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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Janelle on March 18, 2002, at 16:14:03
My post further above got side tracked into a discussion of a specific med, so I'm reposting because I really need some support here.
I've been feeling so hazy, detached, foggy, lethargic, unmotivated, absentminded, my memory seems shot, I feel scattered, can't concentrate or focus very well. I'm in a real slump.
Have others experienced these things from meds they're on or is it the depression or BOTH the meds and the depression?
Thanks.
Posted by JohnX2 on March 18, 2002, at 16:46:40
In reply to Need SUPPORT:do others experience this (cause?), posted by Janelle on March 18, 2002, at 16:14:03
hi Janelle,Looks like lots of depression symtoms. Sometimes medicines may trigger some fog too, but its hard to read between the line at times also.
best regards
John> My post further above got side tracked into a discussion of a specific med, so I'm reposting because I really need some support here.
>
> I've been feeling so hazy, detached, foggy, lethargic, unmotivated, absentminded, my memory seems shot, I feel scattered, can't concentrate or focus very well. I'm in a real slump.
>
> Have others experienced these things from meds they're on or is it the depression or BOTH the meds and the depression?
> Thanks.
Posted by fachad on March 18, 2002, at 20:37:37
In reply to Need SUPPORT:do others experience this (cause?), posted by Janelle on March 18, 2002, at 16:14:03
I still think it's probably mostly the meds. It's very tricky because some of the symptoms overlap.
You asked what others have experienced, so I'll tell you what I've had.
My first course of Prozac gave me horrible early morning awakening, but my pdoc at the time told me that early morning awakening was a symptom of depression. I didn’t realize what was going on until years later when I went back on Prozac and *WHAM* I was waking up at 2 or 3 AM every day.
It was only then that I realized that I may have been depressed, but the insomnia was a side effect of the meds, not a symptom of the depression.
Another thing I experienced from Zoloft was extreme tiredness. Not just sleepiness, but a massive overwhelming weariness. I felt too tired to breathe. Each time I inhaled it seemed like so much effort, and then I felt discouraged that I had to then expend more effort to expel the air from my lungs. I did not feel like doing anything, and I hardly felt safe to drive. I nearly lost my job. That horrible lethargy - fatigue from SSRIs - was the worst thing that ever happened to me. It was worse than my depression.
And my pdoc told me that the tiredness and fatigue were symptoms of my depression! Wrong. Yes, tiredness can be a symptom of depression, but THAT extreme unnatural tiredness was a side effect of SSRIs.
I think your fog is from your meds. Especially if you have had depression before, maybe all your life, but you were always a high achiever until now, after meds.
Have you ever been this depressed before? Did you have this fog before, even during your worst depressed time, before you started meds?
> My post further above got side tracked into a discussion of a specific med, so I'm reposting because I really need some support here.
>
> I've been feeling so hazy, detached, foggy, lethargic, unmotivated, absentminded, my memory seems shot, I feel scattered, can't concentrate or focus very well. I'm in a real slump.
>
> Have others experienced these things from meds they're on or is it the depression or BOTH the meds and the depression?
> Thanks.
Posted by Janelle on March 18, 2002, at 21:11:18
In reply to Re: Need SUPPORT:do others experience this (cause?) » Janelle, posted by fachad on March 18, 2002, at 20:37:37
It sure is a tricky question I've raised because as you noted, the symptoms of depression and the side effects of meds do overlap.
Thank you for sharing your experience with me. Interestingly, I have heard that early morning awakening such as what you described CAN be a symptom of depression, but in your case, since it coincided with your being on Prozac then stopped while you were off Prozac, I'd say it was definitely the Prozac, not depression.
Interestingly what you described while being on Zoloft is how I feel while in a depression - I do not feel like doing a thing, and I cannot even drive (reflexes are shot, not alert enough)
I gather that due to the lethargy and fatigue you got from SSRI's that you don't take any -- what meds are you currently on and how are they working for you?
I'm not sure what to make of what's causing my *fog* because I was a high achiever until depression set in (in other words before I ever started on meds) but I was also a high achiever for a number of years not too long ago while on Paxil and Klonopin. I was working, going to school, in a relationship, having a full and fulfilling LIFE.
To answer your questions, each time I fall into a depression it's slightly different than the previous one, but I can say that yes, I have been this depressed before.And yes, I did have this fog before, even during my worst depressed time BEFORE I started meds.
