Question:

i notice that when i do NYC races in central park (freddiemac 5K most recently) i become terribly asthmatic after about a mile.  i don’t have this problem in the NJ suburbs where i live and run other races. i am on asthma medications (serevent, flovent and nasonex.) and these do a good job for me. wondering if it’s the air quality in central park. -rei

Response:

wondering if it’s the air quality in central park.

It could very well be. I would think the ground level pollution is higher in NYC (more concentration of cars) than in the suburbs…particularly in the warmer months. For example, I used to have chronic bronchitus when I lived in the city.  When I moved to NJ the problem cleared up. Johanna "forever young" Young

Response:

Question:

Olanzapine (Zyprexa) works great for me (a formerly rapid cycling bi polar).

– Hide quoted text — Show quoted text – http://www.mhsanctuary.com/bipolar/network.htm (The Below Bipolar Disorder Research Comes From Bipolar Network News & Various Other Resources) "(The BNN is published four times a year by an international group of investigators working with patients with bipolar disorder to better understand the long-term course and treatment of the illness. The goal of the Network is to help develop new and more effective treatments for bipolar disorder. http://www.bipolarnetwork.org, email: Genetics 378 genetic markers were examined and a linkage was found "between bipolar illness vulnerability and loci on chromosomes 15q14 and 7q11. Lithium Lithium: The literature was reviewed of patients taking lithium long term to patients that discontinued it. "Suicidal acts rose 22-fold, and fatalities increased 14-fold, within the first year after discontinuing the lithium." There are increased cases of goiter in 100 patients taking lithium that was related to dose and duration. This was prevented by thyroxine. Bipolar Disord 1999 Sep;1(1):5-10 Perspectives on lithium treatment of bipolar disorder: action, efficacy, effect on suicidal behavior. Schou M. The Psychiatric Hospital, Risskov, Denmark In bipolar disorder the choice of prophylactic drug must be based on a weighing of efficacy against tolerability, interactions, ease of management, use during pregnancy and lactation, and expense. Lithium should be the preferred prophylactic drug in patients with typical bipolar disorder and in patients who are at high risk of committing suicide, that is, patients with severe depressions or depressions combined with persistent suicidal ideas or with suicide attempts in the past. Antidepressants Mood stabilizers taken with newer (second generation) antidepressants induce mania less than older antidepressants – tricyclics and MAOI. Bupropion (Wellbutrin), sertraline (Zoloft), and venlafaxine (Effexor) are examined in consumers with the bipolar disorder who experience "break through depression," even though medicated. There is a moderate antidepressant response in 33% and a 12% rate of triggering mania in this study of 100 bipolars. Buproprion (Wellbutrin) vs. Desipramine (Norpramin) were studied. The rate of cycling between mania and hypomania was significantly greater in the Desipramine group (37%). Buproprion (13%,p<0.05). Paxil studied in a randomized, controlled six week trial. It was found to be "equally effective for depression breaking through ongoing mood stabilizer treatment as an addition of a second mood stabilizer, typically valproate to lithium, or vice versa." "…the risk of depressive relapse for 27 bipolar patients after antidepressant discontinuation was 67% versus 39% in the 18 patients who" stayed on their antidepressants. Mood Stabilizers The treatment of combining one or more mood stabilizers with an antidepressant to prevent manic episodes, needs to be explored further. "…using the newer antidepressants earlier to supplement mood stabilizers should be considered." New medication and combining medications can produce remarkable improvement. Lamotrigine (Lamictal) Lamotrigine (Lamictal) has assisted many consumers whose illness has not responded to other treatments. (Frye et al, 2000, J Clin Psychopharmacol, in press; Calabrese et al., 1999, J Clin Psychiatry 60: 79-88). Proceed slowly with Lamictal to reduce risk of rash and other side effects. Lamotrigine (Lamictal) was superior to both gabapentin and placebo in a six-week monotherapy trial for refractory patients. 437 outpatient study, double-blind, placebo-controlled; Lamotrigine is equal to desipramine and superior to placebo in unipolar depression. Gabapentin (Neurontin) Gabapentin (Neurontin) is helpful for residual manic and depressive symptoms, but not rapid cycling. Neurontin has better response with patients who are associated with younger age, shorter duration of illness, and lower initial body weight. Gabapentin failed to exceed placebo in an outpatient study of acute mania. Gabapentin is not an effective medication for acute mania. Study: 10 wk., double-blind, placebo-controlled trial dosed between 900 and 3600 mg/day. Gabapentin was "not superior to the placebo for bipolar I symptoms of hypomania, mania, or mixed states." Gabapentin has also been "effective in some anxiety disorders including social phobia and is widely used for adjunctive treatment in pain syndromes." 218 patient study of Gabapentin in the treatment of bipolar disorder shows that if it is "combined with antidepressants, neuroleptics, lithium, and other anticonvulsants, had a high rate of response in combination (69%) and in monotherapy (42%)." Bipolar Disord 1999 Sep;1(1):61-5 Altshuler LL, Keck PE Jr, McElroy SL, Suppes T, Brown ES, Denicoff K, Frye M, Gitlin M, Hwang S, Goodman R, Leverich G, Nolen W, Kupka R, Post R. UCLA Mood Disorders Research Program, UCLA Medical Plaza, CA 90095-7057, USA Gabapentin appears to have acute anti-manic and anti-depressant properties as an adjunctive agent for refractory bipolar illness. Prospective double-blind studies are needed to further delineate its acute efficacy when used as monotherapy and its prophylactic efficacy as monotherapy or in conjuction with other mood stabilizers. Divalproex (Depakote) Divalproex (Depakote) vs. Lithium were both equally effective in 43 patients. The patients that did not respond to Lithium, responded to Depakote and vice versa. "Depakote monotherapy was notably effective in treating depressive symptoms." Topiramate (Topamax) Topiramate (Topamax) find a 56% much or very much improved response in "16 patients after 6 weeks, four of the 16 had unpleasant sense of touch and two had word finding difficulties," in the treatment of bipolar disorder. All patients lost weight at an average of 10 pounds. "Dr. R. McIntyre and colleagues at the Centre for Addiction and Mental Health, Toronto, compared topiramate (50-300 mg/day) to bupropion SR (Wellbutrin, 100-400 mg/day) for eight weeks as adjuncts to mood stabilizers in 26 bipolar out patients with major depression. Both bupropion SR and topiramate showed a significant reduction in depressive symptoms and were not statistically different from each other. No patients switched into a manic episode on either treatment. These preliminary results suggest that topiramate may have comparable antidepressant activity to bupropion SR, a remarkable finding if replicated." Mexiletine (Mexitil) Mexiletine (Mexitil) has anticonvulsant, antiarrhythmic, and analgesic properties. In a study of 13 treatment resistant bipolars at doses from 200 – 1200 mg/day had a full response in 45% of patients. Another study: 8 out of 26 patients treated with Mexiletine had a positive therapeutic effect. ECT (Electro Convulsive Therapy) "…low dose, right unilateral (one-sided) was ineffective in two different studies of major depression (i.e., 23% improvement or 17% improvement respectively). However, high dose right unilateral ECT was as effective as bilateral (two-sided) ECT, and bilateral ECT clearly produced more lasting amnesia and memory defects. (Sackeim et al, 2000; Arch Gen Psychiatry 57: 425-434). rTMS and ECT are generally equally effective in "patients with nondelusional major depression. ECT superior to patients with delusional depression than rTMS. Bipolar Brains Study of 10 bipolar brains during autopsy compared with "11 nonpsychiatric control subjects. Dr. Rajkowska found decreased density of layer 3 in the dorsolateral pre-frontal cortex (Brodman’s area nine), comprised of a decrease in the numbers of pyramidal cells but not other neuronal elements, a decrease in glial cell density, and an increase in glial size." "…bipolar patients showed: 1) decreased dorsolateral prefrontal cortex NAA bilaterally; 2) decreased prefrontal white matter NAA bilaterally; and, 3) increased thalamic NAA bilaterally. These data thus supplement a growing amount of structural imaging data suggesting alterations in size or chemistry of the prefrontal cortex, amygdala, and hippocampus in bipolar patients compared with controls." Neuroleptics Olanzapine (Zyprexa) Olanzapine (Zyprexa) was statistically significantly superior to placebo in the treatment of rapid cycling Bipolar I patients. Bipolar Disord 2000 Sep;2(3 Pt 1):196-9 Ghaemi SN, Cherry EL, Katzow JA, Goodwin FK. Harvard Bipolar Research Program, Massachusetts General Hospital, Consolidated Department of Psychiatry, Boston 02114, USA. "Olanzapine appears to be moderately effective in open add-on treatment in patients with mainly depressive symptoms. Accumulating evidence suggests that olanzapine, and atypical antipsychotics in general, possess mild to moderate adjunctive antidepressant properties." "Dr. R. Baker and co-workers from Lilly Research Laboratories and Harvard Medical School found that in two inpatient double-blind, randomized trials investigating the efficacy of olanzapine for acute mania, worsening of mania occurred more often on placebo than on olanzapine, in contrast to previous reports in open trials that olanzapine induced or exacerbated mania." "Dr. J. Frazier from Harvard Medical School and colleagues conducted a study of olanzapine monotherapy (2.5-20 mg/day) in 23 juvenile bipolar patients (ages 5-14) with mania or mixed symptoms. Sixty-one percent of patients responded, and 22

