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Author Topic: SSRIs not working for me  (Read 239 times)

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Offline NickT76

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SSRIs not working for me
« on: August 25, 2014, 02:47:42 PM »
Hi everyone.

I started seeing a psychiatrist and psychologist to help me with my Anxiety.  It's gotten to a point where i think I'm going to die of a horrible disease or heart attack.  The psychiatrist feels I should be on some meds for a while to help me out.

Anyway I first started taking zoloft (5mg) about a month ago and had to stop after 3 days.  The tremors, sleeplessness and restless feelings were way too much for me.

I was switched to Zoloft (25mg) and I took it for 6 days.  I must say I was okay for the first 5 days; I was able to sleep, no real side effects... until yesterday.  Although I didn't have any chest pains, I had a spaced out exhausted feeling all day long but unable to sleep / relax.   I had a buzzing/tingly feeling in the back of my head all day long and even in my fingers.   After going to bed I found myself tossing and turning all over again.   This morning after about 1/2 hour awake the feelings started again.  I skipped my dose today

This is not for me.  I had my weekly therapy session and flat out said I can' t deal with these meds.. not for me.  Most people like that floating feeling... not me!!  We checked with the doctor and she said I can stop the meds for now and we can discuss alternatives in 2 weeks.   For some reason the chest pains are back again.... came on during therapy today.

I found that in the past I've done real well on Cymbalta and Zanax to have in my back pocket for panic attacks.  The only thing was it was really expensive and I gained a bunch of weight

What do you guys think?  I know there is an adjustment period but it's way too much for me as I need to be clear headed all day.  I don't want to commit my life to maintenance meds.  I've heard the longer you are on them the longer and harder it is to come off of them. 

I'm going to give the psychotherapy some time and then see where it goes.

Anyone with similar experiences?   Did speech therapy work and how long did it take?  I'm only 2 session in.

Thanks
Nick
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Offline candescentin

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Re: SSRIs not working for me
« Reply #1 on: August 25, 2014, 03:59:02 PM »
I know exactly what you mean. I'm currently 3 weeks in to taking zoloft and have just upped from 25 to 50. The side effects are really worrying me and if anything exacerbate the anxiety. This morning I woke up with a weird burning feeling in my head that terrified me.
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Offline insights

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Re: SSRIs not working for me
« Reply #2 on: August 25, 2014, 05:46:05 PM »
I found that in the past I've done real well on Cymbalta and Zanax to have in my back pocket for panic attacks.  The only thing was it was really expensive and I gained a bunch of weight.

If you did well on a SNRI then you may find a tricyclic antidepressant (TCA) just as effective. They are long out of patent so dirt cheap, tend to have fewer startup side-effects aided by the low dose 10mg tablets many come in which are much smaller relative to the therapeutic dose (75-200mg for most) compared to what is available in SSRIs and SNRIs. The downside is that they tend to have more ongoing side-effects such as dry-mouth and constipation. The TCA with the best side-effects profile is desipramine (Norpramin). In many cases it produces less side-effects than the SSRIs.

Quote
I don't want to commit my life to maintenance meds.  I've heard the longer you are on them the longer and harder it is to come off of them.

There is no reason why that should be the case. For many anxiety disorders and depression are chronic conditions they have to deal with off and on for life, in which case there are strong arguments for staying on antidepressants permanently.

Quote
Did speech therapy work and how long did it take?

You're doing speech therapy for an anxiety disorder?

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Never-Quit

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Re: SSRIs not working for me
« Reply #3 on: August 25, 2014, 06:19:01 PM »
IME and IMO - I keep seeing doctors prescribe SSRI without any type of Benzodiazepine - which tends to create more problems than it solves  ::)  This is a very disturbing trend that is getting worse over the last 10 years here in the U.S.

