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Dr. Bob is Robert Hsiung, MD,
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Posted by CoutureMan on October 30, 2007, at 6:23:38
In reply to You know Zoloft isn't working when, posted by Maxime on October 29, 2007, at 14:28:14
Maxime,
I can empathize with your suffering. I’m not bipolar but med resistant unipolar with severe GAD. Also, I have constant serious GI pain caused by: 1) Constipation needing high doses of Miralax (laxative) and 2) Complications (bloating and gas) from a nissen fundaplication surgery needed because of barrett’s esophagus (pre-cancerous condition). Each day is misery. I sleep most of the time to escape and often wish I could end my suffering.I can only offer two suggestions from what I’ve read about you on the boards. First you need to find a way of getting some restorative sleep. Second you need to find a way to eat more than 100-300 calories of food a day. There is no way your body and brain can function with starvation that extreme for long periods of time.
I am not anorexic but I was a high school wrestler some 30 years ago. To compete at a high level and eventually garner an athletic scholarship to college I dropped a lot of weight to be in a lower weight class. Even though this was totally voluntary and time limited (would eat after the matches) it was brutal to be so hungry. This was before my mental illness but my parents said that I seemed depressed when I was not eating. I know I couldn’t concentrate at school when all I was thinking about was food. Even now I would find it difficult to sleep if I were hungry.
I don’t know how you can conquer your ED but I would bet if you could get your calorie count out of the starvation range your brain would begin to work more effectively. Possibly, even sleep would come. You have my sincere hope that things improve for you.
Take care,
CM
Posted by tecknohed on October 30, 2007, at 12:50:35
In reply to Re: You know Zoloft isn't working when » Polarbear206, posted by Maxime on October 29, 2007, at 19:38:45
> The psych meds I am on are:
>
> - zoloft
> - adderall
> - trileptal
> - clonazepam
> - tryptophanYou've told me the Adderall is no longer working. If its not working then get off it fast! Your mood & lack of energy will suffer in the short term but after around 10 days your brain should have recovered from the amphetamines onslaught, no matter what the dose or how long you took them for.
A tricyclic or Provigil might help with the withdrawal.From someone who KNOWS thier amphetamines!
Kev. x
P.S. PLEASE STAY WITH US!!!
Posted by Maxime on October 30, 2007, at 15:30:42
In reply to Re: You know Zoloft isn't working when » Maxime, posted by tecknohed on October 30, 2007, at 12:50:35
The adderall isn't working like it used to. When I don't take it I notice that I have a lot less energy. However, it is not helping my concentration as it used to when I first started it.
I can't use a tricyclic because of my heart and Provigil gives me a nasty headache.
xx
Maxime
> > The psych meds I am on are:
> >
> > - zoloft
> > - adderall
> > - trileptal
> > - clonazepam
> > - tryptophan
>
> You've told me the Adderall is no longer working. If its not working then get off it fast! Your mood & lack of energy will suffer in the short term but after around 10 days your brain should have recovered from the amphetamines onslaught, no matter what the dose or how long you took them for.
> A tricyclic or Provigil might help with the withdrawal.
>
> From someone who KNOWS thier amphetamines!
>
> Kev. x
>
> P.S. PLEASE STAY WITH US!!!
Posted by Maxime on October 30, 2007, at 15:33:23
In reply to Re: You know Zoloft isn't working when » Maxime, posted by CoutureMan on October 30, 2007, at 6:23:38
I'm sorry to hear that you are suffering so much as well.
I know I need to increase my caloric intake. I am trying, but not having any success right now. I know it would help me, yet my brain tells me I am fat and not to eat ... or that I don't deserve to eat.
Maxime
> Maxime,
> I can empathize with your suffering. I’m not bipolar but med resistant unipolar with severe GAD. Also, I have constant serious GI pain caused by: 1) Constipation needing high doses of Miralax (laxative) and 2) Complications (bloating and gas) from a nissen fundaplication surgery needed because of barrett’s esophagus (pre-cancerous condition). Each day is misery. I sleep most of the time to escape and often wish I could end my suffering.
>
> I can only offer two suggestions from what I’ve read about you on the boards. First you need to find a way of getting some restorative sleep. Second you need to find a way to eat more than 100-300 calories of food a day. There is no way your body and brain can function with starvation that extreme for long periods of time.
