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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 tulip04 on September 12, 2004, at 8:11:47
Anyone had problems with SSRI's making depression worse? I've been diagnosed with GAD and depression, but every SSRI I've tried tend to make me feel worse after a few weeks. Was on celexa for 6 weeks, the first 3 I felt great, then the last 3, I didn't want to get out of bed, was so tired and unmotivated to do anything. So the pdoc switched me to zoloft, its been about 3 weeks, but this 3 weeks has been horrible, I don't want to do anything, talk to anyone, go to work... And I'm normally a very social person. Am I just not giving zoloft enough time, I know they say 4 weeks, but I thought since I was on something before it wouldn't take that long... Should I try switching again??? I'm also on xanax when the anxiety attacks get bad and lately, they are bad, because it drives me crazy that i'm so tired all the time and so I dwell on being depressed and have anxiety attacks, its a bad circle... any advice on meds to try or what is next????
Posted by awatts on September 12, 2004, at 10:20:43
In reply to SSRI's making depression worse - help!, posted by tulip04 on September 12, 2004, at 8:11:47
>>I'm also on xanax when the anxiety attacks get bad and lately, they are bad, because it drives me crazy that i'm so tired all the time and so I dwell on being depressed and have anxiety attacks, its a bad circle... any advice on meds to try or what is next????
I'd take the Xanax only when absolutely necessary for a full blown panic attack. Klonopin (0.5 mg twice a day) helps me with GAD and SP.
Posted by Denise1904 on September 12, 2004, at 12:57:25
In reply to SSRI's making depression worse - help!, posted by tulip04 on September 12, 2004, at 8:11:47
Hi,
I was wondering about the symptoms of depression you had before getting depression, I mean you say normally you are a sociable person but depression tends to make people withdraw from society andyway.
Are you sure it's not the depression that is making you anti-social rather than the medication? Also, I had two years of hell trying different meds, I had such a bad time on the starting dose I never got as far as increasing the dose. However after 2 years the doc decided to try me again on Seroxat only straight away at a double dosage and it seemed to do the trick. Well it's helping anyway. I seemed to have more horrible side effects on a lower dose than I do on a higher dose.
So maybe it's worth you trying a higer dose. And I usually believe you sort of know within about 2 or 3 weeks whether a particular medication on a certain dose is going to work for you or not?
All the Best...Denise
Posted by BJM on September 12, 2004, at 14:39:10
In reply to SSRI's making depression worse - help!, posted by tulip04 on September 12, 2004, at 8:11:47
I hope this might help a little. Every AD that I have taken has eventually made me worse. Especially Zoloft. Prozac works best for me but only at VERY low dosages. When you said that you would feel better for a couple of weeks and then start getting worse it is possible that a lower dose is good for you but over time your blood level gets higher and is too much. I know that since Prozac has such a long half life it takes quite a while for the level to build up. Prozac helps me almost right away and the doctors used to tell me that it had to be a placebo effect because it takes several weeks to work. Well it wasn't placebo effect after all. It was that the lower blood level was best for me. And actually, if overwhelming sedation happens with you after being on an AD for a period of time it can mean that the dose is too high. Depends on the AD but it might be something to look at.
BJM
Posted by 4WD on September 12, 2004, at 17:20:04
In reply to Re: To Tulip, posted by Denise1904 on September 12, 2004, at 12:57:25
> Hi,
>
> I was wondering about the symptoms of depression you had before getting depression, I mean you say normally you are a sociable person but depression tends to make people withdraw from society andyway.
>
> Are you sure it's not the depression that is making you anti-social rather than the medication? Also, I had two years of hell trying different meds, I had such a bad time on the starting dose I never got as far as increasing the dose. However after 2 years the doc decided to try me again on Seroxat only straight away at a double dosage and it seemed to do the trick. Well it's helping anyway. I seemed to have more horrible side effects on a lower dose than I do on a higher dose.
