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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Felix Guattari on November 13, 2008, at 22:44:59
First, I want to say that this, from what I've seen, is a great forum. If my psychiatrists had half the curiosity and fidelity to research, logic and evidence shown by many members of this board, perhaps I wouldn't be in this situation.
I'll try to keep the background to my question reasonably short. I was diagnosed with depression and aspergers syndrome at a fairly young age, and was accordingly put on SSRIs; first fluvoxamine, then fluoxetine, then sertraline. I suspect there were at least some ADHD-spectrum issues present as well, but since I didn't respond to methylphenidate, the doctors attributed the symptoms to my other disorders. For all I know, the fluvox. and fluox. were fairly effective, or at least well-tolerated, (though I recall some amount of emotional blunting from the second) as I was on them for around ten years total.
Halfway through high school I asked my GP for something for anxiety, and was given sertraline. My junior year was OK academically, but my ability to concentrate was slowly waning. At the time, I coped with this by spending more time socializing, in lieu of reading, which had been my previous pastime of choice. By halfway through my senior year I had become depressed, and found it harder and harder to read or do schoolwork. I took up smoking cigarettes at this time, as I found it helped me get work done.
I landed a fairly challenging independent-study at a local private college in my chosen major (philosophy) over the summer, but found it impossible to get work done, though I was intensely interested in the subject matter. I also enjoyed socializing less and less, but spent increasing time doing so in order to avoid doing work. I left for college, but experienced a depressive breakdown at the beginning of the year. I struggled to keep up in class, but things quickly fell apart and I was forced to drop most of them and barely scraped by in the rest. I then also started experiencing terrible anxiety, for which I started smoking weed. I would sit in my room and sleep for days at a time, and often missed doses of sertraline. Writing and reading were by this time nearly impossible, but I associated it with depression.
I came home after the first quarter, my parents were upset with me at having failed out of (an expensive) school, and things got worse when my psychiatrist increased the zoloft several times, throwing me into an akathisic hell. I tried several other medications to treat my depression and newly-found ADHD (I couldn't and still can't read), but nothing helped. Worst was fluvoxamine, the akathisia from which necessitated hospitalization.
It has now been almost a year since sertraline, and more than a month since fluvoxamine, and I still experience crippling akathisia, cognitive impairment, anhedonia, embarassingly short attention span, declining memory and fatigue and insomnia. I was never a hotheaded or impulsive individual before, but I catch myself saying mean-spirited things and acting impulsively on a regular basis. I've lost my job, dropped out of school, been kicked out of my house several times and still cannot read and understand more than a sentence at a time. While writing is somewhat easier, this post took nearly a week to compose, and there's no way I could read it all in one sitting.
Before the above came to pass, I was a voracious reader, self-educated on many subjects and relatively happy. I was planning on going into academia for philosophy and/or doing translation work. I am only nineteen. My sometimes-friends are getting jobs, moving out, getting educations... I'm nostalgic for being sixteen.
I apologize for the melodrama, but does anyone else think this looks iatrogenic? It is undeniable that SSRIs made things worse, but can I point to them as a cause of my problems? SSRI-induced tardive akithisia seems like the only explanation for the variety of symptoms with which I've been left; the 'depression', at least insofar as it is dissociable from the akathisia/concentration/reading difficulty complex of symptoms, even seems to lift with every ray of false hope. But the EP-like symptoms don't seem to be going anywhere.
If it is indeed iatrogenic, what might the prognosis be? Is there any hope I will be able to read or go to school or even hold a job again?
Furthermore, is there another possible way of approaching the problem? I left a lot out in order to make the tasks of writing (for my sake) and reading (for others) easier, but feel free to ask for any bit of information that might be helpful.Thanks,
FG
Posted by iforgotmypassword on November 14, 2008, at 3:34:35
In reply to persistent SSRI withdrawal symptoms - prognosis?, posted by Felix Guattari on November 13, 2008, at 22:44:59
i react a lot to your use of "tardive akathisia" to describe. but i may be way off base. may be better that way, my life has never recovered despite so much effort, but in case otherwise, you may have better cog. ability still with you and hopefully more access to health care practitioners who actually problem solve.
