Husband's Prescription Cocktail

[LonelyLucy]

I am posting out of frustration with my husband and his pdoc. My husband is on Effexor XR 450mgs., Provigil 200mgs, Ambien 10mgs and Mirapex 1mg.

Husband is on these medications for depression/anxiety. The ambien, of course to help him sleep. The mirapex for RLS (terrible RLS!). And the Provigil .. I am assuming, to help him stay awake after taking all of his night time medications? I guess the provigil is also supposed to help in augmenting the Effexor ..?

Husbands new(er) pdoc began him on this "cocktail" approximately three years ago. I believe I have totally lost my husband .. the man I thought I knew and loved.

Approximately six months after beginning this totally new medication regimen, husband begin frequenting the bar .. night after night. He is NOW what I would call an alcoholic. He cannot/does not want to go without drinking. He used to be able to sit in the bar all night (when we would go together .. a couple of times a month) and drink beer. He was happy with that. Since he has been on the new regimen, he (currently) drinks up to six (or more?) shots of jaeger along with his 12 (or more) beers .. nightly.

He spend money wrecklessly .. of course the drinking being the prime culprit. But there are other instances where it appears like he has no idea of the amount of money he is spending on a daily basis. He is oblivious??

He claims that he can't work anymore. It used to be that he claimed (relayed to me and his pdoc) that he could not focus, remember ,etc on the jobs he would work on. He is a self-employed building contractor. Now it finally comes out that he does not enjoy working his business any longer, so he is not even trying to pursue jobs to bring in a monthly income.

Husband also has beome even more of a slob. Sorry .. but he really didn't care much about taking care of himself or the environment (his home) around him before. Since he has been on his new medication regimen .. unbelievably it has gotten worse!

I accompanied my husband to his three month med check appt a couple of months ago. At that appt. his pdoc insisted that he could not/would not change my husband's medication unless he got off (or cut back dramatically) his drinking. He claims that he can't tell what it is (or isn't) doing for him. I understand his reasoning.

My theory is that it is husband's current medication cocktail that put him where he is. I am so terrribly frustrated about this! I believe that the high dose Effexor XR that he is on (450mgs) has given him the alcohol cravings. I am also thinking that the Mirapex (1 mg) that he takes nightly is contributing to the compulsiveness .. having to have to drink.

Does anyone here agree with me? If not, can you explain to me (in simple terms) how/why these medications would not do this to him. I have been reading a lot on my internet searches, but am not totally understanding the medical terminology.

After reading several posts on this board, it appeared to me that there are many well educated people that could (maybe?) explain to me what might be (or not?) happening to my husband.

Any feedback you can give would be very much appreciated!

LL

[wifezilla]

Obviously he has a problem. But you can't fix it for him.

And you are under no obligation to stand by and watch someone destroy himself.

[LonelyLucy]

Hello WZ,

I guess I do understand that I am not able to "fix" this for him.

My husband and I have been married for 28 years and I am feeling like I'm not willing to throw in the towel (just yet?) .. because my husband is not able to pull himself out from a dr. induced (prescribed) hell.

I have read (on another board) whereby a spouse stepped in and things got better .. once there was a medication change. I don't know, of course, if this can or will happen in my husband's situation.

Thanks for your response,

Lonely

[wifezilla]

You're in a really crappy spot. I had to threaten to leave my husband (and it wasn't and idle threat either) before he got the help he needed. I told him at the time that I loved him very much but I wasn't going to waste my time and energy towards our future if he was going to sabtage and undermine it by not seeking help and working hards towards stability.

It's one thing if shit hits the fan when a person is on the right meds and getting therapy...that's just life. It's quite another when they are not taking the necessary steps to fix a bad situation.

[resonance]

For the question you didn't ask but WZ answered - no, you don't have to put up with it.

For the question you did ask: Did this happen when he started the new cocktail, or six months after? Suddenly, or gradually? Most side effects kick in pretty quickly.

I have not personally heard of alcoholism being a side effect of Effexor, but I'm not qualified to say whether it is for him... Another possibility is that his med regime was not fully controlling his depression/anxiety and he began self-medicating, which made the meds work less well, so he self-medicated more, etc.

Is he unhappy with how he's feeling (regardless of whether it's depression or anxiety or alcoholism)? If he was willing to go to a med check, maybe he would be willing to get a second opinion.

[LonelyLucy]

Of course you're right. I guess what I keep thinking (over and over) is that he feels like he is not able to do anything. This is what he has said to me repeatedly .. and I truly believe that HE believes this! He is feeling pretty powerless.

I know you're probably thinking that I'm sounding pretty foolish .. but some of the searches I pulled up .. linked to high dose Effexor XR and even the Mirapex .. well, they were pretty convincing as to how badly they could ruin a persons life.

His doc said something to him .. when he began this whole regimen three years ago and that is that the Effexor he is on is kind of like a "silver bullet". My husband has taken that to heart and feels like if he goes off the Effexor that he will finally be "done". That there is no other "answer" for his depression and anxiety. I told him that's nonsense, but because I'm not the doc .. of course, he doesn't believe me.

I just keep thinking that .. considering husbands mindset .. it really is a vicous circle for him! Even if he realizes how deep his problem is .. because of the meds that he is on, it is making it impossible for him to be serious about wanting to (and working towards) that.

I feel like if I walk out on my husband .. it would be kind of like walking out on him because he became wheelchair bound after a bad accident. Kind of like deciding I don't love him anymore because of something he had no control over. I know you don't believe this because of what I'm seeing as his alcoholism, but he was never like he is NOW .. until he began on all of these new meds.

Wifezilla .. what kind of a situation was your husband in?

[LonelyLucy]

What I remember (because of the Thanksgiving holiday) is that I mentioned to his doc (at one of his first appointments) that I thought husband was doing excellent on his new med regimen. I also told husband's pdoc that I thought problems began when he started going to the bar frequently (at or around Thanksgiving .. three years ago.) Which was at approximately the six month mark of when he began on his new regimen. The reason this works .. in my mind, is that it took him that long to build up on all of the higher doses of all of the medications he was taking.

Yes, he is unhappy with how he is feeling. It takes him a lot to change drs. It took him about six years before he changed to this one .. and I am feeling like he went from the frying pan right into the fire! The only reason husband keeps going back to this doc, is to make sure that he gets his scripts written for all of his refills!

I would hope that eventually I would be able to talk him into changing to another doc. He puts way too much stock into his doctors. (Almost as if they are beyond making a mistake!)

Thanks for your response,

LL

[OreoKitty]

He spend money wrecklessly .. of course the drinking being the prime culprit. But there are other instances where it appears like he has no idea of the amount of money he is spending on a daily basis. He is oblivious??

LL

Your comment about spending money reminds me of my hypomanic and manic moods. Of course I don't know if someone can sustain a hypomanic mood for 3 years. If it was a shorter period of time, I'd wonder if the effexor and/or provigil pushed him into being hypomanic. Manic and hypomanic don't have to be elated moods. They can be irritable, edgy, uncomfortable and even paranoid. And I did self-medicate my moods with alcohol.

But, I am not a doctor at all. Just the spending wrecklessly struck a cord with me.

You could try Alanon for yourself to help deal with his drinking. Good luck.

Oreo

[Cetkat]

I have not personally heard of alcoholism being a side effect of Effexor, but I'm not qualified to say whether it is for him... Another possibility is that his med regime was not fully controlling his depression/anxiety and he began self-medicating, which made the meds work less well, so he self-medicated more, etc.

Is he unhappy with how he's feeling (regardless of whether it's depression or anxiety or alcoholism)? If he was willing to go to a med check, maybe he would be willing to get a second opinion.

My husband has taken that to heart and feels like if he goes off the Effexor that he will finally be "done". That there is no other "answer" for his depression and anxiety.

I think resonance is right about the self-medicating. It's not that the Effexor is causing him to drink; it's the fact that it's not working for him. He's not happy & tries to fix that with booze. Yes, booze can make the drugs less effective.. but I think the non-responsiveness came first from the sound of it. The only thing Effexor can do is increase or limit toleration of alcohol. I'm on Effexor, and it gives me a higher toleration so I don't or can't really get drunk. That could lead to drinking more for some people.

It's sad that your husband believes that Effexor is all that is out there that can help him. There is so much more. I really would push for a second opinion if I were you. Drinking and meds is a circular relationship.. but that doesn't mean other things can't be tried. I'd take him to someone else.

[scatty]

People with mental illness usually have to go through several months (if not years) of med adjusting before they find a combo that works for them. It sounds like he just took the first things that were offered and his mind is closed to other options. When I was given an AD I went totally insane within months, because I really was bipolar. Not saying that he's been misdx'ed, but it's something to think about. You really have to have him be honest with his providers. If he isn't, it's never gonna change. Only you can decide if you want to be with someone who refuses to help themselves. Would he be willing to be evaluated by another pdoc? Go inpatient to be observed for a few weeks? Give him a choice- get treated properly or get out. If he had diabetes and refused to find a med that worked for it, would you just stand by and watch him die slowly? Sorry to be harsh but he needs a good kick in the ass in the right direction, IMO. Good luck, it can get better if he's willing to try.

[null0trooper]

Does anyone here agree with me? If not, can you explain to me (in simple terms) how/why these medications would not do this to him. I have been reading a lot on my internet searches, but am not totally understanding the medical terminology.

