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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Sigolène on September 8, 2001, at 3:28:21
No psychiatrist wants to believe me when i say I'm a complete serotonine enhancers intolerant. No matter which way the med. acts, i'm even intolerant to natural products like plants wich have a very small effect on serotonine. I also can't tolerate lithium because it acts on serotonine. I need a very specific norepinephrine active med, wich is not easy to find.
All serotonine meds are worsening my depression very fast (3rd day), and there is no ulterior improvement.When I say this to any psychiatrist, they answer that if serotonine enhancers could worsen depression, it should be known for a long time, and they never heard about that. They think this king of remark is due to my "personality disorder", which makes my incapable of objective judgment... I hate hearing things like that.
I think that if there is no research reporting complete intolerance to serotonine enhancers, it's because it's against the interests of medication industry, which finances nearly all med. researchers.
If anyone of you knows even one research reporting about that intolerance effect on 5HT enhancers, I would really appreciate that you gave me the reference of it, in order to show it to those narrow minded psychiatrists. Thank you.
And if you are like me, complete serotonine enhancers intolerant, I would be glad to know you, so please answer to that message. I'll know then that i'm not alone against medications industry.Sigolène
Posted by SalArmy4me on September 8, 2001, at 3:34:35
In reply to any serotonine enhancers intolerance, possible ?, posted by Sigolène on September 8, 2001, at 3:28:21
Try something that is the opposite of Paxil, yet works wonders: Tianeptine - http://www.smart-drugs.net/tianeptine/tianeptine-articles.htm
Posted by adamie on September 8, 2001, at 10:49:00
In reply to any serotonine enhancers intolerance, possible ?, posted by Sigolène on September 8, 2001, at 3:28:21
> No psychiatrist wants to believe me when i say I'm a complete serotonine enhancers intolerant. No matter which way the med. acts, i'm even intolerant to natural products like plants wich have a very small effect on serotonine. I also can't tolerate lithium because it acts on serotonine. I need a very specific norepinephrine active med, wich is not easy to find.
> All serotonine meds are worsening my depression very fast (3rd day), and there is no ulterior improvement.
>
> When I say this to any psychiatrist, they answer that if serotonine enhancers could worsen depression, it should be known for a long time, and they never heard about that. They think this king of remark is due to my "personality disorder", which makes my incapable of objective judgment... I hate hearing things like that.
>
> I think that if there is no research reporting complete intolerance to serotonine enhancers, it's because it's against the interests of medication industry, which finances nearly all med. researchers.
>
> If anyone of you knows even one research reporting about that intolerance effect on 5HT enhancers, I would really appreciate that you gave me the reference of it, in order to show it to those narrow minded psychiatrists. Thank you.
> And if you are like me, complete serotonine enhancers intolerant, I would be glad to know you, so please answer to that message. I'll know then that i'm not alone against medications industry.
>
> Sigolènehi. i have had a very similar problem. all seratonin meds have made me worse. on paxil I didn't notice it enough at first because I was completely horrible before starting it, but 24 days into it I was convinced it was making me worse. I just felt very very bad. I stopped and 3-4 days after there was a miracle improvement. I was so naturally living life again, but not quite my normal self yet, but at least things were enjoyable. this lasted for 1 week then it got worse and i just really wanted to try another med. I was put on effexor. On the first day I noticed it was making me feel very detached and just worse. but i thought that would pass. it didn't. the 2nd day wasn't too bad but then the 3rd and following because progressively horrible. I felt suicidal. The constant mind torture was too much. I stopped the med and 3 days later I was better but I was put on another med before I could recover from the effexor. this time i was put on zyprexa along with wellbutrin. this combo is supossed to work for only a small portion of seratonin, most dopamine and norepinephrine. at first i didn't feel really worse. i guess i was recovering from the effexor. then after my mood was just getting steadily worse. not a good sign. so i stopped that also and just went on 5htp. after 3 days i was slightly better. 5 days after i was even better. There were moments where I could enjoy things a bit. And no mind torture!