If you have any further thoughts after reading this, please let me know and I'm also curious about what meds you are on and for what symptoms.
THANKS very much!
-Janelle
Posted by fachad on March 19, 2002, at 20:31:31
In reply to FACHAD: answers, more: » fachad, posted by Janelle on March 18, 2002, at 21:11:18
Janelle,
Thanks for taking the time to read my reply. I get so long winded here on PSB, but in person I'm quiet and considered to be a "man of few words".
You asked what I am taking and how it works.
I’m on:
Prozac 10 mg/day (works, but very negative side effects and long term consequences)
Dexadrine 40 mg/day (works great, minimal side effects, minimal long term problems)
Temazepam 30 mg at bedtime (doesn’t work – will replace at next pdoc visit)
I’m taking Prozac 10 mg/day for depression. Yes, I hate SSRIs but last year I had a bad depression caused by a long period of (medically supervised and approved) narcotic pain killer usage from a back injury. The Prozac took care of the depression, but it immediately caused sleep problems and after about a month the old SSRI induced lethargy and fatigue set in.
For a long time before this current depression and Prozac course, I was taking Concerta (methylphenedate) 54 mg. All along it had cured my SSRI induced apathy, lethargy and fatigue. It had also finally relieved my depression and prevented any relapse for about 4 or 5 years, until the painkillers. During this time I did not develop “tolerance” or have to increase the dose.
Anyway, I wanted to remedy the new round of SSRI induced lethargy, it had developed while I was taking Concerta, so I reasoned that I would need something other than Concerta to reverse it.
I tried Adderall, but it was intolerable for me. It made me jittery and gave me dry mouth. So now I’m on Dexadrine 40 mg/day, and I’m slowly tapering my Prozac.
I started Ambien to remedy the Prozac induced insomnia. Again, people always assume the insomnia is from the pstims, but I had no problem before I started the Prozac. Ambien costs a fortune, and I was still waking up at 2 or 3 AM, so I asked my pdoc for something else and got temazepam. It doesn’t work, so I’ll get something else next visit.
Once I am off Prozac I think I will be able to discontinue the sleep meds and go back to stimulant monotherapy. For me, pstims have the greatest benefits and the fewest side effects of any psych meds.
So that’s what I’m on. I had really tried to keep the answer brief – I guess I was only moderately successful.
I really wanted to vent and discuss the dilema of long term effects of psych meds and how side effects get confused with illness symptoms, but to keep this from being ridiculously long I’m going to post that in another thread called “The Delima of Confusing Side Effects & Symptoms."
Take Care.
> It sure is a tricky question I've raised because as you noted, the symptoms of depression and the side effects of meds do overlap.
>
> Thank you for sharing your experience with me. Interestingly, I have heard that early morning awakening such as what you described CAN be a symptom of depression, but in your case, since it coincided with your being on Prozac then stopped while you were off Prozac, I'd say it was definitely the Prozac, not depression.
>
> Interestingly what you described while being on Zoloft is how I feel while in a depression - I do not feel like doing a thing, and I cannot even drive (reflexes are shot, not alert enough)
>
> I gather that due to the lethargy and fatigue you got from SSRI's that you don't take any -- what meds are you currently on and how are they working for you?
>
> I'm not sure what to make of what's causing my *fog* because I was a high achiever until depression set in (in other words before I ever started on meds) but I was also a high achiever for a number of years not too long ago while on Paxil and Klonopin. I was working, going to school, in a relationship, having a full and fulfilling LIFE.
>
> To answer your questions, each time I fall into a depression it's slightly different than the previous one, but I can say that yes, I have been this depressed before.
>
> And yes, I did have this fog before, even during my worst depressed time BEFORE I started meds.
>
> If you have any further thoughts after reading this, please let me know and I'm also curious about what meds you are on and for what symptoms.
>
> THANKS very much!
> -Janelle
Posted by Janelle on March 19, 2002, at 22:38:34
In reply to What I'm Taking and How It's Working » Janelle, posted by fachad on March 19, 2002, at 20:31:31
Posted by fachad on March 19, 2002, at 23:53:34
In reply to FACHAD: what are ''pstims''? (nm) » fachad, posted by Janelle on March 19, 2002, at 22:38:34
Pstims is PSB jargon, but I like it.
Pstims is a shortening of Psycho-stimulants. They are sometimes referred to as CNS stimulants or just stimulants.