Effexor is a serotonin reuptake inhibitor (and more, at the dosage described) and elevated serotonin can cause RLS, albeit not usually and in a roundabout way. So he's on enough of that to numb out his emotions and then regain some energy; but it's also enough to jack up his anxiety and RLS. So two meds are added to that, and a third to deal with the new/worsened side effects.

In all this, nearly every big-name transmitter is being sledghammered in one direction or another, with a combo that would send many bipolar people through the roof and I imagine that he still feels dead inside. I really wonder if Cymbalta or Wellbutrin wouldn't do better, backed up with just enough of a more stimulating or more anxiolytic med to even things out.

The one thing I know for sure is that your husband needs to clear the air with the doctor about how he feels and how his life has been falling apart. Whether that works or not, he's overdue for a second opinion.

[december_brigette]

hi,

i think there are only a few who will admit this....but my personal experience was that effexor xr made me drink. effexor xr was the only med i was on. and by "made me" - i HAD TO drink. Ive never had that kind of feeling before or after effexor xr.

but, maybe thats just me.

db

[Penny Century]

hi,

i think there are only a few who will admit this....but my personal experience was that effexor xr made me drink. effexor xr was the only med i was on. and by "made me" - i HAD TO drink. Ive never had that kind of feeling before or after effexor xr.

but, maybe thats just me.

db

this happened to me, and to other people that i know as well.

[LonelyLucy]

The below quotes are from a couple of internet searches I did sometime back:

"Mirapex is a dopamine agonist and works by mimicking the effects of the neurotransmitter dopamine. Dopamine helps people control their movements and increases feelings of happiness and satisfaction. Because Parkinson's Disease occurs because of a lack of dopamine in certain areas of the brain, Mirapex can help ease some of the symptoms associated with Parkinson's. Mirapex's link to compulsive behavior is thought to result from the rush that dopamine can give in anticipation of a reward or excitement, such as gambling. Mirapex is currently the most prescribed drug in the dopamine agonist class of drugs."

"Effexor XR is the brand name of the extended release version of the previously available medicine Venlafaxine. The XR version is more convenient in that it is usually taken only once a day, usually in the morning. It also seems to be even more easily tolerated than the regular form of Effexor. Effexor XR is unique in that it not only increases the neurotransmitter serotonin (via reuptake inhibition) at low doses (like other SRI's such as Prozac, Zoloft, Paxil, Luvox, and Celexa) but it also increases norepinephrine (via reuptake inhibition). At the higher doses it even increases dopamine. Effexor XR is useful in treating both depression and anxiety. It and other medicines with dual action (Serzone, Remeron, combining a SRI with Wellbutrin, or the older tricyclic antidepressants) may work better for severe depressions than single action medicines."

"Effexor is a serotonin reuptake inhibitor (and more, at the dosage described)"

null0trooper, in regards to your comment made .. "and more", in regards to the Effexor xr .. were you referring to the fact that (too) will increase dopamine?

This is where my concern comes in. There is information out there (already) about how Effexor can (and does) cause alcohol cravings. The whole dymanics of that .. I'm not quite understanding. (Maybe someone can chime in here and explain?)

Husband is already increasing his dopamine levels with 1mg mirapex daily along with his high dose Effexor that is also increasing dopamine. Thus increasing chances for compulsive behaviour.

I might mention, that husband even admitted to me, in the past .. after I mentioned it, that he knows that he has what might be considered an addictive personality. Throw two different drugs at him that increases those "feel good" feelings .. and what else would happen. In my opinion .. nothing but the inevitable.

By the way, an RLS doc that I consulted seemed to think that 1mg .. for RLS, was too high. Not sure what's with that .. other than husband's pdoc thinking that with the high dose Effexor he is on, he needs 1mg mirapex to counteract the big time RLS caused by the Effexor ..??

[Cetkat]

Interesting...

I'll leave n0t to reply, but I just wanted to throw out that Effexor only acts on dopamine at 300mg and above.. so perhaps a med adjustment would be in order if your observations hold true.

Edit: Also, Effexor was too activating for me when it hit norepinephrine at 225mg. I dropped it down to 150mg and added a norepinephrine stimulant (metadate) to pick up the slack with positive results. So not all activating meds would necessarily cause the RLS.

[LonelyLucy]

Yes, Cetkat .. exactly what I am thinking.

I'm not understanding exactly what it is that the norepinphrine does in the system ...?

Has RLS ever been an issue with you? Are you saying that because you dropped down to the 150mg Effexor .. and then added the metadate stimulant, you did not struggle with RLS?

Thanks for your response.

[LonelyLucy]

Brigett and Penny,

If you ever stop back in on this thread .. and see this post, I would be very interested in knowing any specifics you would be willing to share about your personal experiences with Effexor XR.

Were you on a high dose? Do you feel the "negatives" of Effexor was only in regards to making you need to drink .. or were there more? (As if there needs to be more .. I know!) Once you weaned yourself off .. did the drinking problem automatically stop being a problem for you? .. Or because of the "addiction" it caused, do you still find yourself struggling with alcohol? Any specifics you would be willing to post, would be much appreciated!

Thanks much for your affirming posts!

LL

[Velvet Elvis]

Mirapex has been known to make a lot a chronic compulsive behaviors worse. Compulsive gambling is the big one it's famous for. If he's got a predisposition to an impulse control problem, it's likely that one that's making it worse.

[LonelyLucy]

Mirapex has been known to make a lot a chronic compulsive behaviors worse. Compulsive gambling is the big one it's famous for. If he's got a predisposition to an impulse control problem, it's likely that one that's making it worse.

Hi VE,

Isn't it the dopamine that causes the compulsiveness (impulse control problems)? I really am very ignorant about the mechanics of medications .. and that includes the mirapex and effexor. But, I was thinking that it was probably both of the medications. The high dose Effexor AND the mirapex. Can you explain to me why you think it is mainly (only?) the mirapex?

My theory is (has been ..) that yes, there is a lot of information out there in regards to the compulsiveness that the Mirapex causes. Add high dose Effexor XR (450mgs) and.. well, it's like adding gasoline to the fire ... Not sure if I am right or wrong on that one. Husband's pdoc didn't seem to agree with me ..

Just trying to learn ..

Thanks for your response!

LL

[Velvet Elvis]

The where is a lot more important than the what. There are dozens of dopamine receptor subtytpes each of which acts differently. Where the receptors are in the brain also has an effect. Medications increase the availability of dopamine at specific locations.

The effect of effexor on dopamine at that dose is going to to be minimal anyway. I have heard that it can cause alcohol cravings, now that I think about it.

Anyway. Yes, he likely could benefit from a med change.

[Cetkat]

Yes, Cetkat .. exactly what I am thinking.

I'm not understanding exactly what it is that the norepinphrine does in the system ...?

Has RLS ever been an issue with you? Are you saying that because you dropped down to the 150mg Effexor .. and then added the metadate stimulant, you did not struggle with RLS?

Thanks for your response.

Norepinephrine is all about alertness, focus, flight-or-fight, aniexty, etc.. Too little and you can't concentrate - too much and you can get anxious and restless.

I never got RLS, but I did have higher anxiety, blood-pressure, and tremor on 225mg and higher of Effexor. But, like VE says, different medications work differently. Effexor's norephinephrine was negative for me, whereas another source of the same chemical created a positive result of higher focus and awakeness only.

So, basically, I'm saying that it's possible - if dopamine/Mirapex is a problem - to lower the Effexor to the point where he doesn't have RLS (meaning you could take out the Mirapex), and augment it with another medication that doesn't produce RLS to get the same positive effect the Effexor has now without the inhibition.

..Just a theory...

[Penny Century]

Brigett and Penny,

If you ever stop back in on this thread .. and see this post, I would be very interested in knowing any specifics you would be willing to share about your personal experiences with Effexor XR.

it was a few years ago, so the details are hazy. basically i went from not being a drinker to having a serious binging problem. then when i was switched off effexor to cymbalta i didn't have the urge or ability to drink as much. i do think it made me drink heavier and more often. but i also have a family predisposition to alcohol. however, i've been able to be relatively sober since then. (other than the glass of wine with dinner or a few drinks at a party, etc.)

Were you on a high dose? Do you feel the "negatives" of Effexor was only in regards to making you need to drink .. or were there more? (As if there needs to be more .. I know!) Once you weaned yourself off .. did the drinking problem automatically stop being a problem for you? .. Or because of the "addiction" it caused, do you still find yourself struggling with alcohol? Any specifics you would be willing to post, would be much appreciated!

i was on 350mg

the other negative for me is that i just don't do well on meds that play with seratonin.

the drinking didn't automatically stop, but i found myself unable to drink as much, and not wanting to drink as much in the first place after a few weeks off effexor. i didn't seek out AA type help. though perhaps i should have. however, i do not still find myself struggling with alcohol.

keep in mind this is just my personal experience.

AA or something along those lines can really help.

[LonelyLucy]

"Norepinephrine is all about alertness, focus, flight-or-fight, aniexty, etc.. Too little and you can't concentrate - too much and you can get anxious and restless."

Gosh, this I think that THIS hits home .. way too close. That is one of the things that husband complains of .. not being able to sit still .. being very restless .. thus, he heads up to the local watering hole. Supposedly as "something to do". (Ha!) He has also complained of NOT being able to focus and NOT being able to remember very simple things while working jobs in his business. (Not sure if that would be caused by high dose Effexor or not?)