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Response:

I take mine at night as well.  I don’t find it making me sleepy though. Carrie

– Hide quoted text — Show quoted text – Gained 5 or 10 pounds, have to take it at night. No, not sleepy at all.  I don’t believe there has been any weight gain from it.  But I’ve not jumped on the scales and only started Zyprexa last week. Any weight gain for you?  That is one side effect that just sucks with some meds! Carrie Does it make you sleepy too? Gain any weight? Works well for me, too.  This is the best I’ve ever felt in 3 years. I take it with Neurontin.  I’m nearly normal and ready to take on the world. Well, some of it.  I’ll leave the thorny parts until I’m at my very best. LOL. Carrie Olanzapine (Zyprexa) works great for me (a formerly rapid cycling bi polar). http://www.mhsanctuary.com/bipolar/network.htm (The Below Bipolar Disorder Research Comes From Bipolar Network News & Various Other Resources)

Response:

Does it make you sleepy too? Gain any weight?

– Hide quoted text — Show quoted text – Works well for me, too.  This is the best I’ve ever felt in 3 years.  I take it with Neurontin.  I’m nearly normal and ready to take on the world. Well, some of it.  I’ll leave the thorny parts until I’m at my very best.  LOL. Carrie Olanzapine (Zyprexa) works great for me (a formerly rapid cycling bi polar). http://www.mhsanctuary.com/bipolar/network.htm (The Below Bipolar Disorder Research Comes From Bipolar Network News & Various Other Resources)

Response:

No, not sleepy at all.  I don’t believe there has been any weight gain from it.  But I’ve not jumped on the scales and only started Zyprexa last week. Any weight gain for you?  That is one side effect that just sucks with some meds! Carrie

– Hide quoted text — Show quoted text – Does it make you sleepy too? Gain any weight? Works well for me, too.  This is the best I’ve ever felt in 3 years.  I take it with Neurontin.  I’m nearly normal and ready to take on the world. Well, some of it.  I’ll leave the thorny parts until I’m at my very best. LOL. Carrie Olanzapine (Zyprexa) works great for me (a formerly rapid cycling bi polar). http://www.mhsanctuary.com/bipolar/network.htm (The Below Bipolar Disorder Research Comes From Bipolar Network News & Various Other Resources)

Response:

Gained 5 or 10 pounds, have to take it at night.

– Hide quoted text — Show quoted text – No, not sleepy at all.  I don’t believe there has been any weight gain from it.  But I’ve not jumped on the scales and only started Zyprexa last week. Any weight gain for you?  That is one side effect that just sucks with some meds! Carrie Does it make you sleepy too? Gain any weight? Works well for me, too.  This is the best I’ve ever felt in 3 years. I take it with Neurontin.  I’m nearly normal and ready to take on the world. Well, some of it.  I’ll leave the thorny parts until I’m at my very best. LOL. Carrie Olanzapine (Zyprexa) works great for me (a formerly rapid cycling bi polar). http://www.mhsanctuary.com/bipolar/network.htm (The Below Bipolar Disorder Research Comes From Bipolar Network News & Various Other Resources)

Response:

Works well for me, too.  This is the best I’ve ever felt in 3 years.  I take it with Neurontin.  I’m nearly normal and ready to take on the world.  Well, some of it.  I’ll leave the thorny parts until I’m at my very best.  LOL. Carrie

