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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 47. This is the beginning of the thread.
Posted by SLS on February 22, 2009, at 13:31:50
Could people describe in what ways they experience med-sensitivity?
1. Describe the symptoms or effects?
2. List some drugs and dosages?
3. Also, it would be important to know if one had experienced one or more withdrawal syndromes from discontinuing drugs too quickly prior to becoming med-sensitive.
Thanks.
- Scott
Posted by Phillipa on February 22, 2009, at 17:44:20
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
Scott during menopause very sensitive to anything but benzos. I'd take an ad and get sick. Did stay on paxil l0mg for about two years with benzos. Now just stay on the luvox and benzos and they now make me tired the benzos that is. Been on all the SSIr's and cymbalta strange as could take 60mg hence when found babble and weaned off it as didn't notice a thing from it. Then up here that doc Rx'd 30mg cymbalta one week, 60mg second week, 90mg third week, and then 120mg. He scared me and I only lasted this time for a week. So many stories could tell. Love Phillipa ps withdrawal only from paxil tiny bites of the pill and dizzyness zaps gone. Now this luvox different story can't get off the low dose how dumb is that?
Posted by sam K on February 23, 2009, at 8:54:09
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
luvox....... gave me this awareness in my teeth all the time it seemed like. I hate that, its just so unfair. I played with my teeth with my tongue and lips all the time and they felt loose. Now I get it from all the ssris when I never used to....
Posted by sam K on February 23, 2009, at 8:55:26
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
oh yeah and abilify at 1 mg I had real bad tiredness. It was like I was shot with a dart and I just was out automatically for and hour. I felt real weird also.
Posted by SLS on February 23, 2009, at 9:20:32
In reply to Re: Being Med-Sensitive., posted by sam K on February 23, 2009, at 8:54:09
> luvox....... gave me this awareness in my teeth all the time it seemed like. I hate that, its just so unfair. I played with my teeth with my tongue and lips all the time and they felt loose. Now I get it from all the ssris when I never used to....
Did you go through withdrawal when you discontinued Luvox? How about any other drugs?
- Scott
Posted by NewQuestions on February 23, 2009, at 15:01:39
In reply to Re: Being Med-Sensitive. » sam K, posted by SLS on February 23, 2009, at 9:20:32
After years on SSRI's, I have become severely hypersensitive to:
1. B vitamins, magnesium, choline (too activating)
2. Amino acids like 5-thp and inositol (more depressed and nauseous within 24 hours)
3. Any antidepressant that affects sertonin dompanine or norepinhperine (usually, I experience a boost the first few days (boost of adrenalin?) and after a few weeks every side effect in the book kicks in)
4. Benzos (more depressed within 24 hours)I do not appear hypersensitive to:
1. Most foods
2. Caffeine
3. Vitamin E (other vitamins?)
4. LamictalSome have surmised the cause is a hyperactive glutamatergic system from withdrawal. Does anyone have any other theories?
Posted by SLS on February 23, 2009, at 16:17:59
In reply to Re: Being Med-Sensitive., posted by NewQuestions on February 23, 2009, at 15:01:39
> After years on SSRI's, I have become severely hypersensitive to:
>
> 1. B vitamins, magnesium, choline (too activating)
> 2. Amino acids like 5-thp and inositol (more depressed and nauseous within 24 hours)
> 3. Any antidepressant that affects sertonin dompanine or norepinhperine (usually, I experience a boost the first few days (boost of adrenalin?) and after a few weeks every side effect in the book kicks in)
> 4. Benzos (more depressed within 24 hours)
>
> I do not appear hypersensitive to:
>
> 1. Most foods
> 2. Caffeine
> 3. Vitamin E (other vitamins?)
> 4. Lamictal
>
> Some have surmised the cause is a hyperactive glutamatergic system from withdrawal. Does anyone have any other theories?Who besides me has offered this as a hypothesis? I would love to read what they have to say. Maybe there are similarities in our conclusions and supporting evidence.
http://www.dr-bob.org/babble/wdrawl/20050214/msgs/460726.html
- Scott
Posted by NewQuestions on February 23, 2009, at 16:36:07
In reply to Re: Being Med-Sensitive., posted by SLS on February 23, 2009, at 16:17:59
See: http://paxilprogress.org/forums/showpost.php?p=528943&postcount=317
The poster goes by "altostrata". She has been researching this issue for over 4 years. See other posts by her for additional explanations on this site.