"I never got RLS, but I did have higher anxiety, blood-pressure, and tremor on 225mg and higher of Effexor. But, like VE says, different medications work differently. Effexor's norephinephrine was negative for me, whereas another source of the same chemical created a positive result of higher focus and awakeness only."

Yes, I have, at times, seen my husbands hands shaking as he hands me something over the table top, etc.. I thought that was coming from all of the alcohol .. but maybe its from the high dose Effexor? Do you mind me asking what the "other source" of the same chemical was/is that worked positively for you?

"So, basically, I'm saying that it's possible - if dopamine/Mirapex is a problem - to lower the Effexor to the point where he doesn't have RLS (meaning you could take out the Mirapex), and augment it with another medication that doesn't produce RLS to get the same positive effect the Effexor has now without the inhibition."

That is what I will be hoping to talk my husband and his pdoc into at his next appt. (I think that is in probably about two weeks.) I just wish there was hard core data that I could print out to take to that appointment, so his doc can't tell me I'm just being "the frantic wife".

I appreciate you taking the time to respond to me! All things for me to think about and try to find more info/data on.

LL

[LonelyLucy]

"it was a few years ago, so the details are hazy. basically i went from not being a drinker to having a serious binging problem. then when i was switched off effexor to cymbalta i didn't have the urge or ability to drink as much. i do think it made me drink heavier and more often. but i also have a family predisposition to alcohol. however, i've been able to be relatively sober since then. (other than the glass of wine with dinner or a few drinks at a party, etc.)"

I think someone may have mentioned this to me .. somewhere before? They also said that was all it took .. going off the Effexor. They did not need to go through a twelve step program .. nothing. Isn't it bizarre? Is there not anywhere that this is "officially" documented? Are pdocs aware of these kinds of (terrible) things going with their patients? (Just a little rant there!)

"i was on 350mg"

"the other negative for me is that i just don't do well on meds that play with seratonin."

My husband was on Paxil and Buspar for years and years. Of course, it did absolutely nothing for him. It was the Paxil/Buspar regimen that he was on when he made the drastic change to the new(er) prescription cocktail.

I am wondering why one couldn't safely say that my husband doesn't do well on meds like Effexor?

[Penny Century]

I am wondering why one couldn't safely say that my husband doesn't do well on meds like Effexor?

i can't speak for what kind of medication your husband should be on. obviously the effexor is a problem, but i wouldn't advocate encouraging him to go off psych meds completely because effexor is a problem.

i would say that i think his psychiatrist is taking a wrong approach is saying he won't change his meds until he stops drinking. it seems like the effexor might be contributing to the drinking, so it would be logical (to me) that your husband should switch from effexor to something else.

increased drinking is a relatively common problem relating to effexor, though i haven't read any official documentation about it.

could you talk to your husband about his drinking and effexor? maybe he could convince his doctor to switch his meds around. maybe get a new doctor.

but, keep in mind, even if the pdoc does switch his meds, it might not be a miracle cure.

[null0trooper]

"Effexor is a serotonin reuptake inhibitor (and more, at the dosage described)"

null0trooper, in regards to your comment made .. "and more", in regards to the Effexor xr .. were you referring to the fact that (too) will increase dopamine?

That it's well into the range where the medication is also a noradrenaline reuptake inhibitor, and could be in the range where it is reputed to be a dopamine reuptake inhibitor.

The magic catch to dopamine reuptake inhibition with regard to mood and cognition is that it must be released in the appropriate areas of the brain at appropriate levels. If it ain't released so well, all a DRI will do is screw with your coordination, as dopamine is a major player in voluntary muscle control.

With strongly elevated serotonin levels or an AP in one's system, more stray serotonin molecules can go play with the D2 (and maybe other D*) receptors, so that dopamine does NOT get released without extra effort. One potential result feels like RLS, but is more of an EPS. (By the way, this is somewhat common with APs, uncommon with AAPs, and luckily quite rare with SSRIs)

I.e., it's all a HUGE balancing act that requires a patient to keep his doctor fully informed on what s/he feels from the meds, and a good doctors to keep track when a complex cocktail is used.

[null0trooper]

Isn't it the dopamine that causes the compulsiveness (impulse control problems)?

Poor impulse control is a hallmark symptom of ADHD - one cannot normally stay on a set track of activities without getting distracted by something more interesting/frustrating/noisy... As one person has said "Do NOT talk about driving off the road while I'm on an overpass! I just *might* do it before thinking about it."

Compulsive behaviors are extremely difficult to sidetrack, no matter how shiny the distraction. Just ask someone with OCD or an addiction.

[LonelyLucy]

"Effexor is a serotonin reuptake inhibitor (and more, at the dosage described)"

null0trooper, in regards to your comment made .. "and more", in regards to the Effexor xr .. were you referring to the fact that (too) will increase dopamine?

That it's well into the range where the medication is also a noradrenaline reuptake inhibitor, and could be in the range where it is reputed to be a dopamine reuptake inhibitor.

The magic catch to dopamine reuptake inhibition with regard to mood and cognition is that it must be released in the appropriate areas of the brain at appropriate levels. If it ain't released so well, all a DRI will do is screw with your coordination, as dopamine is a major player in voluntary muscle control.

With strongly elevated serotonin levels or an AP in one's system, more stray serotonin molecules can go play with the D2 (and maybe other D*) receptors, so that dopamine does NOT get released without extra effort. One potential result feels like RLS, but is more of an EPS. (By the way, this is somewhat common with APs, uncommon with AAPs, and luckily quite rare with SSRIs)

I.e., it's all a HUGE balancing act that requires a patient to keep his doctor fully informed on what s/he feels from the meds, and a good doctors to keep track when a complex cocktail is used.

Gosh, I hate to appear ignorant .. but I have to ask what AP, AAP, and AD (does AD = antidepressant?) are .. for sure. I know that SSRI is Selective Serotonin Reuptake Inhibitors ...

[LonelyLucy]

Isn't it the dopamine that causes the compulsiveness (impulse control problems)?

Poor impulse control is a hallmark symptom of ADHD - one cannot normally stay on a set track of activities without getting distracted by something more interesting/frustrating/noisy... As one person has said "Do NOT talk about driving off the road while I'm on an overpass! I just *might* do it before thinking about it."

Compulsive behaviors are extremely difficult to sidetrack, no matter how shiny the distraction. Just ask someone with OCD or an addiction.

Well .. my husband definitely has compulsive behaviour. It does not matter what he says/promises to himself (or anyone else) it's the drinking that seems to be all that he can focus on. (Yes, I know .. that is an addiction.)

But, I also believe that he has (somewhat) of ADHD tendencies. Especially since he has been on the new(er) meds. (Does this .. CAN this make sense?) He has claimed, many times over the past three years that he can't focus on his work (when he works). He is constantly distracted and moves from one project to the next. Now that I've typed this out, I do remember reading somewhere that heavy duty alcohol can do this to a person . ..

[Penny Century]

Gosh, I hate to appear ignorant .. but I have to ask what AP, AAP, and AD (does AD = antidepressant?) are .. for sure. I know that SSRI is Selective Serotonin Reuptake Inhibitors ...

it's okay if you don't know all our acronyms.

AP=antipsychotic

AAP= atypical antipsychotic

and yes, AD=antidepressant

there's also a glossary in new user info.

[Cetkat]

"Norepinephrine is all about alertness, focus, flight-or-fight, aniexty, etc.. Too little and you can't concentrate - too much and you can get anxious and restless."

Gosh, this I think that THIS hits home .. way too close. That is one of the things that husband complains of .. not being able to sit still .. being very restless .. thus, he heads up to the local watering hole. Supposedly as "something to do". (Ha!) He has also complained of NOT being able to focus and NOT being able to remember very simple things while working jobs in his business. (Not sure if that would be caused by high dose Effexor or not?)

Yes, I have, at times, seen my husbands hands shaking as he hands me something over the table top, etc.. I thought that was coming from all of the alcohol .. but maybe its from the high dose Effexor? Do you mind me asking what the "other source" of the same chemical was/is that worked positively for you?

That describes alot of how I felt at a higher dose. It is possible that the Effexor could be causing the lack of focus, but it also could be that he just has a problem with that anyway (it's common for depression) and the Effexor doesn't suffeciently help it. Either way, it seems the Effexor is too activating for him. Unless he drinks enough to have withdrawl, I'd definitely attribute the shaking hands to the med. The med I switched to is Metadate CD.. a newer form of the stimulant Ritalin. But, I'm further down in my treatment.. his doc may not want to rx a stimulant without trying something else (like Cymbalta - a good med to try in this circumstance, I think).

That is what I will be hoping to talk my husband and his pdoc into at his next appt. (I think that is in probably about two weeks.) I just wish there was hard core data that I could print out to take to that appointment, so his doc can't tell me I'm just being "the frantic wife".

What kind of hard core data are you looking for? The possible side effects of Effexor, or dopamine and drinking? I don't think you're being frantic. It's good to find out about other possible options - that's smart for any patient to do.

[Guest Guest]

sounds like youve already found the culprit but thought i would add that i had to stop taking ambien last year because it was making me sleep walk but when i recently asked new doc if i could go back on it very short term she said she didnt know any dr that would prescribe it not just because of sleepwalking but because they believe it causes extemely negative personality changes. she didnt elaborate on this, really put me off. Iv seen that quite a lot of people on this site take it to no ill effect though but maybe worth changing.

