SSRIs

Question:

> My son used to take Celexa and I believe he took it in the morning.  It > couldn’t hurt for you to try for a few days and see what happens.  I always > take my prozac in the morning, but then the pdoc recommends that as well.

i take an SSRI too, sertraline (Zoloft)… i was told to take it in the morning because SSRIs have a mild stimulant effect and can cause sleep disturbance if you take them at night… what matters i think is that you take them at the same time each day, regardless of when… hugs m — ~~~~~~>><:>~~~~~~ iriXx " you can try the best you can    you can try the best you can …the best you can is good enough" radiohead: optomistic

Response:

hi there.. Here is my current med regime – my question follows: Morning: 37.5 mg Effexor  <— am being weaned off this, won’t take it next week              900 mg Gabapentin Evening:  50 mg. Celexa              1200 mg. Gabapentin Okay you Celexa folks, do you take your Celexa in the morning on in the evening? I am starting to think it may not be the best med for me to take at night as I am not sleeping well. I get 3-4 hours very light sleep if I don’t take a sleep med, or 5 – 6 hours of a deeper sleep if I give in and take 7.5 mg. Imovane (Canadian non-benzodiazepine sleep med). Gabapentin folks – do you think it is the Gabapentin keeping me on such a light sleep regime? thanks so much everyone, Compucat  >^+^<

Response:

- Hide quoted text — Show quoted text – > hi there.. > Here is my current med regime – my question follows: > Morning: 37.5 mg Effexor  <— am being weaned off this, won’t take it next > week >              900 mg Gabapentin > Evening:  50 mg. Celexa >              1200 mg. Gabapentin > Okay you Celexa folks, do you take your Celexa in the morning on in the > evening? I am starting to think it may not be the best med for me to take at > night as I am not sleeping well. I get 3-4 hours very light sleep if I don’t > take a sleep med, or 5 – 6 hours of a deeper sleep if I give in and take 7.5 > mg. Imovane (Canadian non-benzodiazepine sleep med).

My son used to take Celexa and I believe he took it in the morning.  It couldn’t hurt for you to try for a few days and see what happens.  I always take my prozac in the morning, but then the pdoc recommends that as well. > Gabapentin folks – do you think it is the Gabapentin keeping me on such a > light sleep regime?

Fo me I am having a lot of trouble with neurontin (gabapentin) making me sleepy.  I take a larger dose of it at bedtime and it usually helps me to sleep better.  But then that just shows how different we all are with the same meds. I hope your sleep gets better soon Compucat. Bonnie – Hide quoted text — Show quoted text -> thanks so much everyone, > Compucat  >^+^<

Response:

Question:

hi there. yea im on neurontin as a mood stabilizer. xanax for anxiety(i have it badly) and zyprexa to chill me out from leaping off tall buildings at a single bound. you have a good xmas too! harp

– Hide quoted text — Show quoted text -> thanks.i will do my best.so far so good. > and i have been on zoloft for a number of years now with good results. > of course they could be better. > im on 200 mgs a day. > whats ther highest dosage they can use??? > harp > as far as i know the highest dose for sertraline hydrochloride is > 250mg… 200 is the standard highest dose though. it makes sense if > you’re on that much that it would be very painful for you cutting > down… i was on 150mg but it aggravated my hypomania so i cut back to > 100mg… that was very hard though, i had a big depressive reaction even > though i did it in small stages, i actually split the pills in half for > a week and took 125mg… i do think its good stuff…. it keeps me > balanced enough while i’m working on the deep things and long-term > solutions with my therapist. yeah, i couldbe better too… maybe adding > a mood stabiliser would be a good idea… do you take a MS ? > hope you’re feeling more stable now, and that you can enjoy a peaceful > day tomorrow, > take care > m > — > ~~~~~>><:>~~~~~ > iriXx > www.iriXx.org > "… faith is being sure of what we hope for, > and certain of what we cannot see"

Response:

> thanks.i will do my best.so far so good. > and i have been on zoloft for a number of years now with good results. > of course they could be better. > im on 200 mgs a day. > whats ther highest dosage they can use??? > harp

as far as i know the highest dose for sertraline hydrochloride is 250mg… 200 is the standard highest dose though. it makes sense if you’re on that much that it would be very painful for you cutting down… i was on 150mg but it aggravated my hypomania so i cut back to 100mg… that was very hard though, i had a big depressive reaction even though i did it in small stages, i actually split the pills in half for a week and took 125mg… i do think its good stuff…. it keeps me balanced enough while i’m working on the deep things and long-term solutions with my therapist. yeah, i couldbe better too… maybe adding a mood stabiliser would be a good idea… do you take a MS ? hope you’re feeling more stable now, and that you can enjoy a peaceful day tomorrow, take care m — ~~~~~>><:>~~~~~ iriXx www.iriXx.org "… faith is being sure of what we hope for, and certain of what we cannot see"

Response:

thanks.i will do my best.so far so good. and i have been on zoloft for a number of years now with good results. of course they could be better. im on 200 mgs a day. whats ther highest dosage they can use??? harp

– Hide quoted text — Show quoted text -> thanks A BUNCH! > im stayin on it. > i havent seen the new pdoc yet so i dont know what he will want.im sure if > im(reasonably) stable he will keep me on what i take. > my recently"dismissed" pdoc wanted me off all meds. > she was terrible! > harpy > yes, that does sound terrible. i sacked one of my p-docs who decided to > mess with my meds and put me on reboxetine which gave me a terrible > anxiety reaction (((. then he tried to blame it on me cos "im ill, i > cant possibly know"… i thought those sorta doctors werent around any > more… but ho hum… anyhow after him i saw my current p-doc. she just > wanted to make sure i was stable because that incident messed me up so > much. i am really glad of this, she doesnt even want to try me on a mood > stabiliser yet, even though its gonna be the next logical thing, because > she thinks i need time just being stable on what im on. i think thats > really important – always remember that its your choice in the end, and > the doctor is there for you (and not the other way round, the way some > of them seem to like to think! ;o))) > i would think if you are stable he would be happy to keep you on zoloft. > it has a good reputation for being calming too, which im sure has a > slight calming effect on my hypomania as well as helping lots with my > depression. just make it clear to him you want to stay stable, im sure > he will be happy to keep you on it )))). yeah, stay on it until you > see him too… coming off any AD is hard work… and there’s no harm you > can do in taking it, its not like its addictive or anything…. > hope you can have some peace of mind this xmas ))) > take care > m > — > ~~~~~>><:>~~~~~ > iriXx > "… faith is being sure of what we hope for, > and certain of what we cannot see"

