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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Phil on December 18, 1998, at 19:12:07
I posted on 12/16 about Paxil and Ritalin combo. I seem to do pretty well when I am engaged at work but at home or on days off I just don't seem to care much about anything. I was on amitryp. for years and used to exercise, run and bike, alot. On this combo I am apathetic. I see a psychopharmachologist that I trust but would greatly appreciate second opinion. Would Wellbutrin be a logical choice? Time my Paxil/Ritalin doses differently? Laack of libido still troubling- same as tryp days. Thanks, Phil
Posted by Matt on December 19, 1998, at 2:08:45
In reply to Need opinion from Docs, posted by Phil on December 18, 1998, at 19:12:07
Somewhere in Dr. Bob's psych. tips there is something about SSRIs causing apathy. I don't remember the heading of the bit, though.
Matt
Posted by Dr. Bob on December 19, 1998, at 2:48:31
In reply to Re: Need opinion from Docs, posted by Matt on December 19, 1998, at 2:08:45
> Somewhere in Dr. Bob's psych. tips there is something about SSRIs causing apathy. I don't remember the heading of the bit, though.
http://www.dr-bob.org/tips/split/SSRIs-and-apathy.html
BTW, if you're not sure what heading something might be under, you can always just search for a term like "apathy"...
Bob
Posted by Barbara on December 19, 1998, at 8:18:17
In reply to Re: Need opinion from Docs, posted by Matt on December 19, 1998, at 2:08:45
> Somewhere in Dr. Bob's psych. tips there is something about SSRIs causing apathy. I don't remember the heading of the bit, though.
> Matt
In addition to Dr. Bob's psych tips, there is a small but informative Q & A entitled "Paxil and the Blunted Affect" on the web at a site called "Ask the Expert."
THe doctor says the dull apatheitc feeling occurs after a period of week or months of successful treatment -- and goes on to describe ir as a "kind of frontal lobe syndrome, characterized by apathy, lack of emotional responsivity, and feeling flat or "blah." I dont think I was depressedat the point and depression is not what I was feeling -- just didnt really much care about anything -- except what I wanted to do -- it was a fairly awful thing for me as a legal professional because it touched on all parts of my life.Additionally I had significant memory loss.
He goes on to say.". . .that SSRISs indirectly reduce dopamine levels in some brain regions, perhaps the area of the brain concerned with reward and pleasure," And he says that these effects can sometimes be overcome by adding a dopminergic agent like Ritalin or Wellbutrin.
I had this response to Prozac -- it was disastrous because of the added effect the loss of dopamine had on the symptoms of ADHD. I went off the Prozac (gradually) and started on Wellbutrim augmented by Cytomel in addition to the Dexedrine 40 mg. spansules I take daily. I stopped the Prozac 4 months ago and although I feel much better, I am not back to my self yet. Sort of blah still. I used to be a hard charger -- I havent seen that person in a while and I miss her.
I have not been able to find very much on this topic on the web.
Good luck.
This is the end of the thread.
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