– Hide quoted text — Show quoted text – Olanzapine (Zyprexa) works great for me (a formerly rapid cycling bi polar). http://www.mhsanctuary.com/bipolar/network.htm (The Below Bipolar Disorder Research Comes From Bipolar Network News & Various Other Resources) "(The BNN is published four times a year by an international group of investigators working with patients with bipolar disorder to better understand the long-term course and treatment of the illness. The goal of the Network is to help develop new and more effective treatments for bipolar disorder. http://www.bipolarnetwork.org, email: Genetics 378 genetic markers were examined and a linkage was found "between bipolar illness vulnerability and loci on chromosomes 15q14 and 7q11. Lithium Lithium: The literature was reviewed of patients taking lithium long term to patients that discontinued it. "Suicidal acts rose 22-fold, and fatalities increased 14-fold, within the first year after discontinuing the lithium." There are increased cases of goiter in 100 patients taking lithium that was related to dose and duration. This was prevented by thyroxine. Bipolar Disord 1999 Sep;1(1):5-10 Perspectives on lithium treatment of bipolar disorder: action, efficacy, effect on suicidal behavior. Schou M. The Psychiatric Hospital, Risskov, Denmark In bipolar disorder the choice of prophylactic drug must be based on a weighing of efficacy against tolerability, interactions, ease of management, use during pregnancy and lactation, and expense. Lithium should be the preferred prophylactic drug in patients with typical bipolar disorder and in patients who are at high risk of committing suicide, that is, patients with severe depressions or depressions combined with persistent suicidal ideas or with suicide attempts in the past. Antidepressants Mood stabilizers taken with newer (second generation) antidepressants induce mania less than older antidepressants – tricyclics and MAOI. Bupropion (Wellbutrin), sertraline (Zoloft), and venlafaxine (Effexor) are examined in consumers with the bipolar disorder who experience "break through depression," even though medicated. There is a moderate antidepressant response in 33% and a 12% rate of triggering mania in this study of 100 bipolars. Buproprion (Wellbutrin) vs. Desipramine (Norpramin) were studied. The rate of cycling between mania and hypomania was significantly greater in the Desipramine group (37%). Buproprion (13%,p<0.05). Paxil studied in a randomized, controlled six week trial. It was found to be "equally effective for depression breaking through ongoing mood stabilizer treatment as an addition of a second mood stabilizer, typically valproate to lithium, or vice versa." "…the risk of depressive relapse for 27 bipolar patients after antidepressant discontinuation was 67% versus 39% in the 18 patients who" stayed on their antidepressants. Mood Stabilizers The treatment of combining one or more mood stabilizers with an antidepressant to prevent manic episodes, needs to be explored further. "…using the newer antidepressants earlier to supplement mood stabilizers should be considered." New medication and combining medications can produce remarkable improvement. Lamotrigine (Lamictal) Lamotrigine (Lamictal) has assisted many consumers whose illness has not responded to other treatments. (Frye et al, 2000, J Clin Psychopharmacol, in press; Calabrese et al., 1999, J Clin Psychiatry 60: 79-88). Proceed slowly with Lamictal to reduce risk of rash and other side effects. Lamotrigine (Lamictal) was superior to both gabapentin and placebo in a six-week monotherapy trial for refractory patients. 437 outpatient study, double-blind, placebo-controlled; Lamotrigine is equal to desipramine and superior to placebo in unipolar depression. Gabapentin (Neurontin) Gabapentin (Neurontin) is helpful for residual manic and depressive symptoms, but not rapid cycling. Neurontin has better response with patients who are associated with younger age, shorter duration of illness, and lower initial body weight. Gabapentin failed to exceed placebo in an outpatient study of acute mania. Gabapentin is not an effective medication for acute mania. Study: 10 wk., double-blind, placebo-controlled trial dosed between 900 and 3600 mg/day. Gabapentin was "not superior to the placebo for bipolar I symptoms of hypomania, mania, or mixed states." Gabapentin has also been "effective in some anxiety disorders including social phobia and is widely used for adjunctive treatment in pain syndromes." 218 patient study of Gabapentin in the treatment of bipolar disorder shows that if it is "combined with antidepressants, neuroleptics, lithium, and other anticonvulsants, had a high rate of response in combination (69%) and in monotherapy (42%)." Bipolar Disord 1999 Sep;1(1):61-5 Altshuler LL, Keck PE Jr, McElroy SL, Suppes T, Brown ES, Denicoff K, Frye M, Gitlin M, Hwang S, Goodman R, Leverich G, Nolen W, Kupka R, Post R. UCLA Mood Disorders Research Program, UCLA Medical Plaza, CA 90095-7057, USA Gabapentin appears to have acute anti-manic and anti-depressant properties as an adjunctive agent for refractory bipolar illness. Prospective double-blind studies are needed to further delineate its acute efficacy when used as monotherapy and its prophylactic efficacy as monotherapy or in conjuction with other mood stabilizers. Divalproex (Depakote) Divalproex (Depakote) vs. Lithium were both equally effective in 43 patients. The patients that did not respond to Lithium, responded to Depakote and vice versa. "Depakote monotherapy was notably effective in treating depressive symptoms." Topiramate (Topamax) Topiramate (Topamax) find a 56% much or very much improved response in "16 patients after 6 weeks, four of the 16 had unpleasant sense of touch and two had word finding difficulties," in the treatment of bipolar disorder. All patients lost weight at an average of 10 pounds. "Dr. R. McIntyre and colleagues at the Centre for Addiction and Mental Health, Toronto, compared topiramate (50-300 mg/day) to bupropion SR (Wellbutrin, 100-400 mg/day) for eight weeks as adjuncts to mood stabilizers in 26 bipolar out patients with major depression. Both bupropion SR and topiramate showed a significant reduction in depressive symptoms and were not statistically different from each other. No patients switched into a manic episode on either treatment. These preliminary results suggest that topiramate may have comparable antidepressant activity to bupropion SR, a remarkable finding if replicated." Mexiletine (Mexitil) Mexiletine (Mexitil) has anticonvulsant, antiarrhythmic, and analgesic properties. In a study of 13 treatment resistant bipolars at doses from 200 – 1200 mg/day had a full response in 45% of patients. Another study: 8 out of 26 patients treated with Mexiletine had a positive therapeutic effect. ECT (Electro Convulsive Therapy) "…low dose, right unilateral (one-sided) was ineffective in two different studies of major depression (i.e., 23% improvement or 17% improvement respectively). However, high dose right unilateral ECT was as effective as bilateral (two-sided) ECT, and bilateral ECT clearly produced more lasting amnesia and memory defects. (Sackeim et al, 2000; Arch Gen Psychiatry 57: 425-434). rTMS and ECT are generally equally effective in "patients with nondelusional major depression. ECT superior to patients with delusional depression than rTMS. Bipolar Brains Study of 10 bipolar brains during autopsy compared with "11 nonpsychiatric control subjects. Dr. Rajkowska found decreased density of layer 3 in the dorsolateral pre-frontal cortex (Brodman’s area nine), comprised of a decrease in the numbers of pyramidal cells but not other neuronal elements, a decrease in glial cell density, and an increase in glial size." "…bipolar patients showed: 1) decreased dorsolateral prefrontal cortex NAA bilaterally; 2) decreased prefrontal white matter NAA bilaterally; and, 3) increased thalamic NAA bilaterally. These data thus supplement a growing amount of structural imaging data suggesting alterations in size or chemistry of the prefrontal cortex, amygdala, and hippocampus in bipolar patients compared with controls." Neuroleptics Olanzapine (Zyprexa) Olanzapine (Zyprexa) was statistically significantly superior to placebo in the treatment of rapid cycling Bipolar I patients. Bipolar Disord 2000 Sep;2(3 Pt 1):196-9 Ghaemi SN, Cherry EL, Katzow JA, Goodwin FK. Harvard Bipolar Research Program, Massachusetts General Hospital, Consolidated Department of Psychiatry, Boston 02114, USA. "Olanzapine appears to be moderately effective in open add-on treatment in patients with mainly depressive symptoms. Accumulating

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Response:

Question:

Does anyone have experience with taking Celexa vs. Prozac?  Thanks so much.

Response:

Does anyone have experience with taking Celexa vs. Prozac?  Thanks so much.

I tried Prozac once a long time ago, but I had to stop after a few days. Prozac made me extremely anxious. Celexa is the best SSRI I have taken. I just switched from Zoloft to Celexa, and Celexa is equally or more effective as an anti-depressant with fewer and milder side effects than Zoloft, which is already a lot better than Prozac.

Response:

Question:

- Hide quoted text — Show quoted text – x-no-archive: yes the pdoc decided not to hospitalize me, as the suicidal impulses have passed for now. instead, she increased my zoloft dose again, renewed my klonny prescription and added trazodone for sleep. hopefully this will help me get eight *consecutive* hours of sleep a night. and i have to go back and see her next week. she also got me set up with a counselor who specializes in self-esteem issues, and my first appointment is February 23rd. if the trazodone doesn’t work, she’ll refer me to the sleep disorder clinic, and i will be spending a few nights there in order for them to find out why i wake up after three hours. thanks, everyone who wished me well. i appreciate it more than i can say. SK SK, I’m on the exact same meds. Took up to three dosage increases to find the right combination for me. 200mg of Zoloft in the morning, along with .05 Klonny; another Klonny around 11:00AM, and a third one around 4:30.  Then, 100mg of Trazadone about an hour before I’m ready to go to sleep. Getting a full night’s sleep was never a problem after my original Traz dose of 50mg was increased to 100mg. Frank i could use a full night’s sleep myself.  what is the klonny like? diana

Diana, Well, the Trazadone is for sleep.  The Klonny is an anti-anxiety med. I find it takes the edge off things, if that makes any sense. I like it, myself. Doesn’t make me tired, or any other side effects; it helps make things tolerable that might otherwise get me frazzled. Frank

Response:

just a quick note on the sleepins meds trazadone always left me doped up the next day i’m on Sonata now, can be taken when you wake up in the middle of the night…just need 4 hrs to be able sleep afterwards i do know meds are very indivual, just thought i’d bring it up

Response:

i’m glad you’re safe, Sunkitty.   hugs, Timmy

Response:

– Hide quoted text — Show quoted text – x-no-archive: yes the pdoc decided not to hospitalize me, as the suicidal impulses have passed for now. instead, she increased my zoloft dose again, renewed my klonny prescription and added trazodone for sleep. hopefully this will help me get eight *consecutive* hours of sleep a night. and i have to go back and see her next week. she also got me set up with a counselor who specializes in self-esteem issues, and my first appointment is February 23rd. if the trazodone doesn’t work, she’ll refer me to the sleep disorder clinic, and i will be spending a few nights there in order for them to find out why i wake up after three hours. thanks, everyone who wished me well. i appreciate it more than i can say. SK SK, I’m on the exact same meds. Took up to three dosage increases to find the right combination for me. 200mg of Zoloft in the morning, along with .05 Klonny; another Klonny around 11:00AM, and a third one around 4:30.  Then, 100mg of Trazadone about an hour before I’m ready to go to sleep. Getting a full night’s sleep was never a problem after my original Traz dose of 50mg was increased to 100mg. Frank

i could use a full night’s sleep myself.  what is the klonny like? diana

Response:

- Hide quoted text — Show quoted text – x-no-archive: yes the pdoc decided not to hospitalize me, as the suicidal impulses have passed for now. instead, she increased my zoloft dose again, renewed my klonny prescription and added trazodone for sleep. hopefully this will help me get eight *consecutive* hours of sleep a night. and i have to go back and see her next week. she also got me set up with a counselor who specializes in self-esteem issues, and my first appointment is February 23rd. if the trazodone doesn’t work, she’ll refer me to the sleep disorder clinic, and i will be spending a few nights there in order for them to find out why i wake up after three hours. thanks, everyone who wished me well. i appreciate it more than i can say. SK