[Glen]

He spend money wrecklessly .. of course the drinking being the prime culprit. But there are other instances where it appears like he has no idea of the amount of money he is spending on a daily basis. He is oblivious??

LL

Your comment about spending money reminds me of my hypomanic and manic moods. Of course I don't know if someone can sustain a hypomanic mood for 3 years. If it was a shorter period of time, I'd wonder if the effexor and/or provigil pushed him into being hypomanic. Manic and hypomanic don't have to be elated moods. They can be irritable, edgy, uncomfortable and even paranoid. And I did self-medicate my moods with alcohol.

But, I am not a doctor at all. Just the spending wrecklessly struck a cord with me.

You could try Alanon for yourself to help deal with his drinking. Good luck.

Oreo

I think you hit the nail on the head. It sounds more like Bipolar Disorder being aggravated by ADs. Insofar as the length of time (3 years) as casting suspicions, it very well may be that alcohol is responsible for this. IMO, one of the reasons that many people with BD are attracted to alcohol is that it is very effective in sedation. Whereas traditional benzodiazepines are not. Perhaps it is the feeling of relief that drinking provides that makes it so attractive.

Dr. Jim Phelps spells it out very clearly...........

What is the anxiety of bipolar disorder like? Patients describe it as "agitation", and sometimes that is quite obvious: their foot bounces on the floor while we talk; they pick at their nails; sometimes they can't even bear to sit still and will get up and pace around the office during our interview. But sometimes the agitation is only "inside": patients experience "too much energy inside my skin", like they're going to "explode", and usually their thoughts are going very fast (sometimes called "racing thoughts"). However, when this is severe, people may not experience that fast thinking, but instead just an extremely disorganized thinking -- not being able to keep their mind on one thing for more than a few seconds, not being able to accomplish anything. Of course that can make "anxiety" worse as people recognize that they are really ill with something that is not obvious to anyone else, yet they are not really functioning either. How do you explain that to someone?

When this kind of anxiety is present with other manic symptoms like irritability, it can create an awful experience people feel desperate to get out of. (Very often they discover that alcohol can help settle this down for an hour or two. Unfortunately when it wears off, the symptoms come back, very often worse than before. If a person responds to that by drinking more, that can cause a worsening of the condition over several days or weeks -- but because they get brief relief from drinking, they keep doing it and often have to drink more over time to keep their symptoms controlled.

http://www.psycheducation.org/depression/Anxiety.htm

[LonelyLucy]

sounds like youve already found the culprit but thought i would add that i had to stop taking ambien last year because it was making me sleep walk but when i recently asked new doc if i could go back on it very short term she said she didnt know any dr that would prescribe it not just because of sleepwalking but because they believe it causes extemely negative personality changes. she didnt elaborate on this, really put me off. Iv seen that quite a lot of people on this site take it to no ill effect though but maybe worth changing.

Well, my husband has definitely had the negative personality changes! He takes his Ambien and Mirapex, come hell or high water. He claims that he cannot .. and will not go without it. There is no sleep for him if he misses either one of these night time medications. The problem with my husband (on a night that he hasn't been at the bar) is that he will take the Ambien and Mirapex, lay in bed for a couple of minutes, decides he can't sleep and then gets up. This "alone" would not be an issue, but it really is rather "disgusting" to see how he looks, as he is walking around, eating (and eating and eating and eating) and watching t.v. He goes on what I call his "feeding frenzy" once he takes those two meds. Then, when he decides he STILL can't sleep, he will head out to his shop to work. (Scarey, huh?) I'm here to tell you that it IS scarey. He works with all kinds of tools that he should not be after taking Ambien. My husband is very argumentative during this time .. too. (As I said, this is all very frustrating for me.)

.. And then, on the nights that he does drink heavily .. well, I have just learned to stay clear of him (sleep in the extra bed in my daughters room) and then I generally clean up the terrible mess he makes throughout the night the next morning (Food on the floor, etc.) This is (I know) is because of the mixture of the alcohol, ambien and mirapex.

I hadn't thought about Ambien being part of the culprit in my husbands long-term/daily situation .. but maybe it is ..?

LL

[LonelyLucy]

Glen,

"I think you hit the nail on the head. It sounds more like Bipolar Disorder being aggravated by ADs. Insofar as the length of time (3 years) as casting suspicions, it very well may be that alcohol is responsible for this. IMO, one of the reasons that many people with BD are attracted to alcohol is that it is very effective in sedation. Whereas traditional benzodiazepines are not. Perhaps it is the feeling of relief that drinking provides that makes it so attractive. "

'

I guess I am a bit confused about your comment in regards to the 3 years length of time and alcohol being responsible.. ? Do you mean that he has been (or could be) in a (more or less) hypo manic state forthe past three years? .. And that the alcohol is the contributing factor to that "length of time"?

Dr. Jim Phelps spells it out very clearly...........

"What is the anxiety of bipolar disorder like? Patients describe it as "agitation", and sometimes that is quite obvious: their foot bounces on the floor while we talk; they pick at their nails; sometimes they can't even bear to sit still and will get up and pace around the office during our interview. But sometimes the agitation is only "inside": patients experience "too much energy inside my skin", like they're going to "explode", and usually their thoughts are going very fast (sometimes called "racing thoughts"). However, when this is severe, people may not experience that fast thinking, but instead just an extremely disorganized thinking -- not being able to keep their mind on one thing for more than a few seconds, not being able to accomplish anything. Of course that can make "anxiety" worse as people recognize that they are really ill with something that is not obvious to anyone else, yet they are not really functioning either. How do you explain that to someone?"

Goodness, it doesn't matter where we are at, if my husband has to sit still, his feet and legs are moving. When he would go to church (been a long time since he has been back there) the whole pew would "vibrate" because of his foot bouncing. Since he has been on his newest medication regimen (past three years) his complaint to me and his doc has been that he can hardly stand to sit still/stay at home at night. We don't go to the movies or theatre (or anything of the like) because he can't stand to sit still. I think he says that his RLS kicks in right away .. if he "knows" he has to sit still. He has also had several (what has been diagnosed) as anxiety attacks over the past 10 years or so. I think I probably mentioned this in some of my previous posts, but he complains of not being able to focus or stay on task while working on his jobs. What baffles me is that he CAN stay focused on the projects or hobbies that he "wants" to do. (???) Or at least he appears to.

"When this kind of anxiety is present with other manic symptoms like irritability, it can create an awful experience people feel desperate to get out of. (Very often they discover that alcohol can help settle this down for an hour or two. Unfortunately when it wears off, the symptoms come back, very often worse than before. If a person responds to that by drinking more, that can cause a worsening of the condition over several days or weeks -- but because they get brief relief from drinking, they keep doing it and often have to drink more over time to keep their symptoms controlled."

This makes sense to me in relationship to my husband's situation. My husband becomes very irritable, very easily. (Imo) he cannot handle the stressors of every day life. I have always viewed husbands horrible responses to any kind of problem that comes up as total immaturity. This is how he comes across to others too. But .. maybe he just really isn't able to control this?

In my opinion, as long as I don't burden my husband with any problems, don't make any (in his mind) unreasonable requests of him, he will be happy go lucky. The minute something goes wrong, he falls back into his deep dark hole.

Thanks much for your input Glen!

LL

[Glen]

I guess I am a bit confused about your comment in regards to the 3 years length of time and alcohol being responsible.. ? Do you mean that he has been (or could be) in a (more or less) hypo manic state forthe past three years? .. And that the alcohol is the contributing factor to that "length of time"?

Without getting technical, The booze acts like a benzodiazepine (sedative), where traditionally benzo's are not very effective for those with BD. So, frankly speaking it is possible that alcohol is the most effective 'medicine' that he is currently using. As such he craves the relief that it provides. The effects of his drinking are masking and (or) confusing an already cloudy clinical presentation. My best advice is to look for an expert in BD in your area and get a second opinion.

[dadagirl]

hi,

i think there are only a few who will admit this....but my personal experience was that effexor xr made me drink. effexor xr was the only med i was on. and by "made me" - i HAD TO drink. Ive never had that kind of feeling before or after effexor xr.

but, maybe thats just me.

db

this happened to me, and to other people that i know as well.

Hi, I'm new here so I may screw up the formatting. I have been struggling with increased alcohol comsumption for some time now. I've been on300mg effexor 200mg Wellbutrin (generic Global ER) for some years now. I first started this med hokey-pokey back in the mi d 90's w/ zoloft, and even then I felt a difference around alcohol, that I metabolised it diffferently. One glass of wine went down like water...My drinking has changed to what does feel more ike self-med. have been mentioning this to me pdoc and therapists for so long now but we get into that loop of: if you stop the drinking the meds will help you/but i think the meds may be making me crave drinking! no, no, they say...you have a drinking problem...but, but I quaver, could i have instead a meds problem?

I've been in some deep depressions over the last year on the above dosages, and find myself wondering about the self I was before I started on this merry-go-round. I miss that self. Does it still exist? I have not been doing "well" for even before the deep, recent slides.

I'm doing what I would never encourage anyone else to do: taper off my meds on my own. I've become so frustrated with both my pdoc and therapist situations.

Convincing anyone that getting off these may be as productive an experiment as continuing to stay "on" -- we'll just change things around! -- makes me feel crazier than striking out on my own.

I have been on 175 Eff for about 7 weeks now.

