Need advice on finding a medication - Social Anxiety Forum
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post #1 of 21 (permalink) Old 03-11-2006, 06:09 PM Thread Starter
 
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Need advice on finding a medication


I have friends in town this weekend and I can't go out of my house because I'm so depressed and embarassed about my weight. I have to go on antidepressants, it's not really an option anymore. I need to find an antidepressant that works on the depression and won't make me gain weight. I also have thyroid disease. I took lexipro before but it didn't work. Didn't have trouble getting on or off of them and it made me extremely tired. I took Effexor for a day but I had a hallucination and stopped immediately. I've read that Wellbutrin doesn't make you gain weight but how can I know if it will work for me? Has anyone had any bad side effects from it? Can anyone recommend other antidepressants? Of course anything that is posted here I will take as informational and allow a doctor to make the decision. I just want to be as informed as possible.
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post #2 of 21 (permalink) Old 03-11-2006, 06:12 PM
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What thyroid meds are you on?

Medication-related posts are for brainstorming purposes only. Talk to your doctor.

My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #3 of 21 (permalink) Old 03-11-2006, 06:15 PM Thread Starter
 
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Synthroid and Cytomel. Why?
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post #4 of 21 (permalink) Old 03-11-2006, 06:34 PM
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Just curious. If you were hypothyroid and not on meds, you'd want to be; also the thyroid meds may need tweaking as you go along with the antidepressants, esp. the Cytomel. There is evidence that SSRI + T3 has extra antidepressant efficacy.

If you are concerned about weight gain with antidepressants, probably the better choices are going to be Wellbutrin (or Zoloft among SSRIs), just off the top of my head, but there's no guarantee they will work or that they will not cause weight gain. Statistically speaking, I understand that these two are associated with less weight gain but I could be wrong.

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post #5 of 21 (permalink) Old 03-11-2006, 06:56 PM Thread Starter
 
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I know the T3 helps with depression and it did until I went on the birth control patch. I've been off of it for a year now but I'm still depressed (not as severely as when I was on it). I'm pretty sure this is the cause of my depression which is now causing my SA to be worse since I'm having a hard time leaving the house. So I don't have a choice anymore, I have to do something and I HATE medication. I wouldn't be dealing with this at all if it weren't for medication in the first place. Anyway, I've been going to my thyroid doctor often but he says that my numbers are fine and doesn't believe that the depression and weight gain are from my thyroid problems.

I have only heard the good things about Wellbutrin and I want to know the negative effects so maybe someone who has taken it can post.
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post #6 of 21 (permalink) Old 03-11-2006, 07:04 PM Thread Starter
 
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I just read that Wellbutrin causes insomnia and seizures. Is that true? This stuff is so frustrating
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post #7 of 21 (permalink) Old 03-11-2006, 07:23 PM
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Quote:
Originally Posted by pixiedust
I just read that Wellbutrin causes insomnia and seizures. Is that true? This stuff is so frustrating
Add anxiety to the list of stuff it can cause. It's a stimulating AD, and it's almost never prescribed for SA (or other anxiety disorders), at least not all by itself.

My brother tried Wellbutrin many years ago when his idiot doctor misdiagnosed his OCD as depression. It made his insomnia worse.

I'll assume it really does increase the risk of seizures, since the FDA forces them to mention that one in every TV ad they run for this drug. Of course, this doesn't mean that you're going to have a seizure. My mother has been taking Ultram for the last 6 years and it increases the risk of seizure and she has yet to have a seizure. Just because a side effect is possible doesn't make it likely. Most drugs have long lists of possible side effects, most of which rarely happen.

As for weight gain, GlaxoSmithKline did study Wellbutrin as a weight loss drug, but the FDA rejected their application for this use, saying that the weight loss wasn't significant enough to market it as a weight loss med.
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post #8 of 21 (permalink) Old 03-11-2006, 07:27 PM
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Insomnia yes.

Seizures, almost never. It has a bad rep on the seizure thing because it was withdrawn in the 80s for this reason (on the immediate release pills, people were taking too much at once). As far as I know there isn't any study comparing seizure rates from Wellbutrin to other antidepressants, but as far as I know all antidepressants lower your seizure threshold so this really holds no water.

Medication-related posts are for brainstorming purposes only. Talk to your doctor.

My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #9 of 21 (permalink) Old 03-12-2006, 02:52 AM Thread Starter
 
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I have no idea what to do.
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post #10 of 21 (permalink) Old 03-12-2006, 10:52 AM
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I just read that Wellbutrin causes insomnia and seizures. Is that true? This stuff is so frustrating
Wellbutrin worked great for me until I has a seizure (my one and only). But after the seizure I had an EEG done which showed that I have a susceptibility for seizure. I shouldn't even have been on it. They say you should not take it if you or your family have a history of seizure. I personally think that anyone going on Wellbutrin should have a EEG done to make sure that they do not have the susceptibility for seizure.

My sister is on Zoloft for depression and it has helped her a lot. Her depression is greatly improved and she has lost weight combined with a better diet.
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post #11 of 21 (permalink) Old 03-12-2006, 05:37 PM
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Wellbutrin for me caused some dizziness at first and it definately supressed my appetite. So if your looking to lose weight, Wellbutrin is the drug for you. The part about seizures, well I didn't have any from the drug and I have had seizures in the past so. As for insomnia just take it in the morning.