Just handing out an SSRI or any AD without a low-dose benzodiazepines to offset initial anxiety, and the ADDED anxiety of most SSRI - will cause people to just discontinue SSRI therapy, due to side effects that INCREASE anxiety.  IMO/IME this practice is not in accord to 'best psychiatric practices" in starting patients out on AD therapy.  I find that most psychiatrist don't have a problem with this, but many GP doctors do... ::)

I would never had been able to stay on over 10+ SSRI/AD/SNRI over the last 20 years if I didn't have a good psychiatrist or doctor who employed The Industry Standard "Combination Medication Therapy".

My doctor explained to me that "Combination Medication Therapy" would accomplish the following:

1.   My doctor used both an Antidepressant/SSRI and a low dose of Benzodiazepine - which really helped me immensely. :yes:

2.   My doctor explained that the Antidepressants will take up to 4 to 8-12 weeks  ::) to begin relieving anxiety symptoms and in some people if used alone - it can actually increase anxiety initially during the first few weeks  (as It did with me…) .  Which is one reason I had such a hard time staying on antidepressant.

3.   My doctor, further explained to me that the benzodiazepines are fast acting anxiety blockers (bringing me relief within 30-60 minutes) to stop my Panic Attacks caused by a Panic Disorder, and could also  help shield me from additional anxiety that may initially arise from the SSRI or Antidepressant that I was taking (Prozac) . :happy0151:

You may want to ask your doctor about this, It really made a world of difference for me!  :grinning-smiley-003:

My advice, (IME of 20+ years )  is to not accept an AD/SSRI without a low dose benzodiazepine - If your doctor is not willing to prescribe a benzodiazepine, I would really consider getting a second opinion from another doctor.  I have had to this numerous times.  Remember, the benzodiazepine is to help you stay on your SSRI by offsetting the side effects - so you can complete the full 4-12 week - that is required for these ADs and SSRI to work, and give the medication a fair trial to work!  Also, you are NOT REQUIRED to take the benzodiazepine if you don't need it or want it, It is just nice to have it available if needed- to ensure you stay on your SSRI/AD for the next 4-12 weeks.


Remember you are the customer (Patient), in the end you are fully responsible for your own health, take control, do your research and take the wheel.  You are paying for a service, and you deserve to have a supportive and understanding doctor that will work with you!




Combination Medication Therapy -

The strategy is to hold the individual on low-dose benzodiazepines (e.g., alprazolam 0.25 to 0.5 mg tid or qid plus antidepressant) for four to eight weeks. When the patient's panic has abated and antidepressant levels are adequate, the benzodiazepine can be slowly withdrawn.


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Never, never, never give up. -Winston Churchill

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Offline insights

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Re: SSRIs not working for me
« Reply #4 on: August 25, 2014, 06:28:08 PM »
This morning I woke up with a weird burning feeling in my head that terrified me.

This is reasonably common and nothing to be concerned about. You may also get burning sensation elsewhere.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline NickT76

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Re: SSRIs not working for me
« Reply #5 on: August 26, 2014, 11:48:09 AM »
Well my psychiatrist gave me the all clear to stop taking the Zoloft cold turkey.  Today is day 2 and I'm completely exhausted.  The lightheadedness has subsided a bit but I'm sooooo tired. 

Last night I must have been tossing and turning for a good 3 hours before finally falling asleep. 

Is this a normal reactoin to coming off these meds?  I know when I quit Lexapro cold turkey after 4 days I was okay.  For some reason now I feel like I'm going to pass out from exhaustion after stopping Zoloft

How long does it typically take to get my mind back to it's normal chemical makeup?  I hope I haven't done any permanent damage to my brain.

Thanks for any feedback you can provide guys....
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Offline Never-Quit

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Re: SSRIs not working for me
« Reply #6 on: August 26, 2014, 01:59:51 PM »
I found that in the past I've done real well on Cymbalta and Zanax to have in my back pocket for panic attacks.  The only thing was it was really expensive and I gained a bunch of weight

Hi Nick,

I also have been on Cymbalta, Lexapro, Zoloft, - I did notice that your Doctor placed you Cymbalta and Xanax, I would like you to consider the possibility that maybe most of your success was a result of Xanax - which is VERY EFFECTIVE for Panic Attacks.

