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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 shearmadnesss on July 19, 2008, at 12:45:32
Hi. I have been on every sort of medication in the past 10 years and most recently was on a combination of lexapro and wellbutrin for over 2 years. It worked and I was doing great but then I felt like it completely stopped working. My psychiatrist that I had been seeing for the past 10 years (and the only one I have ever seen) changed his practice and cut all of his patients over the age of 15 off......but anyways thats not what I am writing about.
I saw a new psychiatrist (whom I am no longer seeing) who prescribed me pristiq and said he has had a lot of good feedback on it. I decided to try it. I have now been on it for about 8 weeks and have had VERY mixed reactions to it. I should also mention that I am taking adderrol for extreme tiredness. Sometimes I have had good reactions and am very happy. Other times I am extremely sad and all I want to do is cry. I am taking the summer off my masters program due to this extreme depressive episode but continue to work as a preschool teacher. Sometimes the only thing that can get me through the day is the kids.....I feel like I want to give pristiq more time, but sometimes my thoughts and sadness are unbearable. Yes I have had the weight loss, but I also have suffered a loss of a 2 year relationship during these hard times (great boyfriend right). I don't know what to do with myself half the time and most of the time feel very lonely and sad. My family also thinks I have been getting extremely angry for unnecessary reasons, but that is their observation, not mine.
As of right now, I want to switch meds, but I have been on so many different ones that I don't want to deal with it. However, I need to feel better so I am willing to try anything.does anybody have similar experiences? advice? suggestions? I don't know if this post even makes sense but I can continue to write and answer questions if people have them. I haven't switched to something else yet because this is supposed to be so "wonderful" yet I haven't felt "wondeful" in months.
Posted by raisinb on July 19, 2008, at 16:27:58
In reply to bad luck with pristiq??, posted by shearmadnesss on July 19, 2008, at 12:45:32
I haven't been on Pristiq, but I think it's supposed to be basically the same as Effexor, a very popular drug. The drug co changed the name and changed the compound slightly in order to avoid losing their patent $$. Understandable--I read that Effexor makes them 3.8 *billion* a year!
Anyway, no drug is *wonderful* for everyone, or even most patients. Just as an example, Zoloft has worked beautifully for me, while causing a close friend nonstop panic attacks. It sounds like a) it's not the right drug for you, or b) you need to increase the dosage.
If you're not at the max, increasing is probably better for now, so you don't have to taper and then go on something completely new. There's a good chance that will work. Augmenting with something else might do the trick too. I'm not an expert, but maybe add Wellbutrin again, since that worked before?
Posted by raisinb on July 19, 2008, at 16:30:02
In reply to bad luck with pristiq??, posted by shearmadnesss on July 19, 2008, at 12:45:32
I looked at the article again, and it says early trials showed Pristiq is actually more effective at lower doses. Maybe you're taking too much!
Here's the link:
http://psychcentral.com/blog/archives/2008/03/04/pristiq-versus-effexor-xr/
Posted by shearmadnesss on July 19, 2008, at 17:42:41
In reply to actually, posted by raisinb on July 19, 2008, at 16:30:02
I know, I am taking the lowest dose of pristiq. When I posted before I was so sad for NO reason. that is very frustrating. Then, all the sudden I am fine now. I wish I always felt that way because of course I don't want to be overmedicated...........
Posted by bleauberry on July 19, 2008, at 18:27:19
In reply to bad luck with pristiq??, posted by shearmadnesss on July 19, 2008, at 12:45:32
Just a thought, but maybe adderall is messing with things? Peaks and troughs in blood level, peaks and troughs in tolerance, stuff like that?
I also can't help thinking the fatigue has something to do with the overall clinical picture. You might need thyroid T3, regardless if lab tests look normal or not. It is a fairly common approach with pdocs to augment ADs with either lithium or T3. With fatigue, ask for T3. You might have burned out adrenal glands from all the stress, in which case a small amount (physiological replacement dose 5mg-20mg) of hydrocortisone for a year should allow healing to take place. Has to be confirmed first though with a saliva cortisol test taken 4 times in a day to see the daily curve. Adderall can sure help fatigue in the short run, but also be the monster that worsens it in the long run.
And of course if wellbutrin was good to you before, maybe it might be again?
The journey to get off adderall might not be easy and should take a couple months in tiny steps so as not to rock the boat too much, but I would think about doing that.
In the stimulant class, modafinil is a lot friendlier than adderall and frequently gets high ratings from people who use it.
And one more thing. In a study with prozac, a fairly decent percentage of people who had not shown much response at 8 weeks were in remission at 12 weeks. Might just need some more time?
Posted by Phillipa on July 20, 2008, at 0:08:56
In reply to pristiq-something better out there? side effects.., posted by shearmadnesss on July 19, 2008, at 17:42:41
So this morning you felt bad and now fell good? Or did I misread it? If not what do you attribute it too? And did you ever take effexor for a comparison? Thanks Phillipa
Posted by shearmadnesss on July 20, 2008, at 10:07:50
In reply to Re: bad luck with pristiq??, posted by bleauberry on July 19, 2008, at 18:27:19
I have had thyroid tests before and have taken thyroid meds (I am not sure what they are called though).
I would love something that gives me energy and keeps me awake that ISN'T adderrol. I just don't know what to do.
I am seeing someone new who seems to be good, but I have only seen her 3 or 4 times. She is very much into the homopathic way of dealing with things, which I would love to work for me but at this point just doesn't. I have an appointment with her on tuesday so I will take all of this advice into consideration. Thanks.
Also, with the pristiq, I haven't heard much negative feedback on it except for me--which is why I am hesitant to get off it and deal with finding something new.
This is the end of the thread.
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