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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Stef on July 28, 2001, at 18:57:53
Well,after much consideration,I think I'm not very happy with effexor. I feel like I'm on a whole lot of speed,my thinking is impaired,and the sweats are just unbearable. Mind you,I'm not depressed,but I feel like a speed freak. I usually adjust very quickly to meds,and I think I have given this one ample adjustment time.
So I have been through zoloft,paxil,and now effexor. Does anyone have any suggestions for a med for clinical depression with anger? That will give me a middle ground? (The paxil made me a zombie,the effexor makes me seem like a speed freak).
Something right in the middle of those two would be perfect. I'm getting a little frustrated,and frankly a tad bit upset that I have to withdraw off this and go to yet again another med.
Anyone have any ideas?
Thanks! Stef
Posted by mila on July 28, 2001, at 20:30:57
In reply to effexor about to be stopped.*PLEASE READ*, posted by Stef on July 28, 2001, at 18:57:53
Hi,
try to go back to paxil. that is what i did. I switched from Paxil to Effexor and then went back to paxil and had no side effects that bothered me first time I was on it, but all the positive stuff was in there as before, although a bit milder. The key here is to always stay medicated until you heal completely. Also, you might want to consider lower doses of paxil, even 5 mg was working for me. My doc was amazed, but on 20 mg I was sleeping 17 hours a day, no time left for life.
mila
Posted by SalArmy4me on July 28, 2001, at 22:10:01
In reply to effexor about to be stopped.*PLEASE READ*, posted by Stef on July 28, 2001, at 18:57:53
More scientific studies have been done on the role of Fluoxetine in Anger Episodes, so I'll present that first... Prozac might provide relief from sedation also, as most people find it stimulating:
1) Salzman, Carl MD. Effect of Fluoxetine on Anger in Symptomatic Volunteers With Borderline Personality Disorder. Journal of Clinical Psychopharmacology. 15(1):23-29, February 1995.
2) Fava, M. Anger Attacks in Unipolar Depression, Part 1: Clinical Correlates and Response to Fluoxetine Treatment. Year Book of Psychiatry & Applied Mental Health. 1995(10):463-464, Annual 1995:"Anger attacks were reported at baseline by 44% of patients. Compared with patients without anger attacks, these patients had significantly higher scores for anxiety, somatization, and state and trait hostility. All of these scores decreased significantly after fluoxetine treatment, and the attacks disappeared in 71% of treated patients. Patients with anger attacks had a somewhat greater degree of overall clinical improvement than those without attacks..."
Other ideas: Nefazodone
Domon, Steven E. M.D.. Andersen, Mark S. M.D.. NEFAZODONE FOR PTSD. Journal of the American Academy of Child & Adolescent Psychiatry. 39(8):942-943, August 2000:
"We have found that nefazodone may be particularly useful in addressing the symptoms... These include improvements not only in anger and aggression, but in restlessness, insomnia, and even concentration. In the context of residential treatment we have observed an improvement in avoidance, anhedonia, and detachment. Our patients often report an improvement in both sleep duration and quality. Improvement in sleep and the symptoms of hyperarousal are consistent with those changes observed in adult patients..."
Valproate:Davis, Lori L. MD. Comprehensive Review of the Psychiatric Uses of Valproate. Journal of Clinical Psychopharmacology. 20(1) Supplement 1:1S-17S, February 2000:
"Four of the eight completers were rated as responders for overall pathology, four were responders on scores for mood, and three were responders on scores for anxiety, ANGER, impulsivity, and rejection sensitivity. There was a significant decrease in the self-rated Symptom Checklist-90. The total score on the Overt Aggression Scale decreased, but not significantly. There was a significant decrease in global subjective irritability. Thus, treatment with VPA (Valproic Acid) in combination with psychotherapy led to overall improvement in 50% of the patients who completed the 8-week trial."
Helpful Links:
http://www.dr-bob.org/tips/split/Fluoxetine-for-irritabilit.html
http://www.dr-bob.org/tips/split/Mood-stab-stim-for-anger.html
This is the end of the thread.
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