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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 izzy on March 29, 2001, at 17:22:20
since 1993, i've been on prozac, zoloft, paxil, serzone, and now effexor xr. prozac was most effective but wore off after about 18 months, plus i put on weight i have never been able to lose. effexor xr wore off after 12 weeks on 75mg. daily, then again after 12 weeks at 150mg. (the others were awful, especially serzone.)
what is next for those of us for whom ssri's stop working?
i refuse to up my effexor xr dosage every 12 weeks. it made me gain even more weight, and causes sweating and a constant feeling of bloating.
i'm very interested in hearing from people who have had the same experience of ssri's and if they have been able to successfully treat their depression with different medication.
Posted by jb on March 29, 2001, at 18:10:14
In reply to when ssri's stop working, what's next?, posted by izzy on March 29, 2001, at 17:22:20
Hi. You have lots of alternatives. First, the SSRI's inhibit serotonin reuptake, thereby making more serotonin available for message transmission. Serzone, alternatively, does not inhibit reuptake, but antagonizes or blocks a serotonin receptor post-synapse. Essentially, an alternative to achieving the same end goal. Wellbutrin also is different from the SSRI's, as are some other meds. The MAOI's, work through a different mechanism, and I find their dietary restrictions to be somewhat overblown. Parnate, an MAOI, is somewhat stimulating, and caused me to lose about 10 pounds. Also, both Serzone and Wellbutrin are supposed to be without weight gain effects.
Alternatively, your psychdoc, who, I hope, is well versed in pharmacology, could tried augmentation and combination therapies, to give you a more robust response.
Please discuss it with your psychdoc. By the way, in general, I find the most informed and least cautious psychdocs are with university based psychiatric programs. You may want to go to the nearest one for a consult.
Best of luck.
JB
Posted by ItsJustMe on March 29, 2001, at 19:50:02
In reply to when ssri's stop working, what's next?, posted by izzy on March 29, 2001, at 17:22:20
I know how you feel. I've been on Prozac (60 mgs), Wellbutrin, and Effexor XR (450 mgs)
I now take Elavil (150 mgs), Risperdal (1 mg) and Zyprexa (2.5 mg) - it's hard to know if this combination is working, as I am going through some situational depression right now. Once this "situation" passes, I'm anxious to see how I'll feel.
Have you tried any tricyclics? or something like Risperdal or Zyprexa to augment?
Dave
> since 1993, i've been on prozac, zoloft, paxil, serzone, and now effexor xr. prozac was most effective but wore off after about 18 months, plus i put on weight i have never been able to lose. effexor xr wore off after 12 weeks on 75mg. daily, then again after 12 weeks at 150mg. (the others were awful, especially serzone.)
>
> what is next for those of us for whom ssri's stop working?
>
> i refuse to up my effexor xr dosage every 12 weeks. it made me gain even more weight, and causes sweating and a constant feeling of bloating.
>
> i'm very interested in hearing from people who have had the same experience of ssri's and if they have been able to successfully treat their depression with different medication.
Posted by ChrisK on March 30, 2001, at 4:40:59
In reply to when ssri's stop working, what's next?, posted by izzy on March 29, 2001, at 17:22:20
There's a reason that the tricyclics haven't disappeared in favor of the SSRI's. They still work best for a lot of people. I went through the SSRI's and Efexor and Remeron ,etc. only to end up with Nortriptyline. In the best I had reacted to Immiprimine and my father took amitriptyline. It was a big difference in the depthh of my depression.
It wasn't the cure all as I did finally do even better once I found the right med to augment my AD. If you have something that works and then poops-out you may want to talk to your doctor about augmenting with something like Zyprexa or Naltrexone. (Do a search on this site for those words and you will find many threads involving successs with augmentation.)
Good Luck with whatever you try next.
Chris
Posted by izzy on March 30, 2001, at 12:22:53
In reply to Re: when ssri's stop working, what's next?, posted by ChrisK on March 30, 2001, at 4:40:59
i am seeing my psych in 2 weeks and will ask him about all the suggestions i receive on this site, so thanx to everyone for taking the time to post your responses.
of all the meds i've tried, serzone gave me the greatest number of problems. i turned into a shuffling zombie, and finally got to the point that i couldn't bring myself to put another pill in my mouth. i feel myself getting to the same point with effexor xr but i know i must be weaned off them because i just stopped taking serzone and spent one of the worst weekends of my life, suffering withdrawal symptoms.
the psychiatrist i see is affiliated with a counseling service; i don't know whether or not he works at a teaching hospital too. before starting on effexor xr, we discussed welbutrin but he said that it wouldn't deal with one of my problems, although i can't recall which. i suffer from anxiety, depression and i guess what you would call inertia.
thanx, again, to everyone for their advice. keep it coming!
:)
This is the end of the thread.
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