Response:

> thanks A BUNCH! > im stayin on it. > i havent seen the new pdoc yet so i dont know what he will want.im sure if > im(reasonably) stable he will keep me on what i take. > my recently"dismissed" pdoc wanted me off all meds. > she was terrible! > harpy

yes, that does sound terrible. i sacked one of my p-docs who decided to mess with my meds and put me on reboxetine which gave me a terrible anxiety reaction (((. then he tried to blame it on me cos "im ill, i cant possibly know"… i thought those sorta doctors werent around any more… but ho hum… anyhow after him i saw my current p-doc. she just wanted to make sure i was stable because that incident messed me up so much. i am really glad of this, she doesnt even want to try me on a mood stabiliser yet, even though its gonna be the next logical thing, because she thinks i need time just being stable on what im on. i think thats really important – always remember that its your choice in the end, and the doctor is there for you (and not the other way round, the way some of them seem to like to think! ;o))) i would think if you are stable he would be happy to keep you on zoloft. it has a good reputation for being calming too, which im sure has a slight calming effect on my hypomania as well as helping lots with my depression. just make it clear to him you want to stay stable, im sure he will be happy to keep you on it )))). yeah, stay on it until you see him too… coming off any AD is hard work… and there’s no harm you can do in taking it, its not like its addictive or anything…. hope you can have some peace of mind this xmas ))) take care m — ~~~~~>><:>~~~~~ iriXx "… faith is being sure of what we hope for, and certain of what we cannot see"

Response:

thanks A BUNCH! im stayin on it. i havent seen the new pdoc yet so i dont know what he will want.im sure if im(reasonably) stable he will keep me on what i take. my recently"dismissed" pdoc wanted me off all meds. she was terrible! harpy

– Hide quoted text — Show quoted text -> yes, it does… i take zoloft and i find if i miss a dose , i’ll be a > weepy wreck by the evening. im on 100mg. > my pdoc has always said to me if it helps being on it then i should stay > on it… we’ve talked about the alternative of switching me to a MS, but > she doesnt want to do that just because stability is so important to me > right now. i reckon you could make that point to your p-doc as well, > that being stable is what you need…. is he trying to take you off it? > i’d suggest dont worry about decreasing it right yet…. just try to > keep stable, and raise the point with him if and when he suggests coming > off it… sometimes you might need to be on them for some time (im > thinking maybe i might need to be on them for life or at least another > few years…) > take care and i hope you feel better soon > ((((((((((((((harpy)))))))))))))))) > m > does it exist? sure feels like it when i try to get off it no matter how > little i decrease it. > i dont WANNA  get off it but it would be good to have something concrete to > take to my new pdoc should he try and get me off the med. > my head feels like a damned baloon when i try and come off that stuff and i > cant think or function. > but it helps me tenfold being on it. > any good advice on this is welcome or input. > thanks > harpy > — > ~~~~~>><:>~~~~ > iriXx > www.iriXx.org > "…faith is being sure of what we hope for, >   and certain of what we cannot see"

Response:

thanks jim.yep..those are the bad effects described to a tee. im staying on it thats for sure!!! harp

– Hide quoted text — Show quoted text -> I took Zoloft for about a year and then the pdoc changed me over to > wellbutrin SR 300MG.  I experienced a lot of headaches and malaise during > that time but she still changed it.  I hope you can persuade him to keep you > on it if it works for you. > Jim > does it exist? sure feels like it when i try to get off it no matter how > little i decrease it. > i dont WANNA  get off it but it would be good to have something concrete > to > take to my new pdoc should he try and get me off the med. > my head feels like a damned baloon when i try and come off that stuff and > i > cant think or function. > but it helps me tenfold being on it. > any good advice on this is welcome or input. > thanks > harpy

Response:

yes, it does… i take zoloft and i find if i miss a dose , i’ll be a weepy wreck by the evening. im on 100mg. my pdoc has always said to me if it helps being on it then i should stay on it… we’ve talked about the alternative of switching me to a MS, but she doesnt want to do that just because stability is so important to me right now. i reckon you could make that point to your p-doc as well, that being stable is what you need…. is he trying to take you off it? i’d suggest dont worry about decreasing it right yet…. just try to keep stable, and raise the point with him if and when he suggests coming off it… sometimes you might need to be on them for some time (im thinking maybe i might need to be on them for life or at least another few years…) take care and i hope you feel better soon ((((((((((((((harpy)))))))))))))))) m > does it exist? sure feels like it when i try to get off it no matter how > little i decrease it. > i dont WANNA  get off it but it would be good to have something concrete to > take to my new pdoc should he try and get me off the med. > my head feels like a damned baloon when i try and come off that stuff and i > cant think or function. > but it helps me tenfold being on it. > any good advice on this is welcome or input. > thanks > harpy

– ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

does it exist? sure feels like it when i try to get off it no matter how little i decrease it. i dont WANNA  get off it but it would be good to have something concrete to take to my new pdoc should he try and get me off the med. my head feels like a damned baloon when i try and come off that stuff and i cant think or function. but it helps me tenfold being on it. any good advice on this is welcome or input. thanks harpy

Response:

I took Zoloft for about a year and then the pdoc changed me over to wellbutrin SR 300MG.  I experienced a lot of headaches and malaise during that time but she still changed it.  I hope you can persuade him to keep you on it if it works for you. Jim

– Hide quoted text — Show quoted text -> does it exist? sure feels like it when i try to get off it no matter how > little i decrease it. > i dont WANNA  get off it but it would be good to have something concrete to > take to my new pdoc should he try and get me off the med. > my head feels like a damned baloon when i try and come off that stuff and i > cant think or function. > but it helps me tenfold being on it. > any good advice on this is welcome or input. > thanks > harpy

Response:

Question:

Hi M, > thanks heaps lynda ))) > yes… i think the fact that alcohol is a depressant is the main thing – > as you know i’ve had a low this week, so it was triggering off things > that were already there.

Yes. > the meds and ETOH was something i did get thinking about… before one > of the two alcohol-induced lows i’ve had this week, i’d also taken some > valium the previous day… yes, i’m a very naughty girl, i’m on > sertraline as well (no MS’s as yet, thats still under consideration). so > the coctail of all of those would have done me no good at all!!!

