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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Jenny F. on October 27, 2000, at 16:24:21
Hi,
I'm 43 years old and have manic-depression since 1993. I've been on all kinds of antidepressant drugsin the past years. About a year ago my Pdoc put me on neurontin 300mg 3x a day. About two months ago I started feeling anxious asnt the Pdoc told me that I can up my neurontin to 1 more pill (300mg) a day. Well, I didn't do it and now I'm in major depression. My Pdoc is out of town for a month and I had to see my primary doc. She told me to start the paxil at 10mg a day for a week. Well the paxil gave me that stone and tired feeling most of all the time. Then she told me to stop the paxil and to start effextor xr in a couple of days. Well, by now after reading all the babbles about the effextor, I'm worried about its side effects. I'm in a 17 year relatioship with my boyfriend and for the past 6 years we've been having problems with sex. Right now the both of us are getting counseling for this issue. I'm worried that the effextor xr may make things worst for us at this point in time. Can anyone help to giveme some advice or feedback on this situation? Is there any recommendations on the meds that I can take that won't give me sexual dysfunctions and the less side effects?
Jenny
Posted by R.Anne on October 27, 2000, at 16:40:09
In reply to Re: Worried!!!, posted by Jenny F. on October 27, 2000, at 16:24:21
You won't be able to tell if the Effexor gives you sexual side effects unless you try it first. I take it and it's okay by me. Side effects vary with the individual.
****
> Hi,
>
> I'm 43 years old and have manic-depression since 1993. I've been on all kinds of antidepressant drugsin the past years. About a year ago my Pdoc put me on neurontin 300mg 3x a day. About two months ago I started feeling anxious asnt the Pdoc told me that I can up my neurontin to 1 more pill (300mg) a day. Well, I didn't do it and now I'm in major depression. My Pdoc is out of town for a month and I had to see my primary doc. She told me to start the paxil at 10mg a day for a week. Well the paxil gave me that stone and tired feeling most of all the time. Then she told me to stop the paxil and to start effextor xr in a couple of days. Well, by now after reading all the babbles about the effextor, I'm worried about its side effects. I'm in a 17 year relatioship with my boyfriend and for the past 6 years we've been having problems with sex. Right now the both of us are getting counseling for this issue. I'm worried that the effextor xr may make things worst for us at this point in time. Can anyone help to giveme some advice or feedback on this situation? Is there any recommendations on the meds that I can take that won't give me sexual dysfunctions and the less side effects?
>
>
> Jenny
Posted by JohnL on October 27, 2000, at 17:30:07
In reply to Re: Worried!!!, posted by Jenny F. on October 27, 2000, at 16:24:21
Jenny,
Sorry to here about your situation. It's very troubling I know. Maybe some ideas to think about...The only antidepressants known for being prosexual are Wellbutrin or Serzone. But since you've already been on all kinds of antidepressants, as you say, I would almost be tempted to not even go there. Been there, done that, right? Wasn't the right way, right?
Your depression could be caused by some part of your brain that is not influenced by antidepressants, and thus their failure for you. Side effects as you mentioned can be limiting too. One doctor kept track of what percentage of patients got completely well (after years of not getting well, like you) on which medications. What is interesting is that some of the things that worked had no clinical justification. Neurontin was probably a good move in that respect. Sad it didn't work out. But here are ideas to think about:
Serotonin antidepressants Worked completely for 34% of patients
Norepinephrine antidepressants Worked completely for 7%
Mixed antidepressants 6%
Lithium 29%
Benzodiazapines 15%
Antipsychotics 13%
Stimulants 12%
Depakote 11%
Tegretol 3%
Thyroid, even when blood tests were OK 28%Just based on what worked for others, take a look at Lithium. No wonder it's a top choice by many doctors. It works best when combined with a serotonin antidepressant though. Normal dosing is usually low, such as 300mg to 900mg, which is pretty mild in my own experience. Benzo choices might be Xanax or Clonazepam, probably if you have an anxiety component with your depression. On the other hand, if your depression is the blah kind, a stimulant like Ritalin or Adderall might be considered, and usually work better when combined with a low dose serotonin antidepressant.
Have you ever tried Prozac? It is usually the least offensive for sex, and sometimes even good for sex, among the SSRIs. If you need a serotonin AD as a base with something else, like stimulant, antipsychotic, or Lithium, Prozac might be considered. Paxil and Zoloft on the other hand are notorious sex offendors.
Lamictal could also be a fine choice for a Neurontin replacement. Antipsychotics of choice would be first Zyprexa, and then maybe Risperdal. Is this all overwhelming, or what? That's why I think it's helpful to look at the list of statistics, start with you best odds, and work your way down the list until you find what's right for you.
