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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Onestone on January 16, 2009, at 15:42:55
Hi, everybody, and happy new year!
First of all, sorry I never got back to all the people who commented on my last thread. I've not been feeling that brilliant.
The saga so far: decades long anhedonia; crippling lethargy; new psychiatrist open to creative thinking in December.
In December I asked her about dopamine drugs, and she replied she'd have to find out about that, "but in the mean time, why don't you try this stuff (venlafaxine)". I said yes. It can't do any harm, surely?
WRONG!!! After 17 days on 37.5 mg/day (actually, three of those were on 75mg/day), it's been unbroken misery - impotence, difficulty getting to sleep, increased lethargy, inability to practice my musical instrument (I'm another anhedonistic (amateur) musician), worsened lethargy, ....
On this drug, I've lost much of my connection with other people and much of my grip on reality. I'm only just able to look after myself in no more. It's effect is a sedative one, which is exactly what I don't need. I need one which will stimulate, motivate, and above all, relieve the anhedonia at least a little. It feels much like the Citalopram I tried a decade ago.
The psychiatrist assured me in December that "there shouldn't be any ramping up problems" with venlafaxine. Does that mean I'm peculiarly sensitive to this drug in some way?
I had another appointment with her yesterday. Her view was that "there's no point chopping and changing between drugs, and first I should press on with the venlafaxine, building up to a working dose (150 mg/day), so as to give it a good try out. "If" that doesn't work, then we could try xxxxxxx, a dopamine/noradrenaline reuptake inhibitor". In essence, it was a blazing row, but because we're both soft-spoken "reasonable" people, the outward form was of a polite, reasonable, but firm discussion. She won.
She didn't appear to have any particular expectation it would work, no big ideas. But she wasn't going to back down. Why should this drug work? It's a serotonin/noradrenaline reuptake inhibitor. Neither of the two components separately were any good, so why a combination. Hey, it might work - why shouldn't it? So I'm going to lose another two months of my life on the faint chance that venlafaxine might, just might, relieve my anhedonia.
I don't think I can stand this drug, even if it does settle down in another two weeks or so. I can't even work at my computer at the moment, I don't have the intellectual capacity. Surfing the internet and posting on forums is about my limit.
How did I get myself into this? I feel duped, manipulated, conned. I don't yet think or believe I've been duped, but it feels like it. I desperately want to try out a dopamine drug. Even if it ends up not working, at least it would be something different, a genuine attempt, a radically new point from which to triangulate my intractable problem. It can't do any harm, at least no more harm than any other antidepressant. Why are psychiatrists so reluctant to try dopamine thingies?
Posted by Phillipa on January 17, 2009, at 0:29:10
In reply to Venlafaxine. :-((((, posted by Onestone on January 16, 2009, at 15:42:55
I'm sorry sounds like you're having a bad time. Some say adding wellbutrin can help with adding a kick. Phillipa
Posted by Neal on January 19, 2009, at 20:33:43
In reply to Re: Venlafaxine. :-(((( » Onestone, posted by Phillipa on January 17, 2009, at 0:29:10
Phillipa's right. Sometimes cocktails do work better, but you're still early in your trial of Effexor, 17 days is a short time. Anything almost, is better than crippling depression so don't give up without another plan. Having said that, you may want to do a search (the link is at the top of the page) of Effexor to see what others have said about it. Remember, though, that those with success rarely post, while those with complaints post often.
Some Pdocs are very into "control". Others not as much. There's lots of Pdocs out there. Most will not be a good fit. When I found that one in a hundred - I knew.
I'm not a Pdoc just spinning ideas
Posted by Onestone on January 20, 2009, at 8:56:17
In reply to Re: Venlafaxine. :-((((, posted by Neal on January 19, 2009, at 20:33:43
> Phillipa's right. Sometimes cocktails do work better, but you're still early in your trial of Effexor, 17 days is a short time.
I've stopped it. It was intolerable. It made me stupid, it drained away what feeling I had, it had banished me to the the land of the shades.
Nobody told me that these effects would go away soon.
>Anything almost, is better than crippling depression so don't give up without another plan.
Sorry, have to disagree! Feeling nothing is worse than feeling misery. After all, nothing is what you feel when you're dead (I hope!). Just because things are very bad is no reason why they can't get far, far worse.
Still, I've learnt something - never start on an antidepressant without having a good understanding of why, and what it is supposed to achieve. Venlafaxine suppresses misery, but it doesn't seem to put anything positive in its place.