She made brief reference to a Dr. Shelton who suggested "dephospherization" (sp?) of the receptors or something like that. Have you ever heard of that? Not sure she buys it.
Any idea why I am hypersensitive to some things but not other things?
Also, do you think transcranial mangnetic stimulation would help the protracted withdrawal symptoms? Or is the fact that I am hypersensitive rule it out?
Posted by SLS on February 25, 2009, at 12:31:29
In reply to Re: Being Med-Sensitive., posted by NewQuestions on February 23, 2009, at 16:36:07
> See: http://paxilprogress.org/forums/showpost.php?p=528943&postcount=317
>
> The poster goes by "altostrata". She has been researching this issue for over 4 years. See other posts by her for additional explanations on this site.Thanks.
> She made brief reference to a Dr. Shelton who suggested "dephospherization" (sp?) of the receptors or something like that. Have you ever heard of that? Not sure she buys it.
No. It sounds like a second messenger ATP thing?
> Any idea why I am hypersensitive to some things but not other things?
It would be very helpful to have a list of the medications that you are and are not hypersensitive to, and whether or not you ever experienced a severe or protracted SRI discontinuation withdrawal syndrome.
> Also, do you think transcranial mangnetic stimulation would help the protracted withdrawal symptoms?I don't think it would help. The foci of the magnetic flux are located in the prefrontal cortex, a region that is downstream from serotonergic pathways. The magnetic field does not make it much beyond the skull, so deeper brain regions are unaffected directly. Just a guess.
> Or is the fact that I am hypersensitive rule it out?
There is just too little study in this area to be able to draw from. That leaves us laymen to have to guess and theorize about things we barely understand. My kindling theory is just that, an uncorroborated theory. I don't think it is a complete explanation for all of the symptoms of the post-discontinuation withdrawal syndrome. I should think that dysregulated receptor function as the result of chronic bathing in serotonin is partially to blame.
Ask more questions. It helps provoke creative thought.
- Scott
Posted by NewQuestions on February 25, 2009, at 12:45:34
In reply to Re: Being Med-Sensitive. » NewQuestions, posted by SLS on February 25, 2009, at 12:31:29
See prior post for a list of meds I am hypersensitive to. The only thing I am on now is lorazapam (the only benzo I could tolerate), but I think it is now making me MORE depressed and confused, so I am tapering pretty quickly.
Posted by bleauberry on February 25, 2009, at 18:10:30
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
If you could take the number 100 and divide into two parts...one part efficacy and one part side effect intensity, here is my symbolic description of med sensitivity...
Normal sensitivity = 75 parts efficacy,
25 parts side effectsMed-sensitive = 5 parts efficacy,
95 parts side effectsFor me, 1.25mg Zoloft today feels in terms of side effects the way 50mg used to feel years ago, and the efficacy it now has is only a whimper, if anything at all, of what it used to have. Counting the number of side effects is multitudes higher than the few that used to exist.
In the same category of med-sensitivity, as I believe, is paradoxical reaction. That is, whatever type of mechanisms used to be somewhat helpful and tolerable (ie ssris) now profoundly worsen the baseline symptoms and have completely intolerable side effects, as well as a long list of side effects that never previously existed.
20mg prozac used to feel somewhere between neutral and a good cup of coffee...a pleasant but sligth buzz without much in the way of side effects sexually, appetite, sleep, or anything else. Today it feels like being shot with an elephant dart, total castration, complete loss of ability to eat, and a deep rapid plunge into a serious dark place where all one can think about is the hospital, and body wide inflammation response, and on and on.
1.25mg Zoloft now feels like super powerful poison, where 50mg used to feel like I wasn't sure I was taking anything at all except for the clue that there was some mild anorgasmia. And people say I look so down and ask if everything is ok.
1mg xanax used to feel slightly antidepressive, relaxing, and desirable. Now it feels like an overdose of a barbituate.
I used to take 3 300mg tabs of St Johns Wort without much problem. A bit stimulating, some teeth grinding. Now it is a serious chore to start at 1/4 pill and increase to 150mg, which feels like what taking 20 pills at a time might have felt like years ago.
Wellbutrin used to be tolerable, though not effective, at 300mg, with only ringing in the ears, slight loss of appetite, slightly disturbed sleep, and slight boost in sex drive as side effects. Today a mere 75mg is like total castration and a trip to the coffin.