SK, I’m on the exact same meds. Took up to three dosage increases to find the right combination for me. 200mg of Zoloft in the morning, along with .05 Klonny; another Klonny around 11:00AM, and a third one around 4:30.  Then, 100mg of Trazadone about an hour before I’m ready to go to sleep. Getting a full night’s sleep was never a problem after my original Traz dose of 50mg was increased to 100mg. Frank

Response:

Fingers crossed for you!!!!!  =^..^=

– Hide quoted text — Show quoted text – x-no-archive: yes the pdoc decided not to hospitalize me, as the suicidal impulses have passed for now. instead, she increased my zoloft dose again, renewed my klonny prescription and added trazodone for sleep. hopefully this will help me get eight *consecutive* hours of sleep a night. and i have to go back and see her next week. she also got me set up with a counselor who specializes in self-esteem issues, and my first appointment is February 23rd. if the trazodone doesn’t work, she’ll refer me to the sleep disorder clinic, and i will be spending a few nights there in order for them to find out why i wake up after three hours. thanks, everyone who wished me well. i appreciate it more than i can say. SK x-no-archive is in headers; please respect it. thanks MSN: SunKitten — ICQ: 92790525

Response:

Question:

The interesting thing with St. John’s Wort, is that it alters the ‘mood/mind’ enough to allow an objective and clear perspective of the Self. And therefore a clear insight into those parts of the Self that causes the depression. Is your intent to clear yourself of the depression?… or clear yourself of the sources of that depression?

Translation: SJW is not strong enough to cure many cases of depression by itself, and works best with psychotherapy combination. By extension, an SSRI plus that kind of psychotherapy ought to be better yet? —

Response:

commonly used slow serotonin reuptake inhibitor (SSRI)

ROTFL!  What a load of BS … —   -john

Response:

Recent studies have shown SJW to be equally as effective as Zoloft (sertraline) and Prozac (fluoxetine) in mild to moderate depression. It also seems to have a better side-effect profile. See the references below: – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – Equivalence of St John’s wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression. Schrader E Int Clin Psychopharmacol 2000 Mar;15(2):61-8 Treatment with St John’s wort extract tablets (hypericum Ze 117) and the commonly used slow serotonin reuptake inhibitor (SSRI) fluoxetine was compared in patients with mild-moderate depression with entry Hamilton Depression Scale (HAM-D) (21-item) in the range 16-24, in a randomized, double-blind, parallel group comparison in 240 subjects; fluoxetine: 114 (48%), hypericum: 126 (52%). After 6 weeks’ treatment, mean HAM-D at endpoint decreased to 11.54 on hypericum and to 12.20 on fluoxetine (P < 0.09), while mean Clinical Global Impression (CGI) item I (severity) was significantly (P < 0.03) superior on hypericum, as was the responder rate (P = 0.005). Hypericum safety was substantially superior to fluoxetine, with the incidence of adverse events being 23% on fluoxetine and 8% on hypericum. The commonest events on fluoxetine were agitation (8%), GI disturbances (6%), retching (4%), dizziness (4%), tiredness, anxiety/nervousness and erectile dysfunction (3% each), while on hypericum only GI disturbances (5%) had an incidence greater than 2%. We concluded that hypericum and fluoxetine are equipotent with respect to all main parameters used to investigate antidepressants in this population. Although hypericum may be superior in improving the responder rate, the main difference between the two treatments is safety. Hypericum was superior to fluoxetine in overall incidence of side-effects, number of patients with side-effects and the type of side-effect reported. – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – - – "Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study." Brenner R, Azbel V, Madhusoodanan S, Pawlowska M Clin Ther 2000 Apr;22(4):411-9 BACKGROUND: Hypericum (St. John’s wort) has been shown to be as efficacious and well tolerated as standard antidepressants in the treatment of depression but has not been compared with selective serotonin reuptake inhibitors (SSRIs). OBJECTIVE: This study compared hypericum and the SSRI sertraline in the treatment of depression. METHODS: In a double-blind, randomized study conducted in a community hospital, 30 male and female outpatients (19 women, 11 men; mean age, 45.5 years) with mild to moderate depression received 600 mg/d of a standardized extract of hypericum (LI 160) or 50 mg/d sertraline for I week, followed by hypericum 900 mg/d or sertraline 75 mg/d for 6 weeks. RESULTS: The severity of symptoms, as assessed by scores on the Hamilton Rating Scale for Depression (HAM-D) and the Clinical Global Impression scale, was significantly reduced in both treatment groups (P < 0.01). Clinical response (defined as a or =50% reduction in HAM-D scores) was noted in 47% of patients receiving hypericum and 40% of those receiving sertraline. The difference was not statistically significant. Both agents were well tolerated. A post hoc power analysis indicated that failure to reach statistical significance between treatments resulted primarily from an absence of clinical differences rather than the small sample size. CONCLUSION: The hypericum extract was at least as effective as sertraline in the treatment of mild to moderate depression in a small group of outpatients.

– Hide quoted text — Show quoted text – The interesting thing with St. John’s Wort, is that it alters the ‘mood/mind’ enough to allow an objective and clear perspective of the Self. And therefore a clear insight into those parts of the Self that causes the depression. Is your intent to clear yourself of the depression?… or clear yourself of the sources of that depression? Translation: SJW is not strong enough to cure many cases of depression by itself, and works best with psychotherapy combination. By extension, an SSRI plus that kind of psychotherapy ought to be better yet? —

com for the reply address.

Response:

I am interested in info. on St. John’s Wort and Kava for OCD and anxiety.

Here is some info. I found on St. John’s Wort and OCD: "Gridrunner: Have you heard of some success using St. John’s Wort or 5-htp to lessen OCD? Dr. Jenike: Yes, there are a few cases where St. John’s Wort has helped OCD. In Germany, there are dozens of studies using SJW for mild to moderate depression, but its use for treating OCD is relatively new. I have tried it in quite a few patients, with not much success. But then again, most of the patients I see now, are on the more severe end of the spectrum." – http://www.healthyplace.com/Communities/OCD/site/transcripts/obsession s_ocd.htm See also: http://www.biopsychiatry.com/stjohnocd.htm

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Dear R.P.,      I have used Kava for anxiety and it does help though if your anxiety is high it may take a few days for it to really catch up with you.  To be on it is to be mellow but alert at the same time so I think it would help with OCD.                    Rusty

– Hide quoted text — Show quoted text – I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

Response:

In article <   "Bill & Ida Kern" < My psychiatrist said it was useless for OCD. Only good for *mild* depression. Ida

The interesting thing with St. John’s Wort, is that it alters the ‘mood/mind’ enough to allow an objective and clear perspective of the Self. And therefore a clear insight into those parts of the Self that causes the depression. Is your intent to clear yourself of the depression?… or clear yourself of the sources of that depression? The Wort (like LSD; magic mushrooms; kava-kava) open-up the psyche for deeper investigation… rather than offer a cure-all. Later Gerrit

Response:

My psychiatrist said it was useless for OCD. Only good for *mild* depression. Ida

– Hide quoted text — Show quoted text – I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

Response:

I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

Response:

I am interested in info. on St. John’s Wort and Kava for OCD and anxiety. Thank you.

I had a lot of luck with Kava Kava for anxiety, but it brought back eczema that had lain dormant for over 6 years (and which I have yet to get rid of). Take care if you have any dermatological problems.

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Question:

– Hide quoted text — Show quoted text – Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work. After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ?

Hi, Patrick….. I have been taking the same dose of Xanax for about 15 years now…… 0.5mg three times a day.  If I have a really bad pa, or if I’m facing something very challenging for me, I have my pdoc’s permission to take an extra tablet or two…… What it seems to do *for me* is to keep the panic and anxiety more *at bay*…… I rarely have a full-blown pa anymore…… maybe once a year.  As I remember, the Xanax was rather quick…….I didn’t have to wait weeks for it to help…. While you may likely become *dependent* on it after a long time (meaning you would have to wean off of it very slowly), it is not addictive…… I have never had the urge to take more and more….. as I said, I’m still at the same dosage I began with 15 years ago. I hope this helps a bit…… and I hope you get to feeling better soon, guy! I know it must suck to be feeling puny all the time….. Take care….. MikeH

Response:

- Hide quoted text — Show quoted text – Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work. After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety.

Serzone is not a first choice med for PAD although it works for some people. But stopping it suddenly will cause a reaction like yours. All AD’s should be weaned off. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ?

