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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Sef on February 6, 2000, at 19:19:24
I am not sure when my depression started or if I have always had it. Anyway, about 7 years ago I 'crashed,' I couldn't get out of bed or get in the shower to go to work. Since that time I have struggled, been 'cured' and strugled again. Here is my med history....when I first 'crashed' I was given 20mg of Prozac and Xanax to help me sleep at night. After 1 month it did not work so my pdoc gave me desipramine too. About a week later, it kicked in. I couldn't believe how well it worked, it was a miracle! I took the meds for 8 months, decided I was cured and stopped going to the pdoc. My weight had stabilized, I lost my urges to binge on snickers, my thoughts of suicide left, and I had energy and optimism! I'm not sure how much time passed, but my depression came back again. I didn't want to go to a pdoc again so I tried herbal remedies, but I continued to spiral. Finally, I went to my MD and asked to try Prozac again. It worked like a miracle again, but as before, the effects wore off. So my MD increased my dosage to 40mg, which helped alittle, but it was still not like before. Frustrated with the costs I was incurring and no relief, I quit all meds again. I bottomed out again and swallowed my pride, I went to a pdoc again. He tried Effexor (which made me throw up), Paxil (which made me sleep ALOT and gain weight), Zoloft (which I had a bad reaction to), and then finally he put me on Prozac again, along with Impramine. I had to stop the Impramine because of a reaction, but he kept me on the Prozac. Again it worked like a miracle, but after about 6 months, stopped working. Again I had an increase to 40 mg and then to 60 mg, but I could not tolerate 60 so he dropped me down to 50 mg. But it is not working. At one point he prescribed me neurotin, but when I found out it was an anti-convulsive med I got scared and stopped taking it. Is there anything out there that won't stop working after a while? What should I do? I wonder sometimes if I have a defective gene or something because I have 3 siblings who also suffer with debilitating depression. One has attempted suicide, one has been hospitalized for it , and the other also has OCD. Help!!!!!!
Posted by Cheryl on February 6, 2000, at 19:30:49
In reply to Help! My Prozac stopped working, what should I do?, posted by Sef on February 6, 2000, at 19:19:24
Sometimes meds wear out. mine work about 6 months before I have to move on. I am thankful for a dr that trys to stay ahead of my body.Good luck on your search.
Posted by Sef on February 6, 2000, at 19:54:11
In reply to Re: Help! My Prozac stopped working, what should I do?, posted by Cheryl on February 6, 2000, at 19:30:49
> Sometimes meds wear out. mine work about 6 months before I have to move on. I am thankful for a dr that trys to stay ahead of my body.Good luck on your search.
Thanks for the info. I had no idea.
Posted by Sef on February 6, 2000, at 20:34:54
In reply to Help! My Prozac stopped working, what should I do?, posted by Sef on February 6, 2000, at 19:19:24
> If anyone has had a similar experince or a sugestion for a new med for me to try I would really appreciate it. Thanks!
Posted by Cam W. on February 6, 2000, at 22:03:07
In reply to Any suggestions for a new med for me?, posted by Sef on February 6, 2000, at 20:34:54
> > If anyone has had a similar experince or a sugestion for a new med for me to try I would really appreciate it. Thanks!
Sef - Maybe talk to you doc again about the Neurontin. Just because a drug is used for one condition (eg epilepsy) doesn't mean that it will not work for another. Neurontin has been used successfully in a couple of different disorders (eg as a mood stabilizer; also in some pain disorders) and may augment the Prozac you were (are?) taking. Most medications work at a number of different receptors and recptor subtypes. This is what leads to what we call "side effects." While treating epileptics for convulsions in clinical trials, one of the "side effects" that they noticed was that Neurontin improved the mood of the people taking it. Recently, clinical trials using Neurontin have been done for mood stabilization in bipolar disorder and in neuropathic pain (I believe). While not everyone has seen improvement using Neurontin alone, many have had dramatic results when using it as an add-on agent. I have heard of it being used successfully with antidepressants in bipolar depression, I cannot remember seeing any studies actually using it unipolar depression. Since bipolar depression is usually much harder to treat than the bipolar kind, it may be worth a try to use Prozac with Neurontin. Give it an adequate trial of a month or two to see if it helps. Neurontin is a relative safe drug compared to some of the others used in psychiatry. Also, you problems with Prozac ("Prozac Poop-out") is not that uncommon and using the strategy of adding an augmenting agent for this is also not uncommon. Hope this has helped. Good luck - Cam W.
Posted by Noa on February 6, 2000, at 22:36:50
In reply to Re: Any suggestions for a new med for me?, posted by Cam W. on February 6, 2000, at 22:03:07
I agree with Cam. You had some response to Prozac, but then had poop out, and instead of dropping the Prozac, it would be a good idea to augment it. Neurontin is one way.
Also, it is common for a med to not work as well the second time around after stopping it. I took Prozac successfully for a year, stopped for a year, took it for another year, stopped for two years, and then started again. This third time, I needed higher and higher doses until I got a rash. After that, my depression was increasingly resistant to treatment.
Posted by jd on February 7, 2000, at 2:59:18
In reply to Re: Any suggestions for a new med for me?, posted by Noa on February 6, 2000, at 22:36:50
Sef,
Sorry to hear about the "poop-out". The trick is probably to try a number of novel augmentation strategies until you find something that helps. One thing I'm not sure you've considered yet is naltrexone (an opioid blocker most frequently prescribed to people with drug or alcohol addictions.) It's been much discussed on this site as a way of combatting "poop-out", especially as an add-on to Prozac or other SSRIs. Some people have claimed to have had terrific results--definitely worth looking into, in any event. (For more info, see last years postings and some very detailed information from doctors on the "tips" part of the dr-bob site.)Best to you,
jd
> I agree with Cam. You had some response to Prozac, but then had poop out, and instead of dropping the Prozac, it would be a good idea to augment it. Neurontin is one way.