>
> I am not anorexic but I was a high school wrestler some 30 years ago. To compete at a high level and eventually garner an athletic scholarship to college I dropped a lot of weight to be in a lower weight class. Even though this was totally voluntary and time limited (would eat after the matches) it was brutal to be so hungry. This was before my mental illness but my parents said that I seemed depressed when I was not eating. I know I couldn’t concentrate at school when all I was thinking about was food. Even now I would find it difficult to sleep if I were hungry.
>
> I don’t know how you can conquer your ED but I would bet if you could get your calorie count out of the starvation range your brain would begin to work more effectively. Possibly, even sleep would come. You have my sincere hope that things improve for you.
>
> Take care,
> CM
>
>
>
>
Posted by tecknohed on October 30, 2007, at 16:07:35
In reply to Re: You know Zoloft isn't working when » tecknohed, posted by Maxime on October 30, 2007, at 15:30:42
> The adderall isn't working like it used to. When I don't take it I notice that I have a lot less energy. However, it is not helping my concentration as it used to when I first started it.
>
> I can't use a tricyclic because of my heart and Provigil gives me a nasty headache.
>
> xx
> MaximeI just feel that the prolonged exposure to the adderall may be making you more depressed than you would be otherwise. And yes, of course you will have less energy when you go without it, but it takes TIME to recover from long term amphetamine use.
I'm also surprised a doctor would give someone with anorexia amphetamines in the first place. Are you sure you're not just holding onto the adderall to curb your appetite?I'm sorry if I sound harsh, and I'm sorry if I 'really' am wrong. I'm just VERY concerned.
I know what daily amphetamine use 'feels' like. I've been there myself. I may not have anorexia but I have first hand experience of how the drug can screw one's head up, even in small amounts.
If you REALLY NEED a psycho-stim for your concentration, then have you considered methylphenidate (Ritalin). I've read that its a lot less 'harsh' on the mind than adderall (better tolerated, less side effects) & less likely to cause loss of appetite, at least in comparison to amphetamine.
Kev. x
Posted by Polarbear206 on October 30, 2007, at 16:54:36
In reply to Re: You know Zoloft isn't working when » Polarbear206, posted by Maxime on October 29, 2007, at 19:38:45
>
> > Are you only on Zoloft? What has been your experiences with other meds? Diagnosis?
> >
> > PB
>
> I am med resistant. The only meds that have worked for me are Parnate and Prozac and they pooped out on me.
>
> I have been on EVERY med.
>
> I am bipolar type 2 and anorexic.
>
> The psych meds I am on are:
>
> - zoloft
> - adderall
> - trileptal
> - clonazepam
> - tryptophan
I would seriously consider ditching the Adderal. These kinds of meds and bipolar are not a good mix. It could very well be exacerbating your depression. How about effexor instead of zoloft? You obviously need one that targets more than serotonin, since Parnate worked for some time for you. Also, you may need to try another mood stabilizer down the road that may augment your AD. The problem is, you can't do too many things at one time. I would start with the adderal and go from there. Of course you should discuss this with you doctor first. Don't give up, PLEASE hang in there!! I have walked in your shoes.PB
Posted by Racer on October 30, 2007, at 17:49:09
In reply to Re: You know Zoloft isn't working when » Maxime, posted by tecknohed on October 30, 2007, at 16:07:35
> >
> I just feel that the prolonged exposure to the adderall may be making you more depressed than you would be otherwise.I gotta agree here, that the Adderall may be adding to your depression. That ain't got nothin' to do with your eating disorder, by the way -- but increased depression is one known side effect of Adderall.
Personally, if I were in your shoes right now, I would strongly consider swapping Adderall for methylphenidate. Adderall increased my depression a very great deal in a very short period of time. Ritalin boosted my mood almost as soon as it hit my system, and has been a good and trusted friend. (Well, its big sister Concerta has been the friend lately, but still...)
Maxime, I know you're hurting, and believe me, I know how dark and hopeless it gets to feeling. I hope you'll give Zoloft a fair chance to work, since you know it's going to take a while. I hope you can hold your judgment on it for a while longer, because there is a chance that it will, indeed, work for you. Talking to your doctor about switching stims might help, too -- it's got to be worth a try, if there's a chance it will help, right?
I suspect this is the pot/kettle time, but I hope you'll hold off on any permanent decisions. (For that matter, I might hope that I hold off, too.)
Posted by stargazer2 on October 30, 2007, at 18:15:17
In reply to You know Zoloft isn't working when, posted by Maxime on October 29, 2007, at 14:28:14
Maxime,
I too suffer with a treatment resistent condition.
Everything you wrote sounded like I did, with the exception of writing an obituary.How is your doctor? Does he give you hope that something will help you? Does he know what you are planning?
