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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Julian Grow on February 6, 1999, at 16:48:19
My wife is suffering from Tachy Phylaxis. Her antidepresant stops working after nine months. This occurs every year for the last four years. She has to get off all medication for one month. Then it takes another month for the meds to start woking. In the interim she suffers from deep depression. She stays in bed crying etc. Has anyone heard of this condition? If so is there any way to prevent this from happening again? I want to help her but I can't. It is very frustrating.
Posted by Wayne R. on February 7, 1999, at 6:00:40
In reply to When the medicine stops working, posted by Julian Grow on February 6, 1999, at 16:48:19
Please see my posting titled "Naltrexone for SSRI poop out" to see what has worked for me. Best wishes... Wayne
Posted by Carol on February 9, 1999, at 8:07:07
In reply to Re: When the medicine stops working, posted by Wayne R. on February 7, 1999, at 6:00:40
> Julian,
I'm not familiar with the diagnosis for your wife, but I'm very familiar with meds working for a while, and then fading out. I took Prozac for about 6 years, then I noticed that it just wasn't working anymore, and I got really depressed. All during the cycle of finding new meds, I'd be "up" for the chance to find a new med, then I would get more upset as the meds didn't seem to do enough.
You need to look at the timing of your wife's down cycles. Is it related at all to the onset of winter and the reduced amount of sunlight? If so, she's got SAD (seasonal affective disorder) which is adding to her problems, and possibly changing the balance of the meds in her system.There are 3 basic approaches to meds which fade in effectiveness: 1) switch meds; 2) Increase dosage on existing medication ; and 3) add another medication into the mix to help potentiate the initial medication.
It sounds like method 1 isn't working for the two of you. Increasing the dosage is dependant on how well your wife tolerates the medication, and what are the max. recommended dosage levels. A careful Dr. and careful evaluation of the personal side effects might enable higher doses, even beyond the recommended levels.
The third approach, to add an additional med, again requires close supervision from the Dr. and by your wife. Since some side effects will be more likely in combination therapy, she will need to observe her reactions closely.
Some doctors are more likely than others to help build combined medication systems, and are willing to push the limits, based on the history with the patient. I've got a doctor who is very helpful, and I am also quite good at reporting side effects and watching for areas of concern.
I'm on a 3-way med combination, mostly because my depression has always been "drug-resistant", and so involves relatively high doses of the primary medication (Wellbutrin), and the addition of Desyrel and lithium has helped with my sleep patterns and being able to wake up refreshed in the morning.I hope some of this is helpful. I've been challenged when I've been between meds to keep hoping that the next one would work. Getting adequate sleep will help some, as will some exercise (walking, even inside a mall).
Good Luck, and take care
Carol
Posted by Julian on February 10, 1999, at 6:53:02
In reply to Re: When the medicine stops working, posted by Carol on February 9, 1999, at 8:07:07
Dear Carol and Wayne,
Thank you for your concerns. My wife has been off all meds for one month. She is about to go on Paxil. Once she gets better, and she will, we will be searching for an answer to stop this from happening again. We have an excellent Dr.but he has not come up with an answer yet.
Wayne, can you tell me how often do you take Naltrexone and at what dosage? This might be what we are looking for.
As for SAD, our Dr. says that she does not have any of the symptoms.
I will let you know what is happening. We can't live like this every year.
Thank you again,
Julian
Posted by Wayne R. on February 10, 1999, at 14:31:06
In reply to Re: When the medicine stops working, posted by Julian on February 10, 1999, at 6:53:02
> Wayne, can you tell me how often do you take Naltrexone and at what dosage? This might be what we are looking for.
Generally 25 mg once a day is suggested and that works wonderfully for me. There does seem to be an adjustment period and I would suggest starting slowly and building to 25 over a week or so.
I have seen suggestions to take it with the evening meal however I take Prozac and Naltrexone at the same time first thing in the morning.
Naltrexone can be used to augment any of the SSRI antidepressants, not just Prozac.
Best wishes... Wayne
Posted by Elizabeth on February 10, 1999, at 17:26:22
In reply to When the medicine stops working, posted by Julian Grow on February 6, 1999, at 16:48:19
Julian,
Has your wife always been using the same antidepressant (Paxil, you say later), or has she used different ones every time?
Sometimes antidepressants can cause rebound depression when they stop working; it sounds like that is what your wife is experiencing. Naltrexone might be appropriate for this.
Good luck to both of you.
-Elizabeth
Posted by Julian on February 13, 1999, at 16:57:58
In reply to Re: When the medicine stops working, posted by Elizabeth on February 10, 1999, at 17:26:22
Thank you Elizabeth,
We will be trying Naltrexone when the meds stop working the next time. For now she has started on Paxil. Once she gets better we will be exploring all other alternatives to see that this doesn't happen again.