I noticed that with Lexapro and currently the Zoloft - It appears the doctor did not prescribe Xanax or any other Benzodiazepine with your SSRI, which explains the increased anxiety and quick discontinuation of these SSRIs.  (I had the SAME ISSUES, starting SSRI and AD - the majority of the ones I used spiked my Anxiety levels a mile high for the first two weeks - luckily my doctor had prescribed a benzodiazepine along with my SSRI - that allowed my to stay on SSRI and control my anxiety).

FWIW:

I Hope this information may be of help, so you won't have to go through the pain and misery I had to go through!  :action-smiley-065:
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Never, never, never give up. -Winston Churchill

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Offline Never-Quit

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Re: SSRIs not working for me
« Reply #7 on: August 26, 2014, 03:31:54 PM »
Well my psychiatrist gave me the all clear to stop taking the Zoloft cold turkey. 

I hope I haven't done any permanent damage to my brain.


Hi Nick,

As you are finding out, trying to quit any AD or Benzodiazepine 'Cold Turkey' is very PAINFUL AND UNNECESSARY... Good news is it will soon pass  :yes:

As far any damage, No  - SSRIs are extremely safe,  many people - about 30% discontinue their SSRIs.

But, as Ian (Insights)  - one of our senior members - has pointed out in an informative post - that discontinuing AD meds restarting them can reduce their effectiveness.


"Conclusion: This observation supports the hypothesis that tachyphylaxis may develop after repeated antidepressant drug trials."

Tachyphylaxis - (Rapid appearance of progressive decrease in response to a given dose after repetitive administration of a pharmacologically or physiologically active substance.) 

Here is the original post:

According to one study - http://www.karger.com/Article/FullText/226611 - the odds of antidepressants working after each restart drops by nearly 20%. Note that this applies to all antidepressants, not just the one/s you've taken in the past.

http://www.anxietyzone.com/index.php/topic,91589.msg510934.html#msg510934


 :action-smiley-065:
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Offline insights

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Re: SSRIs not working for me
« Reply #8 on: August 26, 2014, 06:12:03 PM »
Is this a normal reactoin to coming off these meds?

I don't think it's the med causing this, but your psychological response. You were on only a very small dose for a week, not long enough to cause a physical reaction on quitting.

Quote
How long does it typically take to get my mind back to it's normal chemical makeup?  I hope I haven't done any permanent damage to my brain.

Antidepressants repair brain damage, they don't cause it, but I suspect your conviction that they do has been the main reason for your problems with Zoloft.

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline AncientMelody

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Re: SSRIs not working for me
« Reply #9 on: August 26, 2014, 09:23:05 PM »
IME and IMO - I keep seeing doctors prescribe SSRI without any type of Benzodiazepine - which tends to create more problems than it solves  ::)  This is a very disturbing trend that is getting worse over the last 10 years here in the U.S.

Just handing out an SSRI or any AD without a low-dose benzodiazepines to offset initial anxiety, and the ADDED anxiety of most SSRI - will cause people to just discontinue SSRI therapy, due to side effects that INCREASE anxiety.  IMO/IME this practice is not in accord to 'best psychiatric practices" in starting patients out on AD therapy.  I find that most psychiatrist don't have a problem with this, but many GP doctors do... ::)

I would never had been able to stay on over 10+ SSRI/AD/SNRI over the last 20 years if I didn't have a good psychiatrist or doctor who employed The Industry Standard "Combination Medication Therapy".

My doctor explained to me that "Combination Medication Therapy" would accomplish the following:

1.   My doctor used both an Antidepressant/SSRI and a low dose of Benzodiazepine - which really helped me immensely. :yes:

2.   My doctor explained that the Antidepressants will take up to 4 to 8-12 weeks  ::) to begin relieving anxiety symptoms and in some people if used alone - it can actually increase anxiety initially during the first few weeks  (as It did with me…) .  Which is one reason I had such a hard time staying on antidepressant.

