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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Amo on October 19, 2000, at 19:04:10
Two years ago I experienced more emotional pain than I thought was humanly possible. I couldn't sleep, lost 20 lbs., couldn't concentrate, had daily panic attacks and cried incessantly. After a few months of this living hell I went to the doctor who prescribed 20mg Paxil; because that treatment was effective for my sister's depression. After a month or so, I began feeling like myself again. Working, living, traveling, playing-finally I was back. I stayed on the Paxil, either at 20 or 30 mg, for a year and a half. I decided to go off the Paxil because I felt fine and stable, and I hoped the incident was an isolated event. BUT, for about two months now I've had a recurrence of the depression. Loss of appetite, sleep disturbance, anxiety, panic, long crying bouts-ugh. I went to the shrink immediately and started the Paxil again. I went from 20mg-no good at 3 weeks. Up to 30mg for the next 2 weeks. I had a good response for 10 days and then I was back to crying and panic. He just put me up to 40mg and I am desperately praying this is it. But I'm scared! I never expected, or ever wanted, too feel this horrible again. I'm so scared I'm going to have to deal with this the rest of my life and I don't know what I'll do if this pain doesn't end soon!
Posted by noa on October 19, 2000, at 19:31:36
In reply to depressed again and I'm scared !, posted by Amo on October 19, 2000, at 19:04:10
I had a similar experience, where the 2nd time on Prozac didn't have as good an effect.
You have many options, so if the Paxil at this dose doesn't suffice, don't panic.
There are meds that can be added in combination with Paxil to improve the effect. There are other meds to try.
There are lots of people here to offer lots of ideas and opinions about strategies to consider.
Posted by R.Anne on October 19, 2000, at 19:52:36
In reply to depressed again and I'm scared !, posted by Amo on October 19, 2000, at 19:04:10
I learned after a few bouts of my depression that I would most likely need the medicine the rest of my life. Sometimes it bothers me but I am accepting it more these days. I am on 20 mg. of Paxil and 2-3 (37.5 mg.) effexor now. Once Paxil was all I needed for depression and it lost its effect on my. Now, it works for my OCD and the Effexor works for the depression. More than 20 megs. of Paxil makes me too sedated I've found. It is a scarey thing to realize that we have these serious illnesses to deal with for who knows how long. But I hope you realize that you are not alone and people here, including me, can relate to you and be here to "talk" to. I know it's difficult. At times I'm terrified when my medicines don't seem to work and I think I'll be in the awful state I'm in forever. I've had to change medicines many times. I try to remember that there are more medicines out there and some help available. I'm having a hard time finding a therapist suitable to my needs and feel like that is getting hopeless now because lots of them don't take my insurance. It's always something for us but we aren't alone. I sometimes just pray even if I'm not a church goer it seems to give me some comfort. Taking a walk or hot bath helps, too. Hang in there-I think it will get better. I'm wishing good things for you!
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> Two years ago I experienced more emotional pain than I thought was humanly possible. I couldn't sleep, lost 20 lbs., couldn't concentrate, had daily panic attacks and cried incessantly. After a few months of this living hell I went to the doctor who prescribed 20mg Paxil; because that treatment was effective for my sister's depression. After a month or so, I began feeling like myself again. Working, living, traveling, playing-finally I was back. I stayed on the Paxil, either at 20 or 30 mg, for a year and a half. I decided to go off the Paxil because I felt fine and stable, and I hoped the incident was an isolated event. BUT, for about two months now I've had a recurrence of the depression. Loss of appetite, sleep disturbance, anxiety, panic, long crying bouts-ugh. I went to the shrink immediately and started the Paxil again. I went from 20mg-no good at 3 weeks. Up to 30mg for the next 2 weeks. I had a good response for 10 days and then I was back to crying and panic. He just put me up to 40mg and I am desperately praying this is it. But I'm scared! I never expected, or ever wanted, too feel this horrible again. I'm so scared I'm going to have to deal with this the rest of my life and I don't know what I'll do if this pain doesn't end soon!
Posted by Racer on October 20, 2000, at 1:13:43
In reply to depressed again and I'm scared !, posted by Amo on October 19, 2000, at 19:04:10
Hey, kiddo, don't worry so much! There are tons of new drugs, and one or more of them will help you.
Just don't give up, and make sure you can work well with your doctor.
This time, though, check on the duration of your treatment. I've read studies which suggest that if you stop an AD within two years of good effect, it can increase the likelihood of a recurrence of the depression -- AND reduce the likelihood of the same drug working again.
