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 Post subject: anti-depressant question
PostPosted: Thu Apr 29, 2010 3:23 pm 
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Hey Guys,

So, I’m not sure if this is in the right place…it isn’t really about suboxone, but it is miscellaneous…so I’m at least half right. Anyway, the question is about anti-depressant medications. I have been on and off SSRI’s for about 15 years (I was on Prozac as a teen before there was a generic…that’s how old I am!!). Anyway, I found that Prozac, Zoloft and Wellbutrin (which was my favorite) all worked great for the depression. But, about 5 years ago, I started having a lot more trouble with anxiety than depression, and none of these seemed to help me with that problem.

Initially after going on the sub (for about the first 6 months) I didn’t have any problems with anxiety. But, over the past 6-8 weeks, I have really had a hard time. I spoke with my sub doctor (who has been my therapist for 5 years), and he started me on Effexor XR, starting at 37.5mg, then increasing to 75mg after one week. As soon as I started, I felt HORRIBLE :shock: ….I expected some stomach issues and a little fuzzy-headedness (is that a word?) , but nothing like this!! I toughed it out for the first week, didn’t get any better, stayed at 37.5 a few more days to try and adjust, didn’t get any better, then went up to 75mg last weekend, and didn’t do well at all. I called my doctor on Monday, and he told me to stop taking it, wait for it to get out of my system, and call him next week, and we’ll try something else.

My question is, for those who are comfortable talking about it, what has worked for you? Is there anything that has worked well for anxiety without horrible side effects? Specifically, what are the reviews on Lexepro, Cylexa, and Pristique? Has anyone else had similar problems with Effexor XR?

Obviously, I will ultimately do what my doctor tells me to, but I am really trying to find any ideas to help with this….I am sick of feeling like this!!!

Thanks!!!

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PostPosted: Thu Apr 29, 2010 3:50 pm 
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Hi E,
I think I've been on some kind of anti-depressant for at least as long as you have. I've struggled with major depression and PTSD my entire adult life. So I've tried many of them.

I used to take Effexor and it did well for me for a long time. I didn't have your reaction. But that's whats great about anti-depressants, there are so many that are similar, yet different enough that if one doesn't work another might. I couldn't take Prozac - it had me bouncing off the walls like a crazy woman. Currently I'm on Celexa and I'm very pleased with it. I don't notice any side effects and it seems to help my fibromyalgia a bit, too.

Let's see, I also took Paxil for awhile and I hear that helps with anxiety, but Paxil is a bitch to get off of, that's for sure. I haven't tried Cymbalta, but I've heard good things about it.

Most SSRI's or SNRI's are supposed to help with anxiety and nowadays seem to be preferable than using benzos, especially for people like us on suboxone.

Lastly on the subject of anxiety, have you seen the thread I posted about meditation? I used to be on massive doses of xanax before I started subs, so I had to learn to live without them. Meditation is what helped me do that. I know it sounds cheesy, or trendy, or cliche', but meditation/guided imagery/self-hypnosis is a great tool. Yoga too is said to help with anxiety.

I hope your doctor can find the right anti-depressant for you without having to go through several first. I don't know if this helps at all, but I thought I'd add my experience into the mix.

Take care.

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PostPosted: Thu Apr 29, 2010 5:13 pm 
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Thanks hatmaker...I had totally forgotten about Paxil and Cymbalta....What is so hard about getting off the Paxil? The weird thing is that I have been reading all sorts of crazy things about Effexor online....people saying that they can't get off, that they are having "brain shocks" (electrical shocks/pain in the head and throughout the body), dizziness, fainting....all sorts of crazy stuff. Trust me, I don't take much of this seriously as there are lots of crazy people on the internet (non on THIS site of course.... :lol: ). But, still, I've never heard of anything like this with an SSRI/SNRI.


(AAAHHH...I have "Sober House" on in the background while I clean, and they are showing the part where Mike Starr asks for suboxone, and they make it sound like he is trying to get high off it, and then Dr. Drew refuses to give him the sub....this is NOT helping the anxiety :twisted: )

I have absolutely seen the benefits of meditation, but I am never able to sit still long enough to get anything out of it. When I was a grad student, I did work with dialectical behavior therapy (DBT) and addiction, and we used mindfulness exercises to reduce anxiety and cravings. They are basically short versions of meditation that bring the mind back into the present moment and away from unhealthy thoughts. I was always amazed how well it worked!! I'll definitely read that thread....I think part of addict behavior is always looking for medication as the only solution to a problem, when there are a lot of other things that can help as well.

