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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by wideawake on January 13, 2001, at 4:37:03
I have been treated for depression for 18 months now until 2 weeks ago I was treated with various SSRi, although not much help infact at times I felt very suicidel,my GP decided to change my medication to Reboxetine. I have been taking Reboxetine for almost 2 weeks in that time I have experienced hot flushes which I can live with. I also am suffering from terrible insomnia for the first six days I did not sleep at all, for the rest of the time if I do manage to go to sleep it's when my head spins i'm so tired, but within an hour or at the most two hours i'm wideawake again although i'm exhausted,accompanied with the insomnia is lightheadedness and dizzyness on standing or turning my head, my GP has told me to bare with it for a bit longer. I'm due to return to work next week with young and vulnerable children I need to know if the dizzyness etc is short term otherwise I feel I may have to give up a job I adore as at times i feel so dizzy I need to sit on the floor not good when with children. Please tell me it gets better thanks. Wideawake
Posted by JohnL on January 13, 2001, at 5:13:04
In reply to How long do the side effects of Reboxetine last?, posted by wideawake on January 13, 2001, at 4:37:03
I must admit I am disgusted with the way your doctor is handling this. I mean, how is anybody supposed to get well if they can't get sleep? You could take even a normal person and deprive them of sleep for six days and you'll definitely see a dramatic destruction of both their physical and mental state. They'll completely unravel and turn into nut cases. Why doesn't this doctor try going six days without sleep himself and see how HE feels? Hhmmm? Geez. Sleep is crucial to physical and mental wellbeing.
I think at the very least he should be giving you a sleep-aid. Preferably one with antidepressant qualities. Remeron would be a top pick. Another would be Zyprexa. Both also happen to work very well on depression when combined with antidepressants. At a bare minimum, he should be giving you Xanax or Ambien for sleep. But to give you nothing at all is pure cruelty and ignorance as I see it, and is also extremely counterproductive to getting well. It defeats the whole goal. Now instead of trying to climb up from the bottom of a hill, you're looking at climbing up a cliff instead.
Quite frankly I must admit also that there are few people here who have tried Reboxetine that ended up liking it. In most cases it actually made people worse than they were to begin with, or gave them nasty side effects. The literature promotes this drug as being very effective and without the common side effects of antidepressants. I have found that to be totally false. In many cases it is much worse than other antidepressants in a lot of ways.
I would think if your doctor wanted to try other classes of antidepressants with you, it would have made a lot more sense to go with Nortriptyline, or Imipramine, or Amitriptyline. These time-tested tricyclics, as old as they are, still offer many benefits that newer antidepressants just don't have. Primarly, they not only target other chemistries than just serotonin, but they also help you sleep.
Remeron would also have been a better pick, in my opinion. Or even better, Effexor+Remeron. Now that's a 'big gun' therapy (as stated in Dr Bob's Tips) with one added crucial benefit....the ability to sleep!
Regardless of what drugs someone tries, good sleep is like a good foundation under a house. Without it, the house crumbles. No drug, no matter what it is, is going to be miraculous enough in any way to overcome such an obstacle.
My personal opinion...stop the Reboxetine immediately, see the doctor immediately, switch to a tricyclic, Remeron, Effexor, preferably a combination of any of these, and make sleep a top priority. Sleep should be at the top of the priority list. Right below it on the priority list would be curing the depression. I think your doctor has it all backwards. And though he may mean well, I think he is making your situation much worse.
Just the fact that Reboxetine is making you so dizzy is a clear clue to me that it is the wrong med to begin with. I would ditch it immediately. You'll have to do what you think is best, but these are my thoughts, and I hope something here is helpful to you.