I will lets everyone know what happens.
Julian
Posted by Julian on February 13, 1999, at 17:01:53
In reply to Re: When the medicine stops working, posted by Wayne R. on February 10, 1999, at 14:31:06
> > Wayne, can you tell me how often do you take Naltrexone and at what dosage? This might be what we are looking for.
>
> Generally 25 mg once a day is suggested and that works wonderfully for me. There does seem to be an adjustment period and I would suggest starting slowly and building to 25 over a week or so.
>
> I have seen suggestions to take it with the evening meal however I take Prozac and Naltrexone at the same time first thing in the morning.
>
> Naltrexone can be used to augment any of the SSRI antidepressants, not just Prozac.
>
> Best wishes... WayneWayne,
Sorry to bother you but can you tell me if you take Naltrexone all year round and what are the side effects.
Thank you... Julian
Posted by Ruth on February 13, 1999, at 20:23:56
In reply to Re: When the medicine stops working, posted by Julian on February 13, 1999, at 16:57:58
First, Julian- I do hope that the medication change will help. It must be very difficult both for you and for your wife.
I just discovered this chatroom and this thread couldn't be more timely for me. I've been on combo of parnate, lamictal and respirdal for a number of months and after trials of many many medications which preceeded that it seemed that we had finally found a combination that worked. But then over the past months things started going downhill. It's frightening for me since when things deteriorate there is no way of knowing whether it is a backslide or a free fall. My doctor is excellent and is comfortable with trying combinations of meds. For now he's having me stop the parnate so that he can start me on something else.
It would be helpful to hear from any of you about how to manage the discouragement and the uncertainty. Thanks- Ruth
Posted by Julian on February 14, 1999, at 12:44:06
In reply to Re: When the medicine stops working, posted by Ruth on February 13, 1999, at 20:23:56
> First, Julian- I do hope that the medication change will help. It must be very difficult both for you and for your wife.
> I just discovered this chatroom and this thread couldn't be more timely for me. I've been on combo of parnate, lamictal and respirdal for a number of months and after trials of many many medications which preceeded that it seemed that we had finally found a combination that worked. But then over the past months things started going downhill. It's frightening for me since when things deteriorate there is no way of knowing whether it is a backslide or a free fall. My doctor is excellent and is comfortable with trying combinations of meds. For now he's having me stop the parnate so that he can start me on something else.
> It would be helpful to hear from any of you about how to manage the discouragement and the uncertainty. Thanks- RuthRuth,
I understand what you are going through.
Wayne R went through the same thing. He said his life was saved by adding Naltrexone together with his antidepressent. This seemed to inhance the antidepressent's effects. We will be trying that drug if all other ideas do not work.We too have a good MD but he can't know everything. This chatroom is great for helping you and your doctor to get other opinions.
Good Luck to you
Julian
Posted by Wayne R. on February 19, 1999, at 17:20:46
In reply to Re: When the medicine stops working, posted by Julian on February 13, 1999, at 17:01:53
I take the Naltrexone constantly. My experience with side effects was muscular aches expecially in my back and sholders. It disappeared over several weeks and I now consider that I have NO side effects. Wayne
Posted by Julian on February 20, 1999, at 16:37:23
In reply to Re: When the medicine stops working, posted by Wayne R. on February 19, 1999, at 17:20:46
> I take the Naltrexone constantly. My experience with side effects was muscular aches expecially in my back and sholders. It disappeared over several weeks and I now consider that I have NO side effects. Wayne
Thank you Wayne. As soon as my wife gets better we will be exploring this with our MD.
Julian
Posted by Ruth on February 23, 1999, at 17:06:19
In reply to Re: When the medicine stops working, posted by Julian on February 20, 1999, at 16:37:23
Julian, thanks for your concern.
I'm not familiar with naltrazone. Is it an SSRI? I'm on lamictal and respirdal and have been on an MAOI but not an SSRI in combo with them. I'm sure my doctor has something in mind, but I always like to have the questions to ask so I can understand his decision making. Having said that I do trust and have always gone with his prescriptions.
Ruth
He's mentioned getting another consult. I've had a couple in the 3 years I've been working with him. My inclination is to say no, but I don't no if that is the depression talking or it is reasonable to just want to stick with him. Any thoughts?
Posted by Wayne R. on February 24, 1999, at 16:05:32
In reply to Re: When the medicine stops working, posted by Ruth on February 23, 1999, at 17:06:19
> I'm not familiar with naltrazone. Is it an SSRI?
Ruth, Naltrexone is not an antidepressant in itself. It is used to augment SSRI antidepressants like Prozac, Zoloft, Paxil, etc. when they won't keep working by themselves.
Wayne
This is the end of the thread.
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