But it isn't just meds. I suspect if most people who are med sensitive took some detailed labs to test for food intolerances and reactions, they would find a bunch they aren't aware of. For me it is gluten, but there could be others. I used to be able to drink 4 to 5 large cups of coffee a day like it was water. Now I can not handle any more than 2 small half-filled cups in a day or else there is serious overstimulation, irritation, agitation, and general dysphoric nervousness. But it used to be as benign as water and I drank it for the taste since it had no effect.
My LLMD is very familiar with med sensitivity since most Lyme patients display extreme sensitivities and paradoxical reactions. He says when administering psych meds he has developed a better mousetrap, though I don't yet know what that is. I suspect it is probably multiple meds all in extremely tiny doses. He did make a rather bold statement, "I have never had a patient's depression I couldn't fix." Wow.
I do not believe med sensitivity lies in the glutamate circuitry, though that could certainly play a part. I believe it is a body-wide reaction involving multiple systems of immune, digestion, liver, receptor sensitivity, amino acid metabolism...basically, everything. The whole body and all its functions.
One theory I have is that when someone is med senstivite, they are sensitive to the basic mechanism of the med, not the med itself. For example, with a long history of reuptake inhibitors and recently developed med sensitivity, it would suggest to me their reuptake inhibitor days are over and they now must focus on other mechanisms, ie maois.
I hate the whole reuptake inhibitor theory anyway. The more I think about it the more it seems so stupid. Those receptors serve more functions than merely taking up spent serotonin. Go block those things and you're asking for longterm trouble. Better to just increase the neurotransmitters themselves, ie maois or natural precursors, and let all the receptors do what they are supposed to do. Just give them more of what they need without messing with them directly. In this day and age, they're probably already clogged up enough from lead and mercury and who knows what.
All I know for sure is, I have never heard of any longtime maoi user becoming med sensitive. But 100% of the people who have become med sensitive did so with a history of reuptake inhibitors.
I'm just rambling now. Enough.
Posted by NewQuestions on February 26, 2009, at 7:49:38
In reply to Re: Being Med-Sensitive., posted by bleauberry on February 25, 2009, at 18:10:30
Great Post! I agree with everything! How do you react to benzos? They make me depressed and confused. Have you tried ldn?
Posted by NewQuestions on February 26, 2009, at 8:12:24
In reply to Re: Being Med-Sensitive., posted by bleauberry on February 25, 2009, at 18:10:30
Is there anything you are not sensitive too?
Posted by NewQuestions on February 26, 2009, at 8:16:40
In reply to Re: Being Med-Sensitive., posted by bleauberry on February 25, 2009, at 18:10:30
Do you think you should just stop taking everything and let the body heal?
Posted by raisinb on February 26, 2009, at 10:29:38
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
Hi Scott,
The one med I was extraordinarily sensitive to was Wellbutrin. It made me hypomanic (maybe even full-blown manic) within a couple of days. I felt euphoric and incredibly interested in every little ting (I became totally fascinated with even commercials). Every movie I watched was the best movie ever. I found deep meanings and conflicts in them all. I had huge reserves of energy--would walk five or six miles, still feel restless. It wasn't an unpleasant feeling at all. Mihály Csíkszentmihályi talks about "flow"--the state when you feel incredibly, deeply immersed in your work, etc. I have experienced that state when writing essays in the middle of the night. On Wellbutrin, I felt like I was in that state all the time no matter what I was doing.
However, I did not sleep. I would take 5 or 6 mg of Lunesta (twice the max dose) and sleep for maybe 2 hours. Because of the lack of sleep, I quickly started to experience mood swings. Euphoria for a couple of days, then moody and weepy for a couple of days.
I say I'm "sensitive" because nobody else I've talked to has had such an extreme reaction to WB. I was only on 100 mg when this happened. The other meds I've taken, my side effects seem to be in line with what most others experience.
Posted by garnet71 on February 26, 2009, at 10:53:50
In reply to Re: Being Med-Sensitive. » SLS, posted by raisinb on February 26, 2009, at 10:29:38
"I say I'm "sensitive" because nobody else I've talked to has had such an extreme reaction to WB. I was only on 100 mg when this happened."
Wow, I would agree that's pretty sensitive. It didn't do all that for me even at 450 mg. From what you wrote, however, I can say I had your effect but maybe 1/10 of the intensity you described; in other words, it made me feel normal again.
What I find very interesting about your situation is that you didn't display amplified negative side effects (such as severe anxiety and agtitation), but amplified positive effects of Wellbutrin.
