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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by sweetmarie on July 20, 2001, at 14:45:44
I seem to always turn to this board when I`m feeling desperate. So, as usual, I`m desperate.
I`ve been in hospital for 3 months (I`m currently on home leave) and for the past 10 weeks I`ve been on a combination of Mirtazapine, Venlafaxine and Lamotragine. I`ve been on the `therapeutic dose` for 5 weeks now.
One of my key nurses there has me keeping a mood diary, detailing my mood (out of 10) and what I have been able to do.
I didn`t think that things were improving, but looking at these charts I can see that there has been a gradual shift over the past 6 - 7 weeks. This was encouraging as I`ve been in a severe state for ages and ages (3 years in total, but `flatlining` at zero for the past 10 months). Anyway, there was a definite shift - not anything massive (I wouldn`t trust that anyway), but certainly an improvement.
However, the past week and a half has seen a dip. Not a return to the same situation I was in prior to admission, but a `slump` all the same. For example, I was having an average of 5 `good` periods per week (I count 3 out of 10 and above as `good`). The recent week or so I`ve only had a few good periods, and the lows have been LOW.
There is stuff going on, namely: imminent discharge (3 weeks` time), and home leave this w/end is difficult as I`ve come back to an empty house (my parents are away and I`ve said that I`d look after the house and feed their cats). Also, I feel under pressure to get things `in place` for after discharge in order that I maintain what small momentum I`ve achieved. Finally - and this may sound trivial - my financial situation is in a mess (I`m very overdrawn due to various mistakes in my state benefit), and I`m worried about this.
So, what`s my point exactly? I suppose I`m looking for reassurance. I have a big concern that I`ve `gone back to square 1`, and the past weeks improvement have been wiped out. Could it be that outside stuff can effect recovery?
My psychiatrist doesn`t seem to be alarmed and say that I am where he would `expect` me to be right now. Fo myself, I would be loath to change meds, esp when they seemed to have been working (albeit slowly).
Can anyone help?
I`d be really grateful.
Ta,
Anna.
Posted by Edward on July 20, 2001, at 15:37:59
In reply to HELP !! , posted by sweetmarie on July 20, 2001, at 14:45:44
I don't know if I can say anything to help, but I think I understand what you're going through. I'm leaving hospital for good in three weeks (day patient at the moment), and I'm not better. I've been on mirtazapine for months, and my psychiatrist sees a big improvement that I'm not feeling. I started going to the hospital last september and hit a low around february, which I'm out of now, but if anything I'm worse than I was when I was first admitted.
According to my psychiatrist it's normal for your mood to fluctuate as it improves over a long period of time. Maybe the last week and a half hasn't been good, but that doesn't mean that you won't continue to improve.
Let your parents know when you're finding things difficult. I felt a lot of pressure from mine to get better and get my life going quicker than I felt able to, but when I eventually talked to them about I found that I'd misunderstood, and they just wanted to support me as much as they could.
Good luck,
Edward
Posted by sweetmarie on July 20, 2001, at 18:11:29
In reply to Re: HELP !! , posted by Edward on July 20, 2001, at 15:37:59
> I don't know if I can say anything to help, but I think I understand what you're going through. I'm leaving hospital for good in three weeks (day patient at the moment), and I'm not better. I've been on mirtazapine for months, and my psychiatrist sees a big improvement that I'm not feeling. I started going to the hospital last september and hit a low around february, which I'm out of now, but if anything I'm worse than I was when I was first admitted.
>
> According to my psychiatrist it's normal for your mood to fluctuate as it improves over a long period of time. Maybe the last week and a half hasn't been good, but that doesn't mean that you won't continue to improve.
>
> Let your parents know when you're finding things difficult. I felt a lot of pressure from mine to get better and get my life going quicker than I felt able to, but when I eventually talked to them about I found that I'd misunderstood, and they just wanted to support me as much as they could.
>
> Good luck,
> EdwardHi Edward
Thanks for your reply - it helps to know that I`m not alone, although I`m obviously sorry to hear that you`re not good.
The whole `parents` thing is complicated (isn`t it always?). I did tell my mother that I was nervous about this w/end, but she got mad with me and told me that I should think about her `for a change`. They fluctuate between being really supportive and understanding, being really distant, and getting fed up and cross about the whole situation. I guess that`s natural, but I was quite upset that she was so `off` about the w/end. Still, the hospital are aware of the situation, and how worried I am (about the w/end and my dip in mood). I was really upset this morning before I went to get the bus, and (unusually for me) I spoke to one of them. They told me that I could ring at any time, which was good of them. I know that I won`t though.