One week off the Bup, completely. Not wise, I admit that one. Think I feel that more than the Eff. Very emotional, nauseaous, high edge.

The issues w/ generic Wellbutrin prompted me to try this. What I can glean suggests that the problems are with the Teva (sp?) products, but any reports about the Global ER variety?

Personally I think the alcohol issue within this mix could be very important.

thanks to you all.

[Cetkat]

FWIW, Effexor does increase my tolerance for alcohol.. and others have said it drives them to drink more.

Also, I've heard of Ambien causing nighttime food binges.

[LonelyLucy]

This morning I accompanied my husand to his pdoc appointment. Of course .. as expected, there was not the outcome I wanted/expected. I was hoping that through the pdoc's questioning husband on how he is feeling .. and pdoc realizing that nothing has changed - that pdoc would now begin considering a serious medication change for husband. Husband's pdoc still holds his stance that until/unless husband can cut out the drinking (for the most part) that he could not start to be more creative with husband's medication regimen. (???)

Towards the end of the appointment I brought up the fact that husband's Ambien is not keeping him asleep (early on). Pdoc did not like that, because my husband gets out of bed, wanders around and even goes out to work in his shop after taking the Ambien. So now the pdoc has added yet another medication in .. Trazodone (Desyrel). Husband is to take 50mgs when he goes to bed. If that does not keep him asleep, when he gets up he should then take an Ambien. Is anyone here familiar with Trazodone?

Last but not least .. I brought up, once again, the fact that I was still not understanding the issue with Effexor and husband's drinking. I said once again (AND said this in my long letter to pdoc some months back!) that my husband's real drinking problem did not begin until after he began the Effexor (and the rest of his medication cocktail.) Pdoc looked at me .. more like peered at me. He was thinking and thinking and repeated that statement several times back to us. It was like this was the first he had this from me! (???) After looking like he was really giving that some thought .. he ended the appointment with saying that he wanted to see how husband does over the next three months .. he is hoping that the alcohol consumption would get even better. But .. pdoc said that he was going to be giving my Effexor= alcohol problem statement some more thought.

Just posting my thoughts/rant here. Probably more as journaling than anything else.

Hope everyone has a fantastic Thanksgiving!

LL

[december_brigette]

Hi,

I apologize for not responding sooner.

before effexor xr - i would occasionally drink - go out with people from work on fridays - that was my drinking.

when i started the effexor xr 37.5 it was fairly instantaneous. and it went from beer to wine. had to be wine. and like others said - i drank it like water, daily. as my effexor dosages went up, so did the drinking. at 150mg i went totally completely out-of-my-mind. i SHOULD HAVE BEEN hospitalized. however, i was living with an old dude (much older than me) and i think he was afraid of "losing me" and insisted he would help me get "off" effexor because it really was horrible. and at this time i was only seeing my gp. so i tapered down fairly quickly and with great success. thank god!!!!!!!!!

when i was completely off effexor xr the desire to drink changed. i have never had that kind of experience with any other medication.

i know there are some pdocs in this world who refuse to acknowledge that effexor xr can increase one's desire to drink & subsequently the amount of alcohol one drinks. these are the same pdocs who think seroquel does not cause nightmares or drastic changes in sleep dreams.

i wish much success for your husband,

december

[LonelyLucy]

Hi Brigette,

I appreciate you taking the time to respond to me. Your comment about your desire to drink "changing" once you went off the Effexor is what others have said .. time and time again.

It is so very frustrating for me that more doctors are not aware of this!

Thanks for your post.

Have a beautiful Thanksgiving,

LL

[ConfusedCat]

when i started the effexor xr 37.5 it was fairly instantaneous. and it went from beer to wine. had to be wine. and like others said - i drank it like water, daily. as my effexor dosages went up, so did the drinking. at 150mg i went totally completely out-of-my-mind. i SHOULD HAVE BEEN hospitalized.

My hubby went through the exact same thing and finally, thank God, has gotten off of the effex and has just started lamictal titration. Ok even though it has only been two weeks he has drank less and right now, anything less is a great sign. I know he could really have an addiction problem- hell who wouldn't after drinking like a fish for three years? But surely I know as he explained it to me he hates drinking but felt not only a craving but a COMPULSION to drink.

I also never knew his true mixed state hell and that the drinking- self medicating- was really the only thing keeping him from harming himself. He felt awful inside but the drinking makes him not have to feel a thing. Problem solved. So it is like the drug (for some people) creates its own hell then creates the craving for the hell's fix, then you are locked into this weird world of perceived "passing" as a viable condition/solution.

How anyone can live like that and not fight to get out of it, instead of finding ways to stay in it, is beyond me. I just wanted to post and let you know I feel for you. I really don't know what I would do if once I finally got him there the doc didn't listen/ *hear* me.

I fully believe the effex and/or/mirapex combo could be doing your hubby in. Because I have seen it first-hand.

Would these posts here, not help enlighten at least your hubby to the possibility? (of course don't do anything that will be detrimental to yourself if this is private)

I just wanted to reach out, one wife to another. I have felt your pain.

I have hope for a better outcome now. Whatever it brings at least I will know I am not trying to beat a horse with a rubberband.

CC~

[ConfusedCat]

I also wondered from anyone on the boards who have more brain chem knowledge...

As it may be the dopamine that influences lack of inhibitions though obviously unless there is something we don't truly know about effexor that isn't the whole story because many people are having the overwhelming alcohol cravings at even the lower doses. This evidence is easily seen all over the web by hundreds of similar stories at all ranges of doses.

We also know that alcohol hits dopa and GABA receptors. Thus many times those on topamax, gabapentin and other meds find it at times almost impossible to drink and there is some use of it now as an anti-drinking therapy in fact.

(mostly I am just thinking out loud) If anyone can explain more about these hits and misses and chains of reactions/ possibilities, for general discussion I would find it interesting.

CC~

[LonelyLucy]

"My hubby went through the exact same thing and finally, thank God, has gotten off of the effex and has just started lamictal titration. Ok even though it has only been two weeks he has drank less and right now, anything less is a great sign. I know he could really have an addiction problem- hell who wouldn't after drinking like a fish for three years? But surely I know as he explained it to me he hates drinking but felt not only a craving but a COMPULSION to drink. "

CC,

It's awful to have to go through, isn't it? I think it's absolutely wonderful that your husband has gotten off the Effexor! Do you mind me asking what it was that made him .. or his pdoc, decide that they wanted/needed to change/get him off the Effexor?

I have been slowly "working on" my husband's pdoc. His last appt. (Nov. 20) when he finally "got" what I have been saying for the last six months or so .. husband's pdoc looked at me like he was seriously thinking about it. He said to me, "You mean to tell me that you think that it is the meds that is making him drink like that?" His face was kind of screwed up in a kind-of like "thinking mode" .. like it was the first time he heard it come out of my mouth. (??) So, I had a moment of hope there. And then my husband added, "My wife spends way too much time on the internet doing her own research. I can't believe that anything she comes up with would have any validity." Well, he may have not said exactly that, but the implication was there. Husband and his pdoc then continued to joke about the "internet doc's and how many quacks are "out there". Needless to say it was very, very frustrating for me.

That said, one good thing did come out of that appointment .. in my opinion, and that is that husband's pdoc took him off of the ambien .. totally. I told the pdoc about how husband does not stay in bed after taking it .. that he a lot of times goes out to work in his shop (scarey, huh?). The pdoc did not like that at all and gave husband a prescription for Trazodone (desyrel). At first my husband really was mad at me for telling his pdoc about the ambien problem. But he's not talking about it any longer and the Trazodone, in my opinion, seems to be working.

Thanks much for your support, CC!

Have a wonderful holiday season!

LL

[ConfusedCat]

"My hubby went through the exact same thing and finally, thank God, has gotten off of the effex and has just started lamictal titration. Ok even though it has only been two weeks he has drank less and right now, anything less is a great sign. I know he could really have an addiction problem- hell who wouldn't after drinking like a fish for three years? But surely I know as he explained it to me he hates drinking but felt not only a craving but a COMPULSION to drink. "

CC,

It's awful to have to go through, isn't it? I think it's absolutely wonderful that your husband has gotten off the Effexor! Do you mind me asking what it was that made him .. or his pdoc, decide that they wanted/needed to change/get him off the Effexor?

I have been slowly "working on" my husband's pdoc. His last appt. (Nov. 20) when he finally "got" what I have been saying for the last six months or so .. husband's pdoc looked at me like he was seriously thinking about it. He said to me, "You mean to tell me that you think that it is the meds that is making him drink like that?" His face was kind of screwed up in a kind-of like "thinking mode" .. like it was the first time he heard it come out of my mouth. (??) So, I had a moment of hope there. And then my husband added, "My wife spends way too much time on the internet doing her own research. I can't believe that anything she comes up with would have any validity." Well, he may have not said exactly that, but the implication was there. Husband and his pdoc then continued to joke about the "internet doc's and how many quacks are "out there". Needless to say it was very, very frustrating for me.

That said, one good thing did come out of that appointment .. in my opinion, and that is that husband's pdoc took him off of the ambien .. totally. I told the pdoc about how husband does not stay in bed after taking it .. that he a lot of times goes out to work in his shop (scarey, huh?). The pdoc did not like that at all and gave husband a prescription for Trazodone (desyrel). At first my husband really was mad at me for telling his pdoc about the ambien problem. But he's not talking about it any longer and the Trazodone, in my opinion, seems to be working.