I agree about the benzo stuff. I took Klonopin for a while, but was always really careful with the dose....I just liked it way too much. I even refused a script for Xanax at the ER when I was having panic attacks several years ago (I took some in the ER, but didn't want to take it home). Go figure, I turn down the benzos because I know I could easily become addicted, but run all over the city to get opiates....the addict brain :roll:

BTW....has anyone taken Buspar?? I know that we had a few patients on a combo of Prozac and Buspar when I worked at the rehab center...not sure what it is exactly....anyone tried it?

Any other opinions and experiences are appreciated!!

Thanks!

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"Don't hope for a life without problems. An easy life results in a judgmental and lazy mind."
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PostPosted: Thu Apr 29, 2010 5:23 pm 
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Ah yea, buspar. I took it years ago and found no benefit from it at all. After I gave up the xanax I asked my shrink about buspar and she almost laughed - said it doesn't work well for anxiety at all, that an SSRI is better.

What you described about coming off Effexor is basically the same problem with Paxil. I'm pretty sure those were documented problems. I loved Paxil when I was on it, but I did have withdrawals coming off. Not pretty. Interestingly enough, I had ZERO problems stopping the Effexor. You never know until you try it.

Feel free to PM me if you have specific questions.

Melis

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PostPosted: Thu Apr 29, 2010 9:28 pm 
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ene -

I too have taken various SSRI's and mainly wellbutrin for over 20 years, and I have had major issues with anxiety. I used to take Klonopin, and before that I took Ativan for my anxiety & panic disorder.

My doc let me stay on Klonopin while I was on Sub, but I wanted to stop taking it. I was able to stop by using meditation - if you can't sit still to meditate you can do walking meditation or yoga. Another thing to remember is that you can't expect that you'll be able to sit still for 30 minutes the first time you try. You have to work up to that! Breathing exercises can also be useful for ending an anxiety attack.

I also paid attention to what was triggering my anxiety and worked on those issues. I stopped using any caffine for a while and that helped tremendously. I drink cofffee a few times a week now that I'm back in school, but it doesn't bother me so much as it used to. Other things that triggered anxiety were hormonal fluctations and just generally not respecting my own boundaries. As I became healthier, I worked on these issues and the anxiety went away.

Exercise is also really useful. You can work out a lot of ish just by going for a long walk.

There are some herbs you can use for anxiety - valerian and kava have helped me in the past.

I think that we (as a culture) tend to pathologize our feelings too much these days. Sometimes it's good to see what the root of a feeling like anxiety is, and address that if possible. Or to learn that the feeling, while uncomfortable, is not going to kill you. This was really hard for me, but eventually I was able to stay with an anxious feeling and breathe through it and instead of turning into an anxiety attack, it would either peter out or I would be able to figure out what was going on. I think that just habitually repressing those feelings makes them come back stronger.

Why do you think your anxiety is back? What's going on in your life & your recovery? I'm not asking you to answer me, I'm just saying think about why now, what's going on, when does it happen, what does it relate to? Anxiety is not necessasarily an illness...it's really just energy that doesn't know where to go.

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PostPosted: Thu Apr 29, 2010 10:26 pm 
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Like all of you, I have tried many different antidepressents.. For me lexapro worked the best..Although I am not on it anymore, I weaned off and did fine..
But , I just recently asked my sub doctor about going back on it..He said he wanted me to take wellburtrin. I asked why ,and he explained to me that it is the one best for opiate brains., something about dopamine? I am not in the medical field, but would like to find out more about this...aimee


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PostPosted: Fri Apr 30, 2010 12:16 am 
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Hey i know what your going thew ive dealt with anixety for a long time. b4 sub i self medicated on weed for 8 years and that worked great but i live in buffalo so its a non medical state and once i got on sub i realized if i truely want to get clean i had to quit. any ways at first i just tryed to deal with it but started haveing panic attacks every couple weeks to the point were like u i ended up in the er and was giving xanax and unlike u i took it home an that made things worst. cause it worked great for my anixety but once i ran out back to square 1. so i talk to my head doc about what i was gong threw and they first started me on a ssri but i for got the name but that didnt work mind u i also have terriable ocd so they switch me to prozac an that has worked wonders for me. but im starting to get small panic attacks after i take it for some reason adn have to tak to my dr about this next week. any ways ive had great success with prozac for my mental health issues i know u said you took it a while back. what about giving it another shot? do you think it could maybe work for your problems now adays since its been a while?