Are you worse on Zoloft? I became suicidal on Zoloft so if you are feeling worse than before starting it, it may be the wrong med.
I would let my pdoc know how badly I was feeling and go and see him (or her). You may need to get off Zoloft. Not all meds make us feel better, some can make us feel worse and that is what it sounds like 'Z' is doing to you.
I know how badly you are feeling. I would recommend you call your doc and get in to see him ASAP. You meds need to be adjusted.
Good luck, we are all pulling for you.
Stargazer
Posted by Maxime on October 30, 2007, at 18:19:02
In reply to Re: You know Zoloft isn't working when » Maxime, posted by tecknohed on October 30, 2007, at 16:07:35
I will talk to my pdoc about it.
Adderall never curbed my appetite. I didn't have any side effects from it at all. I even took it while taking Parnate.
Ritalin is nasty for me as is dexadrine. I would crash so badly at night and end up cutting.
But I am willing to consider stopping the Adderall and see if that helps.
Thanks.
x
Maxime
> I just feel that the prolonged exposure to the adderall may be making you more depressed than you would be otherwise. And yes, of course you will have less energy when you go without it, but it takes TIME to recover from long term amphetamine use.
> I'm also surprised a doctor would give someone with anorexia amphetamines in the first place. Are you sure you're not just holding onto the adderall to curb your appetite?
>
> I'm sorry if I sound harsh, and I'm sorry if I 'really' am wrong. I'm just VERY concerned.
>
> I know what daily amphetamine use 'feels' like. I've been there myself. I may not have anorexia but I have first hand experience of how the drug can screw one's head up, even in small amounts.
>
> If you REALLY NEED a psycho-stim for your concentration, then have you considered methylphenidate (Ritalin). I've read that its a lot less 'harsh' on the mind than adderall (better tolerated, less side effects) & less likely to cause loss of appetite, at least in comparison to amphetamine.
>
> Kev. x
Posted by Maxime on October 30, 2007, at 18:24:04
In reply to Re: You know Zoloft isn't working when, posted by Racer on October 30, 2007, at 17:49:09
Ritalin was a nasty med for me. I crashed so hard at night. I've tried Provogil, but it gave me nasty headaches. Dexedrine made me crash as well.
But I am willing to give up the adderall and see if it helps.
I am still in the decision making process. My only fear is that I will mess it up and end up in worse shape.
Thanks Racer.
Maxime
> > I just feel that the prolonged exposure to the adderall may be making you more depressed than you would be otherwise.
>
> I gotta agree here, that the Adderall may be adding to your depression. That ain't got nothin' to do with your eating disorder, by the way -- but increased depression is one known side effect of Adderall.
>
> Personally, if I were in your shoes right now, I would strongly consider swapping Adderall for methylphenidate. Adderall increased my depression a very great deal in a very short period of time. Ritalin boosted my mood almost as soon as it hit my system, and has been a good and trusted friend. (Well, its big sister Concerta has been the friend lately, but still...)
>
> Maxime, I know you're hurting, and believe me, I know how dark and hopeless it gets to feeling. I hope you'll give Zoloft a fair chance to work, since you know it's going to take a while. I hope you can hold your judgment on it for a while longer, because there is a chance that it will, indeed, work for you. Talking to your doctor about switching stims might help, too -- it's got to be worth a try, if there's a chance it will help, right?
>
> I suspect this is the pot/kettle time, but I hope you'll hold off on any permanent decisions. (For that matter, I might hope that I hold off, too.)
Posted by Maxime on October 30, 2007, at 18:27:55
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Polarbear206 on October 30, 2007, at 16:54:36
I go manic on Effexor so it's not an option.
Trileptal is the mood stabiliser that I have been able to tolerate.
Yes, maybe I will give up the Adderall. It has never made me hypomanic and I have been on it for 2 years.
Thanks.
Maxime
> I would seriously consider ditching the Adderal. These kinds of meds and bipolar are not a good mix. It could very well be exacerbating your depression. How about effexor instead of zoloft? You obviously need one that targets more than serotonin, since Parnate worked for some time for you. Also, you may need to try another mood stabilizer down the road that may augment your AD. The problem is, you can't do too many things at one time. I would start with the adderal and go from there. Of course you should discuss this with you doctor first. Don't give up, PLEASE hang in there!! I have walked in your shoes.
>
> PB
Posted by Maxime on October 30, 2007, at 18:32:48
In reply to Re: You know Zoloft isn't working when, posted by stargazer2 on October 30, 2007, at 18:15:17
Thank you.
