI's. He perscribed it for me (20 mg) so I am going to try it anyway and hope for the best. I am going to a mental health clinic in a few weeks so I feel a little better about that. I don't want to get pyschotic again on Celexa and be far away from reality. I found it extremly hard to communicate with my family on Paxil and I didn't like this one bit. Maybe the "I don't care" feeling is the only way for me to beat depression and anxiety. I hope to find the best meds for my problems. Oh, I forgot to mention I have a neurological disorder called terrets syndrome. Terretts is a form of OCD where you have uncontrolable tics. it is really awful. When I was a child I would do everything from making weird noises in class to jumping up and down uncontrolably but now it's settled down to problems with twitching my eyes and neck muscles. Paxil helped this ALOT.
I was a very social person on Paxil but now off the Paxil I try to avoid certain social cituations and my OCD, anxiety and depression symptoms are returning.
I was never diagnosed with Generalized Anxiety Disorder but I have all of the symptoms of this and I read that Celexa makes GAD worse!!
I hate living like this. The only thing that keeps me going is knowing that other people have these very same problems. I used to seriously think that I was the only person experiencing these problems.
Sorry If I didn't explain myself very well. I'm spaced out a little bit today. I hope for the best though.
Posted by MM on August 3, 2001, at 17:58:04
In reply to Re: I never had a panic attack for 2 years until now!, posted by AVR on August 3, 2001, at 13:38:04
I hope the celexa works better for you, but if not, you'll be able to recognize it sooner I think, and tell someone at least.
Does anyone know if an SNRI would be better for AVR?
Posted by AVR on August 3, 2001, at 21:55:50
In reply to AD experts, help AVR out , posted by MM on August 3, 2001, at 17:58:04
Thanks MM! I think you may be right. I think I should try effexor which seems right for me due to my Dysthymic symptoms and G.A.D./O.C.D which effexor is approved for.
I was recently perscribed Celexa but I am not going to try it due to my Paxil experience which is almost the same drug as Celexa. I hate to be up and down on anti-depressants but I think effexor is my way to go. Does anyone have any advice? Thanks
Posted by MM on August 3, 2001, at 22:25:57
In reply to Re: AD experts, help AVR out , posted by AVR on August 3, 2001, at 21:55:50
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Posted by Cam W. on August 3, 2001, at 22:59:59
In reply to Re: AD experts, help AVR out , posted by AVR on August 3, 2001, at 21:55:50
AVR - The Effexor may be the way to go, but it may not take away all of the OCD symptoms, but should help with the GAD. Also, it may take a while to treat the OCD symptoms effectively (if it does); sometimes up to 6 months.
The most common agent we use is probably Paxil for GAD/OCD, and then Zoloft, but since you have problems with the SSRIs, Effexor may be the next step.
To further help the OCD symptoms, psychotherapy, especially things like desensitization, and the like, so that you can learn to deal with the residual OCD symptoms (if they occur).
Ask your doctor about these and see what he/she says about the things I have mentioned.
I hope that this is of some help. - Cam
This is the end of the thread.
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