Thanks much for your support, CC!

Have a wonderful holiday season!

LL

It is good to hear that you are keeping up the pressure and at least you got the Ambien in check. That was a win!

Your endurance and fortitude must be amazing. I wish you continued luck as you advocate for your husbands best interests.

My Hubby is improving. He is in that mixed titrating state where each moment is up and down but slowly better and better.

I know he is still frustrated but he has enough hope now to WANT to climb out of the hole and looks forward to the lamictal making that possible. Whereas before he didn't believe anything would/could change where he was at. He truly thought the Effexor had rewired his brain to alcohol induced self destruction forever.

So far hardly a side effect form the lamictal (except good), lets hope that continues...

Hanging in here with you-

CC~

[KG85]

I have been slowly "working on" my husband's pdoc. His last appt. (Nov. 20) when he finally "got" what I have been saying for the last six months or so .. husband's pdoc looked at me like he was seriously thinking about it. He said to me, "You mean to tell me that you think that it is the meds that is making him drink like that?" His face was kind of screwed up in a kind-of like "thinking mode" .. like it was the first time he heard it come out of my mouth. (??) So, I had a moment of hope there. And then my husband added, "My wife spends way too much time on the internet doing her own research. I can't believe that anything she comes up with would have any validity." Well, he may have not said exactly that, but the implication was there. Husband and his pdoc then continued to joke about the "internet doc's and how many quacks are "out there". Needless to say it was very, very frustrating for me.

That said, one good thing did come out of that appointment .. in my opinion, and that is that husband's pdoc took him off of the ambien .. totally. I told the pdoc about how husband does not stay in bed after taking it .. that he a lot of times goes out to work in his shop (scarey, huh?). The pdoc did not like that at all and gave husband a prescription for Trazodone (desyrel). At first my husband really was mad at me for telling his pdoc about the ambien problem. But he's not talking about it any longer and the Trazodone, in my opinion, seems to be working.

Thanks much for your support, CC!

Have a wonderful holiday season!

LL

First off, I want to commend you ladies on having the intelligence and piece of mind to truley recognize the nature and complexity of depression/mental 'illness' as something that keeps people from fully being themselves. It is heartwarming to hear the stories of you standing by and supporting your husbands as best you can because you love them through such a complex situation. It gives me hope, as I have always assumed that no woman would understand or have the patience to help me, much less even bother hanging around as I work through my issues of depression/anxiety etc (im 22 and have only had one real girlfriend). The comments made about it not being worth the time and effort if the person isn't committed to helping themself certainly are true however.

Anyways, I just wanted to comment quickly how appaling that situation you described with your husbands doc was. I havnt read through any but a couple of the first few posts and the last few posts so I dont know the full situation, but for godsakes get a new doc. Alcohol abuse is a rare side effect of effexor. It probably would be a helluva lot less rare if the effexor trials were done solely on prone-to-abuse-or-addiction individuals. My brother, for example (a former alcoholic) hasnt drank in years and years but he finds effexor increases the desire for alcohol greatly for him. The exact same is true for my sister. Add to that the high incidence of compulsivity mirapex is documented as inducing and you described it well as 'gasoline on the fire'.

Your pdocs lack of knowledge and his lack of interest/dissent towards your research is revolting and disturbing. Your husband can be forgiven for being ignorant, and hence condescending to the research youve done, but your doctor cannot. For godsakes, put your foot down and fire that doc and see a new one, no matter what your husband thinks.

[wifezilla]

I have always assumed that no woman would understand or have the patience to help me

Hubby and just had our 21st wedding anniversary (and we still like each other!)

[LonelyLucy]

"Anyways, I just wanted to comment quickly how appaling that situation you described with your husbands doc was. I havnt read through any but a couple of the first few posts and the last few posts so I dont know the full situation, but for godsakes get a new doc. Alcohol abuse is a rare side effect of effexor. It probably would be a helluva lot less rare if the effexor trials were done solely on prone-to-abuse-or-addiction individuals. My brother, for example (a former alcoholic) hasnt drank in years and years but he finds effexor increases the desire for alcohol greatly for him. The exact same is true for my sister. Add to that the high incidence of compulsivity mirapex is documented as inducing and you described it well as 'gasoline on the fire'.

Your pdocs lack of knowledge and his lack of interest/dissent towards your research is revolting and disturbing. Your husband can be forgiven for being ignorant, and hence condescending to the research youve done, but your doctor cannot. For godsakes, put your foot down and fire that doc and see a new one, no matter what your husband thinks."

Yes, KG .. I agree! It IS appalling. I have thought so all along .. and could not understand why husband's pdoc did not believe anything I said .. or put credence to any of it! His mantra all along has been, "I can't change anything in your husband's medication regimen unless/until he has a dramatic change in his drinking habits." (???)

My mantra to husbands pdoc has consistently been .. "But, he did not GET THIS WAY until six months after he started your whole new prescription regimen!" Apparently that makes no difference in the pdocs mind. Pdoc said that (in his notes) from when my husband first began seeing him, he had written that husband mentioned that he does drink. I tried to tell him that his drinking was absolutely nothing like it is now. In my opinion .. and others, my husband is a bonafide alcoholic .. NOW!

Husband and I have been married 29 years this July.

My daughter received a diamond on Christmas. They are trying to arrange everything so that they can marry by the end of May (2008!). Lot's to do .. but we already have many of the "big things" arranged/reserved. Why do I bring this up? Well, I have pretty much decided that I will be attending one more of my husbands pdoc appts. with him. (February). At that time, I will lay it on the line to both the pdoc and my husband. Don't know if it will do any good .. but I have had it. After daughters wedding in May, I believe I will be ready to say good by .. IF pdoc does not change his approach or husband refuses to begin seeing someone else.

My husband has been out of town working on a job ..(Yes, he is working.. which is great. But I happen to know that he is partying hard too.) Anyway, he has been gone so far for two weeks. Something is wrong .. with ME .. this time. I do NOT miss him. I might "miss" the man he used to be, but I know that he is no longer "that" person . I have put myself (with all of the worrying and feelings of hopeless) in my own state of depression. I "feel" myself pulling out of that .. slowly while he has been gone. ... And dreading next weekend when he will be heading home.

Sad .. I know. But enough is enough. I am done hitting my head up against a brick wall.

LL

[KG85]

"Anyways, I just wanted to comment quickly how appaling that situation you described with your husbands doc was. I havnt read through any but a couple of the first few posts and the last few posts so I dont know the full situation, but for godsakes get a new doc. Alcohol abuse is a rare side effect of effexor. It probably would be a helluva lot less rare if the effexor trials were done solely on prone-to-abuse-or-addiction individuals. My brother, for example (a former alcoholic) hasnt drank in years and years but he finds effexor increases the desire for alcohol greatly for him. The exact same is true for my sister. Add to that the high incidence of compulsivity mirapex is documented as inducing and you described it well as 'gasoline on the fire'.

Your pdocs lack of knowledge and his lack of interest/dissent towards your research is revolting and disturbing. Your husband can be forgiven for being ignorant, and hence condescending to the research youve done, but your doctor cannot. For godsakes, put your foot down and fire that doc and see a new one, no matter what your husband thinks."

Yes, KG .. I agree! It IS appalling. I have thought so all along .. and could not understand why husband's pdoc did not believe anything I said .. or put credence to any of it! His mantra all along has been, "I can't change anything in your husband's medication regimen unless/until he has a dramatic change in his drinking habits." (???)

My mantra to husbands pdoc has consistently been .. "But, he did not GET THIS WAY until six months after he started your whole new prescription regimen!" Apparently that makes no difference in the pdocs mind. Pdoc said that (in his notes) from when my husband first began seeing him, he had written that husband mentioned that he does drink. I tried to tell him that his drinking was absolutely nothing like it is now. In my opinion .. and others, my husband is a bonafide alcoholic .. NOW!

Husband and I have been married 29 years this July.

My daughter received a diamond on Christmas. They are trying to arrange everything so that they can marry by the end of May (2008!). Lot's to do .. but we already have many of the "big things" arranged/reserved. Why do I bring this up? Well, I have pretty much decided that I will be attending one more of my husbands pdoc appts. with him. (February). At that time, I will lay it on the line to both the pdoc and my husband. Don't know if it will do any good .. but I have had it. After daughters wedding in May, I believe I will be ready to say good by .. IF pdoc does not change his approach or husband refuses to begin seeing someone else.

My husband has been out of town working on a job ..(Yes, he is working.. which is great. But I happen to know that he is partying hard too.) Anyway, he has been gone so far for two weeks. Something is wrong .. with ME .. this time. I do NOT miss him. I might "miss" the man he used to be, but I know that he is no longer "that" person . I have put myself (with all of the worrying and feelings of hopeless) in my own state of depression. I "feel" myself pulling out of that .. slowly while he has been gone. ... And dreading next weekend when he will be heading home.

Sad .. I know. But enough is enough. I am done hitting my head up against a brick wall.

