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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by linkadge on May 17, 2003, at 4:21:15
For people here, what do you consider the
most troublesome SSRI side effect. I can tolerate
the sexual dysfunction just fine, but its the insomnia that kills me. Do people here get over the insomnia. It seems to be persistent with me.Linkadge
Posted by Caleb462 on May 17, 2003, at 5:02:47
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
> For people here, what do you consider the
> most troublesome SSRI side effect. I can tolerate
> the sexual dysfunction just fine, but its the insomnia that kills me. Do people here get over the insomnia. It seems to be persistent with me.
>
> LinkadgeI'd say sexualy dysfunction, definitely. I never got insomnia with any SSRI. I did it experience it with Effexor, but it passed.
Posted by Pfinstegg on May 17, 2003, at 7:19:18
In reply to Re: most troublesome SSRI side effect, posted by Caleb462 on May 17, 2003, at 5:02:47
The sexual side effects bothered me the most; however, after about 6 years on them, I began to notice anhedonia, and that bothered me even more. Insomnia was a problem, but I always thought it was caused by the depression rather than the medication; I assumed I had high cortisol levels at midnight, rather than really low ones the way one is supposed to.
Pfinstegg
Posted by daizy on May 17, 2003, at 8:33:07
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
Yes the insomnia was a pain when I was on effexor!
Posted by noa on May 17, 2003, at 9:42:10
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
The insomnia, for me, is taken care of by the Serzone. I have been taking the effexor-serzone combo for a long time, but over time have tweaked the ratio quite a bit. Now, I take more Serzone than Effexor (500:225). I take the serzone at night. It is sedating for me. I also take a benzo, in very small dose, for the other sleep-disrupting SE--restless legs.
Without the combo approach, for me, the insomnia would persist.
At the moment, since the insomnia is under control, I would have to say the worst SE for me is bladder urgency.
Posted by Larry Hoover on May 17, 2003, at 10:40:47
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
> For people here, what do you consider the
> most troublesome SSRI side effect. I can tolerate
> the sexual dysfunction just fine, but its the insomnia that kills me. Do people here get over the insomnia. It seems to be persistent with me.
>
> LinkadgeMy personal experience, and what drove me to try and find alternatives, was also insomnia on SSRI meds. I recall a gradually decreasing sleep duration, first six hours, then five, four, and so on, right down to zero sleep. My doctors wouldn't listen to me, claiming that I slept but just was not conscious of it. I drank (after years of abstinence), and for a little while, that helped. I got to the point where five bottles of wine after supper did not put me out. After about a week at zero sleep, I began to hallucinate (horrid, horrid). I lost the ability to speak, at times, as my mind was way faster than my mouth. I tried to call an ambulance, but I could not get words out. I just kept my faith that "this too would pass", as my doctors assured me that I would eventually become tired enough to sleep. During that time, I lost the ability to self-assess. In hindsight, it is so freakin' obvious that I should have stopped the med, but I just kept taking it, as per doctor's instructions.
It took Mellaril at 200 mg/day to bring me down. I also had to enter an inpatient addiction treatment facility, once I'd regained my ability to recognize my situation.
Your brain may vary.
Lar
Posted by johnj on May 17, 2003, at 11:56:08
In reply to Re: most troublesome SSRI side effect, posted by Larry Hoover on May 17, 2003, at 10:40:47
Hi Larry,
Hope things are going well. How is the Endad/TMG going?
I have a situation I would like to run by you in regards to sleep. I have had major stress at work due to an unforgiving manager and right now the upper management is trying to change things. My manager is bright but has run out many engineers over the years and now this has become unacceptable since the cat has been let out of the bag. I have always had motivation and like to be part of a group that stimulates each other and works as a team. Currently, everybody in our department lives in fear of our managers wrath and does not play nice in a group. Quitting is not an option right now either. Sorry for the extraneous background info.