I sympathise with you about your psychiatrist`s view of your state of mind as opposed to your own. Everyone around me is convinced that I`ve come on in leaps and bounds - nurses, psychiatrist, family etc. It`s really frustrating.
Anyway, I hope that all goes well for you and thanks again.
Best wishes,
Anna.
p.s. which hospital are you at?
Posted by JohnL on July 21, 2001, at 3:57:17
In reply to HELP !! , posted by sweetmarie on July 20, 2001, at 14:45:44
> Can anyone help?
>
> I`d be really grateful.
>
> Ta,
>
> Anna.Hi Anna,
In your shoes, with the benefit of hindsight, I would simply substitute Zyprexa in place of Remeron. I could go on and on about why I feel this way, and there is a ton of research to back it up.I too felt the same kind of subtle improvement as you with Remeron in the mix, and I still had some dips, like you, but when I changed to Zyprexa instead of Remeron, a whole new world opened up for me. The two drugs feel similar in a lot of ways, except that Zyprexa has a much broader effect on dopamine, norepinephrine, and serotonin than does Remeron. In your case, you could keep the Effexor where it is, possibly reduce Lamictal dosage, and add 5mg Zyprexa at dinner time. No Remeron.
John
Posted by sweetmarie on July 21, 2001, at 7:25:08
In reply to Re: HELP !! , posted by JohnL on July 21, 2001, at 3:57:17
I too felt the same kind of subtle improvement as you with Remeron in the mix, and I still had some dips, like you, but when I changed to Zyprexa instead of Remeron, a whole new world opened up for me. The two drugs feel similar in a lot of ways, except that Zyprexa has a much broader effect on dopamine, norepinephrine, and serotonin than does Remeron. In your case, you could keep the Effexor where it is, possibly reduce Lamictal dosage, and add 5mg Zyprexa at dinner time. No Remeron.
> JohnJohn
Thanks for replying.
I`m being treated by a specialist at the minute (and for the foreseeable future), so I really have to go along with his `plan`. I`m not sure what the situation would be re. suggesting new meds etc - although I would like to. I may broach the subject with him before I`m discharged - i.e. just ask him whether input would be welcomed or not.
The other thing is that I don`t know what Zyprexa is. Is it a US thing? It may go under another name in this country (UK). What is it`s generic name?
Anyway, thanks again - all input is gratefully received.
Ta,
Anna.
Posted by Edward on July 22, 2001, at 10:25:33
In reply to Re: HELP !! » Edward, posted by sweetmarie on July 20, 2001, at 18:11:29
> p.s. which hospital are you at?
Riverside adolescent unit, in Bristol. I'm the UK too. They confuse me on this site with the American brand names. I told everyone about my terrible paxil withdrawal symptoms thinking that paxil was the American name for fluxovamine. Actually it was paroxetine which I gave up with no trouble at all. Whoops.
E
Posted by sweetmarie on July 22, 2001, at 11:15:31
In reply to Re: HELP !! » sweetmarie, posted by Edward on July 22, 2001, at 10:25:33
Riverside adolescent unit, in Bristol. I'm the UK too. They confuse me on this site with the American brand names. I told everyone about my terrible paxil withdrawal symptoms thinking that paxil was the American name for fluxovamine. Actually it was paroxetine which I gave up with no trouble at all. Whoops.
Hello again Edward
You must be awfully young ... mind you, I imagine that you will think me really old (34), but I don`t feel any different than I did when I was in my teens (i.e. dazed and confused).
I`m at the Royal Victoria Infirmary in Newcastle-upon-Tyne. I actually live in Leeds, but this is a specialist research unit for treatment resistant depression and eating disorder sufferers. All the patients there have been several times around the block treatment-wise, and have been referred there by baffled psychiatrists. I`ve had depression on and off for as far back as I can remember, and have been in hospital 3 times prior to this admission. I completely swore never to go back into hospital after my previous admission, and had to be talked into going up to N`castle (about 200 miles away) because I didn`t want to face the same disappointment again. Which is why I`m really f***ed off about my discharge in 3 weeks` time.
There is a woman up there with me who has been referred from Somerset.
Anyway. Just thought I`d tell you.
Anna.
This is the end of the thread.
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