My plan is something which includes dopamine-reuptake-inhibition. I have to persuade a doctor to prescribe this (or try and get it illicitly).
>Having said that, you may want to do a search (the link is at the top of the page) of Effexor to see what others have said about it. Remember, though, that those with success rarely post, while those with complaints post often.
I've just had a look there, but there's too much stuff there too diffuse for me to focus on anything. Maybe later.
> Some Pdocs are very into "control". Others not as much. There's lots of Pdocs out there. Most will not be a good fit. When I found that one in a hundred - I knew.
I have a healthy sense of autonomy, and because it's about the only psychic thing I have which is healthy I will fight to the death to preserve it.
> I'm not a Pdoc just spinning ideas
Appreciated!
--
Onestone.
Posted by Neal on February 7, 2009, at 11:07:10
In reply to Re: Venlafaxine. :-(((( » Neal, posted by Onestone on January 20, 2009, at 8:56:17
(talking about quitting meds)
"Anything almost, is better than crippling depression so don't give up without another plan."
"Sorry, have to disagree! Feeling nothing is worse than feeling misery. After all, nothing is what you feel when you're dead (I hope!). Just because things are very bad is no reason why they can't get far, far worse."
Onestone,
????
Mind running that by me again. So a suicidal person should quit meds? Is that what your advising?_________________________________
Posted by Onestone on February 7, 2009, at 13:20:15
In reply to Re: Venlafaxine. :-((((, posted by Neal on February 7, 2009, at 11:07:10
Hi, Neal!
> (talking about quitting meds)
> "Anything almost, is better than crippling depression so don't give up without another plan."
> "Sorry, have to disagree! Feeling nothing is worse than feeling misery. After all, nothing is what you feel when you're dead (I hope!). Just because things are very bad is no reason why they can't get far, far worse."
> Onestone,
> ????
> Mind running that by me again. So a suicidal person should quit meds? Is that what your advising?No. I merely meant, that having experienced several decades of depression, some of it really grotty, and several weeks or months of feeling nothing (as a result of SSRIs and friends), feeling nothing is worse than feeling really grotty. Just for me, I suppose. Maybe it's different for other people.
Feeling well is not merely the absence of feeling grotty.
As to whether a suicidal person should quit meds? Possibly, maybe the medicine is making them suicidal, or has clouded their judgement as to whether that's what they really want. Maybe they're giving them the only thing they have, at whatever cost.
Maybe untreatable depression is was what the Abrahamic bible was talking about with the phrases "valley of the shadow of death" and "in the presence of my enemies" in Psalm 23. The writer's own suicidal thoughts, even. It kind of jars cacophonically with idyllic scene in the first part of the psalm. The people in King David's time, maybe King D. himself, even, would have had it even worse than we do.
I'm feeling really grotty at the moment, tears streaming down my face. I've had a week on Wellbutrin (yes, my psychiatrist came up trumps, talked it through with me), and barely spoken to a soul in that time. It's the least bad of the three drugs I've tried recently (Edronax, Venlafaxine), and still might do some good, although there's no sign of that, yet. Somehow, I'm not getting lunch till the middle of the afternoon, kind of 15:30ish, right now. One week isn't long enough to judge. Correction: I'm desperately striving to prevent myself judging prematurely or investigating any other possible drugs, or anything like that.
--
Onestone.
Posted by dcruik518 on February 7, 2009, at 14:28:38
In reply to Re: Venlafaxine. :-(((( » Neal, posted by Onestone on February 7, 2009, at 13:20:15
The venlafaxine doesn't seem to agree with you. In most cases, if you get a bad reaction from a drug early on, chances are it's not going to work well. They're have been studies on this. On the other hand, venlafaxine is a bit different from most of the other SSRI's in that it tends to work better at higher dosages. I'd either quit or ramp up the dose to 225 mg or so, which is around the dose where the norepinephrine action starts to kick in or else just get off it. Your psychiatrist can't force you to take it.
Posted by Neal on February 7, 2009, at 19:51:02
In reply to Re: Venlafaxine. :-(((( » Neal, posted by Onestone on February 7, 2009, at 13:20:15
Hey Onestone,
Sorry I came back at you, with you feelin' bad and all. Sorry you've had a hard time lately. When you find the right med (or med combo), you'll feel better.
You answered like a gentleman. I though you might take off my head with both barrels of double-00 buckshot.
Hey that previous guy sounded like a Pdoc, i.e., knowledgeable. I also take venlaxafine, so I read with interest.
-Neal
This is the end of the thread.
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