Xanax works *immediately*, after 10-40 minutes, that is. It is IMO the best anti-anxiety med around (as a rule). You will get dependent on it which means you will have to stop it by way of a slow taper (like the AD’s) which is easy for some and very difficult for others. Some doctors don’t prescribe benzodiazepines (*benzos*) like Xanax because they confuse *dependence* with *addiction*. This means they haven’t done their homework. Hopefully your doc is not a so-called *benzophobe*. Of the SSRI’s Celexa seems to be the one with the lowest side effect profile. Still, if you had bad experiences with two or three other SSRI’s (after having given them enough time for a fair trial – 6-8 weeks) you might want to ask your doc about a TCA. Don’t mix Serzone and Xanax. It’s a bad combo as Serzone more than doubles the effect of Xanax and generally the two don’t interact well. I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time.

Yeah…tell me about it…. this may well be Serzone withdrawal. Philip

Response:

I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time. Yeah…tell me about it…. this may well be Serzone withdrawal. Philip

I found Serzone to be the most potent meds I was ever on. I just found that I was taking 300mgs a day and after a couple of months stopped it cold turkey. Bad mistake…don’t stop it without your Drs help. I became very sick and depressed for a couple of weeks. Lorri http://hometown.aol.com/lorr1/myhomepage5indexhtlm.html http://hometown.aol.com/lorr1/myhomepage4index.html

Response:

– Hide quoted text — Show quoted text – Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work.   After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ? I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time.

Hi Patrick! I’m hoping you feel better today! Hugs, Di

Response:

Ugh I had a rotten night yesterday. It started out alright – I decided to drop my Serzone and see if maybe that was making me feel so icky lately.  So I never took my morning dose.  Things went fine for most of the day. I had some things to get ready – it was our 3rd year anniversary today and I was waiting for my partner to get home from work.   After supper things really went downhill – I started to feel really nauseated and bloated (it wasn’t my less than wonderful cooking either – Mel my partner was fine).  And from there is just lead to just horrible anxiety – by late in the evening I was just pacing back and forth – wondering if I should head to the emergency or not.  I decided to start the Serzone again and took my evening dose and it seemed to settle things down after about an hour or so.  Serzone does help some of the way for me – but I still don’t feel 100% or even 75% well on it – but it does take me to at least a somewhat toerable level of anxiety. I am making an appointment with the pdoc and see what can be done.  I had horrible luck on  a few of the SSRI’s but I have some good things about Celexa (yes I know it is an SSRI too) so maybe I will suggest that and see what the pdoc thinks.  Oh yes I do have Xanax around but for some reason I never take it – I don’t know why – I just cannot seem to make the decision to take it when I really need it.  If under docs orders of course, I started to take Xanax regularly – would it clear up these anxiety symptoms fast – would I notice a marked improvement almost right away ? – or would it take several weeks of usage to make me feel good again ? I am feeling really achy today – and my stomach is still bothering me. Could be a stomach flu I suppose – but I tend to feel achy a lot these days so who can say for sure (I had all the tests done for achy muscles – there is no physical problem there).  I feel like my body was just beaten up.  I am so tired of feeling sick all the time.

Response:

I know it is hard to up the xanax, but .25 is an extremly low dose. A few years ago , I  started getting panic attacks, and the doc prescibed .25/3X per day. It did abosolutely nothing, but I was too scared to take more. So after 2 weeks of constant attacks and horrible anxiety, I finally told myself "if I take 2 of these, what do I have to lose, I am going to die anyway and I took a .5 dose and another .5 dose 4 hrs later and boom..it was gone..I felt normal again. The point is  a .25 dose is not a dose for us panic sufferers. Dr’s give a dose like that to a patient who does not have PA or GAD , but just "going thru a roughtime". Talk to your Doc and bump the dose up to .5 3x a day. Believe me , it will help. Then when the zoloft kicks in (and it will) start lowering the xanax and soon you will be xanax free. When I was on zoloft, it hit me hard as well for the 1st 2 months, I was up to 4-5 mgs of xanax a day. But by the 5th month, the zoloft was working great and I was completely off the xanax. Hope this helps – Hide quoted text — Show quoted text – I had a pretty rotten night these last two.  The night before last I hardly slept at all but I managed to get to work and get through the day – barely.  Then last night after work I was doing some work on the computer and I felt strange – I started to perspire profusely, got all shaky, hot flushes up and down my body and felt short of breath  - basically it started to get out of hand – I paced the hallway in our apt here for a bit tried to calm myself but I just felt like I was gonna die.  I took a .25 mg Xanax – still phobic about taking anymore for some reason and it help a small bit but not enough.  I couldn’t do it this morning – I took the day off sick and made an appt to see the pdoc again (see him this Tuesday). I am on Zoloft – first 10 days at 25 mg and today would be my fifth day at 50 mg.  I don’t understand why the drug is hitting me so hard this time since when I was on it before for anxiety problems I seemed to handle it better.  Zoloft worked so well for me the last time I took it – I hope it starts to work soon for me here – it seems that it started to work faster for me the first time I took it – the thing that does concern me is that I am not seeing any positive effects after 15 days – I know 4-6 weeks for effect but shouldn’t I be seeing some improvement by now?

Response:

If you had a positive response to Zoloft before, you will most likely have a positive response again. The first few days of any increase in Zoloft dose often results in increased anxiety as a side effect. Xanax 0.25 mg is a very small dose (at least for me). I used to take 10.0 mg/day. I would suggest you increase your dose of Xanax (i.e. take 0.50 or 0.75 mg as needed) until you stop having PAs and this side effect of the Zoloft dissipates. Good luck, Chip last night   I had a pretty rotten night these last two. The night before last I hardly slept at all but I managed to get to work and get through the day – barely. Then last night after work I was doing some work on the computer and I felt strange – I started to perspire profusely, got all shaky, hot flushes up and down my body and felt short of breath – basically it started to get out of hand – I paced the hallway in our apt here for a bit tried to calm myself but I just felt like I was gonna die. I took a .25 mg Xanax – still phobic about taking anymore for some reason and it help a small bit but not enough. I couldn’t do it this morning – I took the day off sick and made an appt to see the pdoc again (see him this Tuesday). I am on Zoloft – first 10 days at 25 mg and today would be my fifth day at 50 mg. I don’t understand why the drug is hitting me so hard this time since when I was on it before for anxiety problems I seemed to handle it better. Zoloft worked so well for me the last time I took it – I hope it starts to work soon for me here – it seems that it started to work faster for me the first time I took it – the thing that does concern me is that I am not seeing any positive effects after 15 days – I know 4-6 weeks for effect but shouldn’t I be seeing some improvement by now?

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Question:

 Well, I have stumbled into a setback the last few days…I am much more functional since I started the Zoloft, and when my time is occupied I do pretty dang well…However, the last couple of days, I have been alone with not much to occupy my time…This has been difficult…Not as bad as before but difficult…Today I cannot enjoy my usual Sunday morning lounge with paper in hand…Now I am begining to worry that I have peaked in the effect I will get from the Zoloft/Xanax combo…Could this be?  I am just about through with week 4 (2 weeks at 50, 2 at 100), will I see more improvement as the weeks go on…I got lots of improvement after 2 weeks, but haven’t seen any since…Need some good stuff today from you all!

Hi Charles, I can only speak from my experience with Paxil, the way I felt at week 4 was alright, the way I felt at  week 8 was good. I had a slow but steady improvement from the second week on Paxil which was the beginning of April, all the way through the summer, even though I didn`t increase my dose past the beginning of May. And I do remember having a off week around week 9 or 10, it had to do with a conflict I had with a family member. And I was so afraid I was having a setback or the med stopped working, which just added to my anxiety. Being alone use to  be a trigger for my anxiety, I think it was a lack of stimulation for me. I can tell you since being on Paxil, I LOVE being alone when I have the opportunity. My husband just had a business trip to Mexico, and normally I would be anxious, I enjoyed him being gone, this tells me I am really doing well( or maybe it is that he annoys the hell out of me <g ) You are having a rough week, but the Zoloft probably has not reached full effectiveness. You have to give it more time. I know this is easier said than done, but you need to occupy your mind. When I had a problem with boredom, what would happen is my thoughts turn inward, thinking about my anxiety and monitoring every sensation and twitch I was having. Even though you are having a bad time, from what you wrote I see improvement.  Sometimes getting better isn`t just measured in  having "good" days, but how we handle our bad days, and you say yourself, it is not as difficult as before. That tells me Zoloft is having a effect on you. Patience my dear friend, you will get there. *Hugs* P.S. And in a few weeks, if you feel you are`nt at the place you want to be, maybe increasing the Zoloft, you can go as high as 200mgs. Jackie "Grant me the serenity to accept the things I cannot change, The courage to change the things I cannot accept, And the wisdom to  hide the bodies of those I had to kill today because they ticked me  off and also, help me to be careful of the toes I step on today, as  they may be connected to the butt I may have to kiss tomorrow.

