SSRIs

[tryp]

So I went to see pdoc yesterday, told her I've been feeling pretty crappy, which is true, I have. And she said it's time to reevaluate my meds (been on Remeron since October, steadily increasing the dosage) and maybe put me on a traditional SSRI instead of Remeron, something that will tackle the anxiety and the depression at once, which Remeron was supposed to do, but it seems it's either crapped out or just not the right med. It's doing something, but not enough.

Umm, to make a long story short, I'm freaking out. Especially about the whole sexual dysfunction thing.

So if anyone wants to tell me good SSRI stories, I will happily accept them.

Also, I'm sort of considering pushing for a quetiapine increase instead. If I remember correctly, my dose is just a little below the augmentation dose, so maybe a little more would let me not switch ADs. Thoughts?

[tryp]

I guess one thing I'm scared of is the cross-taper, because I'm scared about getting worse while I'm waiting for the new AD to kick in and having things get completely out of hand. But I can probably deal with that fear, because even if things do get worse, it should be time-limited, and I know Remeron isn't one of the horrible ones to DC, and I know pdoc will be close at hand to pick me up if I really fall on my ass.

But what I'm really afraid of is not being able to have sex. I know it's really silly to worry so much about something that probably isn't going to happen, but it really could and I'm really terrified about it. Because I'm sort of in the first real relationship of my life and also this is the first time in my life that I haven't been totally immeasurably fucked up about sex and if it gets screwed up, I'll be really upset.

I'm trying really hard not to be stupid about this, but it just keeps spinning around in my head.

Pdoc didn't tell me which med she wants to try, so it's even more amorphous and scary than it would be if I had a specific med to worry about, if that makes sense. So it's partly just general terror. I don't deal well with change (I know - who does? But I guarantee I'm worse than most), so losing the Remeron at all is really scary to me.

And, obviously, being the enormous hypochondriac that I am, I have this totally unfounded fear that I secretly have bipolar and will flip the shit if I take an SSRI. I KNOW it's not true, but my brain is evilly fucking me in the ear.

But it's really the sex thing.

I just keep remembering that one person who was around CB a few months ago with the irreversible sexual dysfunction from SSRIs.

[Vitriol]

Hi Tryp,

Im curious, how come your PDoc started you on Remeron instead of SSRI at first ? You have insomnia ?

Anyway, I took many ADs in the past and the only one who really works for me is Paxil.

The first 7 days was always a lot worst with Paxil than any other AD that I tried. But after that, wow, no more anxiety, panic attack or even stress.

But I am clearly not same person on Paxil. And that is the reason why I quit it 2 times in the past.

I am not me anymore. I am so calm and relax, people around me can feel it.

I am no more depress , BUT, I am still unhappy. I just don't care for anything.

Was I caring too much before, maybe. How would I know how much "care" is normal ?

For the sex part, all side effects went away in the first month. I took a few pounds, but I managed to get rid of them by changing the food I was eating.

Btw, I was only sleeping 5-6 hours a night (I have to take Paxil in the morning because it gives too much energy to take it at night). So I add Trazodone each night. But strangely , the trazodone that was making sleep for 9 hours suddenly stopped working 2 days ago. (I just started it ).

One last thing, I always start to smoke again everytime I am back on Paxil. I really dont get it. Each morning, I crave for a smoke. Without Paxil, I would find this discusting. But this shouldnt be a problem for you.

Vit

[tryp]

Oh hell. I know CB is a say whatever you want site, but that's a scary story. I don't want to become a different person! I know, not going to happen. Arg.

Pdoc started me on Remeron first partly because of the sleep thing, and I think partly because it's one of the few that's been shown to work for PTSD. Probably also because of the sweet side-effect profile.

[Artemisia]

I've had mostly good experiences with SSRI and SNRI antidepressants. They pretty much speuter* me chemically, but they've really made the last 9 years of my life more tolerable. I have no idea where I'd be without them today.

* "spay/neuter"

[BPCharlotte]

Side effects suck. (I should know, and I know you've been reading my blog with my endless whinging about it!) But there comes a time when you need to say to yourself, yes, it's a scary thought, but I need SOMETHING more. And just adding meds is not always the way to go, sometimes you have to be brave and lose a med to replace it with another.

If you don't try it, you won't know. If it sucks big time, you can always D/C as soon as practical. If not, congratulations! But you have to try if you're not doing so well. I mean, I'm struggling. So I'm going to be determined (some would say pig-headed, stubborn, etc) and keep banging my head against the brick wall of my meds until I can be sure that I've exhausted that avenue of treatment. So I can move on without looking back and wondering. What if I'd stuck it out, even with the S/Es, and it would have been the med I need, if only I could have tried harder, not wimped out, not given up so quickly just cos things were rough. And they are, for me. But you might switch and wonder why on earth you never tried to before cos you feel so free from your MI.