John
Posted by Bob on January 13, 2001, at 15:32:17
In reply to Re: How long do the side effects of Reboxetine last?, posted by JohnL on January 13, 2001, at 5:13:04
> I must admit I am disgusted with the way your doctor is handling this. I mean, how is anybody supposed to get well if they can't get sleep? You could take even a normal person and deprive them of sleep for six days and you'll definitely see a dramatic destruction of both their physical and mental state. They'll completely unravel and turn into nut cases. Why doesn't this doctor try going six days without sleep himself and see how HE feels? Hhmmm? Geez. Sleep is crucial to physical and mental wellbeing.
>
> I think at the very least he should be giving you a sleep-aid. Preferably one with antidepressant qualities. Remeron would be a top pick. Another would be Zyprexa. Both also happen to work very well on depression when combined with antidepressants. At a bare minimum, he should be giving you Xanax or Ambien for sleep. But to give you nothing at all is pure cruelty and ignorance as I see it, and is also extremely counterproductive to getting well. It defeats the whole goal. Now instead of trying to climb up from the bottom of a hill, you're looking at climbing up a cliff instead.
>
> Quite frankly I must admit also that there are few people here who have tried Reboxetine that ended up liking it. In most cases it actually made people worse than they were to begin with, or gave them nasty side effects. The literature promotes this drug as being very effective and without the common side effects of antidepressants. I have found that to be totally false. In many cases it is much worse than other antidepressants in a lot of ways.
>
> I would think if your doctor wanted to try other classes of antidepressants with you, it would have made a lot more sense to go with Nortriptyline, or Imipramine, or Amitriptyline. These time-tested tricyclics, as old as they are, still offer many benefits that newer antidepressants just don't have. Primarly, they not only target other chemistries than just serotonin, but they also help you sleep.
>
> Remeron would also have been a better pick, in my opinion. Or even better, Effexor+Remeron. Now that's a 'big gun' therapy (as stated in Dr Bob's Tips) with one added crucial benefit....the ability to sleep!
>
> Regardless of what drugs someone tries, good sleep is like a good foundation under a house. Without it, the house crumbles. No drug, no matter what it is, is going to be miraculous enough in any way to overcome such an obstacle.
>
> My personal opinion...stop the Reboxetine immediately, see the doctor immediately, switch to a tricyclic, Remeron, Effexor, preferably a combination of any of these, and make sleep a top priority. Sleep should be at the top of the priority list. Right below it on the priority list would be curing the depression. I think your doctor has it all backwards. And though he may mean well, I think he is making your situation much worse.
>
> Just the fact that Reboxetine is making you so dizzy is a clear clue to me that it is the wrong med to begin with. I would ditch it immediately. You'll have to do what you think is best, but these are my thoughts, and I hope something here is helpful to you.
> JohnJohn:
Just a quick question here:
You mention the combination of Remeron and Effexor. Seems like quite a hard combo to tolerate. What I was wondering was what this combo brings to the party, that either Remeron or Effexor alone does not? I've actually seen this combo mentioned before on this list.
Bob
Posted by JohnL on January 13, 2001, at 19:28:04
In reply to Re: How long do the side effects of Reboxetine last? » JohnL, posted by Bob on January 13, 2001, at 15:32:17
> John:
>
> Just a quick question here:
>
> You mention the combination of Remeron and Effexor. Seems like quite a hard combo to tolerate. What I was wondering was what this combo brings to the party, that either Remeron or Effexor alone does not? I've actually seen this combo mentioned before on this list.
>
> BobHi Bob,
The technicals involved here are over my head. But basically the two drugs work on serotonin and norepinephrine, except from different angles. There are two disctinct and separate mechanisms, at different levels, with no duplication. Remeron is basically opening up the spigot for release of serotonin and NE, while Effexor blocks the drain. The two work as a team to fill it up with neuros!
I don't think this combo would be difficult to tolerate. It could even be easier than just one or the other. The drugs in some ways have counteracting side effects.
But back to the original post, I just feel Reboxetine is not the right drug in this case. Reboxetine is just causing too much trouble to be worth it, especially when there are other choices that look more attractive, to me anyway.