Posted by raisinb on February 26, 2009, at 16:14:17
In reply to Re: Being Med-Sensitive. » raisinb, posted by garnet71 on February 26, 2009, at 10:53:50
In a way, I was lucky, because it rocketed me out of a suicidal depression in about three days, but it definitely wasn't workable for more than a few weeks.
The doctor added Zoloft, and all the excessive side effects went away. I felt good, but much more normal.
When I describe what it was like to people who know, they say, "sounds just like cocaine!" Makes sense. Both are about a lot of extra dopamine.
Posted by bleauberry on February 26, 2009, at 17:50:01
In reply to Re: Being Med-Sensitive., posted by NewQuestions on February 26, 2009, at 8:16:40
> Do you think you should just stop taking everything and let the body heal?
Well, actually I'm not taking anything, so there is nothing to stop. And except for short little attempts at things in the last 2 years, I have basically not been taking anything.
Do I believe the body can heal? No. If you think about it, we were sick before we ever started on the road of medications, right? That is the place we would probably return to, not a place of being healed.
I feel as if my body is stuck in a place of illness that is too strong to break out of, and that it will take force by way of medication or supplement to break the cycle. That will require tiny starting doses, trying many things to find what is tolerable, and looking at a titrating journey and a healing journey much longer than the average person.
But then again, when someone is med sensitive, it doesn't require normal therapeutic doses to work. Tiny doses can work very well. We are sensitive not only to the bad, but the good also.
I saw at another forum a woman who is very sensitive. She is completely well on 3mg Lexapro. That's right, 3 (three) mg. She takes it in liquid drops to measure it that accurately. She says 4mg makes her more depressed, and 2mg isn't enough to work. 3mg is her magic dose.
THAT is med sensitivity.
Posted by bleauberry on February 26, 2009, at 17:54:20
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
Hi Scott,
I shared some thoughts on sensitivity in a couple other posts in this thread. To kind of highlight it all, I wanted to re-share this example.
A woman at another forum does very well on her Lexapro. 3mg Lexapro. Liquid form, taken in drops. 4mg makes her a lot more depressed. 2mg isn't enough to work. 3mg she is depression free. Heck, 3mg, most people wouldn't even hardly feel that at all any more than a sugar pill.
Now THAT is med sensitivity. :-)
I'm the same way.
Posted by NewQuestions on February 27, 2009, at 9:29:05
In reply to Re: Being Med-Sensitive. » SLS, posted by bleauberry on February 26, 2009, at 17:54:20
Anything your NOT sensitive to?
Posted by SLS on February 27, 2009, at 9:44:54
In reply to Re: Being Med-Sensitive. » SLS, posted by bleauberry on February 26, 2009, at 17:54:20
Hi Bleauberry.
When you first departed on your odyssey of treatment with antidepressants, were you med-sensitive?
Do you have an example of a drug that you were once able to take in large amounts for which you cannot take now?
Thanks.
- Scott
Posted by bleauberry on February 27, 2009, at 17:17:59
In reply to Re: Being Med-Sensitive. » bleauberry, posted by SLS on February 27, 2009, at 9:44:54
> Hi Bleauberry.
>
> When you first departed on your odyssey of treatment with antidepressants, were you med-sensitive?
>
> Do you have an example of a drug that you were once able to take in large amounts for which you cannot take now?
>
> Thanks.
>
>
> - ScottWell, let's see, the first ever was Paxil at 10mg for a week and then 20mg after that and then 30mg. Except for the obvious sexual problems, piece of cake.
Prozac 10mg for 4 days then 20mg. A slight bit of the prozac jitters for a couple weeks and the sleep problems, but basically a pretty mild introduction to a new med.
In my early psych journey, normal doses of just about anything felt rather benign overall.
Zyprexa 5mg smooth as could be.
3 or 4 large coffees a day no prob.
But after about 8 years, all that changed fairly rapidly within a timeframe of perhaps 6 months. The first I noticed was a progressing intolerability of my usual coffee. After that it just all progressed downhill fast.
What am I NOT sensitive to? Hmmm. That's a tough one. Well, Ibuprofen is fine. Olive Leaf Extract is fine (a potent herbal antimicrobial/anti-inflammatory). I seem ok with modest doses of vitamin D or vitamin E, a modest dose of selenium or zinc, but not at all tolerable of any of the other minerals, and especially not tolerable at all in any way to B vitamin supplementation at any dose. The absolute worst are Bs, magnesium, and lithium. I recently tried SAMe for 2 days at 200mg and it was tolerable just fine other than the headache, and its rapid acute antidepressant and antipain effect was a surprise.