Correct. > the first alcohol low happened an hour or two after drinking, but i > guess i was just susceptible… there are still things floating around > your bloodstream that can do this…. > the second one was almost immediate…. this is what made me concerned, > because i have an extreme sensetivity to any form of caffeiene at the > moment, i get hypomanic even from smelling my flatmate’s > espresso-maker!!! so maybe i’m extremely sensetive to both stimulants > and depressants, if i’m in a susceptible mood?….

That sounds plausible. Love, Lynda

Response:

thanks heaps (((((((Lynda)))))))))))) it really helps to check these things out with you cos i know you’ve got a medical background n all… i feel a bit like i’m guessing or trying to make an excuse for something… but i’m glad its all very plausible )) and now i can take control a bit more ))))) thanx again (((((hugs!))))) m – Hide quoted text — Show quoted text – > Hi M, >thanks heaps lynda ))) >yes… i think the fact that alcohol is a depressant is the main thing – >as you know i’ve had a low this week, so it was triggering off things >that were already there. > Yes. >the meds and ETOH was something i did get thinking about… before one >of the two alcohol-induced lows i’ve had this week, i’d also taken some >valium the previous day… yes, i’m a very naughty girl, i’m on >sertraline as well (no MS’s as yet, thats still under consideration). so >the coctail of all of those would have done me no good at all!!! > Correct. >the first alcohol low happened an hour or two after drinking, but i >guess i was just susceptible… there are still things floating around >your bloodstream that can do this…. >the second one was almost immediate…. this is what made me concerned, >because i have an extreme sensetivity to any form of caffeiene at the >moment, i get hypomanic even from smelling my flatmate’s >espresso-maker!!! so maybe i’m extremely sensetive to both stimulants >and depressants, if i’m in a susceptible mood?…. > That sounds plausible. > Love, > Lynda

– ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

((((((((((((((((((((((((((((((((((((((iriXx)))))))))))))))))))))))))))))))) ) ))))))) And take some more out of petty cash.     Thank you for your kind email.  I am always guilty of talking far too much about myself, and for that I am sorry.  But I am so glad you are finding footing in ALL of the posts placed here with such care.  I know that I don’t know anywhere near the entire answer to a problem.  But it seems that the group of us find something close.     There is hope.  Yesterday my wife brought me an India Pale Ale (the original from the Maritimes that was shipped to Her Majesty’s troops in India) but I could only drink about a quarter of it before feeling funny. She didn’t want the remains so I committed a serious crime.  I poured the rest away into the sink.  If the authoroties find out I will likely be stripped of my Canadian citizenship, and deported back to the UK from wence I came.  I will have to sleep on the chesterfield at my brother’s house in Milton Keynes (sp?).  Oh I’d better pack; this does not bode well. Best wishes and good luck to you, Peter et al

Response:

> ((((((((((((((((((((((((((((((((((((((iriXx)))))))))))))))))))))))))))))))) ) > ))))))) > And take some more out of petty cash. >     Thank you for your kind email.  I am always guilty of talking far too > much about myself, and for that I am sorry.  But I am so glad you are > finding footing in ALL of the posts placed here with such care.  I know that > I don’t know anywhere near the entire answer to a problem.  But it seems > that the group of us find something close.

hey, dont worry at all…. and thanx so much for the hugs… most of all i think i need the reassurance of hugs right now… yesterday was pretty scary actually, even though it taught me a lot and resolved so many worries that were going around my mind, why all these sudden lows etc… yes, i guess we’ll never all manage to work it out, but between all of us, we can just support each other and manage to find our way through this strange life… and find hope ))) dont be worried about talking too much about yourself… its been so helpful for me to read about your experiences, in posting, i really just wanted to know if anyone had ever been through the same thing, sometimes just knowing that helps no end ))) >     There is hope.  Yesterday my wife brought me an India Pale Ale (the > original from the Maritimes that was shipped to Her Majesty’s troops in > India) but I could only drink about a quarter of it before feeling funny. > She didn’t want the remains so I committed a serious crime.  I poured the > rest away into the sink.  If the authoroties find out I will likely be > stripped of my Canadian citizenship, and deported back to the UK from wence > I came.  I will have to sleep on the chesterfield at my brother’s house in > Milton Keynes (sp?).  Oh I’d better pack; this does not bode well.

hehe awww ((((((((((((((((((((((peter))))))))))))))))))))))))))))) yes, that is rather worrying, milton keynes i think is a most scary prospect (i’m in the Uk, and know the place rather too well… hehe ;o))) seriously… i’m sorry to hear you cant manage to enjoy an ale at the moment… but i’m kinda encouraged because i didnt realise the effect could be anywhere near as sudden as i experienced yesterday. its quite frightening when it happens isnt it? not to mention i’ve been wondering what i’m gonna do at xmas time – but being on the phone to my best friend, she’s a marvellous cook and has suggested some non-alcy coctails which sound wonderful ))) yes, there is a lot of hope… having taken a good look at yesterday’s experiences, i’ve decided, being clear headed is so much nicer, isnt it? )))… its disappointing, being unable to drink, but i’d much rather enjoy clear-headedness and put those sudden depressions behind me )))) > Best wishes and good luck to you, > Peter et al

thanks heaps, and you too, hugs, m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

I have never had a problem with alcohol myself, but my ex-husband would become extremely and acutely depressed under the influence and tried to kill himself. — ~Shib~

– Hide quoted text — Show quoted text ->     I can only agree.  I was drinking 3 or 4 beers at a time (the Canadian > kind that can be as strong as 9% sometimes, the brand was called "The End of > the Earth" when translated from French) during a long depression.  Then I > was on the mental ward on hourly watch for suicide.  I think there is a > correlation between consumption of alcohol and increased depression.  It is > something to take seriously. > Peter > Hi m, > > does anyone here have alcohol induced lows? > snipped… > > then again, i never used to have any problems with caffeine either – but > > as of a coupla months ago, when my BP became markedly worse, i had to > > give up caffeiene – it makes me race about. cant drink tea, coffee or > > colas, they all make me hypomanic. so i’m wondering if alcohol is making > > me depressed, in the same way? > Alcohol is a depressant and can only worsen a depression. Also, meds and > ETOH do not mix. > Try eliminating ETOH, and evaluate your response. > Yours, > Lynda

Response:

> I have never had a problem with alcohol myself, but my ex-husband would > become extremely and acutely depressed under the influence and tried to kill > himself. > — > ~Shib~

(((((((((((((((((~shib~)))))))))))))))))))) (((((( m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