Response:

Hi Charles! I cannot help with the meds questions, but I did want you to know that I am sending positive thoughts your way1 I hope you feel better soon! Being alone is tough, I know but you will get through it! Hang in there! Steph

Charles Writes: – Hide quoted text — Show quoted text -To all:  Well, I have stumbled into a setback the last few days…I am much more functional since I started the Zoloft, and when my time is occupied I do pretty dang well…However, the last couple of days, I have been alone with not much to occupy my time…This has been difficult…Not as bad as before but difficult…Today I cannot enjoy my usual Sunday morning lounge with paper in hand…Now I am begining to worry that I have peaked in the effect I will get from the Zoloft/Xanax combo…Could this be?  I am just about through with week 4 (2 weeks at 50, 2 at 100), will I see more improvement as the weeks go on…I got lots of improvement after 2 weeks, but haven’t seen any since…Need some good stuff today from you all! Thanks, — Charles Phipps

Response:

Question:

if you are taking effexor and are thinkin of going off for whatever reason, or have thought of trying it out, please be advised that the side effects of going off can be horrendous. have watched friends go off other anti-depress. meds to try newer meds and tho they have reactions (either depression before new med kicks in, or side effects of new drug) they have not had the physical reactions we are having. spoilered for talk of physical reactions, just in case it’s too graphic…no splatteroos 1 2 3 4 5 6 7 8 9 0 1 2 3 been positive we had bone cancer, or lupus, or mono, or hepatitis and trying to move home at same time has been nearly impossible. didn’t know what was wrong. sleep all the time but not the kind that comes with depression, just horrible bone tired exhaustion. joints aching so much it is hard to move body. at all. stomach all messed up, bloated, shooting pains, no appetite. lots of mental confusion (you can snicker, is ok) but not just normal diss kind. hard to put thoughts together and if we can, can’t retain for more than 2 seconds. zip…gone into the murk. sleep is passing out and then jerking awake from aching body. head aches 24/7. thought we had tumor or stroke coming. seriously. started thinking about wanting to die just to make constant physical hurting go away. this is not us. have always been able to diss. away physical discomfort. no painkiller at dentist (don’t need it), had viral menigitis once and didn’t pay attention to hurting till it was real bad. doc freaked and put on lots of meds and sent to bed (no getting up, no moving fast or lifting, be a loaf of bread he said). this is just to say, physical is never big problem. till this effexor. literature says should go off over period of at least 2 weeks. we have been tapering for 6 weeks and effects are getting worse and worse. wasn’t until last night went to pharminfonet and read threads from ppl who went off, are going off…and found every damn symptom (except sore throat that plagues us still) mentioned by ppl. and they all are saying takes way more than 2 weeks to get off. so angry could absolutely…can’t say what we want to do cause it makes us ashamed but still want to do it. hate this drug and company that lies about horrible effects of quitting. docs are not aware of this and so don’t take it into account when prescribing. also, didn’t want to go to doctor because we knew that we would be ignored as crazy person with psychosomatic symptoms. really, honestly thought we were dying. hatehatehate. don’t need more problems. need less. has been good drug as anti-depress. but couldn’t afford it anymore and wanted to try st.johns wort (hypericum). been in the literature for 2400 years. think that is much better track record for us. hypericum has web page for anyone who is curious. anyway. rant rant. hate wyeth drug co. will avoid buying anything they produce. will prolly write a letter when brain clears. not that they give a shit. but will make us feel little better to scream at them. maybe also copy to fda, just for the heck of it. expect no response but maybe someone will notice… so, don’t know what to say. not telling anyone not to take drug. like we say, been good at what it does. but never want to feel this much physical pain again. badhorriblestupid. cause even if didn’t have to go off drug now, someday hope to not have to take meds and so it would happen sooner or later. and no one says how horrible it can be. just vague corporate lies…scum. all done. sorry about anger. is much huger than what is showing. b., geep, KAT, Susie, Rachel — For more information about this service, send e-mail to:

Response:

Thanks for posting about this!  I’ve been taking Effexor for about a year now, and always want to hear what other people’s experiences with it are.  I’ve not been in the position yet to try withdrawal, as so far it’s worked well for me as an anti-d. I hope the nasty withdrawal stuff goes away soon for you… Take good care, Kanga – Hide quoted text — Show quoted text – if you are taking effexor and are thinkin of going off for whatever reason, or have thought of trying it out, please be advised that the side effects of going off can be horrendous. have watched friends go off other anti-depress. meds to try newer meds and tho they have reactions (either depression before new med kicks in, or side effects of new drug) they have not had the physical reactions we are having. spoilered for talk of physical reactions, just in case it’s too graphic…no splatteroos 1 2 3 4 5 6 7 8 9 0 1 2 3 been positive we had bone cancer, or lupus, or mono, or hepatitis and trying to move home at same time has been nearly impossible. didn’t know what was wrong. sleep all the time but not the kind that comes with depression, just horrible bone tired exhaustion. joints aching so much it is hard to move body. at all. stomach all messed up, bloated, shooting pains, no appetite. lots of mental confusion (you can snicker, is ok) but not just normal diss kind. hard to put thoughts together and if we can, can’t retain for more than 2 seconds. zip…gone into the murk. sleep is passing out and then jerking awake from aching body. head aches 24/7. thought we had tumor or stroke coming. seriously. started thinking about wanting to die just to make constant physical hurting go away. this is not us. have always been able to diss. away physical discomfort. no painkiller at dentist (don’t need it), had viral menigitis once and didn’t pay attention to hurting till it was real bad. doc freaked and put on lots of meds and sent to bed (no getting up, no moving fast or lifting, be a loaf of bread he said). this is just to say, physical is never big problem. till this effexor. literature says should go off over period of at least 2 weeks. we have been tapering for 6 weeks and effects are getting worse and worse. wasn’t until last night went to pharminfonet and read threads from ppl who went off, are going off…and found every damn symptom (except sore throat that plagues us still) mentioned by ppl. and they all are saying takes way more than 2 weeks to get off. so angry could absolutely…can’t say what we want to do cause it makes us ashamed but still want to do it. hate this drug and company that lies about horrible effects of quitting. docs are not aware of this and so don’t take it into account when prescribing. also, didn’t want to go to doctor because we knew that we would be ignored as crazy person with psychosomatic symptoms. really, honestly thought we were dying. hatehatehate. don’t need more problems. need less. has been good drug as anti-depress. but couldn’t afford it anymore and wanted to try st.johns wort (hypericum). been in the literature for 2400 years. think that is much better track record for us. hypericum has web page for anyone who is curious. anyway. rant rant. hate wyeth drug co. will avoid buying anything they produce. will prolly write a letter when brain clears. not that they give a shit. but will make us feel little better to scream at them. maybe also copy to fda, just for the heck of it. expect no response but maybe someone will notice… so, don’t know what to say. not telling anyone not to take drug. like we say, been good at what it does. but never want to feel this much physical pain again. badhorriblestupid. cause even if didn’t have to go off drug now, someday hope to not have to take meds and so it would happen sooner or later. and no one says how horrible it can be. just vague corporate lies…scum. all done. sorry about anger. is much huger than what is showing. b., geep, KAT, Susie, Rachel — For more information about this service, send e-mail to:

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thank you veryvery much Pope C. just like figuring out the effexor was causing all this horriblehorrible was huge relief, having the symptoms verified and explained is most empowering. not jus using that word accidentally. it gives me power in the head to know why this is happening and how to compare it with something. better to compare it to real brother, coke drug withdrawal, than to search for as yet unpublished effexor withdrawal symptoms or see it all as similar to dread diseases. we can work better with truth. funny how that works…. we were on drug for almost (i think) two years at 300mg a day which is up at top of dose level. this may be why the crash was so awful. also, 44 years old and ectomorph (is that the skinny body type? if so, thas us) tend to run at higher speeds and crash into feeling things without protection. oh fuzzy brain. does that last make sense. it has always felt like body was not protected by nice cushion and so all physical stuff was sort of heightened, accelerated…something…and then when we finally would notice physical discomfort it was huge and our body totally unprepared.  i think i am babbling. no, no doc to tell us how to go off. just followed what we know of drug withdrawal protocol. 300mg to250 for a week, to 200 for a week, to 150 for a week, and so on, down to taking only fraction (one third down to one quarter) of tablet 3x a day down to twice a day. tried to do it long and slow and careful. think this only prolonged the hurting. once we figured out was the effexor, we just quit. get it out of body now!!! one thing we discovered in last few days is that taking ambien sleeping pill (one at night) has helped make most excruciating symptoms abate for better part of the day. maybe just prolonging the withdrawal this way, but at least we can move around and get simple day to day tasks done without thinking we are dying. maybe this is like your suggestion about painkillers. as well as letters to fda and wyeth, i am going to send letter to dr.sid wolfe at nader founded group called health research group. used to work for organization that housed hrg and think sid will be interested. can i send him copy of your post (minus all identifiers) as it is good foil to my venting about symptoms. gives to hurting (amorphous) a basis in fact. docs like facts. will only do if you say is ok. thank you again for this information. you will never realize how validating and helpful it was. we still feel crappy but at least we know why and how. knowledge really is power. thank you all of Pope C. b. and all of coney s. – Hide quoted text — Show quoted text – : if you are taking effexor and are thinkin of going off for whatever : reason, or have thought of trying it out, please be advised that the : side effects of going off can be horrendous. have watched friends go off : other anti-depress. meds to try newer meds and tho they have reactions : (either depression before new med kicks in, or side effects of new drug) : they have not had the physical reactions we are having. : spoilered for talk of physical reactions, just in case it’s too : graphic…no splatteroos : 1 : 2 : 3 : 4 : 5 : 6 : 7 : 8 : 9 : 0 : 1 : 2 : 3 : been positive we had bone cancer, or lupus, or mono, or hepatitis and : trying to move home at same time has been nearly impossible. didn’t know : what was wrong. sleep all the time but not the kind that comes with : depression, just horrible bone tired exhaustion. joints aching so much : it is hard to move body. at all. stomach all messed up, bloated, : shooting pains, no appetite. lots of mental confusion (you can snicker, : is ok) but not just normal diss kind. hard to put thoughts together and : if we can, can’t retain for more than 2 seconds. zip…gone into the : murk. sleep is passing out and then jerking awake from aching body. head : aches 24/7. thought we had tumor or stroke coming. seriously. started : thinking about wanting to die just to make constant physical hurting go : away. Woof.  That sounds much worse than the "average" withdrawal from effexor, but they’re usually pretty bad from what I hear.  Basically you are going through the equivalent of "speed" or cocaine withdrawal, cold-turkey.  I researched Effexor for a friend last year. Here’s what’s going on, if it would help to know (I wrote something similar for asar last year):    The SSRIs are called that because they are *Selective* serotonin    reuptake inhibitors.  They don’t affect too much else, at least on    purpose.    Effexor is *not* an SSRI; it’s an SRI, but it’s also a dopamine    reuptake inhibitor.  This means it increases the dopamine levels in    your system, which can boost your mood and is why it’s such an    effective anti-depressant, but it means it’s also capable of    becoming physically addictive in the same way that speed or cocaine    are.  (Those are both dopamine-mimics, in the sense that they    stimulate the dopamine receptors in the brain.) Effectively you’re going through the equivalent of a really bad and prolonged amphetamine or cocaine withdrawal.  Yours seems to be worse than usual.  Maybe it will help to know this, I don’t know. Oh yeah, the SSRIs and SRIs all raise the pain threshold – SSRIs are now being prescribed for cancer victims along with conventional painkillers – so going off the SRI component presumably lowers it. That’s probably making the physical pain worse too. [...] : literature says should go off over period of at least 2 weeks. we have : been tapering for 6 weeks and effects are getting worse and worse. Ugh.  They will wear off eventually but it’s awful that it’s going on so long. : wasn’t until last night went to pharminfonet and read threads from ppl : who went off, are going off…and found every damn symptom (except sore : throat that plagues us still) mentioned by ppl. and they all are saying : takes way more than 2 weeks to get off. Yeah, that’s what I warned my friend last year. : so angry could : absolutely…can’t say what we want to do cause it makes us ashamed but : still want to do it. hate this drug and company that lies about horrible : effects of quitting. docs are not aware of this and so don’t take it : into account when prescribing. The drug industry is all excited about Effexor, because it’s the first in potentially a whole new class of phenethylamine-based SRIs.  We can hope that all of them don’t have this kind of effect.  (Phenethylamines are one of the two major families of chemicals from which most psychedelic drugs are derived: mescaline, MDA, X or "Ecstasy", etc. Most SSRIs are distantly related to the other such family, tryptamines.) Unfortunately too many doctors don’t read anything but the PDR for drug info, even though it’s based entirely on info provided by the drug manufacturers.  (And it tends to be updated more slowly than other sources.) I still use it as a source, but I try to look at other sources if I can, and I always do my own research on any drug I’m taking. Did your doctor taper you down very gradually, like they’re supposed to (if they keep up on the literature) or did they cut down the dosage for you more rapidly from full dosage to almost nothing?  (Either because they didn’t know or because of side-effects that were too dangerous to taper down slowly.) Talk to doctor about withdrawal effects, but if they won’t take you seriously, you might try:   1) asking for conventional painkillers to help you get through it;   2) ask if you can start phasing in another SSRI during the      withdrawal (this might not be safe due to untested interactions);   3) drink lots of coffee during the withdrawal period (seriously –      coffee stimulates dopamine release and might somewhat reduce the      effects.) This is purely my own weird advice, not endorsed by any      doctror. : also, didn’t want to go to doctor because we knew that we would be : ignored as crazy person with psychosomatic symptoms. really, honestly : thought we were dying. hatehatehate. don’t need more problems. need : less. I know what you mean… : anyway. rant rant. hate wyeth drug co. will avoid buying anything they : produce. will prolly write a letter when brain clears. not that they : give a shit. but will make us feel little better to scream at them. : maybe also copy to fda, just for the heck of it. expect no response but : maybe someone will notice… It’s a good idea.  Eventually, with enough letters like that, the FDA may force them to at least add more warnings to the PDR and package inserts, which is pretty much all that a lot of doctors read. : so, don’t know what to say. not telling anyone not to take drug. like we : say, been good at what it does. but never want to feel this much : physical pain again. badhorriblestupid. cause even if didn’t have to go : off drug now, someday hope to not have to take meds and so it would : happen sooner or later. and no one says how horrible it can be. just : vague corporate lies…scum. Yep.  That’s corporate America – or at this point, the world.  Most corporations are severely dysfunctional and in denial. <1/2 g : all done. sorry about anger. is much huger than what is showing. Anger is a feeling.  It’s fine to be angry.  You did not use it as an excuse to behave badly towards anyone, at least that I can see, so there is no need to apologize.  Thank you for

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Question:

As I previously posted, I was advised by my PDoc to increase my dosage of Zoloft from 100 mg to 200 mg per day slowly in an attempt to treat my high level of anxiety. I’m up to 125 mg now, and I’m noticing the effect; I wouldn’t exactly describe it as anxiety–more like "antsiness", or agitation.  I feel like I need to be constantly moving, even if it’s drumming my fingers on a table when I’m sitting. Anyone else have a similar experience? Carol

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I’ve been taking Zoloft for almost a month, 50mg and klonopin for anxiety as needed (haven’t yet) and have been very fidgety.  I’m always wiggling but it isn’t bothering me.  We’ll see how things go, I’m feeling tons better than I felt before I got the meds and was depressed/anxious 24/7.  I’ve noticed that I’m very antsy though.   shanti As I previously posted, I was advised by my PDoc to increase my dosage of Zoloft from 100 mg to 200 mg per day slowly in an attempt to treat my high level of anxiety. I’m up to 125 mg now, and I’m noticing the effect; I wouldn’t exactly describe it as anxiety–more like "antsiness", or agitation.  I feel like I need to be constantly moving, even if it’s drumming my fingers on a table when I’m sitting. Anyone else have a similar experience? Carol