so i was off meds and just on 5htp for 10 days. i tried adding st john's wort to it because i read how it enhances 5htp. the first two doses in the day i didn't feel a noticable worsening effect. but then after the 3rd dose i felt like i was losing my mind. like i was going phychotic or something. then strangely i was feeling a bit better afterwards. so i thought i might as well try it again. the next day i just felt kind of worse in general. so i stopped that. just 5htp then.
i dont know if the 5htp was helping me but at least i felt not bad enough to stop it. so i stayed on it for those 12 days or so. what i felt it may have been helping me with was my appetite. I had a pretty big appetite on the 5htp. I dunno what else it was helping me with. 5htp is supossed to increase levels of seratonin, norepinephrine, and dopamine. perhaps i didn't feel worse or just not notice being worse (perhaps I would have been better off it) because perhaps seratonin reuptake inhibiting is bad for me. but not the actual increasing of seratonin. Something those meds did was making me worse.
My depression has been caused by accutane. So basically my brain has had excess vitamin A and it hasn't gone away yet. Somehow the meds for my specific case made me worse. also when my depression is worse the sides of my head feel very very hot. and it would also feel very tight. like my brain was expanding or something.
the last med i have tried was prozac. This too made me worse. much worse. this morning and yesterday have been HELL. and the first day I tried the prozac I was feeling completely horrible for like 4 hours. Enough to want to be hospitalized. It passed but the next few days I just have been progressively much worse than when I was off prozac. It hasn't become as bas as those 4 completely horrible hours but close to it. expecially this morning. almost constant mind torture in bed. I know it's the prozac. No doubt about it. so i will recover from this worsening effect in the next 3-5 days. Aside from the large worsening effect I have also lost most of my appetite, yesterday I hardly ate anything. Also a lot of insomnia. Normally I have slept far too well with this depression. More than when I was my normal perfectly happy self. because I would always think of things and have a big imagination. i liked that about me. so i had trouble sleeping normally. the depression has made me brain dead. so sleeping became kind of easy. with the prozac not only was my thinking ability worse, but also i could hardly sleep at all. the mind torture would make sleeping difficult.
I will try other meds later on. maybe something will not make me worse and i'll be able to keep on taking it to see if it makes me better.
regarding doctors. the one at the hospital too didn't believe me when I told him of the worsening effects of the meds. He said it was impossible. What he deserves is a slap in the face. I know how they make me feel. In the end he didn't take me seriously and even told me he thinks I have some normalicy in mood. I wish. The only time I felt near normal was that miracle period after stopping paxil. take care.
Posted by pellmell on September 8, 2001, at 11:29:36
In reply to Re: any serotonine enhancers intolerance, possible ? » Sigolène, posted by adamie on September 8, 2001, at 10:49:00
adamie,
Have you quit the desipramine too? It seems with these med trials you might be throwing out the baby with the bathwater, so to speak. Desipramine might be your "baby," as Wellbutrin (alone) might have been.
Remember, these meds take time to work. Even Effexor, which is a famously fast-acting antidepressant, took six weeks to work for me.
Good luck, and keep us posted.
-pm
Posted by adamie on September 8, 2001, at 11:46:20
In reply to Re: any serotonine enhancers intolerance, possible ? » adamie, posted by pellmell on September 8, 2001, at 11:29:36
> adamie,
>
> Have you quit the desipramine too? It seems with these med trials you might be throwing out the baby with the bathwater, so to speak. Desipramine might be your "baby," as Wellbutrin (alone) might have been.
>
> Remember, these meds take time to work. Even Effexor, which is a famously fast-acting antidepressant, took six weeks to work for me.
>
> Good luck, and keep us posted.
>
> -pmi wasn't able to get the desipramine. i would stay on the meds if they didn't make me worse. in some cases much much worse.
Posted by JohnL on September 8, 2001, at 14:58:07
In reply to Re: any serotonine enhancers intolerance, possible ? » adamie, posted by pellmell on September 8, 2001, at 11:29:36
Hi there Adamie,
I'm very sorry the Prozac thing hasn't worked out very well. I think at this point you can confidentally conclude the SSRI medications are not appropriate for your chemistry. Whatever the real underlying chemical problem is, it probably has nothing to do with low serotonin.But do people actually get worse on an AD instead of better? Definitely. We hear about it all the time. It happened with me on probably about 60% of the meds I tried, with Serzone or Moclobemide being the absolute worst of all. Any doctor who tells you it isn't possible should probably retire and try something else they might be better at.