– Hide quoted text — Show quoted text -> I have never had a problem with alcohol myself, but my ex-husband would > become extremely and acutely depressed under the influence and tried to kill > himself. > — > ~Shib~ > (((((((((((((((((~shib~)))))))))))))))))))) > (((((( > m

Considering the stuff he did to me I always hoped he would succeed in a way. He tried to jump out of a speeding car once and it was a good thing I wasn’t in the back seat with him.  I probably wouldn’t have stopped him – sad to say. Shib

Response:

> Considering the stuff he did to me I always hoped he would succeed in a way. > He tried to jump out of a speeding car once and it was a good thing I wasn’t > in the back seat with him.  I probably wouldn’t have stopped him – sad to > say. > Shib

oohhh, hon… (((((((((((((((shib))))))))))))))) i’m sorry to hear about all you’ve been through, yes, i cant say i blame you in a way, he must have tested you to your limits… ((( take care ((((hugs)))) m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

– Hide quoted text — Show quoted text -> Considering the stuff he did to me I always hoped he would succeed in a way. > He tried to jump out of a speeding car once and it was a good thing I wasn’t > in the back seat with him.  I probably wouldn’t have stopped him – sad to > say. > Shib > oohhh, hon… (((((((((((((((shib))))))))))))))) > i’m sorry to hear about all you’ve been through, yes, i cant say i blame > you in a way, he must have tested you to your limits… ((( > take care > ((((hugs)))) > m

Thanks.  <hugs>  He did.  He almost pushed me over the edge.  But he is all but gone now and that is what matters. Shib

Response:

> Thanks.  <hugs>  He did.  He almost pushed me over the edge.  But he is all > but gone now and that is what matters. > Shib

i’m glad you are safe now hon…. (((((((((((((((~shib~)))))))))))))))) m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

does anyone here have alcohol induced lows? i think i’m beginning to have quite striking ones…. was just sitting supposedly enjoying a nice pint of ale with my dinner, reading a computer arts mag, and suddenly i feel like crying, totally out of the blue, get lots of negative thoughts…. and i’m only half way through my pint… so i stop drinking, have a little dessert, sober up a little… and feel loads better… still getting waves of depression, but i’m not feeling like i’m gonna burst into floods of tears any more… weird. i had something similiar to this a few days ago too. its never been like this before for me, i’ve always enjoyed a drink or two, actually used to have a big problem with it, i used to drink to numb myself off a few years ago, but i never used to get depressed from it, just pleasantly numb. then again, i never used to have any problems with caffeine either – but as of a coupla months ago, when my BP became markedly worse, i had to give up caffeiene – it makes me race about. cant drink tea, coffee or colas, they all make me hypomanic. so i’m wondering if alcohol is making me depressed, in the same way? atb m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

> does anyone here have alcohol induced lows? > i think i’m beginning to have quite striking ones…. … > then again, i never used to have any problems with caffeine either – but > as of a coupla months ago, when my BP became markedly worse, i had to > give up caffeiene – it makes me race about. cant drink tea, coffee or > colas, they all make me hypomanic. so i’m wondering if alcohol is making > me depressed, in the same way?

Alcohol is a depressant IIRC.  I haven’t experienced this myself.  My mother gets depressed if she drinks gin!

Response:

> Alcohol is a depressant IIRC.  I haven’t experienced this myself.  My mother > gets depressed if she drinks gin!

yes, i’ve come across that one before… gin is apparently quite a strong depressant… what i’m wondering is if it can happen quite that suddenly, on such a small amount of alcohol?… then again… hypomania happens to me that suddenly on a small amount of caffeine… so i guess it makes sense… i’m wondering… thanx heaps ‘care m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

Hi m, > does anyone here have alcohol induced lows? snipped… > then again, i never used to have any problems with caffeine either – but > as of a coupla months ago, when my BP became markedly worse, i had to > give up caffeiene – it makes me race about. cant drink tea, coffee or > colas, they all make me hypomanic. so i’m wondering if alcohol is making > me depressed, in the same way?

Alcohol is a depressant and can only worsen a depression. Also, meds and ETOH do not mix. Try eliminating ETOH, and evaluate your response. Yours, Lynda

Response:

    I can only agree.  I was drinking 3 or 4 beers at a time (the Canadian kind that can be as strong as 9% sometimes, the brand was called "The End of the Earth" when translated from French) during a long depression.  Then I was on the mental ward on hourly watch for suicide.  I think there is a correlation between consumption of alcohol and increased depression.  It is something to take seriously. Peter

– Hide quoted text — Show quoted text – > Hi m, > does anyone here have alcohol induced lows? > snipped… > then again, i never used to have any problems with caffeine either – but > as of a coupla months ago, when my BP became markedly worse, i had to > give up caffeiene – it makes me race about. cant drink tea, coffee or > colas, they all make me hypomanic. so i’m wondering if alcohol is making > me depressed, in the same way? > Alcohol is a depressant and can only worsen a depression. Also, meds and > ETOH do not mix. > Try eliminating ETOH, and evaluate your response. > Yours, > Lynda

Response:

> does anyone here have alcohol induced lows? > i think i’m beginning to have quite striking ones…. > was just sitting supposedly enjoying a nice pint of ale with my dinner, > reading a computer arts mag, and suddenly i feel like crying, totally > out of the blue, get lots of negative thoughts…. and i’m only half way > through my pint

<snip> > iriXx

This happens to me with or without a beer in front of me. Can happen any time. YMMV. Half a pint shouldn’t trigger it necessarily. But of course alcohol is a depressant. jodelli

Response:

> This happens to me with or without a beer in front of me. Can happen any > time. YMMV. Half a pint shouldn’t trigger it necessarily. But of course > alcohol is a depressant. > jodelli

yeah, its been happening to me too lately, for various reasons…. i guess if there’s a strong trigger, then its more likely…. ‘care m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

> Alcohol is a depressant and can only worsen a depression. Also, meds and > ETOH do not mix. > Try eliminating ETOH, and evaluate your response. > Yours, > Lynda

thanks heaps lynda ))) yes… i think the fact that alcohol is a depressant is the main thing – as you know i’ve had a low this week, so it was triggering off things that were already there. the meds and ETOH was something i did get thinking about… before one of the two alcohol-induced lows i’ve had this week, i’d also taken some valium the previous day… yes, i’m a very naughty girl, i’m on sertraline as well (no MS’s as yet, thats still under consideration). so the coctail of all of those would have done me no good at all!!! the first alcohol low happened an hour or two after drinking, but i guess i was just susceptible… there are still things floating around your bloodstream that can do this…. the second one was almost immediate…. this is what made me concerned, because i have an extreme sensetivity to any form of caffeiene at the moment, i get hypomanic even from smelling my flatmate’s espresso-maker!!! so maybe i’m extremely sensetive to both stimulants and depressants, if i’m in a susceptible mood?…. thoughts?…. (((((hugs!))))) m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

