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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by jujube on September 25, 2004, at 17:50:02
I just started Celexa just over two weeks after weaning off Effexor XR for a two-week period. I am now taking 20 mg of Celexa. I was on Effexor for 6 months, and, during that time, I had this underlying apprehension and anxiety that would not go away. I was also becoming extremely apathetic and unmotivated. Hence the switch to Celexa, and my hopes for a better response. However, I am at my wits end, and just want to rid myself of this adhedonia that I have been living with for months now.
I am wanting to add a natural supplement, Rhodolia, to try to augment the Celexa. My doctor did not have a problem with this (although he is not familiar with natural supplements). I have since learned that, athough Rhodiola is not an MAO inhibitor (like St. John's Wort), it does work on MAO by providing a balancing effect. I have noticed in reviewing older threads that people have combined Rhodiola with a SSRI. My questions are: do I need to be concerned about serotonin syndrome? Is is safe to combine a SSRI with Rhodiola?
Sorry for the long-winded message. Anything you can tell me would be greatly appreciated. Thanks so much.
Tamara
Posted by jlbl2l on September 25, 2004, at 17:55:40
In reply to ? for Chemist (If you don't mind please), posted by jujube on September 25, 2004, at 17:50:02
Posted by jujube on September 25, 2004, at 18:47:29
In reply to ....chemist quit the board.... (nm), posted by jlbl2l on September 25, 2004, at 17:55:40
Posted by chemist on September 25, 2004, at 20:15:31
In reply to Yipes!! I really need info. When did he quit? (nm) » jlbl2l, posted by jujube on September 25, 2004, at 18:47:29
hello there, chemist here...the poster jlb121 is not my spokesperson, friend, acquiantance, nor - to my knowledge - is he an administrator of this website: i was blocked from posting for a spell and have been free to post since tuesday last. i have been quite busy with other responsibilities and will be back on PB in a short time. all the best, chemist
Posted by jujube on September 25, 2004, at 20:35:09
In reply to he didn't quit » jujube, posted by chemist on September 25, 2004, at 20:15:31
Thanks so much chemist. I hope you will be able to provide me with some information, when your schedule permits. I hate to sound desparate, but I am. Just kidding. I am hanging in there although it is becoming frustrating and discouraging. Take good care.
Tamara
> hello there, chemist here...the poster jlb121 is not my spokesperson, friend, acquiantance, nor - to my knowledge - is he an administrator of this website: i was blocked from posting for a spell and have been free to post since tuesday last. i have been quite busy with other responsibilities and will be back on PB in a short time. all the best, chemist
Posted by VelvetElvis on September 26, 2004, at 1:49:35
In reply to ? for Chemist (If you don't mind please), posted by jujube on September 25, 2004, at 17:50:02
I'm not chemist.
I can still tell you that it's usualy a bad idea to mix suppliments with pharmacuticals. Choose one or the other. If the med you are on isn't working, don't add suppliments. Get your dose increased or your med changed. The fewer variables you introduce into the process, the easier it will be to find a med or combination of meds that work for you.
Posted by TofuEmmy on September 26, 2004, at 14:38:56
In reply to he didn't quit » jujube, posted by chemist on September 25, 2004, at 20:15:31
Chemist dear - Without you, this board has lacked a certain....hmm.....je ne sais quoi. A certain element is missing. :-)
I do so hope your life calms down so that you can continue to enthrall us with your multisyllabic delicacies -- even tho I only understand every third word.