3.   My doctor, further explained to me that the benzodiazepines are fast acting anxiety blockers (bringing me relief within 30-60 minutes) to stop my Panic Attacks caused by a Panic Disorder, and could also  help shield me from additional anxiety that may initially arise from the SSRI or Antidepressant that I was taking (Prozac) . :happy0151:

You may want to ask your doctor about this, It really made a world of difference for me!  :grinning-smiley-003:

My advice, (IME of 20+ years )  is to not accept an AD/SSRI without a low dose benzodiazepine - If your doctor is not willing to prescribe a benzodiazepine, I would really consider getting a second opinion from another doctor.  I have had to this numerous times.  Remember, the benzodiazepine is to help you stay on your SSRI by offsetting the side effects - so you can complete the full 4-12 week - that is required for these ADs and SSRI to work, and give the medication a fair trial to work!  Also, you are NOT REQUIRED to take the benzodiazepine if you don't need it or want it, It is just nice to have it available if needed- to ensure you stay on your SSRI/AD for the next 4-12 weeks.


Remember you are the customer (Patient), in the end you are fully responsible for your own health, take control, do your research and take the wheel.  You are paying for a service, and you deserve to have a supportive and understanding doctor that will work with you!




Combination Medication Therapy -

The strategy is to hold the individual on low-dose benzodiazepines (e.g., alprazolam 0.25 to 0.5 mg tid or qid plus antidepressant) for four to eight weeks. When the patient's panic has abated and antidepressant levels are adequate, the benzodiazepine can be slowly withdrawn.




Well sometimes medicine is a BIT more nuanced than that. Benzodiazepines are not appropriate for every patient across the board and I wouldn't make that blanket recommendation to everyone when you don't know their medical history. Yes benzos can help start up side effects. So can hydroxyzine. So can starting at very small doses. Patient education goes a long way as well......if a doctor spends more time with a patient preparing them for what to expect rather than writing a prescription after a single 15-20 minute appointment. Some people have a difficult time coming to terms with taking even one medication much less two.
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Offline Never-Quit

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Re: SSRIs not working for me
« Reply #10 on: August 26, 2014, 11:42:37 PM »
Benzodiazepines are not appropriate for every patient across the board and I wouldn't make that blanket recommendation to everyone when you don't know their medical history.

Hi Melody,  :action-smiley-065:

I just want to respectfully, clarify that I am not making a "Blanket Recommendation across the board - regarding Benzodiazepines, SSRI/AD, or any medication" - I am only sharing my first-hand experience in using these medications - and expressing my own opinion, what has worked and what has not worked for me over the last couple of decades, (my battle with Panic disorder began 1979, long before SSRI existed.) - so, I try to preface my opinion with  IME and IMO. 

In the world of medicine there are no absolutes when comes to the diagnosis, prescription and use of any medications, whether it be SSRI/AD, BZD, or even aspirin.  The general rule is that all medications have some side effects.  Thus, this important task belongs to the licensed professional - "the Patient's Doctor" - who does know first-hand information of each person's medical history, any possible complications, allergies, and the ability to spot potential addictive heredity factors and behaviors.  Thus the patient's doctor becomes the "Gatekeeper" of  prescribing appropriate medications and the monitoring their patient's mental/physical health.

I do agree, with you that patient's should have as much education and information as possible to empower them to find the proper solutions for them.

I do agree, that CBT and other forms of therapies are preferable to using medication with all its side effects - whenever possible and proves to be effective for that person.

I do agree, that some medications need to be closely monitored by their doctors, (especially, now that we are learning that some SSRI/AD are now showing a disturbing trend of dependence, tolerance, and withdrawals (Paxil, Effexor..etc.)  - similar to those of the benzodiazepines.

I do agree that "15 minute" dr. visit is wholly inadequate to provide the patient with enough information before prescribing these powerful medications.

In the end, we can only share our own opinions, and experiences that can each person can choose to discard or accept it as starting point for further research in making their own decisions.

(I wish I had this back in 1979  :yes:)

Part of this board's greatest contribution - is the sharing of each person's own experiences and knowledge, that as a whole, we may learn from one another. 

 :action-smiley-065:
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Never, never, never give up. -Winston Churchill

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