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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by gritslad on January 9, 2005, at 16:55:58
I know I should be consulting my doc, but I always like to go in with some information so as to avoid more needless trial and error.
For the past 14 years, I have been on and off various AD's. I've taken Prozac (worked great for many years), Zoloft (did little), Paxil (huge weight gain), Effexor (sex problems) Celexa (ok nothing great) and now Lexapro. Honestly I haven't been taking the Lex much, but plan to start to see if it's the one or if I need to move on.
My depression is definitely worse in the winter. Now my question, from my exhaustive reading I've decided that I may be a candidate for the kinds of AD's that affect dopamine and norepenine (sp) more than the serontonin reuptake drugs. I am often bored and can't seem to find enjoyment from what a 44 year old is supposed to find enjoyment in (a perfect child, a perfectly fine husband, the suburbs). I remind myself too much of Emma Bovary these days, so I'd really like to find an alternative to arsenic. I procrastinate and lack focus. I've also considered the need for ADD drugs. Oh, I know another major depression trigger for me this year is that after 19 years teaching in one school system, I transferred to another system where I feel completely alone and alienated. At my old school system, my kids loved me and my social life has always revolved around my teacher friends. Now I have snotty kids and haven't made many friends yet. I know this may pass, but it's damn hard right now.
If this sounds like any of you, and you have drug recs or advice, PLEASE send them on.
You can also email me at gritslad@hotmail.com
Posted by King Vultan on January 9, 2005, at 23:16:29
In reply to AD recs for me, posted by gritslad on January 9, 2005, at 16:55:58
I would suggest considering Wellbutrin, nortriptyline, and Parnate in that order. All of these have relatively low sexual side effects, and Wellbutrin and Parnate have overt dopaminergic effects that may be helpful for ADD symptoms. I have tried all of these and found Parnate to be the best overall, but it is an MAOI with consequent dietary and drug restrictions (which are really fairly easy to follow IMO).
I did not really start to make any real progress myself until I got away from heavily serotonergic drugs like the ones you mention and started trying drugs with much stronger effects on norepinephrine and dopamine. If you also have seasonal affective disorder (which I do not, but it is relatively common), I would suggest considering some of the therapies that seem to have some effectiveness for this, as well, if you haven't tried some of them already.
Todd
Posted by Emily Elizabeth on January 10, 2005, at 18:21:38
In reply to AD recs for me, posted by gritslad on January 9, 2005, at 16:55:58
You mentioned your doctor--do you see a psychiatrist for meds or just your regular doc? If you don't see a psychiatrist, I would suggest that you start to do so. General practitioners do not have enough specialized training to be effective prescribers for psych meds, especially when they have a patient who doesn't have enough response to the typical "first line" meds. I work in the mental health field and I have seen way too many people poorly treated by general practitioners.
That said, have you ever considered a combo of multiple meds? Sometimes people will like some of the effects of some of the meds that you mentioned, but not like the side effects. Sometimes this can be helped by combining w/ something else (like Welbutrin).
Best,
EE
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