Your Friend, Emmy
Posted by chemist on September 26, 2004, at 14:50:29
In reply to ? for Chemist (If you don't mind please), posted by jujube on September 25, 2004, at 17:50:02
hello there, chemist here...i do agree with Velvet Elvis in re: mixing herbal supplements and prescription medications. my opinion concerning this matter is based on my personal lack of knowledge about the efficacy of various herbal supplements as well as my concerns about the regulations concerning the formulations. from what i do know about St. John's Wort, the mechanism by which it purportedly works is at worst poorly understood and at best attributed to numerous pathways including selective serotonin reuptake inhibition, monoamine oxidase inhibition, and dopaminergic activity. as for rhodiola, i am aware of some studies that report that it is useful in staving off fatigue, and my extent of knowledge ends there. i would venture a guess that a not insignificant amount of your current mental state can be attributed to a switch in medications and that the requisite time needed to titrate to reach plasma levels that afford you maximum effect has yet to be attained. all of that said, if lack of motivation was a problem while you were taking effexor, i suspect it will be more of a problem while you are taking celexa, as celexa will not inhibit norepinephrine reuptake as well as effexor. conversely, the anxiety might be lessened with treatment with celexa vis a vis effexor, although again, this does depend on your biochemistry and i am quite simply using the NERI as a metric here. finally, it might be prudent to reevaluate your diagnosis with your doctor as the problem might be addressed more effectively with an entirely different approach tailored for anxiety reduction and a more aggressive regimen for lifting your spirits. MAOIs such as nardil and parnate come to mind, and i am aware that many proponents of TCAs have reported success in this area as well. in addition to checking in with your doctor after a bit more time has elapsed for the trial with celexa to be in full-swing, you might check in with Sad Panda, King Vultan, SLS, ace, and Larry Hoover concerning alternatives: they are not the only fish in the sea but are better qualified than yours truly to take this particular case any further and i find that the information they provide is quite detailed and almost invariably more comprehensive than my own. in any event, i feel that the advice offered by VelvetElvis is appropriate and that at the very least you and your doctor do need to research the proposed regiment in greater depth. all the best, chemist
> I just started Celexa just over two weeks after weaning off Effexor XR for a two-week period. I am now taking 20 mg of Celexa. I was on Effexor for 6 months, and, during that time, I had this underlying apprehension and anxiety that would not go away. I was also becoming extremely apathetic and unmotivated. Hence the switch to Celexa, and my hopes for a better response. However, I am at my wits end, and just want to rid myself of this adhedonia that I have been living with for months now.
>
> I am wanting to add a natural supplement, Rhodolia, to try to augment the Celexa. My doctor did not have a problem with this (although he is not familiar with natural supplements). I have since learned that, athough Rhodiola is not an MAO inhibitor (like St. John's Wort), it does work on MAO by providing a balancing effect. I have noticed in reviewing older threads that people have combined Rhodiola with a SSRI. My questions are: do I need to be concerned about serotonin syndrome? Is is safe to combine a SSRI with Rhodiola?
>
> Sorry for the long-winded message. Anything you can tell me would be greatly appreciated. Thanks so much.
>
> Tamara
Posted by jujube on September 26, 2004, at 15:01:33
In reply to Re: ? for Chemist (If you don't mind please) » jujube, posted by chemist on September 26, 2004, at 14:50:29
Thanks so much. I appreciate the time you took to respond to my query. I had been prescribed Paxil years ago (I 34 years old, had just quit drinking, and was depressed and extremely anxious. I now have 8.5 years of sobriety - yeah for me). The Paxil actually worked extremely well for me (it was the first AD I was ever on) once the start-up side effects subsided. I had no more anxiety, my mood was elevated and my energy was the same as it had always been. I stayed on Paxil for a number of years, during which period I would often only have to take 1/2 of the dose or would even be able to skip a dose for a day or two (I guess it was like maintenance dosing) and then I stopped using it. Unfortunately, this year when I was in need of an AD again, the Paxil just didn't work (after a trial of 3 months). Granted, I was extremely iron deficient at the time, and the doctor was having a really hard time getting my iron levels up with oral supplementation. I will continue to be patient (which is hard because I feel like I wasted 6 months of my life on Effexor) and give Celexa more time.
Thanks again for your time, and take good care.