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You may wish to refer to an article by Dr. Paul Wenders group at U. Utah:: Reimarr, F et al ,An open trial of L-Tyrosine in the Treatment of Attention Deficit Disorder, Residual Type. AMERICAN JOURNAL OF PSYCHIATRY, 144:8 August 1987, pp 1071-3 This study used doses of 50-150mg/kg in adults with ADD.  Eight of twelve patients had a "marked to moderate" response after 2 weeks, but all developed tolerance at 6 weeks.   In re the comments about tyrosine not effecting CNS levels of dopamine and norepinephrine (as compared to tryptophane — serotonin) I doubt that its that simple.   Why would tyrosine/phenylanaine supplementation have a positive effec in some cases of depression? You may wish to look up some writings by Dr. Richard Wurtman that will correlate amino acid loading with increase in central neurotransmitters. Are you also taking supplements of B vitamine (B6) that will aid the production of dopamine? In closing, you may find as I have that tyrosine used concurrently with a stimulant will have even better results than either alone.  Good luck Bob

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You may wish to refer to an article by Dr. Paul Wenders group at U. Utah:: Reimarr, F et al ,An open trial of L-Tyrosine in the Treatment of Attention Deficit Disorder, Residual Type. AMERICAN JOURNAL OF PSYCHIATRY, 144:8 August 1987, pp 1071-3 This study used doses of 50-150mg/kg in adults with ADD.  Eight of twelve patients had a "marked to moderate" response after 2 weeks, but all developed tolerance at 6 weeks.   In re the comments about tyrosine not effecting CNS levels of dopamine and norepinephrine (as compared to tryptophane — serotonin) I doubt that its that simple.   Why would tyrosine/phenylanaine supplementation have a positive effec in some cases of depression? You may wish to look up some writings by Dr. Richard Wurtman that will correlate amino acid loading with increase in central neurotransmitters.

Just to let you know where I’m coming from, for what it’s worth, here’s a quote from "The Molecular Foundations of Psychiatry" by S.E.Hyman & E.J. Nestler, pg 71:         Tyrosine hydroxylase is the rate limiting enzyme of catecholamine         [i.e. dopamine and norepinephrine] synthesis…Because tyrosine         hydroxylase exists at relatively low levels, and *under normal         conditions* is already supersaturated by the amount of tyrosine         found in the brain, it is very difficult to influence brain         catecholamine synthesis through variations in dietary tyrosine. Notice the qualification "under normal conditions".  There could be exceptions, for example, in persons with abnormal brain chemistry. Stanley – Hide quoted text — Show quoted text -Are you also taking supplements of B vitamine (B6) that will aid the production of dopamine? In closing, you may find as I have that tyrosine used concurrently with a stimulant will have even better results than either alone.  Good luck Bob

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Which is the reason that L-Dopa is used to treat Parkinson’s disease rather than tyrosine.  I beleive that too many people expect too great of results from substances such as amino acids  Similarly too many in the medical/scientific community are just as fast to write off any real effect.   To simply state that tyrosine hydroxylase is the rate limiting factor may be a simplification.  (Does this consider variations depending on time of day?)   The Wender writing stated that a period of two weeks passed before an effect was noticed, which he compared to the delayed response found in most antidepressant drugs.  (Similarly he found no usefulness beyond 6 weeks, tolerance?) To my understanding, tricyclic antidepressants cause an immediate blockage of reuptake and consequential increase in synaptic transmitter levels but clinical response is delayed 2-6 weeks.  Why?  This suggests actions beyond the immediate cast of players, be it amino acids, enzymes, neurotransmitters and/or drugs, on an IMMEDIATE basis. I hope to respond to you giving a few other citations later. I invite your comments on a relate issue, ie, the differing actions of d-amphetamine and methylphenidate.  As a person with ADD, I had extreme problems (anxiety, dysphoria) with larger doses of Ritalin(40-60mg/dose), which my doctor simply excused to my greater awareness to the world.  I have no such problems with ROUGHLY equivalent doses of Dexedrine(15mg).  I have read that these two drugs act on different dopamine pools in the brain, and that methylphenidate actually inhibits the actions of amphetamine.(Research I beleive done by a researcher at Duke, McEwen or similar name reported in TIPS mid 80s)  Similarly methylphenidate seems to provoke epileptic activity, where amphetamine tends to inhibit it (Dexedrine is marketed as an anticonvulsant in Canada, I doubt this is only for its anti-drowsiness effects re phenobarbital) As a child I experienced nocturnal epilepsy but I have read nothing clinically about the selection of antiADD drugs in epileptics for example.  What is the current thinking (theoretically as well as clinically) regarding this diffenence between the actions of thes amphetamine like drugs and the methylphenidate like drugs?. Regards Bob

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Tyrosine is a great way to prevent depletion of neurotransmitters as a result of psychostimulant therapy. Phenylalanine competes with tryptophan for entry to the brain and should not even be considered – it made me angry as all hell!! All by itself its probably nowhere near as effective, because the body is good at keeping levels where it thinks they should be. L-Dopa effectively bypasses this mechanism – anyone got any data on it? L-Dopa can [according to a friend] be made by feeding potatoes lots of tyrosine, then eating them [he didnt say whether they were cooked or not] — Its always the same / Im the only one who’s always left to blame / Take what you can take / Hurt is your only idea of a game / To break away / I dont have that within me / And I’m not afraid / So I bite the hand that feeds me… / When all you do is break me / And put me in a cage     Front 242, Animal.

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Someone posted a message recently about Tyrosine conflicting with antidepressants. Anyone have any details?

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: I really hate these kinds of replies. : Why do you bother doing this without getting the facts?  Gosh.. You’ve : succeeded in making me angry. : I have probably been diagnosed with ADD more times than you have, Ed. : about 3 or 4.  from neurologists and psychiatrists.  I have tried every : drug known from stimulants to wellbutrin. : lay off, and find out the facts before you waste your time talking without : knowing. : If you don know, ASK.  don’t suggest things that have already been done IN : EXCESS! : Now, if someone could INTELLECTUALLY respond to my message,  I would : appreciate it.   : I appologize to all reading this, it just makes me upset to have someone : respond to me like this. Jason, you _asked_ for opinions; and that’s what you got.  Don’t complain that somebody offered you the best advice that anybody could in response to your description of experimenting with self-treatment for ADD "symptoms". I’ve tried Ritalin, switched to Dexedrine, went back to Ritalin, added Effexor along with Ritalin, and still some of my symptoms persist. However, all through this process (a little over 2 years now) I’ve been seeing a therapist (psychologist) on a regular basis, as well at the less frequent appointments with neurologist, neuropsychologist, and psychiatrist. Oh, can’t forget my general practicioner MD, either. For many people, drugs are not enough–some type of therapy or counselling can help them take control over their life.  For some of us it’s the first time ever we’ve felt even close to being in the driver’s seat, and it can be a frightening/frustrating experience–not knowing what we’re supposed to do first, or do next, or do after that, or… Final note: regarding self-prescribed vitamin, mineral, amino acid, "natural" supplements, a biochemical/medical researcher (PhD+) advised me, "I recommend against it; when you start messing with chemical balance in your brain you can really screw things up."   _I’d_ recommend taking Ed’s advice: seek professional help and stick with it. (I apologize if the tone of this post started getting hot, but what you’re  doing _is_ playing with fire.  Be really careful!)       "Well, heck. It sounded like a _really_good_idea_, at the time."

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I really hate these kinds of replies. Why do you bother doing this without getting the facts?  Gosh.. You’ve succeeded in making me angry. I have probably been diagnosed with ADD more times than you have, Ed. about 3 or 4.  from neurologists and psychiatrists.  I have tried every drug known from stimulants to wellbutrin. lay off, and find out the facts before you waste your time talking without knowing. If you don know, ASK.  don’t suggest things that have already been done IN EXCESS! Now, if someone could INTELLECTUALLY respond to my message,  I would appreciate it.   I appologize to all reading this, it just makes me upset to have someone respond to me like this. Jason —- The fear of the unknown is a response to the excesses of the imagination.

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