I wish we could all get well on the same meds. If we could, I would say order some Amisulpride and Adrafinil and be well. Either one or both together worked for me after years and years of just about everything else not working. But without trying those, referring to the above list should help steer you in the right direction.
What can you do right now today? You could go to Wal*Mart, buy a $20 box of NatureMade SAMe, take one pill in mid morning with water on an empty stomach, one more in mid afternoon the same way. After a couple days, double the dose. SAMe has the potential to work very fast, like within 3 days. It may or may not be a longterm fix, but it is a very good stepping stone to buy you some time. Immediate relief is a real potential with SAMe. I find it best in those times of crisis, because it is a solid stepping stone and lifts me out of the deep long enough to wait until I can see the doctor again. While you're waiting and thinking, SAMe can be started right away. Right after you finish reading this. No prob mixing it with 10mg Paxil or Neurontin. It is sometimes used to speed up the response of an antidepressant anyway.
John
Posted by R.Anne on October 27, 2000, at 18:02:54
In reply to Re: Worried!!!, posted by Jenny F. on October 27, 2000, at 16:24:21
Just wanted to add that effexor is not an ssri and I have never heard that only 2 antidepressants are prosexual. I have taken many and have not had sexual problems with many. I take effexor and paxil and have no sexual problems. Like I said, and I firmly believe, side effects vary with the individual-my doctor will confirm that, too. You may or may not have problems with effexor, in other words. As for over the counter remedies-they are not well explored or studied and a pharmacist told me they are drugs, too, and we need to watch what we mix that way. So, please be careful. Best wishes for your wellness.
I hope things get better for you.
*******
> Hi,
>
> I'm 43 years old and have manic-depression since 1993. I've been on all kinds of antidepressant drugsin the past years. About a year ago my Pdoc put me on neurontin 300mg 3x a day. About two months ago I started feeling anxious asnt the Pdoc told me that I can up my neurontin to 1 more pill (300mg) a day. Well, I didn't do it and now I'm in major depression. My Pdoc is out of town for a month and I had to see my primary doc. She told me to start the paxil at 10mg a day for a week. Well the paxil gave me that stone and tired feeling most of all the time. Then she told me to stop the paxil and to start effextor xr in a couple of days. Well, by now after reading all the babbles about the effextor, I'm worried about its side effects. I'm in a 17 year relatioship with my boyfriend and for the past 6 years we've been having problems with sex. Right now the both of us are getting counseling for this issue. I'm worried that the effextor xr may make things worst for us at this point in time. Can anyone help to giveme some advice or feedback on this situation? Is there any recommendations on the meds that I can take that won't give me sexual dysfunctions and the less side effects?
>
>
> Jenny
Posted by MarkinBoston on November 1, 2000, at 17:58:39
In reply to Re: Worried!!!, posted by Jenny F. on October 27, 2000, at 16:24:21
> Hi,
>
> I'm 43 years old and have manic-depression since 1993. I've been on all kinds of antidepressant drugsin the past years. About a year ago my Pdoc put me on neurontin 300mg 3x a day. About two months ago I started feeling anxious asnt the Pdoc told me that I can up my neurontin to 1 more pill (300mg) a day. Well, I didn't do it and now I'm in major depression. My Pdoc is out of town for a month and I had to see my primary doc. She told me to start the paxil at 10mg a day for a week. Well the paxil gave me that stone and tired feeling most of all the time. Then she told me to stop the paxil and to start effextor xr in a couple of days. Well, by now after reading all the babbles about the effextor, I'm worried about its side effects. I'm in a 17 year relatioship with my boyfriend and for the past 6 years we've been having problems with sex. Right now the both of us are getting counseling for this issue. I'm worried that the effextor xr may make things worst for us at this point in time. Can anyone help to giveme some advice or feedback on this situation? Is there any recommendations on the meds that I can take that won't give me sexual dysfunctions and the less side effects?
>
>
> JennyEffexor worked better for me than any SSRI's. It got me out of some major episodes and restored my libido due to the depression lifting. The bad part was anorgasmia, which made my girlfriend feel like she wasn't attractive to me, despite knowing my meds and reassurances etc.. She was thinking I wasn't attracted to her because men are simpler, with little variation compared to finding what succeeds on a woman - so it must be her (it triggered an existing insecurity of hers).
I had no withdrawl problems, just some excess sweating, and apathy. Wellbutrin made me feel like I had the flu, and Serzone initially gave me some sexual dreams, but has stopped doing that. I'm about to give up on it. More than 50/150mg a day fogs my brain and sedates me.
This is the end of the thread.
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