I don't know if I'm helping, but I personally am prepared to do what it takes for the sake of my family, myself, the rest of my life. Just imagine what your life COULD be if you were stable. I know positive thinking is nigh on impossible when you feel so bad, but sometimes you have to have some kind of faith in there being SOMETHING out there that has the potential to change your life for the better.

I hope you can find the courage to embrace this possible med change as a step forward. And if it doesn't work out, hey, you tried! Better than never knowing, right? You deserve to feel positive about your future, and if a new med can do that, I'm right behind you.

[icebird200]

Lexapro does not cause those side effects in me. At least at this dosage and even at 10 mg. Cymbalta also did not cause it whatsoever.

[tryp]

Thanks Susan - that really helps.

I guess I just need to not panic, and discuss it calmly with pdoc and see what we're going to do.

Remeron was my first med, so this is sort of my first major med change, apart from the jerking around the sleep meds and adding/subtracting benzos. I'm still sort of new to all this.

[Vitriol]

Oh hell. I know CB is a say whatever you want site, but that's a scary story. I don't want to become a different person! I know, not going to happen. Arg.

Pdoc started me on Remeron first partly because of the sleep thing, and I think partly because it's one of the few that's been shown to work for PTSD. Probably also because of the sweet side-effect profile.

well , consider this Tryp. I was depressed and making plan to end well, you know what.

Is taking Paxil and not being me (was it that great ?) but finally behave like most of the other humans worth it ? I still dont have an answer for that. But I wont lie to you, I AM NOT THE SAME PERSON. Many could say I was freaking crazy before. So is being not me is being not crazy ? Is this good ? Well I dont know. I remember a girl who is austistic saying that she doesnt want to be cured. Do I want to be cured or not ?

Do you like yourself ? Do you want to like yourself if not ? Would accept to have to deal with a new you ?

Honestly , I dont care much about this anymore. What I care is me not enjoying life. Everything is boring to me, even if I am not depress.

Spending time with my nephews , climbing mountains and riding my bike are probably the only things I like now. I totally forgot my career, having money and even having a girlfriend.

I met a girl a month ago, she is perfect, but I dont care at all.

Is being not crazy worth living ? Well , I dont know.

And Tryp, most people taking SSRI are still enjoying life. You asked for stories, I gave you mine.

Take care,

Vit

[tryp]

Didn't mean that to come out bitchy - maybe it did.

I think I'm just really anxious in general and my brain is latching on to the SSRI thing as something to worry about. I really just need to stop obsessing about this and let pdoc deal with it.

[Vitriol]

Didn't mean that to come out bitchy - maybe it did.

I think I'm just really anxious in general and my brain is latching on to the SSRI thing as something to worry about. I really just need to stop obsessing about this and let pdoc deal with it.

You were not bitchy Tryp . My experience is weird. Finally normal, so of course, finally not all me anymore.

SSRI arent that bad. And you can always try a new one if you have side effects.

Let us know how it is going with your new med.

Vit

[Mayteana]

Hmm, I've done a few SSRI's. They aren't really for me personally depression wise. But what you seemed most concerned about were sexual side effects, so that's what I'm going to address. Not everyone becomes a sexless beast. I've done a few rounds of Zoloft and sometimes it killed my sex drive and sometimes it didn't. So not only do these things vary from person to person but they can vary within the same person. I know a lot of people that have taken SSRI's & SNRI's and kept either their entire libido or enough of it to be more then capable of intimacy when they so desire.

You wanted your pdoc to do something about how bad your depression has been and a med change might be just what you need.

Speaking somewhat bluntly, in terms of the situation as a whole yes, sexual side effects suck. But so does being batshit. It's possible that finding a medication that helps with some of your depression & anxiety and you being able to relax a bit more within yourself... will more then make up for whatever side effects you might get. Intimacy is mostly a mental thing. Having your head in the right place could turn out to be more beneficial for you in that aspect that having your hormones racing.

[AnneMarie]

Tryp, so, um, maybe this will help. A lot of people loose their sex drive / functioning on Seroquel. Is this a problem for you now? Same thing on Remeron. Maybe there just happens to be a very good chance that you will not be effected. Everyone isn't, you know. And, well, if one med is a problem, the next may well not be. What I really know is that all the angst can psych you out as much as or more than any med. Let it go and give a med a go. Know that you can switch or add Wellbutrin. There are other alternatives for dealing with sexual dysfunction problems, too. This isn't a permanent decision. You'll probably be fine based just on your prior med reactions. Hold on to that thought instead of the fears.