I have realized I don't handle or don't have the ability right now to deal with this situation. I take work seriously and it is hard to just leave things at the office and sometimes I wonder what I contributed to after the day is done. My depression/anxiety has always been related to events and this is the only thing that has been extremely trying.
Two weeks ago I had a good week taking 50 mg Mg, and 75 mg or so of Ca. Last Sunday sleep was terrible. Not much anxiety, just could not fall asleep and woke early, about 5. So Maybe about 5 hrs of sleep, but not restful sleep. Monday night I was so tired I slept ok and functioned well, but things went bad on Tues, Wed, Thurs. We had a big meeting about training, since my boss has never figured out how to train people so upper management is making him(us) work with a consultant on getting a training course set up. I can only theorize that the meeting was causing me to not sleep well. I am tired of the BS. So, last night I took 30 mg of remeron since I needed something to knock me out. I tried benadrly the night before with little success(50 mg). My biggest question for you how do you maintain a good sleep regime? For example, what meds? I think some type of counseling is necessary, but wonder if my habits can be changed? I think I will try benadryl tonight and if I can't sleep I will alternate with remeron. I don't know if this is wise but I need sleep to function. The one thing that would help me coper better, and that is sleep, is what evades me. My doc just says insomnia is a symptom of anxiety or depression. In all honesty I didn't feel more anxiety or depression after three days of horrid sleep, just exhausted from lack of sleep and had a very heavy brain.
Two other things: I have had a spaced out feeling after eating. Not sleepy, just spaced out with my balance being out of whack. Any idea on what could cause this? I am not sure what type of doctor to see. My pdoc dismisses this or just writes in down and my family doc just gives me some blood tests and sends the results. I am totally frustrated right now. Since I am on tranzene, lithium, and nortryptline I think somehow this combo is messing me up. Chalk it up to age I guess. I have the need to pee at night much more than usual and I have limited my liquids after 5 pm and still have the problem(lithium?).
Larry, I am sorry to throw so much at you, but you seem to have a good grasp of things much more than myself. Any help or suggestions would be greatly appreciated as always. One thing I did do was add niacinamide and it calmed me, but I wonder if it could be somewhat activating since it is a B vitamin. I take no Mg, and miss it's affect to help sleep greatly, well as far as quality goes that is. Even on Mg I would just fall asleep quick without the usual yawing etc., a little unnatural for me, but it did work for awhile.
Have you ever tried therapy and did it work? I wonder if TMG or Enada would help any spaciness. I just wish I knew what type or could find a doc that knows meds and supplements. Thanks Larry. I hope my questions are not too vauge and you have some theories. I have realized that some supplements are just as powerful as some meds. Take care and drive safe. Maybe between all our troubles we can learn enough to help each other.johnj
Posted by McPac on May 18, 2003, at 16:08:26
In reply to Re: most troublesome SSRI side effect, posted by Larry Hoover on May 17, 2003, at 10:40:47
I can NOT sleep UNLESS "knocked out" by a drug, such as Remeron. I had this problem even before SSRI's. I see a lot of posts re: insomnia caused by a med BUT see NONE in which someone says they can't EVER sleep, indefinitely, on their "own". They may not sleep due to worsening depression, anxiety, etc., but I have lost the ability to sleep on my own.
Posted by McPac on May 18, 2003, at 16:09:49
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
for me, the sexual problems AND anger/temper are the worst s/e's.
Posted by fairnymph on May 18, 2003, at 21:31:29
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
Definitely sexual dysfunction.
I've never had insomnia problems, only if I took the med at night, otherwise I was fine.
On zoloft, it was actually the TREMOR that was unbearable for me.
Prozac was *perfect* except for no libido, no orgasm.
Posted by Ritch on May 19, 2003, at 9:32:13
In reply to most troublesome SSRI side effect, posted by linkadge on May 17, 2003, at 4:21:15
> For people here, what do you consider the
> most troublesome SSRI side effect. I can tolerate
> the sexual dysfunction just fine, but its the insomnia that kills me. Do people here get over the insomnia. It seems to be persistent with me.