LL

You clearly have a good logical and healthy mindset for the situation. It sounds like you have put up with his alcoholism and the stagnation and apparant reversal of his treatment for long enough. It is on your husband alone to decide if he will change his 'treatment's' course of action to try and assuade your frustration. My sister is in a very similiar situation to yours in that her husband is completely uncooperative in trying to find a med he can tolerate that helps his bipolar disorder and she doesnt know what else to do. Miraculous, amazing (and quite immediate) changes truly are possible when it comes to meds and their ability to alter our positive and negative thoughts and behavior (as you have witnessed). However, as was mentioned, the person first has to be open to the treatment process (aka popping pills until you find the most helpfull one). I definetly wouldnt lay down this ultimatum at the psych appointment. I would guess it has a strong possibility of arising some pretty serious passions in your husband. Forcing him or even ever so slightly insinuating he has to make the decision in one sitting really wouldnt give him enough time to comprehend the magnitude of what it is you are demanding or the time needed to deal rationally with all the emotions it will probably give rise to in him. The doc is completely pointless in this situation, you and your husband are just employing his services. Also, if I had a gf or wife that dropped news like this so suddenly in front of another dude, it would drive me batshit. Its a humiliating/emascilating (sp) guy-thing. Ridiculously big no-no as far as im concerned, but of course thats just my opinion which you didnt ask for... You need to be supportive and clear in telling him that this isn't passive (i.e. really about something else) in any way but is directly related to how he has been content with his treatment so far while you feel he has gotten much worse, you are fed up with his behavior and how it is making you feel, and something needs to change, etc.

I can personally relate to your situation. When I was about 13 I was put on adderall because my grades were slipping in school. I was extremelly thankfull and lauding of how much adderall helped me, mainly with my generalized anxiety and social anxiety. It didnt help me with my school work, but I was much more concerned and amazed with the fact that I was no longer suicidal and frozen with anxiety every second of the day. Negatively, it seemed to cause me to sometimes spit out words faster than I could organize them into coherent thoughts, particularly when I got very emotional (which was very frequently. Adderall also tends to ratchet up the intenseness of my moods). At the same time though I also had alot of complements from people on how articulately and clearly I was able to express my thoughts and describe various complex situations (usually parental-conflict type situations). Of course usually I wasn't all emotional when talking with these people like I would tend to get when arguing with my parents or a psychiatrist about intensely sensitive and personal issues. Adderall still has those general kinds of effects that I described on me today, but to a lesser extent with the help of add on meds like I said. Anyway, long story short, after having been on adderall for like 6 months or so and seeing a psychiatrist every week with my parents I was diagnosed by my doc at the time with emerging scizophrenia. His major reasoning was the sometimes disjointedness of my words when trying to convey my thoughts. He also was implying that claims of mine that 'adderall helps my depression' and 'I get really nervous when I try new meds because I can tell that my friends notice a change in my behavior' were delusions because adderall doesnt help with depression and theres no way you could tell that your friends are noticing your behavior is different than normal. From that point on I was essentialy no longer a rational human being to my parents. They just looked at me like a lunatic with blank expressions and wide eyes and told me to settle down or that im not making any sense whenever I would explain how foolish the docters reasoning and logic was. They would completely invalidate any argument I would have by referring to the diagnoses of the docter and insisiting that he is the one who knows whats going on with me and whats best for me is for them and myself to follow his 'orders'.

When my doctor had broke the news to me as to what he thought my diagnoses was, I responded that "while I guess this diagnoses could be correct, wouldnt it make sense to stop the adderall entirely for awhile and see me a few times off of it? You have never seen me once when I wasn't on adderall. One of the rare side effects of adderall is the patient displaying signs indistinguishable from scizophrenia." He just smiled, laughed smugly and condescendingly and told me that this was his diagnosis and that I was going to have to accept it and he wasnt going to discuss it anymore with me.

From then on a few years of pretty intense hell took place that involved forced hospitilazation and plenty of other huge wastes of my time and life. I was completely willing to try any meds they wanted all along. I just wouldnt try meds in the middle of the school year at a brand new school because when my social panick and major depression kicks in (which had already happened as a result of other medications I had already trialed while in school) I get majorly suicidal very quickly and I was afraid for my life, frankly, to be trying meds in such a triggering environment for me.

Anhow, sorry for the length, I just wanted to tell how I too have been a victim of absolutely astonishing stupidity on the parts of certain psych docs, and how it can totally fuck up your life.

By the way im 23 now and still have had absolutely no signs of scizophrenia. I have major depression and social anxiety disorder among some other post traumatic stress issues, and although my life, emotions, and anxiety levels certainly aren't entirely normal, the fact that im still alive and can hold a job pretty easily without much stress is a miracle in itself to me. I got to this point by seeing intelligent docs who actually have up to date knowledge of their field unlike my dumbass first doc and the kind of doc it sounds like your husband is seeing.

Good luck to you.

Kurt,

[LonelyLucy]

Hi Kurt,

Wow, you HAVE been "through the mill", haven't you? Talk about a sorry situation .. the attitude your dr. took towards you and the absolute hell that you had to endure because of him. Is this dr. still practicing? If it was me, I would want to make sure he knew the very grave error that he made. How totally bizarre! All because (obviously) he was just too full of himself to give any credence to your (very accurate) perspective. Gosh! It's only you .. what would you know .. about you, right? UGH!! I am SO sorry!! What do your parents say about all of that NOW? Do they apologize for not listening to you?

But, you have pulled yourself out of "that" and are (probably) even better off for it, right?

"By the way im 23 now and still have had absolutely no signs of scizophrenia. I have major depression and social anxiety disorder among some other post traumatic stress issues, and although my life, emotions, and anxiety levels certainly aren't entirely normal, the fact that im still alive and can hold a job pretty easily without much stress is a miracle in itself to me. I got to this point by seeing intelligent docs who actually have up to date knowledge of their field unlike my dumbass first doc and the kind of doc it sounds like your husband is seeing. "

Interestingly enough, this pdoc's diagnosis for my husband is anxiety and depression, also. I don't think you would call it "social" anxiety disorder though, because my husband is way .. WAY too social. (Unless I am assuming what that diagnosis is wrongly ..?) Your issues .. that you mention, PTS, life, emotions and anxiety levels are certainly what I think my husband is constantly struggling with. Would you mind telling me what kind of doc you are seeing now?

I think (this moment anyway) my plan for my husband's next pdoc appointment will be to "grill" husband's pdoc. This pdoc will (periodically .. at least the few times that I have been there) will ask husband a series of questions and rate them 1-10 .. in regards to how he is feeling with his depression. Two appointments ago, (IMO) his answers were "bad". (He didn't ask husband to rate his symptoms the last time.) I would like to ask the pdoc to compare his levels now vs when he first began seeing him. I am hoping that in talking about the comparison (of which more than likely his levels are the same or worse) he will finally "get" what I have been trying to tell him. I also plan on telling the doc (one more time) that husband's extreme personality change is not a coincidence with happening at the same time of all of his med changes 4 years ago.

This is all "stuff" that I have tried to say at previous (more recent) appointments .. other than having him compare those "levels". I'm not sure what else I will say, but I am thinking on it.

I will not reveal to husband what I am thinking about my thoughts of leaving. That will be brought up (I'm sure) in our spirited discussions that will take place after our daughters wedding. I don't want to/need to bring that up now. Way too much other stuff that my mind needs to focus on.

Thanks for your advice/support!

LL

[KG85]

My parents have never apologized in any manner whatsoever. Something is majorly wrong with them despite them both being extremely intelligent and successfull and both having backrounds in both counseling and psychology. They are seriously lacking in common sense and other communication and relationship areas. Another similiar example of their weird ass and apparantly heartless behavior would be my mom kicking me out of the house for a year when drugs were found in the basement (I then moved in with my dad). She thought they were mine but I took drug tests that same night which proved they weren't. They were actually the drugs of a group of firemen who had been doing construction work on our basement for weeks (who later completely skipped out on finishing the job). Why she wouldn't let me move back in till a year later, I don't know. I lost a huge amount of time and money and was deeply hurt by how distrusting and un-caring she was (and still is) of how much it hurt me and how much it cost me. She has never apologized once for this.

I have never been quite sure if my parents fit the diagnoses or whatever of 'psychologically abusive'. They are very subtle, and bizzare in the passive, emotionally cold ways they use to break down my siblings and my will power whenever we try to have any kind of argument with them. They don't discuss the issue, they just keep changing the subject, or pointing out how you were wrong on something and it invalidates everything or things like that. If it involves them admitting or having to think about them possibly making ANY kind of mistake they will never stop with this passive aggressiveness. They run the argument around and around in circles by changing the subject and belittling us in various ways until we are broken down out of emotional frustration. All of the arguments I watched take place between my siblings and them while I was growing up were like this. Every argument would end in my siblings or myself broken down in tears of frustration and hurt because my parents were seemingly just bullying us with sick mind games instead of trying to work to help solve the problem or understand how we were feeling. They are pure defensiveness.

I am just seeing a psychiatrist. I dont know what else you might mean by "what kind of doc".

I really would suggest getting a new doc and not wasting another dime on your husbands current doc. You are doing his job for him by pointing out blatant negative changes in your husband's behavior which have corresponded closely with his med changes. Its up to you of course but I cant tell you how ridiculous that sounds to me having wasted my time trying to talk some sense into stupid people like that already, and then switching docs and then realizing what an unbelievable waste of time and energy it was to try and do the job of my previous doc for them.

Dont worry about diagnoses for the sake of diagnoses, just get to treating the symptoms. Certainly understanding what someone is feeling and what their troublesome behavior is is important, but putting a label on it accomplishes nothing. These are all my opinions of course and they aren't near complete in explanation.

Good luck to you and your husband. Take care.