i was dx'd w/ aspergers and add as a kid, later in teens went on paxil. started to have wierd akathisia, feelings of urgence, irrationality pacing, and rage, arm and facial twitches, and noticible shivering that developed into the constant chewing/shuffling i cannot stop doing with my teeth today. my symptoms now are becoming blatantly parkinsonian, with stiffness in my physical as much as my mental paralysis now. my benefits from lorazepam do not sustain, but these types of drugs have been the most benefit. though akathitic overdriving anxiety putting screwball sensations into my nerves and creating paradoxical hyperactivity is a huge see-saw factor i have, but not just see-saw the effects are usually both affecting me. result is my nonsensical, uncontrollable person. i am just my nerves. not just to articulate, to even finish thoughts properly is very difficult. my intuitive personality is completely warped. the anhedonia and avolition have developed into complete lack of feeling natural, artistic, capable of inspiration, any creative or productive ability to use language spontaneously, and to feel even slightly normal around people. again i am completely dependant on lorazepam. i think my decline, which is now again accelerating, i ironically i saw as depressive initially in my teens and i ended up on SSRIs, it is likely more a very parkinsonian decline, if not, another type of severe extrapyramidal disability that makes no sense manifesting in a 24 year old.
none of this likely helps, and is pessimistic, and my symptoms keep going on and on, but most are very easily conceived as relating to dopaminergic failure in the brain. which may relate to your symptomology, and not necesarily condemn you to disability. even though none helped in any complete way, and any major improvements to my functioning were short lived, i will list drugs i have taken that have helped:
-lorazepam
-burpopion (wellbutrin SR brand, unsure about generic, have tried, but not the hated "budeprion" by teva; by the time i tried it, i may simply have lost effect from the base chemical totally, i have never benefitted as much from the chemical as when i took wellbutrin SR initially at 18, and it stopped working after a few months)
-lamotrigine (short lived, as in days, but the effect comes back to a degree after abstinence or dosage increase, like lorazepam; this rule has helped less and less over years)
-desipramine felt more on top of things, and and more mature less jittery and overdriven around people, cut oversleeping and overeating dramatically, stopped working after a year, may be the most carcinogenic and genotoxic antidepressant, tangent: not just *cancer* from mutagenic chemicals, but negative effects of chemicals and drugs on the genetic material children can end up with (from the cells of BOTH sexes) i imagine is a much bigger issue than is ever mentioned in our society, i should have tried to put all i collected on this when i tried to start a thread on genotoxicity before, it was not at all far fetched seeming at all. humans need to be careful with these drugs, likely obvioulsly part of the greater need for us to be more careful with chemicals and technology in general.
-atomoxetine strattera was just noticable, because i felt i was regaining ability to grasp and see my complete visual field, rather than a blur; i.e. fleeting cognitive and hedonic benefit, but no executive functioning benefit
-donepezil, may have helped thought and fluency, was too expensive to confirm when benefits on my life were negligablestimulants very unreliable with me, at least is the case with dextroamphetamine and methylphenidate
Posted by elixirmonkii on May 16, 2009, at 19:54:16
In reply to persistent SSRI withdrawal symptoms - prognosis?, posted by Felix Guattari on November 13, 2008, at 22:44:59
In response to the previous thread and also the person in the following response after that. I have developed tardive akathisia/anxiety after taking only a short course of lorazepam and fluoxetine(prozac). Prior to this, I only had minor issues with anxiety which were likely a bad reaction I had to an herbal supplement. They seemed to be abating, but somehow I was talked into taking Prozac, and within hours after taking the first dose, I began to feel agitation/akathisia/racing thoughts among other things. I took a second dose in hopes it would resolve, and just in efforts to give it a second chance, and the symptoms only worsened severely. It seems many people tolerate the drug, and are able to see it through, but it caused akathisia in me, in addition to severe mental impairment (partially resolved)which of the akathisia I assume is permanent, as I am writing a year following discontinuing it, with little improvement this far out. It seems odd that such a short course of drugs could do this, however it is possible that my liver did not metabolize the drug properly, leading to a massive dose causing some sort of serotonin syndrome, and further damage to receptors, and/or that part of the brain. It is truly sad, because I happened to be one of the few that seems to have this reaction from the drug. I am not sure what else to say, as i have found there to be contradicting information on the cause of this syndrome, and so I am still unsure of the cause of the akathisia, and further how to resolve it without causing further damage from other drugs. Hopefully someone down the road will be able to help...
This is the end of the thread.
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