It could very well be that the whole idea of increasing your neurotransmitters by way of reuptake inhibition is just the wrong way to go for you. Instead, perhaps your neurotransmitter levels are fine, but for some reason the receptors are flawed in some way, have poor binding, or whatever who knows what. With that in mind, maybe what you could do is look at drugs that instead stimulate receptors. Such drugs would include Adrafinil, Amisulpride low dose, Zyprexa low dose, Risperdal low dose, Remeron, and of course stimulants. I have been following your situation for a while now, and I am pretty convinced at this point you will find the greatest benefit in one of those drugs. They will act on turbocharging brain chemistries in different ways and in different locations in the brain than the SSRIs did. I think you may well need a drug that is going to enhance existing receptors and neurotransmitters. That would rule out any SSRI, MAOI, or tricyclic generally. It just seems logical at this point that the last thing you want to do is increase the amount of neurotransmitters. The problem more likely lies with the receptors that the neurotransmitters bind to.
So far you fit the description perfectly of someone who could respond well to Adrafinil. I hope that happens. At least you know which kind of drugs to avoid.
Anyway, just thought I would touch base and share my thoughts with you. Hope you're feeling a little better today.
John
Posted by adamie on September 8, 2001, at 19:54:50
In reply to Re: any serotonine enhancers intolerance, possible ?, posted by JohnL on September 8, 2001, at 14:58:07
> Hi there Adamie,
> I'm very sorry the Prozac thing hasn't worked out very well. I think at this point you can confidentally conclude the SSRI medications are not appropriate for your chemistry. Whatever the real underlying chemical problem is, it probably has nothing to do with low serotonin.
>
> But do people actually get worse on an AD instead of better? Definitely. We hear about it all the time. It happened with me on probably about 60% of the meds I tried, with Serzone or Moclobemide being the absolute worst of all. Any doctor who tells you it isn't possible should probably retire and try something else they might be better at.
>
> It could very well be that the whole idea of increasing your neurotransmitters by way of reuptake inhibition is just the wrong way to go for you. Instead, perhaps your neurotransmitter levels are fine, but for some reason the receptors are flawed in some way, have poor binding, or whatever who knows what. With that in mind, maybe what you could do is look at drugs that instead stimulate receptors. Such drugs would include Adrafinil, Amisulpride low dose, Zyprexa low dose, Risperdal low dose, Remeron, and of course stimulants. I have been following your situation for a while now, and I am pretty convinced at this point you will find the greatest benefit in one of those drugs. They will act on turbocharging brain chemistries in different ways and in different locations in the brain than the SSRIs did. I think you may well need a drug that is going to enhance existing receptors and neurotransmitters. That would rule out any SSRI, MAOI, or tricyclic generally. It just seems logical at this point that the last thing you want to do is increase the amount of neurotransmitters. The problem more likely lies with the receptors that the neurotransmitters bind to.
>
> So far you fit the description perfectly of someone who could respond well to Adrafinil. I hope that happens. At least you know which kind of drugs to avoid.
>
> Anyway, just thought I would touch base and share my thoughts with you. Hope you're feeling a little better today.
> Johnthanks for the insight. it gives me a bit of hope that some meds may work. hopefully this horrible mood i am having right now will pass soon. since prozac has a long half life the med will take longer to get out of my system right? normally when a med made me worse it took 3 days to be kind of better, and 4 days to be back to the way i was before meds.
Posted by adamie on September 8, 2001, at 19:57:23
In reply to Re: any serotonine enhancers intolerance, possible ?, posted by JohnL on September 8, 2001, at 14:58:07
> Hi there Adamie,
> I'm very sorry the Prozac thing hasn't worked out very well. I think at this point you can confidentally conclude the SSRI medications are not appropriate for your chemistry. Whatever the real underlying chemical problem is, it probably has nothing to do with low serotonin.