Tamara
> hello there, chemist here...i do agree with Velvet Elvis in re: mixing herbal supplements and prescription medications. my opinion concerning this matter is based on my personal lack of knowledge about the efficacy of various herbal supplements as well as my concerns about the regulations concerning the formulations. from what i do know about St. John's Wort, the mechanism by which it purportedly works is at worst poorly understood and at best attributed to numerous pathways including selective serotonin reuptake inhibition, monoamine oxidase inhibition, and dopaminergic activity. as for rhodiola, i am aware of some studies that report that it is useful in staving off fatigue, and my extent of knowledge ends there. i would venture a guess that a not insignificant amount of your current mental state can be attributed to a switch in medications and that the requisite time needed to titrate to reach plasma levels that afford you maximum effect has yet to be attained. all of that said, if lack of motivation was a problem while you were taking effexor, i suspect it will be more of a problem while you are taking celexa, as celexa will not inhibit norepinephrine reuptake as well as effexor. conversely, the anxiety might be lessened with treatment with celexa vis a vis effexor, although again, this does depend on your biochemistry and i am quite simply using the NERI as a metric here. finally, it might be prudent to reevaluate your diagnosis with your doctor as the problem might be addressed more effectively with an entirely different approach tailored for anxiety reduction and a more aggressive regimen for lifting your spirits. MAOIs such as nardil and parnate come to mind, and i am aware that many proponents of TCAs have reported success in this area as well. in addition to checking in with your doctor after a bit more time has elapsed for the trial with celexa to be in full-swing, you might check in with Sad Panda, King Vultan, SLS, ace, and Larry Hoover concerning alternatives: they are not the only fish in the sea but are better qualified than yours truly to take this particular case any further and i find that the information they provide is quite detailed and almost invariably more comprehensive than my own. in any event, i feel that the advice offered by VelvetElvis is appropriate and that at the very least you and your doctor do need to research the proposed regiment in greater depth. all the best, chemist
>
> > I just started Celexa just over two weeks after weaning off Effexor XR for a two-week period. I am now taking 20 mg of Celexa. I was on Effexor for 6 months, and, during that time, I had this underlying apprehension and anxiety that would not go away. I was also becoming extremely apathetic and unmotivated. Hence the switch to Celexa, and my hopes for a better response. However, I am at my wits end, and just want to rid myself of this adhedonia that I have been living with for months now.
> >
> > I am wanting to add a natural supplement, Rhodolia, to try to augment the Celexa. My doctor did not have a problem with this (although he is not familiar with natural supplements). I have since learned that, athough Rhodiola is not an MAO inhibitor (like St. John's Wort), it does work on MAO by providing a balancing effect. I have noticed in reviewing older threads that people have combined Rhodiola with a SSRI. My questions are: do I need to be concerned about serotonin syndrome? Is is safe to combine a SSRI with Rhodiola?
> >
> > Sorry for the long-winded message. Anything you can tell me would be greatly appreciated. Thanks so much.
> >
> > Tamara
>
Posted by chemist on September 26, 2004, at 15:13:19
In reply to Re: The board minus Chemist » chemist, posted by TofuEmmy on September 26, 2004, at 14:38:56
> Chemist dear - Without you, this board has lacked a certain....hmm.....je ne sais quoi. A certain element is missing. :-)
>
> I do so hope your life calms down so that you can continue to enthrall us with your multisyllabic delicacies -- even tho I only understand every third word.
>
> Your Friend, Emmy
>
hello there, chemist here...i thank you for your kind words. i have been preoccupied with other matters in my life that have precluded more extensive participation in this forum. more to come on the future. all the best, chemist
Posted by jujube on September 26, 2004, at 17:45:22
In reply to Re: CYMBALTA Side Effects Reports, posted by VelvetElvis on September 26, 2004, at 1:49:35
I appreciate your taking the time to respond, and your words of warning. I had asked my doctor if it was ok to take the Rhodolia with the AD, and he didn't have a problem (but he is not familiar with Rhodiola). I was a little concerned when I came across some additional information that said it works on MAO, but is not a MAO inhibitor. I know that combining a MAO inhibitor with a SSRI can be risky and probably dangerous.
I had previously asked my doctor if I could supplement with amino acids (these are not herbal). He is more familiar with these, and didn't have a problem with supplementation. As a result, I will likely stay away from the Rhodiola and try something like Picamilon (which I have heard is quite good for anxiety and could potentially be motivating) and, possibly DL-Phenylalanine once the AD has had a chance to kick in.
Thanks again for your advice it is much appreciated.
Tamara
> I'm not chemist.
>
> I can still tell you that it's usualy a bad idea to mix suppliments with pharmacuticals. Choose one or the other. If the med you are on isn't working, don't add suppliments. Get your dose increased or your med changed. The fewer variables you introduce into the process, the easier it will be to find a med or combination of meds that work for you.
This is the end of the thread.
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