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PostPosted: Fri Apr 30, 2010 6:48 am 
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I too have been on many, many diff. SSRI's. I tried Cymbalta when I first went on suboxone but I'm not really sure if it worked for me because I was still messing around with pills also. My doc did give me a script for it about a week ago and I tried it one day and it really had me feeling weird so I did not take anymore. From what I have read Cymbalta and Effexor have the added ingredient to boost your energy so I'm not sure if I would take them for anxiety. I am thinking about trying the Cymbalta again though. I need something to help with motivation. I'll just have to push through the side effects. I did try Lexapro a few years ago and that had the least side effects for me and seemed to work pretty well at the time. Again I was using at the time so I'm not really sure if it worked or it was all in my head. If the Cymbalta does not work for me this time, I'm going to try Lexapro again. I hope this helps you out some.

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PostPosted: Fri Apr 30, 2010 12:29 pm 
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Thanks for all the replies....I will try to formulate a somewhat coherent response :).

Although I have struggled with anxiety for years, I do think that it has changed over the years. When I was in college (the first time), I had full on panic attacks...this continued for several years, and is when I was on Klonopin. Basically, I would have a panic attack, take a bunch of Klonopin, be fine for a few days, have a panic attack, take some Klonopin....etc, etc. At this time, I was also taking Wellbutrin, which seemed to really help my depression, but not the anxiety. I also have epilepsy, and my neurologist took me off the Wellbutrin since it is apparently not the best medication for epileptics.

After I got married, we moved, and I got a new psychiatrist. He put me on Zoloft, and we began to work on the anxiety from a behavioral position, which has helped more than anything. Although I still have a lot of anxiety in general, I am usually able to control things so that I don't have full on panic attacks. I stayed on Zoloft for a while, but stopped using it when I got really into my addiction (hey....I needed that money for drugs....priorities people!! :roll:). Also, the Zoloft wasn't really doing much for me, to be totally honest....again, no depression, but still had anxiety.

I had been doing ok, but, at my last visit, I mentioned to my doctor that I was having a lot more cravings over the past few months. We talked about it, and he felt that the cravings are probably a result of anxiety (since that is how I dealt with anxiety for so long). He also felt that it would be easier to eventually taper down on the sub if I didn't have all the anxiety to deal with. I have been discussing a lot of the things that could be causing the anxiety with my doctor....some I can change, some I can't. But, I do think that I am at the point where I need some sort of medical help, in addition to the therapy and the behavioral techniques.

My doctor seems to want me to be on some sort of SNRI (probably because, in the past, Zoloft and Wellbutrin didn't really do much for my anxiety). But, that's not necessarily set in stone....I think I just need some trial and error. I am leaning toward Lexepro (it worked well for my father), but am also going to ask him about the Prozac....the original bad ass anti-depressant!!!

BTW....anyone taken Pristique? I don't know ANYTHING about it (other than the commercials).

Thanks again for all the replies!!! :D

Elizabeth

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"Don't hope for a life without problems. An easy life results in a judgmental and lazy mind."
- Zen Master Kyong Ho


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PostPosted: Fri Apr 30, 2010 7:43 pm 
I just started Lexapro about 3 weeks ago and it's helping my depression without side effects. I didn't have anxiety, so I don't know how it will work for that. Previously I had been on Celexa, which has the same active ingredient as Lexapro. Over the years I've been on many of the SSRI's and Celexa/Lexapro has been the best for me. I think they all lower the libido, which is also an issue with Sub, so that is a concern. (For me, Prozac was the worst in that area)

I believe Pristiq has the same active ingredient as Effexor, so you might not want to try that. Good luck. I think you're smart to go with an SSRI or SNRI and avoid the benzos.


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PostPosted: Thu May 06, 2010 4:26 pm 
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Hey guys....quick update. I stopped the Effexor last week (per Dr. instructions....I didn't go rouge or anything :) ). He had me wait a week (to get everything out of my system) and I feel MUCH better now, at least physically. I am still having a lot of trouble with the anxiety stuff (and all the pleasantries that go along with it). Like I said before, I am good at controlling the panic attacks, and keeping a fairly even keel most of the time, and I have even gotten good at being able to calm myself down when I start to get too panicky. The thing is, there is just this overall sense of anxiety all the time....like I am just "on edge" most of the time....can't relax fully, trouble focusing, sleep issues....most of you know the drill. So, we started Zoloft today, and I'm really hoping it works....I'm ready to even out my moods asap. My doctor did reassure me...he told me that he has a list of possible ideas and combinations to try out, and that we may even add something to this after I have time adjusting to it (I think he may have been talking about Abilify, but I'm just speculating).