I have no idea if this is more anecdotal suggestive evidence of a longterm ssri syndrome, or perhaps a pathology of Lyme or Lyme-like (my LLMD sees this with nearly all his patients), a pathology of exposure to unusually large amalgams (not that many at chelation forums seem sensitive like me), or a combination of all the above.
It is a very frustrating situation because it seriously limits the ability to try things, regardless if they are vitamins, herbs, or medicines. The only good side is that if there is to be any benefit from a supplement, it is noticed quickly and at a tiny dose. Example, milnacipran at a mere 6mg bid deserved a standing ovation in producing perhaps a 30% improvement from baseline in under 2 weeks. Heck, that is half the starting dose.
Posted by zzzz7 on February 28, 2009, at 18:24:32
In reply to Re: Being Med-Sensitive., posted by SLS on February 23, 2009, at 16:17:59
SLS, this is from a post I made two months ago. I have a case similar to that of NewQuestions'. Right now, I'm off SRIs totally, and when I get depressed .1mg of Requip works immediately.
From 1997 to 2006 I was on large amounts of SRI drugs. At various points, I was on 400mg clomipramine with 100mg Luvox, 110mg Prozac, 100mg Prozac and 400mg ProVigil, and the like.
in 2006 I entered a deep depression after a sporting injury that caused me to go from a high level of physical activity to none at all for several months. To get out of it, I pushed serotonin levels even higher than I had before. I assumed that drugs were pooping out on me. I even added small amounts of 5HTP. All of this seemed to make things even worse. I backed way off when I developed signs of serotonin syndrome. As I backed off, I felt better. The lower I went, the better I felt. I went down to 1mg Lexapro for a while. I felt better, but still slightly depressed. Then, all the way down to two sand-sized grains of Lexapro. Finally relief. I experimented some more by going off SRIs altogether (in this case Lexapro). The depression came back. So, apparently I'm hyper-sensitive to serotonin (and the same turns out to be case for DA; I found this out by decreasing doses of amatadine to lower serotonin levels when I had taken too much of the SRI).
The problem is that something like exercising will increase DA levels such that I get depressed. One grain too much on Lexapro, I get depressed. I sit on this knife's edge between DA and 5HT, and it's tough not to fall off one side.
Posted by zzzz7 on February 28, 2009, at 18:26:36
In reply to Re: Being Med-Sensitive., posted by bleauberry on February 27, 2009, at 17:17:59
beauberry, are you able to see a common thread in terms of effects of various substances on neurotransmitters?
I've not had problems with things that don't affect dopamine or serotonin.
Posted by bleauberry on February 28, 2009, at 19:12:25
In reply to Re: Being Med-Sensitive., posted by zzzz7 on February 28, 2009, at 18:26:36
> beauberry, are you able to see a common thread in terms of effects of various substances on neurotransmitters?
>
> I've not had problems with things that don't affect dopamine or serotonin.Well, actually with me it seems the there are some categories that help...
Milnacipran with its 3:1 norepinephrine to serotonin balance. Even so, I can only take 1/2 of the introductory starting dose.
Antibiotics make me a lot worse for a couple weeks and then a lot better. Definintely a chronic infection going on. Nearly impossible to diagnose these things, but reactions to blind antibiotic challenge trials tell the unseen story.
SAMe is a darn good antidepressant and works really fast. While it is claimed it increases serotonin and dopamine, I would strongly bet it does not. If it did, believe me, I would know, same as you. It does something else...changes in gene expression, more fluidity in receptors, more receptiveness of receptors, detoxing unknown bodily contaminants, stuff like that.
DMSA is a lead/mercury chelator. I have done 10 rounds of low dose frequent dose for 4 to 7 days each round. Every single round there have been 2 days of incredible improvement. I cannot figure out if it is because I am clearing out a layer of toxic metals, or if I am responding positively to the addition of a strong sulfur source. Coincidentally, SAMe also is a sulfur source.
So anyway, yeah, any psych drug that is pro-serotonin or pro-dopamine is bad business and tricky business for me. But norepinephrine, antibiotics, metal chelators, and good ole SAMe feel a heck of a lot better than $20,000 worth of what the psych world can offer me.
Kind of makes one wonder why the medical profession doesn't expand depression treatment outside the limited confines of psychiatry. Lots of things mess up the brain that no amount of serotonin will fix and can instead make it worse.
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