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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Denise528 on October 7, 2002, at 7:48:39
I'm in a predicimant and was wondering if any of you could advise. I've been on Sertraline now for the last two months, 100mg for the last month plus 50mg of Lamictal. Yesterday, I felt really low, had no motivation and just wanted to ly on my bed all day but felt awful doing that as well. The thing is if I don't take on the following day then I feel better than I did before taking them and better than I do when I'm on them. I really don't think the Sertraline is helping, I can't tolerate them. My psychiatrist is instistent that the Sertraline is working although I keep telling him it istn't. I told him that the only tablet that seems to help is Zyprexa so he wants me to take that as well as the Sertraline. I've told him I don't want to take Zyprexa until I have explored all other options but he won't have it.
Anyway after lying in bed feeling awful yesterday, today I have decided I want to stop the Sertraline, I've left a message for the psychiatrist to ring me back but know I'm going to end up arguing with him. He'll just tell me to take the Zyprexa but I can't understand why he won't try me on other things. He tells me that he won't try me with a stimulant because that's only for resistant cases, he won't try Klonopin because that can make you more depressed. What's the best way of approaching this?
I'm not saying that anything else will work but at least I will know I have tried.
Denise
Posted by k9lover on October 7, 2002, at 7:55:37
In reply to Not sure what to do, posted by Denise528 on October 7, 2002, at 7:48:39
You know what I do - I trust my gut and extensively journal the side effects and how I'm feeling verses what I'm taking, on a regular basis so I can produce evidence when visiting pdocs. I record my mood daily on a scale of 1-10/10, record whether or not I've had some alcohol, good sleep, external events - like fun at a social event or whatever. Bottom line is that you (we) are the ones who intimately know what's happening inside and *they* need to be listening to us - journalling provides evidence.
Hope that helps
Jan
Posted by Denise528 on October 7, 2002, at 9:57:23
In reply to Re: Not sure what to do, posted by k9lover on October 7, 2002, at 7:55:37
Hi,
Thanks for getting back to me, I do keep a journal but all it really tells me is that I've been feeling pretty crap over the last two months. Anyway, as I predicted my psychiatrist rang me back and just told me to either keep taking the Zyprexa or up the lamictal, he won't prescribe anything else. So it sounds as though because the Zyprexa helps he wants me to just keep taking that. Don't get me wrong, I'm grateful for the Zyprexa, I just can't understand why he won't let me try anything else instead.
Denise
Posted by BrittPark on October 7, 2002, at 12:06:38
In reply to Not sure what to do, posted by Denise528 on October 7, 2002, at 7:48:39
Eight weeks sounds like a long enough trial of an AD, and it sounds like your trial has failed. Have you asked your doctor what his rationale is for not trying a different AD? Zyprexa can be an effective augmentation agent for ADs. One usually considers augmentation when there is at least a partial response to an antidepressant. The good side of augmentation is that you usually find out if it's going to work fairly quickly.
But all that is theoretical. The real point is how the sertraline is making you feel. If it's making you feel worse you should stop. Perhaps it's time for a second opinion or a new doctor.
Feel better (you will eventually)
Britt
Posted by denise528 on October 7, 2002, at 12:20:38
In reply to Re: Not sure what to do » Denise528, posted by BrittPark on October 7, 2002, at 12:06:38
Britt,
Thanks for the reply, I am going to try a different psychiatrist but I imagine I'll get the same response. The psychiatrists here in the UK seem to have a set of guidelines that they follow to the rule and won't sway from it. The psychiatrist I am currently seeing is actually the best I've seen so far but that istn't saying much. The other three were from our National Health Service and they seemed useless.
I don't think my response to Sertraline was very good, the only good thing about it was I had more energy but somedays I felt absolutely awful.
I used to be on Sertraline years ago and they worked really well, felt like a completely different tablet, so I know how they work when they do work.
I feel crap off them but just a different kind of crap.
I did ask my psychiatrist what his rationale was for not trying another AD and he said because I have already tried a load and they didn't work so it's pointless trying any others. He won't try me on stimulants because he says he wouldn't prescribe them at this stage, that they usually come further down the line, at what stage he is thinking of trying them I don't know maybe in another 20 years time!!!! I asked him how come he's prepared to prescribe an antipsychotic at this stage but not a stimulant and he didn't answer just skirted around the topic.