The classical pstims are the amphetamines. Currently marketed amphetamine based pstims are:
Adderall, which is mixed salts of different amphetamines
Dexedrine, which is just the dextro salt or dextroamphetamine
Desoxyn, methamphetamine. Very expensive and seldom used because of street abuse.
Then there is methylphenedate (Ritalin). It comes in various immediate release forms and various long acting forms. Now they have released the dextro only form, dextromethylphenedate under the brand name Focalin.
The above pstims are all DEA Schedule II drugs, meaning that the scripts have to be in writing, no refills are allowed, no more that 30 days can be dispensed, maximum hassle for you, your doctor and your pharmacist.
Then there are the "other, non Schedule II" pstims. The oldest is pemoline (Cylert), but it has been linked to liver damage in some rare cases.
There are some pstims that were marketed as diet drugs like fenfluramine (Podamin).
The newest pstim is modafinal (Provigil). It is an active metabolite of Adafranil that we here in the US hear so much about but probably won't ever see. Modafanil, which is here is insanely expensive.
Anyway, that’s what pstims are and which ones are out there. Most pstims boost dopamine instead of serotonin and norepenephrine like classical ADs
The only current approved uses are treatment of ADHD and narcolepsy, but many pdocs are finding them useful for augmenting SSRIs and other ADs.
When you have a minute take a look at something I wrote for BekkaH a bit ago about why Ritalin is not considered an anti-depressant.
Posted by fachad on March 20, 2002, at 0:04:07
In reply to FACHAD: answers, more: » fachad, posted by Janelle on March 18, 2002, at 21:11:18
Janelle you wrote,
Interestingly what you described while being on Zoloft is how I feel while in a depression - I do not feel like doing a thing, and I cannot even drive (reflexes are shot, not alert enough)
I gather that due to the lethargy and fatigue you got from SSRI's that you don't take any -- what meds are you currently on and how are they working for you?
So here's my story on that:A few weeks ago I posted on how Ritalin treated that lethargy for me.
Posted by BLPBart on March 21, 2002, at 0:58:58
In reply to Need SUPPORT:do others experience this (cause?), posted by Janelle on March 18, 2002, at 16:14:03
> My post further above got side tracked into a discussion of a specific med, so I'm reposting because I really need some support here.
>
> I've been feeling so hazy, detached, foggy, lethargic, unmotivated, absentminded, my memory seems shot, I feel scattered, can't concentrate or focus very well. I'm in a real slump.
>Hello, thought I'd respond since your story sounded familiar. When I went into a depression my symptoms were extreme fatigue, unmotivated-just didn't feel like getting up and doing anything and extreme lethargy. My doc started me on prozac which seemed to work well and then I decided I "didn't need it anymore" and quit. A few months later I was back to feeling the same way and extremely suicidal. I went to a new doc who put me back on the prozac. Again, it started out helping with the mood problems, but I immediately began gaining weight and was constantly battling the fatigue and overall lethargy. Then, after being on it for about 6 months I just pooped out. I suddenly went into this lethargic state that was like the earlier posting who said that it took too much effort to breathe. I suddenly was sleeping 12 to 14 hours, could hardly get out of bed in the mornings and was missing a lot of work because there were days I literally lost because I slept through them. I also was having weird side effects like screwed up menstrual periods and muscle and joint pain. My doc dropped my dose of prozac from 20 mg to 10 and added 300 mg/day of wellbutrin SR. Didn't help. Eventually, I went off the prozac completely and after a month or two, my prozac induced problems seemed to clear up but not completely. The joint and muscle pain went away, and I didn't have the extreme fatigue any longer. After that I was just kind of tired all of the time. During this time I took an ADD survey and discussed it with my doc. He felt that I could possibly be ADD (inattentive kind, definitely not hyperactive) and started me on dexedrine spansules 10 mg. I titrated up to 30 and he switched me to concerta because I didn't feel it was really helping. I hated the concerta (I started on 36 mg/day). It made me feel kind of anxious and edgy. Just for a lark I tried taking 40 mg of dexedrine one day and I really felt good on it. Now my doc has me on 300 mg/day wellbutrin SR and the 40 mg/day of dexedrine spansules and I'm feeling better and more energetic than I have in a long time. Additionally, I seem to be getting much more accomplished at work because a) I'm more focused and b) I actually have the energy to do the work rather than sit at my desk staring off into space.
> Have others experienced these things from meds they're on or is it the depression or BOTH the meds and the depression?
> Thanks.
This is the end of the thread.
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