>
> So maybe it's worth you trying a higer dose. And I usually believe you sort of know within about 2 or 3 weeks whether a particular medication on a certain dose is going to work for you or not?
>
>
>
> All the Best...Denise
Denise,What kind of side effects did you have on the Seroxat (paxil)? When I took it, I started at a low dose but my anxiety increased badly. I could never stand it for more than 3 weeks before giving up. Maybe a higher dose would have avoided this?
Marsha
Posted by tulip04 on September 12, 2004, at 19:10:43
In reply to Re: To Tulip, posted by Denise1904 on September 12, 2004, at 12:57:25
Thanks for all the responses. I might try lowering my zoloft to 50mg -- I was on 50 for a few days and my pdoc said I should take 100, for the most protection.
Denise -- In answer to your question, the main reason I was diagnosed with depression was because I complained of being so tired about 5 years ago. At that time I was put on wellbutrin which worked for awhile, but after about a year, I started forgetting all kinds of things, so I went off meds all together for about 6 months. I have very mild depression, usually I'll feel very unsocial for about a day and then snap out of it, but I do suffer from GAD, which can get really bad, so thats where the zoloft came in. The pdoc doesn't want xanax to be my long term solution for the anxiety, so she suggest the ssri's... It just seems after 3 weeks on zolft, I'm constantly feeling down and not myself. All I want to do is lay around. I wouldn't say I'm exactly tired, like I was on the celexa, but very very unmotivated. I love my job, but lately I have the hardest time getting up in the morning and have to drag myself there. Hope, I've answered your questions... Thanks again to everyone for your support!
Jen
Posted by King Vultan on September 12, 2004, at 19:35:40
In reply to SSRI's making depression worse - help!, posted by tulip04 on September 12, 2004, at 8:11:47
I'm trying to think of a way to describe what may be happening from a psychopharmacology perspective without getting too complicated, but I don't think it's possible in this case. I will say that this depression you've experienced may just be part of the natural course of action of the drug and doesn't necessarily mean that it won't eventually work.
That be said, I know how difficult it can be to endure fatigue and depression for weeks at a time, and the truth is that while the Zoloft may work if you give it enough time, it might also not. If you do wind up going to another drug at some point, I would suggest considering a drug that works on both serotonin and norepinephrine, like Effexor or Cymbalta. I believe that the tricyclic AD nortriptyline would also be less likely to make you depressed than the SSRIs you have tried, as this drug is selective for blocking norepinephrine reuptake. It also boosts serotonin, but by a different and somewhat more natural method than the SSRIs do.
Todd
Posted by Bill LL on September 13, 2004, at 8:33:32
In reply to SSRI's making depression worse - help!, posted by tulip04 on September 12, 2004, at 8:11:47
You said that your first 3 weeks on Celexa you felt great. Then you felt bad. This is a classic indication that you needed to increase your dose of Celexa.
Posted by tulip04 on September 13, 2004, at 16:48:31
In reply to Re: SSRI's making depression worse - help!, posted by Bill LL on September 13, 2004, at 8:33:32
I'm really confused now... Some have said that I got tired and sedated because I needed to increase my dose and others say it was because my dose was too high...
I got back to the pdoc next week. Right now I'm on 100 of zoloft, but since I've been feeling so bad, I'm going back to 50mg until I talk with her...
Maybe I do need to try a different type of medicine -- I tend to have problems being tired anyway, so anything thats going to increase those effects is going to make me feel worse.
Posted by BJM on September 14, 2004, at 10:12:19
In reply to Re: SSRI's making depression worse - help!, posted by tulip04 on September 13, 2004, at 16:48:31
It is really confusing. Some people are better with less and some people are better with more. Its like being a guinea pig sometimes. As far as the sedation though Provigil has worked wonders for me for that. It was pretty tough getting used to it at first and I almost gave up on it but after about 2 weeks of slowly increasing the dose it worked great. Wouldn't go without it now.
Good Luck!
BJM
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