I have been on Zoloft before, and I did respond to it (at dose of 250 mg).
My pdoc always tries to give me hope and tells me that I have to keep trying. But he doesn't believe meds will ever really work for me.
He knows that I am suicidal, but not that I am planning anything. I see him on Friday. I don't want to end up in that nasty hospital I was in 2 years ago. It made me worse.
Thanks for your support.
Maxime
Maxime,
I too suffer with a treatment resistent condition.
Everything you wrote sounded like I did, with the exception of writing an obituary.How is your doctor? Does he give you hope that something will help you? Does he know what you are planning?
Are you worse on Zoloft? I became suicidal on Zoloft so if you are feeling worse than before starting it, it may be the wrong med.
I would let my pdoc know how badly I was feeling and go and see him (or her). You may need to get off Zoloft. Not all meds make us feel better, some can make us feel worse and that is what it sounds like 'Z' is doing to you.
I know how badly you are feeling. I would recommend you call your doc and get in to see him ASAP. You meds need to be adjusted.
Good luck, we are all pulling for you.
Stargazer
Posted by Polarbear206 on October 30, 2007, at 19:57:34
In reply to Re: You know Zoloft isn't working when » stargazer2, posted by Maxime on October 30, 2007, at 18:32:48
I didn't know you were on the zoloft before. As Racer said, don't give up on the zoloft yet. You still have a way to go to get to 250mg.
PB
Posted by Maxime on October 31, 2007, at 14:44:08
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Polarbear206 on October 30, 2007, at 19:57:34
> I didn't know you were on the zoloft before. As Racer said, don't give up on the zoloft yet. You still have a way to go to get to 250mg.
>
> PBThanks PB.
I just don't know if the Zoloft will work this time. Nothing works the same the 2nd time. I am really frustrated. It was the second AD I ever took and it pooped out on me.
I feel hopeless.
Maxime
Posted by Maxime on October 31, 2007, at 14:45:47
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Polarbear206 on October 30, 2007, at 19:57:34
So as many of you suggested I didn't take any adderall today. I feel like a slug. How long before that goes away?
Losing hope,
Maxime
Posted by Racer on November 1, 2007, at 12:08:05
In reply to Re: You know Zoloft isn't working when » Polarbear206, posted by Maxime on October 31, 2007, at 14:44:08
>
> I just don't know if the Zoloft will work this time. Nothing works the same the 2nd time.Actually, I haven't found that to be true -- thankfully. It may be that Zoloft will work as well again for you as it did before.
Remind me -- did you try Cymbalta? I ask because of your MS, wondering if it might help that at all?
As for your doctor not believing meds will really help you, what does he recommend to "really" help you? (Of course, I'm a big believer in -- I'll shut up now...) My guess is that something that helped your MS would probably also help your depression -- even though they're different, things like that add on to one another. My hip problem certainly drains my energy, which feeds my depression. (Of course, don't know that there's much to be done about that, so I guess my depression will get to be as fat as I am.)
I'm crossing my fingers that Zoloft works for you again. And I'm also crossing my fingers that you can hold on until it does.
Best luck to you.
Posted by Phillipa on November 1, 2007, at 21:03:26
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Racer on November 1, 2007, at 12:08:05
No cymbalta in Canada. I will do a google search of MS meds as here or elsewhere suggested the same thing. So not off base. Phillipa
Posted by Phillipa on November 1, 2007, at 21:43:26
In reply to Re: You know Zoloft isn't working when, posted by Phillipa on November 1, 2007, at 21:03:26
Here's a list of MS meds looks like TCA's seem to work well for depression with MS. Phillipa
Multiple Sclerosis Health Center Font SizeA A A Multiple Sclerosis (MS) - Medications
Medications for multiple sclerosis (MS) may be used:During a relapse, to make the attack shorter and less severe.
Over a long period of time, to alter the natural course of the disease (disease-modifying therapy).
To control specific symptoms as they occur.
Controlling a relapse
Medications can shorten a sudden relapse and help you recover more quickly. Temporary treatment with medications called corticosteroids is the most common treatment used to control a relapse. These medications have not been shown to affect the long-term course of the disease or to prevent disability.Altering the course of MS using disease-modifying treatment
Strong evidence suggests that MS is caused by the immune system causing inflammation and attacking the myelin-the coating surrounding the nerve and nerve fibers. Medications that change the activity of the immune system can reduce the number and severity of attacks that damage the protective myelin.Currently, interferon beta (Avonex, Betaseron, and Rebif), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and natalizumab (Tysabri) are the only medications that have been approved for this purpose. For people with relapsing-remitting MS, these medications can reduce the number and severity of relapses and can result in fewer brain lesions. They may also delay disability in some people. Betaseron and Novantrone may delay disease progression in some people with secondary progressive MS.