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post #12 of 21 (permalink) Old 03-12-2006, 05:51 PM
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Originally Posted by UltraShy
Quote:
Originally Posted by pixiedust
I just read that Wellbutrin causes insomnia and seizures. Is that true? This stuff is so frustrating
Add anxiety to the list of stuff it can cause. It's a stimulating AD, and it's almost never prescribed for SA (or other anxiety disorders), at least not all by itself.
My psychiatrist refused to prescribe a small amount of wellbutrin in order to counter the sedation Paxil was causing me due to his belief that it would cause anxiety. And it is was my therapist at the time who recomended I ask as some of his other patients had tried that combo.
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post #13 of 21 (permalink) Old 03-12-2006, 05:55 PM Thread Starter
 
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Well after reading the Zoloft thread and getting advice on there I think I might give Zoloft a shot. I have no diagnosis besides depression and anxiety (currently possibly in major depression) so I just have to keep trying different meds. Thanks for all of your advice here.
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post #14 of 21 (permalink) Old 03-13-2006, 10:33 AM
 
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just to add my opinion to the mix, i think almost the best thing to do is just to pick something and try it out. in my experience at least, with the ssris, it is really just trial and error, i've had really noticeable effects from some and none from others. for what it's worth, zoloft took away all feeling for me, both good and bad. lexapro worked really well on my depression but not at all on the anxiety. effexor xr worked well on the anxiety but had no effect/ negative effect on my depression. paxil i refused to try because i've heard too many weight gain stories. if weight gain is what you're worried about, i've never really experienced significant weight change while on meds. good luck, i hope you can find something that works for you.

one other thing about side effects, i often find they're quite bad for the first few days/ week but then they disappear and if i can just make it through that week i'll be ok. this was especially the case for me with effexor. it was awful taking it at first, but i stuck with it, curled up in bed for a week or 2, and eventually emerged in a much less anxious state.
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post #15 of 21 (permalink) Old 03-13-2006, 07:50 PM Thread Starter
 
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thanks umbrellagirl. I appreciate any advice I can get. I didn't have any problems with Lexapro except that it made me tired and possibly made me gain weight. Unfortunately it didn't do anything except make me feel numb. I didn't like the effexor at all. I've been toying with the fact that I may have developed PMDD (the patch significance) and Zoloft is used to treat PMDD. I only know two people that have used it and both (one male, one female) gained weight, were tired, and had sexual side effects. Like you said, I'm going to have to try it and see how it effects me.
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post #16 of 21 (permalink) Old 03-16-2006, 09:09 PM Thread Starter
 
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So I talked to my therapist tonight and she thinks my depression episodes are cognitive and blew off my suggestion about medication.
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post #17 of 21 (permalink) Old 03-16-2006, 09:37 PM
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Hmmm. Most cases of depression are circumstantial or cognitive, not biological. But antidepressants can still be helpful.

According to one of my favorite books, Breaking the Patterns of Depression by Michael Yapko:

The Agency for Health Care Policy Research suggests medication "as the first-choice approach when the following conditions are in effect:

1. The individual's depression is severe
2. The individual has suffered at least two prior depressive episodes.
3. There is a family history of depression.
4. The individual seeking treatment specifically states that he prefers medication as the sole intervention." (p. 39)

...

"Psychotherapy is considered by the panel to be the first-choice approach when:

1. The depression is mild to moderate (as it is in the majority of sufferers), although it may reasonably be used in more severe cases as well;
2. The depression does not involve psychosis, or severe impairments of judging objective reality;
3. The depression is not extremely chronic (long-term) or highly recurrent; and,
4. The individual specifically requests psychotherapy as the desired form of intervention." (p. 44)

I would tend to agree with these recommendations. And of course, combination therapy is often more effective than the two alone. Good luck.

Medication-related posts are for brainstorming purposes only. Talk to your doctor.

My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #18 of 21 (permalink) Old 03-16-2006, 10:45 PM
 
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I'm not sure how bad the seizure thing is. On the restrictions it lists pretty much all AD's and anti-anxiety meds as lowering the seizure threshold(sp). Wouldn't that mean all the AD's could cause seizures.
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post #19 of 21 (permalink) Old 03-17-2006, 11:24 AM
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So I talked to my therapist tonight and she thinks my depression episodes are cognitive and blew off my suggestion about medication.
I have always thought that anti-depressants were just another tool like therapy or exercise to get us out of depression no matter how we arrived there.
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post #20 of 21 (permalink) Old 03-17-2006, 06:18 PM Thread Starter
 
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Originally Posted by Caedmon

1. The individual's depression is severe
2. The individual has suffered at least two prior depressive episodes.
3. There is a family history of depression.
4. The individual seeking treatment specifically states that he prefers medication as the sole intervention." (p. 39)
Well I definitely fall into this category except that I would prefer not to be on medication. Unfortunately I've tried psychotherapy and CBT and neither of them have worked so I don't see any other options besides medication.
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