Is It True?

Friends,
I have to leave here sometimes. I just do. No offense. Everyone is so nice...I just get overwhelmed. I am overwhelmed now. And ignore me if you want to. I do understand.
I've been through another AD poop-out. My Paxil seemed like it was starting to stop working as it should, so my nurse practitioner put me on effexor which helped my anxiety but made me into a very angry upset person! After getting off of it, which was not fun, I am now on prozac 60 mg a day along with gabapentin 600 mg 3x a day and buspar 30 mg 2x a day. However, I am STILL having breakthrough anxiety. I am managing to grit my teeth and bear it, but this is not how I want to live my life! If only they would prescribe me klonopin or xanax as needed! :( They will not prescribe a benzo under ANY circumstances at my clinic! I am not due to go back to my NP until 7/29, however, I am thinking that I might should go on back before then.
Something else has me scared.....on another anxiety forum I was told (I did not feel that I should bother y'all b/c I disappear like I do)
the following:
You could try Celexa (citalopram), which is the SSRI most likely to work when the others have pooped-out, however, IMHO, you've pretty much run your race with the SSRIs so should consider changing to one of the older tricyclic antidepressants (TCAs). They are much less likely to poop-out, I've been taking the same one for nearly 20 years, and another for 8 years before that (switched for better side-effects profile, not because it wasn't working anymore).

Their major drawback is that they tend to produce more ongoing side-effects such as constipation and dry-mouth, they are also less safe in overdose so not ideal for the forgetful. They may also be contraindicated if you have significant heart disease. The TCA least likely to produce these nuisance side-effects is desipramine (Norpramin), which mostly inhibits norepinephrine, aka noradrenaline reuptake. It is only a minor inhibitor of serotonin reuptake, which will make it easier to make the cross-taper switch, and also means the anxiety is being 'attacked' from an angle your brain isn't used to. Most need to take 100-150mg for good results, but as you've needed near maximum SSRI doses you may need to go up the the recommended maximum 200mg, possibly beyond. I have taken up to 350mg of imipramine for a year and have been on 225mg of my current TCA, dosulepine, for nearly 20 years without harm even though it is the most cardio-toxic antidepressant.

So you see, I am being told that the SSRI's may be no longer working for me and that scares me so bad! I want to cry like crazy b/c I'm so upset!
I just don't know what I'm going to do.
jl

Don't feel bad about disappearing here and there. I've been doing the same thing. I'm sorry you're still struggling. Guess what, me too. You and I were talking about this 2.5 months ago. They finally switched me to Pristiq & Buspar almost 3 weeks ago. I'm noticing more better days/nights but my mornings- ugh! I wake up with that dread depressed anxious feeling.

Unlike many others, I'd never had a med poop out on me til earlier this year. Was on Cymbalta for 6 yrs. Worked great then pooped. Switched to Zoloft & that wasn't a good fit.

Did your NP @ Pdoc tell you that you may be treatment resistant or was it someone from a forum? Bc we know that some posters, while well intentioned, can make us feel worse or more scared. You're NOT a lost cause with meds. Call your Pdoc office and tell them what's going on. That's what they're there for, to take calls bc it's outpatient treatment. Don't ever feel a burdon!

What DO they give for quick acting anxiety med if no benzos prescribed??? I'm so surprised they won't give benzo rx. Yes they can be habit forming but most of us take therapeutically that take them.

I'm sorry abt this pit you've been dealing with. Just remember David said in Psalm 40: 2,3 "God lifted me out of the pit. He put a new song in my heart." You may be in a pit but you need to get ready; you're coming out of it. (This was on my FB newsfeed this morning from Joel Osteen).

Hugs!!!
Lisa

Thanks to Heartfelt, Lisa, and Scaredy Cat.
S.C., I go to a mental health clinic where I see a nurse practitioner. She is very nice and seems to really try to listen, considering that the "powers-that-be" there want the NPs to get us in and out in a short period of time. She's put me on gabapentin b/c they aren't allowed to prescribe benzos. :(

Today was a better day for me thankfully. Really, I've felt sort of strange almost....last night I couldn't go to sleep b/c I was stressing and crying a bit and I got onto myself for being such a negative thinker. I decided to get up out of bed to take one benadryl and 3mg of taurine. That helped and I finally fell asleep. Then today (Saturday) was a better day than I've been having.

