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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 jerseygal1 on August 1, 2011, at 12:21:41
I have been feeling more depressed than usual the last 4 days. Feeling like all I want to do is stay in bed but I'm fighting the urge to do so. I've been on pristiq, 50 mg. for 10 weeks, and started zyprexa about one month ago. I started zyprexa at 2.5 mg. then increased to 5.0 mg. about 16 days ago. Is it the pristiq, is it the zyprexa? Could this be the period of feeling worse before the meds finally kick in? I'd appreciate everyone's thoughts. I'll call my pdoc tomorrow if still feeling like this.
Posted by Phillipa on August 1, 2011, at 12:31:55
In reply to More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 12:21:41
No better in l0 weeks? Not at all? I'd call doc today. Phillipa
Posted by B2chica on August 1, 2011, at 13:46:24
In reply to More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 12:21:41
not very helpful, but here's some comments.
-it takes 10-12 weeks (in my personal experience for pristiq to even start so your right on the border of it 'working'.
- zyprexa only rarely does it work at 5 for me. i normally have to go up to 10 for me to feel effects. (but that is also when i have weight gain). one tip, if you go up to 10 of zyprexa start drinking lots of water, that helped me sometimes to not gain as much.
in my experience the zyprexa effects are fairly quick.
so either your depression is worsening either on its own or possibly from the pristiq. would be my best guess.id say call pdoc, but id say if in one week you still feel this bad you've given pristiq a good solid try.
have you ever been on an SNRI before?
b2c
Posted by jerseygal1 on August 1, 2011, at 16:49:10
In reply to More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 12:21:41
You are both always so helpful. Thanks for your input. It's funny but, over the past month, I've had some good days mixed in with the bad. But I haven't felt this low in awhile. Yes, maybe I should give the pristiq one more week and that's it. B2chica, have you ever gone up to 100 mg. on pristiq? I wonder if that's worth a try. And I thought that pristiq was an SNRI?
Posted by Zyprexa on August 2, 2011, at 2:10:40
In reply to More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 12:21:41
I think its the zyprexa. You just increased it 2 weeks ago and 4 days ago you started to feel tired. Thats about how long it would take to reach full effects of tiredness from it. I would try going back to 2.5mg for a week and see if you get better. I've never taken pristic but think you've been on it long enough that you know what its doing now.
Posted by bleauberry on August 2, 2011, at 4:34:43
In reply to More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 12:21:41
Maybe it's both?
Why not prozac and zyprexa? That's the combo with some umph when it comes to zyprexa/AD combos. The others are a pure guess, sort of like trying to copycat prozac/zyprexa under the assumption that any med with zyprexa could do the same as prozac.
Your combo is very heavy on serotonin, very light on norepinephrine, and anti-dopamine. That doesn't sound like a good mood formula to me. IMO.
I would probably be depressed as heck on your combo.
Posted by B2chica on August 2, 2011, at 8:09:52
In reply to Re: More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 16:49:10
the pristiq is an SNRI, just wondering if you've been on one before and negative reaction to it.
i went up to 100 the first time i was on it,but was only there for about week and half, then went back down to 50 and augmented with zyprexa for about a month.
my pdoc at the time said that it wasn't supposed to be anybetter at higher doseage, but its not like he was the brightest chicken in the coop. so take that with a grain of salt.in my opinion its worth a try.
good luck jerseygallb2c.
Posted by B2chica on August 2, 2011, at 8:13:32
In reply to Re: More depressed than usual - zyprexa or pristiq?, posted by Zyprexa on August 2, 2011, at 2:10:40
jerseygall
i think zyprexa has good info on zyprexa med.
i'd try that first. after that, then try to up the pristiq. just dont do both at same time so you can figure out for sure what is working.
best wishes.
Posted by floatingbridge on August 2, 2011, at 10:58:13
In reply to Re: More depressed than usual - zyprexa or pristiq?, posted by B2chica on August 2, 2011, at 8:13:32
jerseygal,
I guess I agree about the zyprexa increase being a possible culprit. B2c has experience. It mirrors my expeience on abilify. The jump from 2 to 5mg undid any benefit for me.
Pristiq at 100mg didn't work for me, but that was quickly apparent in my case, so if you go that route, you might know pretty quickly. Oddly, given my sensitivities, I had no trouble going back to 50mg of pristiq.
Have you ever tried effexor? It preceeded pristiq as an snri. It worked better for me than pristiq ever did. If you hear horror stories about effexor withdrawal, well, pristiq seemed on par with them. In my experience effexor withdrawal was no worse than pristiq (my experience).
I second altering one medication at a time. If you keep a zyprexa on board, BB's serotax (oh my spelling!) has some merit to consider, but Prozac is it's own very different med from what I gather.
Did you call that pdoc? Maybe you don't want to seem bothersome, but you do have a lot at stake, and that's what they are (supposed to be) there for.
Best to you.
> jerseygall
> i think zyprexa has good info on zyprexa med.
> i'd try that first. after that, then try to up the pristiq. just dont do both at same time so you can figure out for sure what is working.
> best wishes.
>
Posted by jerseygal1 on August 2, 2011, at 16:28:26
In reply to More depressed than usual - zyprexa or pristiq?, posted by jerseygal1 on August 1, 2011, at 12:21:41
I called my pdoc today. His opinion was that he did not think the zyprexa was causing my increased feelings of depression. He wants me to try upping my dose to 7.5 mg for a week and, if that doesn't do anything, 10 mg the next week. In the meantime, I'll say my prayers and hope for the best. One of you mentioned trying prozac instead of pristiq. Unfortunately, I was on prozac successfully for 11 years before all this and it pooped out on me. B2chica, you mentioned that zyprexa didn't do anything for you until you went up to 10 mg. so maybe I have the same issue. I just feel like I'm takings all these meds. But there are some on more meds than me so I shouldn't complain. My pdoc actually mentioned wanting to take me off all meds (except remeron for sleep) and try light therapy. He said there have been studies done that show light therapy is just as effective as prozac for some. The thought of doing that scares me to death and I told my pdoc that - what about withdrawals etc.? My pdoc is very good about keeping up on all the latest research etc. but is not much for bedside manner. I'm wondering if I need to find someone that is easier to talk to.
This is the end of the thread.
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