Posted by blueberry on June 10, 2006, at 12:32:25
In reply to Re: What does this mean when this happens.... » blueberry, posted by SLS on June 10, 2006, at 11:00:59
Hi Scott,
What do I feel when I get more depressed starting an AD? Well, basically depression just more intense...lots of uncontrollable crying, despair, hopelessness, worthlessness...feelings that were all there to begin with but somehow get magnified 10 fold.Your other question, yes I have been on therapeutic doses...20mg paxil, 20 prozac. I never had this kind of trouble getting there. I actually felt improvement fairly quickly and just had to bear the side effects as I waited for them to diminish over time. I never had worsened depression at the start. This is new.
Remeron 30mg...hated it. I was on it for a year with prozac. It didn't do much except help sleep a little bit but not enough.
Tried milnacipran for a few days...NE/5HT ratio of 3:1, and this same phenomenon happened. That's what makes me think it is a downregulation thing, or else a bipolar thing where any AD just sends me into a down cycle (though I never have up cycles).
This is all way too much for me and my family. I've had lots of experience with meds, but never the intensity and total incapacitation I have now. I honestly see no realistic option other than hospital to arrest this thing before more damage is done. If it is a downregulation thing, the hospital is the only place I can get through that, where I have encouragement, no job duties, no family concerns, just forget the world and get well. I know from experience that any AD can get me to a place where I am non-depressed, though extremely apathetic amotivational and not really into life, but getting there seems impossible. I would give anything to get back to that ssri numbness again. At least I know how to get rid of that (mentioned it to you in another post, hint hint).
> What do you feel when you get more depressed?
>
> I think your idea regarding downregulation has merit. When I was a patient at the NIH, the doctors there claimed that having an initial blip improvement was a good prognosticator of eventual response. Perhaps you could use pindolol, a 5-HT1a antagonist, as a buffer and accelerate your response. There was quite a bit of interest in using pindolol to augment antidepressants a few years back.
>
> Have you ever managed to get to a therapeutic dosage of any SRI?
>
> Buspar?
>
> I'm sure you noticed that the three drugs you tried are all potent serotonin reuptake inhibitors. Perhaps you ought to look at drugs that don't do that. Something like desipramine or Remeron perhaps?
>
>
> - Scott
>
> >
> > All doses had been very low since I seem very sensitive for some reason. That did not used to be the case in previous years. I have never had trouble starting an antidepressant before. Lexapro was 2.5mg, prozac was 2.5mg, cymbalta was 5mg.
> >
> > I'm wondering...am I having a super difficult time getting through the initial down-regulation stage? Or does this reaction mean I am bipolar? Were the doses too low and I should have just braved normal doses right from the start? Your thoughts?
> >
> > If the consensus is that it is a down-regulation stage, then I may have to go to the hospital or a partial day-hospital program to get through it. If the consensus is bipolar, then I need to look at mood stabilizers without antidepressants.
> >
> > I ask all of you here because both of my doctors don't know what's going on. They keep saying, "that's odd, I've never seen that happen before". Or one doctor said suicidal ideation comes from too much serotonin squashing out norepinephrine and that cymbalta won't cause worsening of depression...but it did.
>
>
poster:blueberry
thread:655187
URL: http://www.dr-bob.org/babble/20060610/msgs/655250.html