>     I can only agree.  I was drinking 3 or 4 beers at a time (the Canadian > kind that can be as strong as 9% sometimes, the brand was called "The End of > the Earth" when translated from French) during a long depression.  Then I > was on the mental ward on hourly watch for suicide.  I think there is a > correlation between consumption of alcohol and increased depression.  It is > something to take seriously. > Peter

(((((((((((((((((peter)))))))))))))))))) i cant really put into words anything to say that doesnt sound feeble, it sounds such a painful experience for you (((…. yes, i know those beers well – a favourite of mine (although fortunately very hard to get in the UK) – is the belgian Verboden Vrucht, with live yeast in it. thinking about it, i know i’ve had lows and even panic attacks in the past when drunk…. its not been the way alcohol usually effects me, and i managed a year of heavy drinking blotting everything out… it didnt get me low then, but it did make me feel very lonely and isolated… and that in itself is a sign of and a trigger for depression….. yes, i’m gonna take it very seriously now… thanks heaps & thanks to everyone for their thoughts… i’d been drinking it to relax, but its all being counterproductive isnt it? ;o)))… i guess i’ve discovered that my body is hypersensetive to stimulants when i’m feeling vulnerable – this can be alcohol as a depressant, or caffeiene as a stimulant which can induce nasty hypomania in me!…. take care hon ((((((hugs)))))) m — ~~~~~>><:>~~~~ iriXx www.iriXx.org "…faith is being sure of what we hope for,   and certain of what we cannot see"

Response:

Question:

Dear All I was hoping you might be able to give me some advice.  I am being treated for depression by my GP (in the uk).  I have taken prozac on and off for several years, and recently doctor suggested that I should go back on it long term.  However, a couple of weeks after starting it I got this really bizarre side effect – my throat felt really swollen and sore, like there was a lump stuck in it.  Went back to the doctor, he took me off the prozac, said I should wait until the throat got better (which it did after 2 1/2 weeks), then start taking Sertraline (Lustral in uk, Zoloft elsewhere?).  After 3 days, the throat symptoms are back. My questions are these – 1) how long should I take the sertraline before knowing for certain that the throat feeling is not going to get better? and 2) if I can’t take prozac and sertraline does that mean I will have the same symptoms with all SSRIs? and 3) if I can’t take SSRIs to help with my depression, what can I take? I have a light box to help with the SAD in winter, and try to exercise whenever I can, but I’m still not really leading a normal life – particularly with all this bother with the throat – it just makes me even more ‘ratty’! Any advice would be greatfully accepted Thanks Alison

Response:

<snip> > My questions are these – 1) how long should I take the sertraline before > knowing for certain that the throat feeling is not going to get better? > and

I don’t know anything about your throat problem, so I can’t comment on that. Though it seems like your doctor should try to figure out what the throat problem is exactly. > 2) if I can’t take prozac and sertraline does that mean I will have > the same symptoms with all SSRIs? and

No, not necessarily. Although the SSRIs are all broadly similar, they do have slightly different side-effect profiles. 3) if I can’t take SSRIs to help > with my depression, what can I take?

There are lots of other anti-depressants available that are also generally well-tolerated and effective. The SSRIs are just the newest class of them, and in some ways considered to have the most tolerable side effects and most effectiveness. Check out a site like www.mentalhealth.com or www.rxlist.com to see some of the others. Bright blessings. Fiona — If we had no winter, the spring would not be so pleasant: if we did not sometimes taste the adversity, prosperity would not be so welcome.      – Anne Bradstreet, Meditations Divine and Moral, 1664

Response:

Thanks for your reply – I think I must have been checked out for most things – I seemed to have about a million different blood tests before the doctor was convinced it was depression.  My blood pressure was quite high for a while too, so they tested loads of things then!  What would be the symptoms of hyperthyroidism? Alison – Hide quoted text — Show quoted text – > Did your GP have you checked for hypothyroidism? > Dear All > I was hoping you might be able to give me some advice.  I am being > treated for depression by my GP (in the uk).  I have taken prozac on and > off for several years, and recently doctor suggested that I should go > back on it long term.  However, a couple of weeks after starting it I > got this really bizarre side effect – my throat felt really swollen and > sore, like there was a lump stuck in it.  Went back to the doctor, he > took me off the prozac, said I should wait until the throat got better > (which it did after 2 1/2 weeks), then start taking Sertraline (Lustral > in uk, Zoloft elsewhere?).  After 3 days, the throat symptoms are back. > My questions are these – 1) how long should I take the sertraline before > knowing for certain that the throat feeling is not going to get better? > and 2) if I can’t take prozac and sertraline does that mean I will have > the same symptoms with all SSRIs? and 3) if I can’t take SSRIs to help > with my depression, what can I take? > I have a light box to help with the SAD in winter, and try to exercise > whenever I can, but I’m still not really leading a normal life – > particularly with all this bother with the throat – it just makes me > even more ‘ratty’! > Any advice would be greatfully accepted > Thanks > Alison

Response:

Hi Alison, Welcome to the ng. > I was hoping you might be able to give me some advice.  I am being

Zoloft can cause difficulty swallowing…what has your Internal Medicine doctor advise? Tehere are several calsse of ADS…TCAs, MAOIS, NARIs…etc. Please discuss options with your doctor. Take care. Lynda

Response:

Alison, I have been taking Cipramil (another SSRI) for most of this year and had a very similar problem a few months ago – feeling like I had a lump in my throat.  I went to my doctor but she couldn’t see anything – my throat looked completely normal.  At the time I was also suffering very badly from headaches and went to get some acupuncture for them.  I also mentioned the strange lump in my throat feeling and the acupuncturalist immediately seemed to know what it was and described it as ‘plum stone throat’, a condition caused by stress.  This did make sense as  the sensation was just  the same as the lump I get in my throat if I’m trying not to cry, except it went on for days – plus I knew the headaches were stress-related anyway.  She treated me for it with needles and it did indeed go away and I’ve not had it again – acupuncture tends to work quite well for me, but it might not for everyone. Do get your thyroid checked out (I’ve had mine checked frequently and it’s fine) but if there’s no physical lump my guess is it’s a stress-related thing, or maybe a side effect of the SSRIs causing a stress-like reaction. Bug