Kurt,

[LonelyLucy]

"My parents have never apologized in any manner whatsoever. Something is majorly wrong with them despite them both being extremely intelligent and successfull and both having backrounds in both counseling and psychology. They are seriously lacking in common sense and other communication and relationship areas."

Kurt, at least your recognizing this. "Knowing" this has got to help somehow .. doesn't it? They both have very evident "deficits" that screwed you up royally .. at least for a period of time.

It sounds like you are on the road to recovery though. If you can accept these facts (the many that you stated in your most recent post) and are able to "get over it" (not an easy thing .. by any means, to do) I would think it will be doing a lot to put you on that road to recovery. Kudos to you for realizing and understanding the mechanism(s) behind the scenes that have put you were you are at .. or "were" ... (probably?) for that matter!

"I am just seeing a psychiatrist. I dont know what else you might mean by "what kind of doc"."

I guess I thought that maybe you were seeing someone that (maybe?) specialized in a certain technique or something .. That's where my question came from.

"Dont worry about diagnoses for the sake of diagnoses, just get to treating the symptoms. "

Well .. I'm truly wondering about this .. now. Husband has been away for almost a month now and I have oodles amount of time to read up (on this board) probably what I should have already read before I even began all of my rantings/posts. I have most recently been reading up on the Borderline Personality Disorder board.

I know that I probably have no business trying to put a diagnosis on my husband, but .. to ME, it appears to me that he (time and time again .. IMO, of course!) meets the criteria for a possible diagnosis of Borderline Personality Disorder.

You may ask .. "so what"? Well, after reading up a bit on this, I discovered a couple of things .. when treating this, if a doc is prescribing an antidepressant .. I found several different sites that were strongly advocating ALSO using a mood stabilizer .. like lithium, etc.

Also, it appears that "medications" are (generally) NOT the only answer for this disorder. I found site after site that advocates .. "based on research and experience, most experts in this field believe that psychotherapy is essential in most cases if you are to gain optimal control over your symptoms and your life."

I have lived with this man .. my husband for almost 30 years. I know him too well. I may not have the right to suggest a diagnosis like this, but I am almost flabbergasted (after reading the pages on this site in connection with the borderline disorder) how well it "fits" my husband.

When husband meets with his doc .. or any doc, for that matter, he always glosses over his "problems". His chief complaint for pdoc is anxiety and depression. He (more than likely) has reiterated that to pdoc many times. (He doesn't come right out and say it, but the intention is very clearly there ... he just wants the doc to give him the pills to make him feel better!) There is no way he would "tell" pdoc the underlying things going on with him. As I am typing this, I realize that YES, that is right. My husband could not/would not admit/accept that there is anything wrong with him other than depression .. "the black dog disease", as he puts it time and time again.

So .. what if I go in and "reveal" to his doc (somehow?) what I think really IS the problem? After 3/4 years why wouldn't this pdoc know this already? (RANT .. I know!)

These are husbands many symptoms that "fit" the borderline diagnostic criteria. (This is MY opinion, of course!)

Chronic/major depression

Helplessness

hopelessness

wothlessness

guilt

anger(including FREQUENT expressions of anger)

anxiety

boredom

emptiness

odd thinking

unusual perceptions

substance abuse/dependence

manipulative suicide gestures

other impulsive behaviors

intolerance of aloneness

stormy relationships

manipulativeness

dependency

demandingness

entitlement - This is something that he has been "focusing" on just recently. His dad passed away about 10 years ago. His mom is elderly (86) and probably won't be around too much longer. He farmed way back when and his dad did not give him the "opportunities" that other farm kids received if they decided to follow in their fathers footsteps. My husband harps and harps on this .. claiming that he will take his sisters to court when his mother passes away because he is not getting anything more as far as inheritance. (His father maintained that my husband already used up his inheritance. .. Very long story.) Anyway, he can't let it go .. is constantly harping on this.

Just my thoughts. Reading up on this disorder has really .. REALLY opened my eyes.

LL

[december_brigette]

hi LL:

I think you should be commended for working so hard on finding answers for your husband. my ex-h has a laundry list of physical ailments and allergies and i never looked this stuff up. but he is a post for another time.

there is another thread on CB about patients "googling" medical info and then questioning their doctors. and drs are getting so upset about this. why? because WE are able to look up info on the internet that people have "translated" into layman terms - thus the patient is able to do far more research than in the past. and i think:

1. this blows the egos of doctors. THEY are the ones supposed to know everything. (me being sarcastic).

2. a patient know more than a doctor?!?! see #1.

and it just occurred to me in 2007 that i could look up my doctors. sometimes i didnt find anything other than my obgyn's given name - and if i was him id use my middle name as the first, too.

i found out a lot about my tdoc before my 1st appt. mostly because he has a couple of websites talking about his practice and then talking about anxiety. i asked him a lot of questions about the info on his sites and he has always been very open to discussing them. we have also talked about some other MI websites and info and he has always been very positive in talking about anything.

I hope you are able to pull that pdoc's head out of his ass. and i think its great you are working so hard for your husband.

love,

december

[KG85]

I didnt mean to imply that I thought your interest in trying to help arrive at a diagnosis for your husband is 'wrong' or unethical or anything. I didnt mean to come off that way. It is very sweet and admirable. My general point is that I feel many docs and patients put way too much importance on determining a diagnosis. Due to this over importance (and maybe because doctors want to satisfy their patients or instill confidence of their ability in their patients) diagnosis are arrived at WAY too quickly many times (IMO).

It is great that you are researching mental 'disorders' and increasing your understanding of them. However, its very easy to see that someones behavior fits certain characteristics for a certain disorder you read about, and mistakenly 'diagnose' them as having that disorder. For example I have all those symptoms you listed for borderline pers. disorder but they are very vague and out of context of real life situations. This makes them practically indistinguishable from a depression diagnoses. I have watched so many 'proffessionals' and people in general be laughably off in their diagnoses and understanding of my thoughts and behavior that I have come to believe that most of the time the only person that can really give an accurate diagnoses of someone is the person you are trying to diagnose. I have researched disorders for 8 years now (not all that thoroughly or intensely, mind you) and am one of the most emotionally introspective people imaginable and yet I still find that every year or so I realize a little bit more about what gives rise to my emotions, how I express them or I learn a tiny bit more about a certain disorder which suddenly makes me realize I fit more into the realm of that disorder rather than my previous diagnoses. In fact while I was writing this, as I looked up borderline personality disorder in a textbook I read about avoidant personality disorder, which seems to fit my thought behaviors much better than schizotypal personality disorder, which I was suspecting might 'fit' me for the last couple weeks. This is, obviously, why a GOOD doctor is usefull.

Diagnosing someone often depends on crystal clear access to the deepest, most honest thoughts and emotions someone experiences. Regarding this, you are exactly right in that you have a good deal of qualification, as his wife, to help him and a doc arrive at a diagnoses. However, you also dont have much knowledge of all the different diagnoses out there and all the intricacies which define and seperate them. You certainly aren't incapable of educating yourself on all of them, but a competent doctor would be a lot less hassle and more immediately helpful then getting your PHd in psychiatry. The only person that can accurately diagnose your husband is your husband. Your doc and you can blindly guess at what his diagnoses is based on his behavior without his full cooperation, but I dont believe you'll ever get anything accurate unless your husband is wholly honest about his thoughts and feelings and you have a competent, patient doctor there to listen.

As might be evident through my story, I know firsthand how having someone you love label you and act as if they know what and how you are feeling when they are completely wrong is one of the most insulting and hurtfull things imaginable. It is also extremely easy to do in a field like psychology where 'playing doc' seems so simple but is more complicated than any of us can imagine. After all, you just have to look at behavior and determine which diagnoses fits the person's patterns, right? No, you must have the individuals full honesty and cooperation in order to get into their head and truely understand what disorder/s they have (I understand certain disorders are probably a bit more cut and dry however).

You say your husband's doc wont change his meds until he stops the alcohol. However you are worried his current meds are what are causing his impulsivity to drinking alcohol. It seems to me you basically have three options: 1. Insist your husband stops drinking regardless of what meds he is on or leave him. 2. Get a new doctor who is open to changing his meds from the ones you think are triggering his alcoholism and then demand he get off alcohol (hopefully the new meds will make this easier for him to do) or you will leave him. 3. Continuing to spend your time and energy arguing against a 'team' of your doctor and your husband who completely invalidate how you feel the meds are contributing to his alcohol abuse and other concerns of yours. Then, when you are frustrated enough from this losing battle, either attempt step one or two or just skip to leaving your husband if you cant put up with it anymore after all of this pointless expenditure of personal energy.

Again, based on my experience, I would strongly advise not wasting any more time on this doc. Even if you do get your ideas to stick in his head, why would you still want someone this illogical as 'your' doctor anyway? Hes likely to just do something stupid like this again in the future. You are the only one working on trying to determine a diagnosis as well as making an intelligent treatment plan at this point. Your husbad's doc sees the case as stagnant. You have a logical idea for a course of action in regards to furthering his treatment: stopping the mirapex (which by the way I tried to get my doctor to let me trial yesterday, but he wouldn't) and then (after seeing how that goes) getting off alcohol. Make this happen by seeing a new doctor instead of unnecessarily expending any more of your energy, it sounds like you are just about out anyway.

Hope I didn't offend in anyway. Just relating my emotions to your situation. Peace.

Kurt,

PS--- Thanks for the kind words regarding my past experiences.