John
Posted by Bob on January 14, 2001, at 0:09:12
In reply to Re: How long do the side effects ....Bob, posted by JohnL on January 13, 2001, at 19:28:04
>
> > John:
> >
> > Just a quick question here:
> >
> > You mention the combination of Remeron and Effexor. Seems like quite a hard combo to tolerate. What I was wondering was what this combo brings to the party, that either Remeron or Effexor alone does not? I've actually seen this combo mentioned before on this list.
> >
> > Bob
>
> Hi Bob,
> The technicals involved here are over my head. But basically the two drugs work on serotonin and norepinephrine, except from different angles. There are two disctinct and separate mechanisms, at different levels, with no duplication. Remeron is basically opening up the spigot for release of serotonin and NE, while Effexor blocks the drain. The two work as a team to fill it up with neuros!
> I don't think this combo would be difficult to tolerate. It could even be easier than just one or the other. The drugs in some ways have counteracting side effects.
> But back to the original post, I just feel Reboxetine is not the right drug in this case. Reboxetine is just causing too much trouble to be worth it, especially when there are other choices that look more attractive, to me anyway.
> JohnInteresting. Thanks for the insight!
Bob
Posted by wideawake on January 15, 2001, at 2:58:46
In reply to Re: How long do the side effects ....Bob, posted by Bob on January 14, 2001, at 0:09:12
> >
> > > John:
> > >
> > > Just a quick question here:
> > >
> > > You mention the combination of Remeron and Effexor. Seems like quite a hard combo to tolerate. What I was wondering was what this combo brings to the party, that either Remeron or Effexor alone does not? I've actually seen this combo mentioned before on this list.
> > >
> > > Bob
> >
> > Hi Bob,
> > The technicals involved here are over my head. But basically the two drugs work on serotonin and norepinephrine, except from different angles. There are two disctinct and separate mechanisms, at different levels, with no duplication. Remeron is basically opening up the spigot for release of serotonin and NE, while Effexor blocks the drain. The two work as a team to fill it up with neuros!
> > I don't think this combo would be difficult to tolerate. It could even be easier than just one or the other. The drugs in some ways have counteracting side effects.
> > But back to the original post, I just feel Reboxetine is not the right drug in this case. Reboxetine is just causing too much trouble to be worth it, especially when there are other choices that look more attractive, to me anyway.
> > John
>
> Interesting. Thanks for the insight!
>
> BobThanks Bob and John
Your answers help, originally I took Prozac, but again experienced sleep problems and my hands shook, but that was as the lack of sleep became a problem. Then I took Effexor me sleep, sleep again was a problem at the suggestion of the CPN I was given Zopiclone to help me sleep but told to take only occassionally, the Zopiclone worked when I took the max dose but the length of time I was prescribed the dose didnot solve the insomnia. Then he changed my Antidepressant to Ciprimal with all I have suffered with insomnia, I found with Ciprimil I could not concentrate on simple things or remember things, to the point where I have had to give my BAhons in Social Psychology up. With Reboxetine I no longer feel sucidel and can reason things out, i'm just exhausted, but I am awre if I don't get my sleep I will be back to as I was before. My GP said you cannot take anything else with Reboxetine. It seems to be a vicious circle what ever he puts me on seems to improve my mood but within days of going back to work I feel my mood slipping reading what you both have said made me realise it is the lack of sleep that is causing the problem a mild depression ghas ended up far worse, due to not getting the sleep sorted thanks again guys I will go tackle my GP again! I actually managed some sleep on Saturday but guess what back to no sleep at all last night. You both seem very knowledable on the different combinations of drugs and how they interact.Thanks again Wideawake
Posted by JohnL on January 15, 2001, at 18:16:25
In reply to Re: How long do the side effects ....Bob, posted by wideawake on January 15, 2001, at 2:58:46
The GP says you can't take any other drugs with Reboxetine? That's totally false. You could take nearly anything with it.
John
This is the end of the thread.
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