>
> Also, it is common for a med to not work as well the second time around after stopping it. I took Prozac successfully for a year, stopped for a year, took it for another year, stopped for two years, and then started again. This third time, I needed higher and higher doses until I got a rash. After that, my depression was increasingly resistant to treatment.
Posted by JohnL on February 7, 2000, at 3:53:40
In reply to Re: Sef--heard of naltrexone for "poop-out"?, posted by jd on February 7, 2000, at 2:59:18
Dittos on Naltrexone. Of all the possible things to do at this point, I would put Naltrexone at the top of the list, high priority.
Up this page just a bit is a post about Luvox. Check out that post and the response for a very similar situation and more info on Naltrexone. Adding 25mg Naltrexone to either 20mg or 40mg Prozac stands a high chance of working wonderfully for many years to come. JohnL
Posted by ChrisK on February 7, 2000, at 5:18:00
In reply to Re: Sef--heard of naltrexone for "poop-out"?, posted by JohnL on February 7, 2000, at 3:53:40
Sef, I've had a good reaction to Naltrexone as an augmentation. I would talk to your doctor about it. In my case I take 50mg at night and feel much better since it was added.
Good Luck with whatever you try,
Chris
Posted by Andy on February 7, 2000, at 10:28:57
In reply to Help! My Prozac stopped working, what should I do?, posted by Sef on February 6, 2000, at 19:19:24
I had a similar problem with prozac--it works great but I can't tolerate it. I've had alot of luck with buspar (60mg/day) taming the side effects of prozac (which for me were anxiety and insomnia). Recently I added 25mg Nortriptyline to help sleep. Maybe 60mg prozac is just what you need, so if you can find a way to tolerate it you're in business.
> I am not sure when my depression started or if I have always had it. Anyway, about 7 years ago I 'crashed,' I couldn't get out of bed or get in the shower to go to work. Since that time I have struggled, been 'cured' and strugled again. Here is my med history....when I first 'crashed' I was given 20mg of Prozac and Xanax to help me sleep at night. After 1 month it did not work so my pdoc gave me desipramine too. About a week later, it kicked in. I couldn't believe how well it worked, it was a miracle! I took the meds for 8 months, decided I was cured and stopped going to the pdoc. My weight had stabilized, I lost my urges to binge on snickers, my thoughts of suicide left, and I had energy and optimism! I'm not sure how much time passed, but my depression came back again. I didn't want to go to a pdoc again so I tried herbal remedies, but I continued to spiral. Finally, I went to my MD and asked to try Prozac again. It worked like a miracle again, but as before, the effects wore off. So my MD increased my dosage to 40mg, which helped alittle, but it was still not like before. Frustrated with the costs I was incurring and no relief, I quit all meds again. I bottomed out again and swallowed my pride, I went to a pdoc again. He tried Effexor (which made me throw up), Paxil (which made me sleep ALOT and gain weight), Zoloft (which I had a bad reaction to), and then finally he put me on Prozac again, along with Impramine. I had to stop the Impramine because of a reaction, but he kept me on the Prozac. Again it worked like a miracle, but after about 6 months, stopped working. Again I had an increase to 40 mg and then to 60 mg, but I could not tolerate 60 so he dropped me down to 50 mg. But it is not working. At one point he prescribed me neurotin, but when I found out it was an anti-convulsive med I got scared and stopped taking it. Is there anything out there that won't stop working after a while? What should I do? I wonder sometimes if I have a defective gene or something because I have 3 siblings who also suffer with debilitating depression. One has attempted suicide, one has been hospitalized for it , and the other also has OCD. Help!!!!!!
Posted by Sef on February 7, 2000, at 11:20:20
In reply to Re: Help! My Prozac stopped working, what should I do?, posted by Andy on February 7, 2000, at 10:28:57
>Thanks to all for your info and letting me know I am not alone. Noa, I took your advice and looked up Naltrexone under 'tips.' I am going to discuss augmentation of it with prozac with my MD. Cam, I will keep your advice and try Neurontin again if the Naltrexone doesn't work.
Posted by Sef on February 7, 2000, at 12:26:50
In reply to Thanks for info, my decision..., posted by Sef on February 7, 2000, at 11:20:20
> >Thanks to all for your info and letting me know I am not alone. jd, I took your advice and looked up Naltrexone under 'tips.' I am going to discuss augmentation of it with prozac with my MD. Cam, I will keep your advice and try Neurontin again if the Naltrexone doesn't work.
(My mistake, thanked wrong person for advice about Naitrexone and 'tips', but also grateful to Noa for advice on Neurontin.)
Posted by jd on February 7, 2000, at 14:54:57
In reply to Re: Thanks for info, my decision...CORRECTION, posted by Sef on February 7, 2000, at 12:26:50
Glad we could be of help, Sef... If you
do decide to give naltrexone a trial,
keep in mind that some people have found
it helpful to start with very small dosages
and work upwards to 25 or 50mg as
tolerated. (You'll see discussion of
this in last year's posts.)
Let us know how it goes.
--jd
> > >Thanks to all for your info and letting me know I am not alone. jd, I took your advice and looked up Naltrexone under 'tips.' I am going to discuss augmentation of it with prozac with my MD. Cam, I will keep your advice and try Neurontin again if the Naltrexone doesn't work.
>
> (My mistake, thanked wrong person for advice about Naitrexone and 'tips', but also grateful to Noa for advice on Neurontin.)
This is the end of the thread.
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