That's OK, though, because Paxil has plenty of newer competitors, with fewer side effects.
Good luck to you.
Posted by MarkinBoston on October 20, 2000, at 13:30:11
In reply to depressed again and I'm scared !, posted by Amo on October 19, 2000, at 19:04:10
I've been on and off meds about 6 times in the last 10 years. One or another has always resolved those major episodes, but did nothing for the low level background depression (dysthymia) and anhedonia, and with the major episode over, the side effects of apathy, weight gain, and inorgasmia from the AD became my biggest problem.
Anyway, a couple times (Prozac and Paxil) a drug worked the first time, but not again. I've not had difficulty usng Effexor a second or third time. After a few major episodes, my pdoc suggested in the most charming way that I should consider just staying on meds. I decided not to and just kept tabs on when I was starting to have more memory and thinking problems and to start up again.
You can get immediate relief from the panic you're feeling with one of the many benzodiazapine class of drugs (Xanax, Klonipin, Valium etc.). Its really just treating a symptom of depression, but you'll feel better while another anti-depressant kicks in.
Panic is a normal component of some types of depression where the endocrine system gets messed up and you maintain high levels of cortisol, the stress hormone. Estrogen exaggerates the response of the body to stress, so you end up with even higher cortisol levels, and thus panic. Probably one reason women experience depression more than men. The AD meds eventually get the endocrine system working better, cortisol drops, and you shouldn't need the anti-anxiety drugs, or as much.
Posted by stjames on October 21, 2000, at 22:29:55
In reply to depressed again and I'm scared !, posted by Amo on October 19, 2000, at 19:04:10
For myself I found that if I reduced the meds the depression
can back so I stopped worring about ever getting off the meds.
We do know that depression can be chronic. In chronic depression
one episode kindles another. The more depressive episodes, the worse
the depression gets. Consider yourself lucky as you only have had
2 episodes, this fact and your sucess with meds b4
incicates you will do well if you stay on meds. Many here have gone thru
many depressions b4 getting treatment so you are fortunate to
have caught things early.
Posted by Amo on October 25, 2000, at 20:29:18
In reply to Re: depressed again and I'm scared !, posted by stjames on October 21, 2000, at 22:29:55
Still feel lousy! I've been taking paxil for 6 weeks-the 40 mg for a week now-and still feel miserable. I'm considering changing, perhaps to effexor. Has anyone had success with this drug after being treated with an SSRI? If so what was your experience? Did you completely taper off the SSRI before you started the effexor? Any comments would be very helpful! Thanks folks.
Posted by JohnL on October 26, 2000, at 5:41:36
In reply to Re: depressed again and I'm scared !, posted by Amo on October 25, 2000, at 20:29:18
> Still feel lousy! I've been taking paxil for 6 weeks-the 40 mg for a week now-and still feel miserable. I'm considering changing, perhaps to effexor. Has anyone had success with this drug after being treated with an SSRI? If so what was your experience? Did you completely taper off the SSRI before you started the effexor? Any comments would be very helpful! Thanks folks.
Amo,
So sorry. Six weeks is a long long time when you're not feeling better, isn't it? I think two weeks would have been enough to make some kind of judgement. There should have been at least a hint of improvement by then IF the medicine was going to work. But at six weeks, you've definitely given it a fair shot.Effexor could be a good choice, because unlike the SSRIs it will provide some action on norepinephrine and dopamine, not just serotonin. In clinical studies, Effexor does have an edge statistically for treating depression and treatment resistant depression over the SSRIs. You won't need to do a washout. You could start taking a very low dose of Effexor and taper it in, while at the same time taper down the Paxil.
Hopefully Effexor will work better for you. In a worst case scenario, if it doesn't work, then it would probably be best to look at other classes of medicines instead of antidepressants. You could briefly, for example, try Zoloft and then Prozac for about one or two weeks each, just to compare to Paxil, and then choose your favorite of the bunch for a low dose longterm base. Then add to it other things, like Lithium, Zyprexa, Ritalin, whatever. Hopefully Effexor alone will do the job. But if not, it may be time to consider that your symptoms are due to some other chemistry, and that a different kind of medicine will target that chemistry in a way that antidepressants can't.
Hope this is somehow helpful.
John
Posted by noa on October 26, 2000, at 6:57:43
In reply to Re: depressed again and I'm scared !, posted by JohnL on October 26, 2000, at 5:41:36
Yes, I went from Prozac to Paxil to Effexor to Effexor XR, which works better than the others for me.
Have you also checked out thyroid functions?
This is the end of the thread.
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