Posted by k9lover on October 7, 2002, at 12:42:03
In reply to Re: Not sure what to do - Britt, posted by denise528 on October 7, 2002, at 12:20:38
For what it's worth Denise - I know it's an awful process - I went through 6 shrinks before I found one who was genuinely interested in MY experience of my own circumstances. The others were (are) regarded as tops in their respective fields here in Toronto, but they didn't help me very well, nor willingly. Shop around if you can mount the courage and necessary energy - we owe it to ourselves to get the most information and best help that is possible to obtain.
Damn the torpedos - full steam ahead!
Posted by denise528 on October 7, 2002, at 12:51:56
In reply to Re: Not sure what to do - Britt, posted by k9lover on October 7, 2002, at 12:42:03
Hi,
Thanks for that note of encouragement, it's nice to know I'm not alone but then again not nice for everyone else. What gets me about this site, is how come so many people on here sound so upbeat and positive. All my notes sound whingey and whiney, never mind.
Denise
Posted by polarbear206 on October 7, 2002, at 17:30:37
In reply to Not sure what to do, posted by Denise528 on October 7, 2002, at 7:48:39
> I'm in a predicimant and was wondering if any of you could advise. I've been on Sertraline now for the last two months, 100mg for the last month plus 50mg of Lamictal. Yesterday, I felt really low, had no motivation and just wanted to ly on my bed all day but felt awful doing that as well. The thing is if I don't take on the following day then I feel better than I did before taking them and better than I do when I'm on them. I really don't think the Sertraline is helping, I can't tolerate them. My psychiatrist is instistent that the Sertraline is working although I keep telling him it istn't. I told him that the only tablet that seems to help is Zyprexa so he wants me to take that as well as the Sertraline. I've told him I don't want to take Zyprexa until I have explored all other options but he won't have it.
>
> Anyway after lying in bed feeling awful yesterday, today I have decided I want to stop the Sertraline, I've left a message for the psychiatrist to ring me back but know I'm going to end up arguing with him. He'll just tell me to take the Zyprexa but I can't understand why he won't try me on other things. He tells me that he won't try me with a stimulant because that's only for resistant cases, he won't try Klonopin because that can make you more depressed. What's the best way of approaching this?
>
> I'm not saying that anything else will work but at least I will know I have tried.
>
>
> DeniseDenise,
What is your diagnosis? If you have some form of bipolar, high doses of antidepressants will exacerbate your deperessions. This is what happened in my case. Hang in there with the Lamictal. This is an excellent drug!! If you go off the zoloft, remember to reduce SLOWLY to avoid ssri discontinuation syndrome. If you have been on the zoloft this long, I don't think its doing any good. I take 100mg of Lamictal. Was able to cut WAY DOWN on the antidepressants since I'm up to a therapuetic dose of Lamictal. Ask the doc if you can slowly up the Lamictal will backing down off the Zoloft.
Posted by denise528 on October 8, 2002, at 12:39:07
In reply to Re: Not sure what to do, posted by polarbear206 on October 7, 2002, at 17:30:37
Polarbear,
I stopped taking Sertraline yesterday. The fustrating thing is a couple of years ago they worked really well, it's such a disappointment. I've decided to come off them straight away rather than weaning myself off them as believe it or not I always feel worse when I taper off them. I've been taking 50mg of Lamictal now for about 3 months and I don't think it's doing anything. I took 100mg yesterday and didn't feel a thing. Is it ok to go straight up to 100mg from 50mg do you know and how long did it take before you noticed any effect?
Denise
Posted by polarbear206 on October 8, 2002, at 16:15:40
In reply to Re: Not sure what to do, posted by denise528 on October 8, 2002, at 12:39:07
> Polarbear,
>
> I stopped taking Sertraline yesterday. The fustrating thing is a couple of years ago they worked really well, it's such a disappointment. I've decided to come off them straight away rather than weaning myself off them as believe it or not I always feel worse when I taper off them. I've been taking 50mg of Lamictal now for about 3 months and I don't think it's doing anything. I took 100mg yesterday and didn't feel a thing. Is it ok to go straight up to 100mg from 50mg do you know and how long did it take before you noticed any effect?
>
> DeniseDenise,
You have to be very patient with titrating up the dose of Lamictal. My doc only had me go up 25mg at a time every 2 weeks. I think alot of people on the board also did it this way. It takes a while to get that therapeutic response. This drug also has a narrow therapeutic window. That's why you have to go slowly. I felt the effects at 100mg. Everyone is different. I plan to see if I can go higher. I want to be on the lowest dose possible of my antidepessants with this drug.
Laura.
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