I really am unsure as to what path to take right now. Should I wait a while longer and see how things go before I go back to see my NP? Some days have been a bit bad-to-fair, but none have been too great overall. Today was the best I've had in a while. My Prozac is at 60mg. The max dose is 80mg. However, I've always been on the max doses of my past ADs as well. Perhaps I do need the max of prozac too.
A couple of other things I think about that I try to take into consideration are that I know that at the end of this year, my Mom is going to finally quit her office cleaning job. I am HAPPY about that! But at the same time, it will be an adjustment for us financially. This month is the first month that medicare has been taken out of Mom's social security check. Again, I am HAPPY that she finally agreed to take her medicare, but b/c it was taken 2 years late, she'll be paying a penalty each month from now on, so her premium is higher. Anyway, when the end of the year comes, I will likely have to give over most of my SSI check to try and make up somewhat for what will be lost. I don't mind for the most part. I want her away from that job and I myself hate it! I haven't liked having to do office cleaning for these past 16 years! But I did it to help her b/c I love her. However, not having hardly any money of my own to spend will be hard. I'm already getting myself used to it by not buying things I'd like. I mostly spend on things that are necessary. Most of the things I want are not frivolous actually though, so it is harder to say no to myself. Oh well. Then there's perimenopause. I'm smack dab in the middle of it. And of course, I am ever thinking about my Mom's health.
So am I expecting too much from my meds? Or could I be helped more? today was more like I think I should feel. Although I was well aware of all the "negatives" as I am like every other day, I did not get all worked up or anxious and such. Why was today different then? I do not know. But I absolutely believe the meds play a key role. Still I am confused and am unsure of what to do right now.
At the end of this month, I have a one-hour appt. with my NP b/c it is time for my annual psych evaluation I was told. Sigh.

So thanks for letting me ramble on and on and thanks for not making me feel any worse for dropping out for a while. I can only handle what I can handle at any given time.

Thanks again to you all!
jl

JL.,

I am wondering if at your yearly eval...if you expess dissatisfaction with you current regimine...if you might be able to get a referral with a psychiatrist.

Not that I think you need more help....but better help.

A P-doc is simply going to have more knowledge about A/D meds and treatment options that an N/P.

Again, glad you are back! We can encourage you during this time, and the transitionary stuff you are going through with your mom.:)

Thoughts and prayers,

S.C.

Oh heck yeah!

The whole peri period for me sent my anxiety and panic and depression into overtime and double duty!

I swear, everything felt amplified. I know that hearing others go through similar experiences doesn't make anything go away, but hopefully it can ease a little stress just knowing that you're not alone, and that it's quite common for us to feel fastened into a crazy roller coaster of hormone induced kooky-ness!

The best part of that is that,.....this, too, shall pass.

Take the time you need and take care of yourself. We will always be here whenever you want to drop in. :)

((hugs))











M.

To ALL that replied, I thank you very very much! :)
It is certainly confusing to know where peri-menopause starts and the anxiety begins...or visa-versa! :P Then I have the change up with the meds thrown in there too. Sigh! Then the rotten cherry on top is that I'm not exactly your "normal" person anyway! PHOOEY!
Oh, before I say anything else, I want to be clear about a couple of things first: Rather than 3 mg of taurine, I took 3000 mg of taurine before bed with the benadryl (love my taurine! It's been a blessing for me!) And more importantly for me to clear up for my own peace of mind is this:
about the financial things with me giving up most of my SSI check eventually... That might have sounded like I've been having loads of money in the meantime, spending it on selfish stuff! Please don't think that! Actually, most of my check goes to our rent right now, then what's left over I basically spend on what I wish. I buy my clothes and such, but have also been buying my Mom's health supplements and other stuff that I've thought might help her. Now when she quits her job, our rent will go down (we live in subsidized housing), but I will then give her the difference over what I used to give towards the rent PLUS as much as I can over that. I just couldn't stand the idea that y'all might think I've been walking around blowing lots of money and was suddenly whining b/c I was going to have to fork some of it over finally!!! I couldn't stand to be that kind of person!

Now that I have that off of my mind, to address SC and Kitt about me needing a psychiatrist's appt., you could very well be right. But I just can't say to my NP that I don't think she's making the grade! If over time I get worse and I have no alternative, then I will do what I have to do then, but right now, I will see how it goes with her. Actually, the last psych. I had is no longer there and I have no idea who is! They try their best to steer their "truly mental" patients to the doctors and us with less dangerous disorders to the NPs. Of course, if I feel that I really need help that I just am not getting, I can ask the receptionist to make me an appt. with a doctor, but I would hate to do it. And even the doctors at the clinic will NOT prescribe benzos! NADA!
I'm in a catch-22. I'm on medicaid. We often get the lowest level care (yes, I am thankful for any care and it's better than nothing). Then I am also on SSI. I have to be so careful not to be seen as a non-compliant patient or a drug-seeking patient. Between the 2 things, being medicaid and SSI, I can't just switch doctors or clinics like some folks can. It's hard to find a decent doctor that will accept medicaid in the first place. Sigh.
So isn't that just hunky-dory for someone who's already dealing with anxiety and depression in the first place?!
Kitt,
You are indeed a treasure, may I say "a gem"? ;)
You are of course correct about not worrying about the things we have no control over and "letting go" is what one really needs to do. I chastise myself ALL the time about that! In Matthew chapter 6, Jesus tells us quite clearly that being anxious will not add one cubit to our life span and that each day has enough anxieties of its own, so we should not worry about things incessantly! I have been trying my best to work in harmony with that. I do ask forgiveness for all the times I fall short though! But I am a work in progress and I will keep working on it until I'm gone or I'm perfect! You are a sweet sweet lady my friend!

Again,
thanks to all!
jl