Currently, there is no effective disease-modifying treatment for primary progressive MS.
Some people have only one episode of a neurological symptom such as optic neuritis, but MRI tests suggest they may have MS. This is known as clinically isolated syndrome. Many of these people go on to develop MS over time. Avonex and Betaseron have been used for people with clinically isolated syndrome in an attempt to prevent MS from developing.
Relieving symptoms
Treating specific symptoms can be effective, even if it does not stop the progression of the disease. Symptoms that can often be controlled or relieved with medication include:Fatigue. Medications to reduce fatigue or help you sleep better may include amantadine (Symmetrel), modafinil (Provigil), or fluoxetine (Prozac).
Muscle stiffness (spasticity) and tremors. Medications that may reduce muscles spasms or stiffness include baclofen (Lioresal), tizanidine (Zanaflex), dantrolene (Dantrium), gabapentin (Neurontin), diazepam (Valium), or clonazepam (Klonopin). Sometimes a combination of these medications works best to reduce your muscle symptoms.
Urinary problems and constipation. Medications used to reduce frequent urination may include propantheline (Pro-Banthine), oxybutynin (Ditropan), or tolterodine (Detrol). Medications sometimes used to relieve constipation include bulk agents such as psyllium (Metamucil) or daily use of laxatives.
Pain and abnormal sensations. Depending on the severity of the pain, both prescription and nonprescription medications may be tried. Prescription medications commonly used to reduce pain associated with MS include baclofen (Lioresal), carbamazepine (Tegretol), or gabapentin (Neurontin). Nonprescription medications may include acetaminophen, ibuprofen, or naproxen sodium.
Depression. Antidepressant medications may be used to reduce depression that often occurs as a result of having MS. Antidepressants often tried include tricyclic antidepressants-such as amitriptyline (Elavil), desipramine (Norpramin), or imipramine (Tofranil)-or selective serotonin reuptake inhibitors (SSRIs)-such as fluoxetine (Prozac) or sertraline (Zoloft) among others.
Posted by Phillipa on November 1, 2007, at 21:44:58
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Racer on November 1, 2007, at 12:08:05
Also looks like prozac and zoloft are used. Phillipa Good luck Maxie it will work this time give it time to kick in.
Posted by Maxime on November 1, 2007, at 23:04:44
In reply to Re: You know Zoloft isn't working when, posted by Phillipa on November 1, 2007, at 21:44:58
> Also looks like prozac and zoloft are used. Phillipa Good luck Maxie it will work this time give it time to kick in.
Thanks Phillipa and Racer. I appreciate your support. But you don't have to worry about me anymore. I hope to gone by Sunday.
Take care.
Maxime
Posted by Maxime on November 1, 2007, at 23:19:59
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Racer on November 1, 2007, at 12:08:05
Thanks Racer.
I've gone back to meds that have worked and they don't work again.
Cymbalta isn't available in Canada.
I'm holding on until Saturday.
Take care and thanks for your help and friendship.
Maxime
Posted by Phillipa on November 1, 2007, at 22:57:16
In reply to Re: You know Zoloft isn't working when » Racer, posted by Maxime on November 1, 2007, at 22:19:59
Maxie why the weekend? And you will get well. Love Phillipa
Posted by Maxime on November 2, 2007, at 12:40:15
In reply to Re: You know Zoloft isn't working when » Maxime, posted by Phillipa on November 1, 2007, at 23:57:16
> Maxie why the weekend? And you will get well. Love Phillipa
Because the weekend is the best time to do it. I can't suffer anymore ... I am broken.
Maxime
Posted by MidnightBlue on November 2, 2007, at 16:37:51
In reply to Re: You know Zoloft isn't working when » Phillipa, posted by Maxime on November 2, 2007, at 12:40:15
Just wanted you to know I care. I'm sorry I can't be any more helpful.
MidnightBlue
Posted by Phillipa on November 2, 2007, at 20:30:12
In reply to Re: You know Zoloft isn't working when » Phillipa, posted by Maxime on November 2, 2007, at 12:40:15
Maxie somehow we have to patch you up and fix you have you read the deplin thread maybe some hope in that????Phillipa
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Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.