>
> Linkadge
I think that sleep-disruption caused generally by SRI's is what tends to bring on manic symptoms for me. The most annoying side effect from SRI's for me is diarrhea and GI-distress (including acid reflux).
Posted by Angel Girl on May 19, 2003, at 15:27:33
In reply to Re: most troublesome SSRI side effect » linkadge, posted by Ritch on May 19, 2003, at 9:32:13
After more than 1 1/2 years, the absolute worst se for me is definitely, without a doubt:
I N S O M N I A
I can't seem to get a handle on it. :(Angel Girl
Posted by Angel Girl on May 19, 2003, at 15:29:56
In reply to Re: most troublesome SSRI side effect, posted by noa on May 17, 2003, at 9:42:10
Noa
I also suffer from RLS. What benzo are you taking and what dosage? Has it eliminated the problem totally?
Thanks,
Angel Girl> The insomnia, for me, is taken care of by the Serzone. I have been taking the effexor-serzone combo for a long time, but over time have tweaked the ratio quite a bit. Now, I take more Serzone than Effexor (500:225). I take the serzone at night. It is sedating for me. I also take a benzo, in very small dose, for the other sleep-disrupting SE--restless legs.
>
> Without the combo approach, for me, the insomnia would persist.
>
> At the moment, since the insomnia is under control, I would have to say the worst SE for me is bladder urgency.
Posted by linkadge on May 19, 2003, at 15:41:22
In reply to Re: most troublesome SSRI side effect » noa, posted by Angel Girl on May 19, 2003, at 15:29:56
I've lost all concept of a good nights sleep.
Even when I *sleep* I am half awake. This has been going on for years. Remeron was fine for sleep but I could not concentrate on anything for the constant hunger.
Linkadge
Posted by linkadge on May 19, 2003, at 15:42:50
In reply to Re: most troublesome SSRI side effect » noa, posted by Angel Girl on May 19, 2003, at 15:29:56
Does anyone know this.
I've heard it is 5HT-2 but which one A,B,C ?
Periactin is short acting antagonist at A, and C.
Would this help the insomnia at all ??
Linkadge
Posted by JaneB on May 19, 2003, at 20:29:12
In reply to Which 5HT receptors involved in insomnia, posted by linkadge on May 19, 2003, at 15:42:50
> Does anyone know this.
>
> I've heard it is 5HT-2 but which one A,B,C ?
>
> Periactin is short acting antagonist at A, and C.
>
> Would this help the insomnia at all ??
>
> Linkadge
>
>I don't know about you but years ago I took Periactin for trigeminal neuralgia and I remember thinking "Wow, I am sleeping better than I have in years." But I also felt sleepy in the day time.
Posted by JaneB on May 19, 2003, at 20:38:23
In reply to Re: most troublesome SSRI side effect, posted by linkadge on May 19, 2003, at 15:41:22
Klonopin has been a sleep saver for me.
Posted by Caleb462 on May 20, 2003, at 3:12:16
In reply to Which 5HT receptors involved in insomnia, posted by linkadge on May 19, 2003, at 15:42:50
> Does anyone know this.
>
> I've heard it is 5HT-2 but which one A,B,C ?
>
> Periactin is short acting antagonist at A, and C.
>
> Would this help the insomnia at all ??
>
> Linkadge
>
>I believe 5-HT2a is associated with SSRI insomnia, so certainly an antagonist at 5-HT2a/5-HT2c could help. Of course, at the same time - antagonism of 5-HT2c can be "activating", so....
Posted by Mama Bear on May 20, 2003, at 22:02:08
In reply to Re: most troublesome SSRI side effect » Caleb462, posted by Pfinstegg on May 17, 2003, at 7:19:18
There are alot of side effects that you may not realize with SSRI medications as well as any psychiatric medication. Do your homework. Search out the side effects. Make sure you know your own medical history and all the medications your on. Some of these medications do have interactions that are not good as well. Good luck. Mama Bear
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