Posted by Cecilia on July 21, 2001, at 5:23:30
In reply to Re: Perfect Drug for Everyone? » Cecilia, posted by Elizabeth on July 20, 2001, at 13:47:36
> > Right now I`m taking 300 mg/day of Trazodone, 20 mg/day of Celexa, 1 mg/day of clonazepam and 100 mg/day of Atenolol(prescribed for blood pressure but maybe helps a little with anxiety).
>
> Interesting mix. One doesn't see trazodone used as an AD that often anymore.
>
> Atenolol can help with jittery feelings, palpitations, etc., but it's not so good for the ruminative, "can't-stop-thinking" sort of anxiety.
>
> > Also temazepam or Ambien "prn" for sleep (trazodone doesn`t make me sleepy at all).
>
> I can't imagine trazodone being a good long-term sleeping pill. When I tried to use it that way, I just kept developing tolerance and having to increase the dose.
>
> > I really don`t know if anything (except the sleeping pills) really does anyhing or not.
>
> Uh-oh!
>
> > Until a year ago I wasn`t on anything regularly except the Atenolol, I just kept trying each new med and giving it up because it didn`t help, or because the side effects were too bad for an adequate trial-the case with most of the tricyclics.
>
> That was my problem with the tricyclics too. But desipramine seems to be doing me some good without any significant side effects. For various reasons, I'd been down on the tricyclics and I didn't really expect desipramine to work, so this comes as a pleasant surprise. Did you manage to stick it out with desipramine?
>
> > Then my doctor told me there wasn`t anything left to try except ECT, which put me into the worst panicky depression of my life and I`ve probably been depressed since childhood-also anxious- I think I was born anxious.
>
> Me too. :-( I didn't have phobias or anything, but I was always very nervous and had (still have) very bad performance anxiety.
>
> Can you say more about your depression and anxiety? Like, what sort of symptoms do you have, and have any of your symptoms been alleviated or worsened by any of the drugs on your list?
>
> I don't think there's *ever* a point where you've tried so many medications that ECT is the only thing left. There are always weird, off-label things you can use. It's not surprising to see that you haven't tried an opioid, but given the large number of things that haven't worked for you, though, it might be worthwhile to look into the possibility, if you think there's a chance that your doctor would be willing. (I'd recommend doing some research before bringing it up, though.)
>
> > ECT (and people at work finding out about it) or suicide.
>
> Suicide isn't scary, but whenever I think about it I feel guilty. You know?
>
> > I got my doctor to prescribe Xanax(later changed to clonazepam) which was the 1st psychiatric drug(other than sleeping pills) that I ever felt had done anything for me at all.
>
> Some depressed people respond to Xanax, especially in high doses, and it's a great anxiolytic. In a situation like yours, where the depression might be secondary to anxiety, a benzodiazepine would seem like a logical thing to try. Do you find Klonopin equally helpful?
>
> > Then I decided to add Trazodone which I`d tried ten years ago but only at a low dose, ( because the doctor who prescribed it at the time was such a jerk that I wasn`t willing to go back to have the prescription increased).
>
> *ouch* :-)
>
> > With the trazodone I gradually got over that horrible panic, but I really don`t know if it WAS the trazodone or simply giving up the ECT idea.
>
> Probably a little of both, I'd think.
>
> > Later, I added Celexa, which I`d previously tried by itself, with buspar, with wellbutrin,and
> > with Neurontin, without ever feeeling it was doing anything, but I did feel more anxious when I went off it so I decided maybe it WAS doing something.
>
> SSRIs can be subtle (to put it mildly). How does Celexa compare to the other ones, since you've tried *all* of them? (I only ever tried Prozac, Zoloft, and Paxil.)
>
> > So, I`m back to my baseline chronic depression but now on several drugs which I`m afraid to go off of in case they ARE helping.
>
> Oh dear. Looking over your list, I see that Nardil is on it. Did that do anything for you? IMO, it's the best AD for anxiety, although it does have some annoying side effects. And what about Neurontin? I tried it briefly once, and it reminded me of Xanax. I got scared and stopped taking it because it was giving me the munchies, though. (I gained 50 lbs on Nardil and only was able to lose the weight because I was so depressed when I stopped taking it; I'm not interested in going through that again!) I also notice that you've tried stimulants. What happened with those?
>
> Also, 1 mg/day of clonazepam really isn't all that much. You could probably increase it safely if your doctor says it's okay to.
>
> Maybe there isn't a perfect drug for you, but I bet that there's a combination that will make things better.
>
> -elizabethDesipramine was the lst AD I ever tried-only lasted 2 weeks on it-coudn`t stand the racing pulse, sweating, anxious caffeinated feeling. The only tricyclic I managed to stick with long enough for an adequate therapeutic trial was Nortriptyline and I only managed that by starting at 10 mg and working up to a therapeutic dose over 2 months-still had plenty of side effects even doing it that way. Of the SSRI`s-only lasted 3 weeks on Prozac, couldn`t take the anxiety and insomnia, Paxil and Zoloft were easy to tolerate with only a little nausea though later when I tried them again with the plan of adding augmentors the side effects were much worse, Luvox made me sick as a dog, Celexa has no side effects. I tried 3 separate times to tolerate Effexor, but even starting with a quarter of a 25 mg tablet couldn`t stand the nausea, diarrhea, insomnia. I only tried Ritalin for 4 days and Dexedrine for 3-more than long enough to convince me that stuimulants were not the way to go. Neurontin had no effects at all except a little dizziness when I got up to 1800 mg/day. I had a strange reaction to Nardil-took it for 4 weeks at 45 mg/ day-no side effects, no benefits, increased to 60 mg/day, no effects for 10 days, then woke up with a terrible headache, took my BP, it was ok so went to work,but felt worse and worse, extreme dryness and pain in eyes, horrible pain and strange "metallic" feeling in muscles and joints, I was too scared to take another pill. Years later I finally got the nerve to try another MAOI but only lasted a week on Parnate it made my anxiety, already very high(This was after my doctor had suggested ECT) even worse. I definitely don`t do well on "activating" meds. When I 1st tried Xanax it did seem to have an AD effect, but it wore off within a week or two, clonazepam is probably better because you don`t have the ups and downs. (Xanax would wake me up at night when it wore off). I really don`t know what else to try, my pdoc is the one at my HMO who deals with the treatment resistant cases and I had a consult with a Big Wig doctor at my city`s university hospital when I was considering ECT.
poster:Cecilia
thread:10400
URL: http://www.dr-bob.org/babble/20010720/msgs/71170.html