– Hide quoted text — Show quoted text -> Dear All > I was hoping you might be able to give me some advice.  I am being > treated for depression by my GP (in the uk).  I have taken prozac on and > off for several years, and recently doctor suggested that I should go > back on it long term.  However, a couple of weeks after starting it I > got this really bizarre side effect – my throat felt really swollen and > sore, like there was a lump stuck in it.  Went back to the doctor, he > took me off the prozac, said I should wait until the throat got better > (which it did after 2 1/2 weeks), then start taking Sertraline (Lustral > in uk, Zoloft elsewhere?).  After 3 days, the throat symptoms are back. > My questions are these – 1) how long should I take the sertraline before > knowing for certain that the throat feeling is not going to get better? > and 2) if I can’t take prozac and sertraline does that mean I will have > the same symptoms with all SSRIs? and 3) if I can’t take SSRIs to help > with my depression, what can I take? > I have a light box to help with the SAD in winter, and try to exercise > whenever I can, but I’m still not really leading a normal life – > particularly with all this bother with the throat – it just makes me > even more ‘ratty’! > Any advice would be greatfully accepted > Thanks > Alison

Response:

Question:

> groetjes en van hartelijk welkom > sorry…. i speak dutch and its a bit rusty… ;o))) > hi and welcome though.

Hi and thank you, you did fine! ) > i know efexor can make you drowsy when you’re first using it too – the > side effects wear off in a couple of weeks though. same with a lot of > other things – hang in there, once your body gets adjusted to them the > side effects can tend to disappear.

Yes, the side effects are gone, but when something "bad" happens, it’s back to "start", same pain in stomach, same feeling of no power… > i’m also waiting for the moment before deciding about mood stabilisers – > but thats cos my bipolar is mild, i have cyclothymia. if you’ve got > bipolar II, maybe thats why your doctor is waiting for a bit.. or if you > have a tendency more towards depression than mania?…

I don’t know which bipolar I have … yes, I have a tendency towards depression. *sighs* > all the best

Thank you, you too! Ragnar – Hide quoted text — Show quoted text –

Response:

>>groetjes en van hartelijk welkom >sorry…. i speak dutch and its a bit rusty… ;o))) >hi and welcome though. > Hi and thank you, you did fine! )

wat leuk! ;o))) well its a few years since i was speaking it… i used to live in Utrecht… but i can still remember a few things i guess…! > Yes, the side effects are gone, but when something "bad" happens, it’s back > to "start", same pain in stomach, same feeling of no power…

(((…. that doesnt sound like much fun…. i still get some side effects from the sertraline i take, they come and go. if its really disturbing you (which it sounds like it is (((… ) then its worth asking your doc about alternatives. i’d definatley ask about a mood stabiliser rather than the ones which are sedating you heavily, as lynda suggested – because with what i’m on, i can hardly feel the meds, which is cool… i feel more like "me", just balanced ))) > I don’t know which bipolar I have … yes, I have a tendency towards > depression. *sighs*

yes, me too… i take sertraline (aka Zoloft or Lustral for us UK peeps) for the depression… at the moment i’m doing something similiar to you and taking diazepam for hypomania… cos mine are only mild. i’ve had a lot of rapid cycles lately though, so its possible i might be thinking about a mood stabiliser – my p-doc is just content to observe for the moment. the different types of bipolar are characterised by how intense and how long the episodes last – bipolar I is the classic "manic-depressive" with longer manic and depressive episodes, bipolar II is less severe but more rapid, hypomania and depression. bipolar III (thats me) is cyclothymia – short cycles of hypomania and depression, sometimes only lasting a few hours or an afternoon. underlying that i have an overall tendency to depression as well. its probably worth you having a look at some of the info that LyndaNP posts – a lot of those pages describe the different types of bipolar very accurately. the main thing to remember is that we’re all individual… its not absolute classifications but rather more like points upon a line… >all the best > Thank you, you too! > Ragnar

no probs ))) take care m — ~~~~~>><:>~~~~ iriXx icq: 125860882 "i’m not here… this isn’t happening…"

Response:

greetings all. I tried to read all the messages, but I couldn’t do it, to restless and my attention went to so many things. I couldn’t concentrate. Doctor says I am bipolar. I take efexor 75 twice a day, and before I go to bed trazodane and seroquel. When I forget to take those pills, I can’t sleep at all. When I take them I feel so fuzzy next day, till late in the afternoon. Many times I think it’s best to end all this. It’s like I have no life. 6 pills a day, no joy, being fuzzy all day, etc. Is this my life for the rest of my life??? Let’s hope not, but it looks like it. I am home since March and I feel I am not progressing at all. Everything I do takes so much energy, and when I have to do something …. it looks like I have to climb a mountain. I sit here all day, staring at this screen. I force myself to be interested in things, but it won’t work. After awhile I go back to bed then, can’t sleep though, mind is going crazy when I am in bed. sorry to bother you, but I wrote this….I don’t know

Response:

> greetings all.

Hello Ragnar… > I tried to read all the messages, but I couldn’t do it, to restless and my > attention went to so many things. I couldn’t concentrate.

Well its not just you some of the messages are a bit loopy :>) > Doctor says I am bipolar. I take efexor 75 twice a day, and before I go to > bed trazodane and seroquel. When I forget to take those pills, I can’t sleep > at all. When I take them I feel so fuzzy next day, till late in the > afternoon. > Many times I think it’s best to end all this. It’s like I have no life. 6 > pills a day, no joy, being fuzzy all day, etc. Is this my life for the rest > of my life??? Let’s hope not, but it looks like it.