>
> But do people actually get worse on an AD instead of better? Definitely. We hear about it all the time. It happened with me on probably about 60% of the meds I tried, with Serzone or Moclobemide being the absolute worst of all. Any doctor who tells you it isn't possible should probably retire and try something else they might be better at.
>
> It could very well be that the whole idea of increasing your neurotransmitters by way of reuptake inhibition is just the wrong way to go for you. Instead, perhaps your neurotransmitter levels are fine, but for some reason the receptors are flawed in some way, have poor binding, or whatever who knows what. With that in mind, maybe what you could do is look at drugs that instead stimulate receptors. Such drugs would include Adrafinil, Amisulpride low dose, Zyprexa low dose, Risperdal low dose, Remeron, and of course stimulants. I have been following your situation for a while now, and I am pretty convinced at this point you will find the greatest benefit in one of those drugs. They will act on turbocharging brain chemistries in different ways and in different locations in the brain than the SSRIs did. I think you may well need a drug that is going to enhance existing receptors and neurotransmitters. That would rule out any SSRI, MAOI, or tricyclic generally. It just seems logical at this point that the last thing you want to do is increase the amount of neurotransmitters. The problem more likely lies with the receptors that the neurotransmitters bind to.
>
> So far you fit the description perfectly of someone who could respond well to Adrafinil. I hope that happens. At least you know which kind of drugs to avoid.
>
> Anyway, just thought I would touch base and share my thoughts with you. Hope you're feeling a little better today.
> Johnjohn. do you feel if say i underwent ECT it could have a worsening effect such as the reuptake inhibiting from the AD's? Or is that very very unlikely? it just makes me wonder that if reuptake inhibiting is bad for me what else could be. I really wish I could get ECT. It is extremely hard sometimes.
Posted by Sigolène on September 9, 2001, at 14:06:13
In reply to Re: any serotonine enhancers intolerance, possible ? » Sigolène, posted by adamie on September 8, 2001, at 10:49:00
Your story seems to be exactly the same as mine. I also had accutane and depression with it. And i have exactly the same reaction as you with SSRI's, St Jhon's, etc...
BUT what I can tell you, which maybe helps,is that the only meds with a positive effect on my depression (and I tried all AD before, and also amisulpride) are mianserine and desipramine.
Your can get both of them in most european countries, through internet pharmacies i think.
I'm quite sure these med would be good for you, because they don't "touch" serotonine, and act only on norepinephrine. I hope you can get them.Sigolène
Posted by Elizabeth on September 12, 2001, at 5:47:46
In reply to any serotonine enhancers intolerance, possible ?, posted by Sigolène on September 8, 2001, at 3:28:21
> No psychiatrist wants to believe me when i say I'm a complete serotonine enhancers intolerant. No matter which way the med. acts, i'm even intolerant to natural products like plants wich have a very small effect on serotonine. I also can't tolerate lithium because it acts on serotonine. I need a very specific norepinephrine active med, wich is not easy to find.
Hi. Why did you go off desipramine? Depending on what country you're in, there may be other selective NE reuptake inhibitors available as well. And what about mianserin, or its metabolite, mirtazapine?
An alternative would be to use a dopaminergic-noradrenergic stimulant, such as d-amphetamine or methylphenidate; bupropion, a non-serotonergic AD; or a selective MAO-B inhibitor such as selegiline (AKA l-deprenyl). Another option would be to try a serotonin reuptake inhibitor, such as tianeptine.
Do you have panic disorder or other significant anxiety? People with these problems are often serotoin-sensitive. SSRIs work by desensitising them gradually, and they usually have to start the SSRI at a very low dose and increase it very slowly, in order to be able to tolerate it.
> When I say this to any psychiatrist, they answer that if serotonine enhancers could worsen depression, it should be known for a long time, and they never heard about that. They think this king of remark is due to my "personality disorder", which makes my incapable of objective judgment... I hate hearing things like that.
That's pretty obnoxious, yeah. Have you tried looking for a more biologically-oriented psychiatrist? They tend to be less judgmental, in my experience.
-elizabeth
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