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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by melodylover on August 19, 2016, at 15:39:38
Hello:
I'm new here. I have been suffering from severe depression after a "nervous breakdown" last year. We've had very little luck finding a medication that either works or that I can tolerate for my depression.
I currently am taking 2 mg of Klonopin and 100 mg of Seroquel at night. Zoloft was ineffective. I couldn't tolerate Wellbutrin. Trintellix gave me massive headaches.
I just started Anafranil a little over a week ago. About 23 years ago I was on Pamelor for a depressive episode. (along with the Klonopin) It worked well. I'd been off it for many years. I didn't realize then that Klonopin was highly addictive, etc. It's a really sore subject for me so I prefer we don't go there for now. Initially my dose was raised but it wasn't helping so I've cut it back slowly to the original dose.
Anyhow, I am very sensitive to medication so we started with a low dose of Anafranil. I did okay on 10 mg but when we went to 25 mg my anxiety went through the roof (even with my current medications) and it is still high.
I read that anxiety can initially increase but usually subsides. However, I don't know how long that might take or if it will even happen in my case. It feels like I have too much adrenaline running through my body.
I want to give this medication a fair chance. But I'm concerned if I have this much anxiety at this low dose how am I going to increase it? Should I be trying Pamelor again instead? Initially I took one dose but it didn't make me sleep and felt somewhat activating (unlike all the years it knocked me out). The anxiety has improved ever so slightly but not enough to increase the dose and it is definitely medicine related. I didn't feel it until I went up to 25 mg. Ugh.
I'm hoping that someone here will be able to share their experience with me. Oh, and I don't really have OCD (although I am obsessed with getting my depression under control so perhaps I do).
Any advice or input would be appreciated.
Posted by melodylover on August 19, 2016, at 16:12:00
In reply to Anafranil start-up anxiety, posted by melodylover on August 19, 2016, at 15:39:38
I apologize for the double post. I'm not sure how that happened.
Posted by Christ_empowered on August 19, 2016, at 17:14:17
In reply to Anafranil start-up anxiety, posted by melodylover on August 19, 2016, at 15:39:38
I'm clearly not any kinda expert, much less the expert(s) handling your situation.
But...maybe first try getting the seroquel up to around 300mgs/nightly? That's the dose that's supposed to do good things for all kinds of depression, agitation, anxiety, etc. 100mgs I think is still where its mostly an antihistamine.
Try not to worry too much about the klonopin. Tapers can be rough ((I've been there)), but there's ways to make it easier, when and if you and your prescriber decide its time to call it a day with the benzos.
Since you're on the TCA family of drugs...maybe Surmontil? Its sedating and not very stimulating, but effective. I don't think it'd be the best idea with seroquel, though...but again, I'm not a doctor.
amoxapine is another one I'd think about. Its a tca, but it has some antipsychotic properties. It supposed to work fast ((if it works for you)), and the built in antipsychotic component is a good thing for some people. Again, I don't know that its the best thing to combine with seroquel...but I'm not your doctor...
the only additional strategy I can think of would be remeron+something in addition. Like...remeron+effexor, remeron+wellbutrin, remeron+prozac, that kinda thing. Remeron tends to be very sedating.I hope this helps. Again, I'm just throwing out ideas for you...don't take this as me trying to tell you what to do or anything.
Posted by melodylover on August 19, 2016, at 17:42:46
In reply to Re: Anafranil start-up anxiety, posted by Christ_empowered on August 19, 2016, at 17:14:17
> I'm clearly not any kinda expert, much less the expert(s) handling your situation.
>
> But...maybe first try getting the seroquel up to around 300mgs/nightly? That's the dose that's supposed to do good things for all kinds of depression, agitation, anxiety, etc. 100mgs I think is still where its mostly an antihistamine.
>
> Try not to worry too much about the klonopin. Tapers can be rough ((I've been there)), but there's ways to make it easier, when and if you and your prescriber decide its time to call it a day with the benzos.
>
> Since you're on the TCA family of drugs...maybe Surmontil? Its sedating and not very stimulating, but effective. I don't think it'd be the best idea with seroquel, though...but again, I'm not a doctor.
>
> amoxapine is another one I'd think about. Its a tca, but it has some antipsychotic properties. It supposed to work fast ((if it works for you)), and the built in antipsychotic component is a good thing for some people. Again, I don't know that its the best thing to combine with seroquel...but I'm not your doctor...
>
>
> the only additional strategy I can think of would be remeron+something in addition. Like...remeron+effexor, remeron+wellbutrin, remeron+prozac, that kinda thing. Remeron tends to be very sedating.
>
> I hope this helps. Again, I'm just throwing out ideas for you...don't take this as me trying to tell you what to do or anything.I appreciate your input. My pdoc was using Seroquel for sleep because nothing else I tried (Elavil, Trazadone, Ambien, etc. would work) I also believe he was using it to poteniate ADs. He actually had me come down to 100 mg. from 150 mg. At the time I was on 100 mg. of Zoloft but felt no change in my depression. So, I'm not sure what his thoughts are on that. But it is something to ask about.
In the past I have not tolerated SSRIs at all. That's how I got on TCAs in the first place. I was shocked to get up to 100 mg of Zoloft. So disappointed that I didn't feel it at all.
There is some question as to whether some of this is hormonally modulated because of my age but still the depression is very severe. So, I need an effective AD.
I mentioned Remeron to him at my last appointment before we moved in this direction. He said if I was sleeping it really wasn't worth considering.
I've not informed him of this medicine induced anxiety yet because I keep hoping that it will pass.
We don't have Surmontil here in the states. It looks more calming. I wish we had it.
I guess I was hoping that someone here has taken the drug that I am on and possibly experienced start-up anxiety only to find that it passed. Or maybe a drug with NE is just not going to work for me.
I wondered if Pamelor had less impact on NE but haven't found an answer. Plus I know everyone reacts differently.
I know that Anfaranil is a good drug for OCD and also for depression. I want it to work so badly. It's been almost a year with no relief.
Prozac & Remeron are something to think about. I just want to give this drug a fair try but unless my anxiety level drops back down...I don't know.
Thank you for the ideas. I appreciate it.
Posted by David1973 on August 21, 2016, at 14:17:24
In reply to Re: Anafranil start-up anxiety, posted by melodylover on August 19, 2016, at 17:42:46
Hi,I haven't taken anafranil but I have been on a few TCA's such as imipramine, trimipramine and amitriptyline. Trimipramine was the only one that didn't cause an increase in anxiety in the first week or so. I`m sure anafranil is very strong on SRI? so hopefully when that kicks in, it will cut off the increase in NA for you. Just keep taking it slow, and don't try remeron - you won't be anxious, just angry !!
Cheers, and good luck, Dave.
This is the end of the thread.
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