But, I started the Zoloft when I got home, and so far no nausea (that was pretty immediate with the Effexor). I have taken Zoloft in the past, and it worked well....so the doctor wants to try it again and get to a higher dose than I was on in the past and then, like I said before, maybe add something to it.

You guys were so supportive, and I just wanted to tell you the result.....keep your fingers crossed for me (given the number of members, that's a lot of fingers!!!) :D .

Thanks again!

E

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"Don't hope for a life without problems. An easy life results in a judgmental and lazy mind."
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PostPosted: Sun May 09, 2010 9:39 pm 
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Paxil does work great, but yeah it's a bitch to come off of. Those "brain zaps" as I call them are AWFUL! And you get really foggy and out of it in a major way. Seems like the anxiety and depression gets worse too. ugh. yucky.


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PostPosted: Sun May 09, 2010 10:20 pm 
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I'm glad you posted an update Elizabeth. Ugh, feeling on edge all the time is the pits. I still go through that from time to time, especially when school gets stressful - it's like that feeling bleeds over into everything. I use a lot of self-talk to get me through those days/weeks and I'm glad they are fewer than they once were.

Zoloft is my second-favorite antidepressant, after Wellbutrin. In my experience it had relatively few side effects and wasn't hard to discontinue taking. The one thing that sucked about it was the low-libido, but I don't think everyone gets that. You speculated that your doc might be thinking of adding Abilify - I just wanted to say that I've taken Zoloft and Wellbutrin at the same time with good results, so he might be looking in that direction too (you said you had success with Wellbutrin in the past, right?) In any case, read up on the Abilify research WRT using it as an add-on treatment for depression. I thought the supporting evidence was kinda slim, especially considering the possible side effects.

I know I already mentioned this, but I wanted to suggest kava-kava and valerian root again. Check with your doc first (of course), but I think they are safe to mix with SSRI's because it was my psychiatrist that suggested them to me. I had this awesome sublingual kava spray that worked great and was minty fresh, and I had a valerian tincture that smelled and tasted like dirty gym socks but really helped with anxiety-related sleep disturbances. And I promise, this is the last time I will try to sell you on the herbs :wink:

I hope you start feeling better soon. And by the way, I'm glad you joined our forum and I've really appreciated your contributions so far. So thanks for that!

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PostPosted: Mon May 10, 2010 12:19 pm 
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RTL....I have read about the "brain zaps"....that term honestly scares me more than anything I went through during opiate withdrawal....at least my brain never "zapped"! :lol:

DOQ...Although I did take Wellbutrin in the past, it is not an option anymore. I was diagnosed with epilepsy about 10 years ago and Wellbutrin is contraindicated for people with seizures. But, my doctor told me that he has several ideas of medication combinations to try out. Thanks for the info about Abilify...I will definitely check that out. I honestly don't know what my doctor is thinking....I have just heard of adding Abilify, so I thought that might be an option he is considering.

I actually have tried Valerian root in the past, when I was trying to get off Ambien, but it made me feel so weird, almost shaky and wired. I'm like that with a lot of medication....Benadryl and Nyquil make me wired and jittery Plus, I really have been doing pretty well with sleep, better than I EVER thought possible, and I am kind of enjoying being able to sleep without taking anything for the first time in 15 YEARS!!! So, I am reluctant to take anything, even herbs, for sleep.

But, I would be interested in the kava-kava. Can you please PM me with the manufacturer information (where you got it, who makes it, how often you use it, etc)? If you have any other herbal suggestions, I am more than open to that as well.

I am on day 5 of zoloft, still at 50mg (going up to 100mg on Thursday and we will adjust the dosage after that as needed). But, I am feeling great....no real side effects at all. I have noticed that the Zoloft makes me feel tired (as all SSRIs usually do to me) so I am taking it at night,and feel fine during the day.

Thanks again!

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"Don't hope for a life without problems. An easy life results in a judgmental and lazy mind."
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PostPosted: Mon May 10, 2010 12:23 pm 
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I just wanted to add that I also take Abilify with my Celexa. It really helps with my mood swings, too. I haven't noticed any real side effects from it, but I'm on so many meds, who can tell anymore? LOL.

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Mon Jun 07, 2010 6:40 am 
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I used to be in depression since a year and I come to know about this after 3 months and consulted doctor, he prescribed me anti-depressant drugs which helped me come out of the hell. Now I have been completely better and started going to work again, but still I have been taking the medicine as it cannot be stopped suddenly.

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