NO NO..it just seems like it at the moment… the way you are feeling… > I am home since March and I feel I am not progressing at all. Everything I > do takes so much energy, and when I have to do something …. it looks like > I have to climb a mountain. > I sit here all day, staring at this screen. I force myself to be interested > in things, but it won’t work. After awhile I go back to bed then, can’t > sleep though, mind is going crazy when I am in bed. > sorry to bother you, but I wrote this….I don’t know

yes you do know ….why and lots of us are exactly like that.. a bit of feedback can be a good thing.. bring the screen alive at least. hello again Bob – Hide quoted text — Show quoted text –

Response:

bobwhelan heeft geschreven> > >Well its not just you some of the messages are a bit loopy :>) >NO NO..it just seems like it at the moment… >the way you are feeling… >yes you do know ….why and lots of us are exactly like that.. >a bit of feedback can be a good thing.. >bring the screen alive at least. >hello again >Bob

Thank you Bob, your kind words are much appreciated. *smiles* Ragnar

Response:

> bobwhelan heeft geschreven> > >Well its not just you some of the messages are a bit loopy :>) >NO NO..it just seems like it at the moment… >the way you are feeling… >yes you do know ….why and lots of us are exactly like that.. >a bit of feedback can be a good thing.. >bring the screen alive at least. >hello again >Bob > Thank you Bob, your kind words are much appreciated. *smiles* > Ragnar

thats OK Ragnar… How are things in Belgium? Here in England we have has a burst of winter ..ice snow and such but its gone now.. While it was here we thought it would go on for ever but it didnt. Of course it will be back.. Carpem Diem.. grasp the time :>) – Hide quoted text — Show quoted text –

Response:

bobwhelan heeft geschreven in bericht: Hello Bob. >How are things in Belgium?

Rainy, chilly, but things are ok, I guess. Sabena, our national airliner is in big trouble, but it’s been that way a very looooong time. Can’t remember otherwise. The euro is coming fast. Oh boy, that will change alot here… we will need calculators and such. It’s very weird when I look at my bank account. I don’t know how much money I still have! Yesterday I installed ZoneAlarm, a firewall. It looks good (crosses my fingers). I have cable and I was advised to install an extra firewall. I truly wish these pills are out of my life…. maybe it will, some day. >Here in England we have has a burst of winter ..ice snow and such but its >gone now.. >While it was here we thought it would go on for ever but it didnt. >Of course it will be back..

Winter …. yukes!!!! The holidays are coming and really I hate that period. It’s so artificial … >Carpem Diem..

Carpe diem, trying to, very hard >grasp the time :>)

Ragnar )

Response:

  Welcome to the ng, > greetings all. > I tried to read all the messages, but I couldn’t do it, to restless and my > attention went to so many things. I couldn’t concentrate. > Doctor says I am bipolar. I take efexor 75 twice a day, and before I go to > bed trazodane and seroquel.

snipped…  May I ask why you are not taking a mood stabilizer for your bipolar Duisorder? The Seroquel and Trazodone can contribute to your lethargy. Peace, Lynda

Response:

>   Welcome to the ng,

Thank you, Lynda. >  May I ask why you are not taking a mood stabilizer for your bipolar > Duisorder?

The doctor says it’s not the time for that, yet. I’ll see him tomorrow. > The Seroquel and Trazodone can contribute to your lethargy.

Yes possible. I do hope this will end some day. > Peace, > Lynda

Peace and thank you, Lynda. Ragnar

Response:

> greetings all.

groetjes en van hartelijk welkom sorry…. i speak dutch and its a bit rusty… ;o))) hi and welcome though. i know efexor can make you drowsy when you’re first using it too – the side effects wear off in a couple of weeks though. same with a lot of other things – hang in there, once your body gets adjusted to them the side effects can tend to disappear. a lot of psychopharmacology is a case of the doctor listening to you, and how discomforting the side effects of your meds are – when i’ve been on things that have given nasty side effects, i’ve often been shifted onto something else – after all, my depression will only get worse if i’m being made miserable by my medication. it *is* possible to find drugs which will both make you feel better and have bearable side-effects ))). i’m also waiting for the moment before deciding about mood stabilisers – but thats cos my bipolar is mild, i have cyclothymia. if you’ve got bipolar II, maybe thats why your doctor is waiting for a bit.. or if you have a tendency more towards depression than mania?… all the best ‘care m — ~~~~~>><:>~~~~ iriXx icq: 125860882 "i’m not here… this isn’t happening…"

Response:

Question:

this is not being passed through AOL, send full message with headers to your own ISP regarding Altopia’s practice of allowing their customers to stalk and abuse with impunity.

Response:

>Path: >lobby!ngtf-m01.news.aol.com!portc01.blue.aol.com!newsfeed.skycache.com.MI

SMATCH!newsfeed1.cidera.com!Cidera!cyclone.tampabay.rr.com!news-post.tampa bay.rr.com!typhoon.tampabay.rr.com.POSTED!not-for-mail – Hide quoted text — Show quoted text – >Newsgroups: alt.support.depression.medication >Lines: 9 >X-Priority: 3 >X-MSMail-Priority: Normal >X-Newsreader: Microsoft Outlook Express 5.50.4807.1700 >X-MimeOLE: Produced By Microsoft MimeOLE V5.50.4807.1700 >NNTP-Posting-Host: 65.35.210.52 >X-Trace: typhoon.tampabay.rr.com 1004879831 65.35.210.52 (Sun, 04 Nov 2001 >08:17:11 EST) >Organization: RoadRunner – TampaBay >this is not being passed through AOL, send full message with headers to your >own ISP regarding Altopia’s practice of allowing their customers to stalk >and abuse with impunity.

Response:

Write to your congressman and senators for laws needed to prohibit bipolars on usenet.

– Hide quoted text — Show quoted text -> ACNP Focuses on Recent Treatment Advances > by Frank Ayd Jr., M.D

Response:

ACNP Focuses on Recent Treatment Advances by Frank Ayd Jr., M.D Psychiatric TimesApril 1999Vol. XVIIssue 4 (This is the second in a series of articles summarizing presentations at the American College of Neuropsychopharmacology-Ed.) Recent advances in the treatment of mental and addictive disorders, along with research findings in basic neuroscience, molecular genetics and molecular biology that contribute to the understanding of such disorders, were discussed at the American College of Neuropsychopharmacology’s 37th annual meeting in Puerto Rico. The following are brief reports from selected presentations. Predictive Value of Early Response to Sertraline for Panic Disorder To examine the relationship of early treatment response to sertraline (Zoloft) for panic disorder (PD), with outcome at 12 weeks, a multicenter, fixed-dose study (n=178) of PD patients, with or without agoraphobia, on sertraline 50 mg/day, 100 mg/day, or 200 mg/day, or placebo, was conducted by Massachusetts General Hospital investigators. Sertraline in the dose range of 50 mg/day to 200 mg/day was more effective than placebo in panic attack reduction; overall response rates were equal for each of the three active medication groups. Of the subjects responding at week 1, 23 of 29 (79%) were in remission by week 12. Of those with less than 50% reduction in panic attacks at week 1, 12 of 38 (32%) met remission criteria by week 12. These study findings support the conclusion that early response to treatment is strongly associated with eventual outcome to sertraline therapy at 12 weeks. Patients having at least a 50% reduction in panic attacks by week 2 of a 50 mg/day sertraline trial are likely to show a full response at 12 weeks of acute treatment. Also, patients with less than a 50% drop in panic attacks by week 2 are relatively unlikely to respond to current treatment; however, they may benefit from a dose increase or additional interventions. Olanzapine’s Effect on Neurocognitive Functioning To assess the efficacy of olanzapine (Zyprexa) on neurological soft signs and neurocognitive functioning in chronic treatment-refractory schizophrenics, New York University Medical School and Manhattan Psychiatric Center investigators conducted a double-blind study of olanzapine and haloperidol (Haldol). Assessment included a variety of neurocognitive tests, neurological soft signs and quantitative clinical scales at baseline and at several time points during the trial. Preliminary results from a sample of 23 patients indicate that, compared to haloperidol, olanzapine significantly improved performance on the Wisconsin Card Sorting Test at the end of the double-blind trial compared to baseline testing. There were no significant changes in neurological soft signs produced by either olanzapine or haloperidol. The lack of significant correlations between the effects of olanzapine on neurocognitive and clinical improvements suggest that these may be separate domains of clinical effects. Clozapine’s Effects on Schizophrenia and Alcoholism Preliminary data from two studies, one naturalistic and one retrospective, of clozapine’s effects in patients with schizophrenia and comorbid alcoholism were presented by researchers from Harvard Medical School, Dartmouth Medical School and the New Hampshire-Dartmouth Psychiatric Research Center. The first study involved 151 patients, 36 of whom were treated with clozapine (Clozaril) and the remainder with conventional neuroleptics. All patients were followed for up to three years. Clozapine-treated patients had significant reductions in severity of alcohol abuse and days of alcohol use compared to those treated with typical neuroleptics. Reductions in alcohol use were not significantly correlated with changes in thought disorder, but were strongly correlated with improvements in negative symptoms as measured by the Brief Psychiatric Rating Scale (BPRS). In the retrospective study of 34 clozapine-treated patients, more than 85% experienced a decrease in alcohol use and 71% achieved abstinence. These results led the investigators to suggest that this could be a potential new use for clozapine that could have important public health implications. Risperidone Treatment for Borderline Personality Disorder Case Western Reserve University investigators reported on 27 patients who have completed an ongoing double-blind, placebo-controlled study of low-dose risperidone (Risperdal) therapy for patients with borderline personality disorder (BPD). Study patients included only BPD patients with no history of schizophrenia or bipolar disorder. They were blindly and randomly assigned to either placebo or risperidone beginning with 1 mg/day. The dose was increased, if necessary, to 4 mg/day by the end of four weeks. The dose at four weeks was kept constant until the end of the eight-week study. Assessments were done with the Hopkins Symptom Checklist 90, the BPRS, and aggression and impulsivity scales. Of the 27 patients who, to date, have completed this ongoing, still-blind trial, all have been found to have had a marked decrease in suspiciousness, impulsivity and aggression. Thus far, no trial participants have dropped out because of side effects. These preliminary data indicate that low-dose risperidone therapy may benefit some BPD patients. Quetiapine’s Effects on Hostility in Elderly Patients with Psychosis The results of an open-label trial of quetiapine (Seroquel) in 169 elderly patients (mean age 76) with psychosis due to Alzheimer’s disease (n=78), Parkinson’s disease (n=40) or schizophrenia (n=36) were reported by investigators from the University of Southern California School of Medicine. Study patients received a median dose of 100 mg/day of quetiapine, dosed according to clinical response and tolerability for up to one year. Various rating scales (e.g., BPRS) were used to measure hostility, suspiciousness and the like. Positive symptoms were assessed by the BPRS symptom cluster score (mean of conceptual disorganization, hallucinatory behavior, suspiciousness and unusual thought content). Improvements detected by test scores suggested that quetiapine treatment may reduce hostility in patients with psychosis related to disorders such as Alzheimer’s disease. Long-Term Fluoxetine Therapy for Bulimia Nervosa The results of a study designed to evaluate the efficacy of fluoxetine (Prozac) therapy versus placebo treatment in preventing relapse of bulimia was reported by Eli Lilly and Company investigators. Subjects for this trial were 150 patients who met acute response criteria (a decrease of 50% from baseline in the frequency of vomiting episodes during the first of two preceding weeks). These responders were randomized to fluoxetine 60 mg/day or to placebo and were monitored for relapse for up to 52 weeks. Patients met relapse criteria if they experienced a return to baseline vomiting frequency that persisted for two consecutive weeks. Following acute response to 60 mg/day, bulimia patients who continued treatment with fluoxetine 60 mg/day had a statistically significantly lower relapse rate than patients switched to placebo. Posttreatment Discontinuation and Residual Fluoxetine Plasma Levels Because of the potential for serious adverse interactions between fluoxetine, a selective serotonin reuptake inhibitor (SSRI), and a monoamine oxidase inhibitor (MAOI), clinicians need to know when it is safe to start MAOI therapy for a patient following fluoxetine treatment. Presently, a five-week interval between stopping fluoxetine and starting an MAOI is suggested. However, the results of a multicenter study in which residual plasma fluoxetine and norfluoxetine levels were measured indicated that a five-week interval may not be safe. In this study, plasma levels were determined, double-blind, five weeks after stopping fluoxetine therapy. Fluoxetine had been taken as follows: 1) 20 mg/day for 50 weeks; 2) 20 mg/day for 38 weeks, followed by placebo for 12 weeks; or 3) 20 mg/day for 14 weeks, followed by placebo for 36 weeks. These were compared against placebo for 50 weeks. Residual plasma fluoxetine and norfluoxetine levels were available from 161 patients, 113 of whom had previously taken fluoxetine for three to nine months. Residual fluoxetine and norfluoxetine 5 ng/mL were found in 6.2% and 14.5% of patients, respectively. The average elapsed time off fluoxetine was 83 days (35 to 260 days). Fluoxetine and norfluoxetine levels ranged from 0 ng/mL to 36 ng/mL and 5 ng/mL to 106 ng/mL, respectively. These findings indicate that some patients taking fluoxetine may be extremely slow metabolizers. Before starting treatment with an MAOI, they require plasma level monitoring even after an extended drug-free period. Concurrent Neuroleptic Therapy/ ECT for Schizophrenia A review of modern literature on studies of concurrent use of electroconvulsive therapy (ECT) and neuroleptics in schizophrenia identified 19 reports published since 1980. The studies include 989 patients with varying degrees of chronicity and treatment resistance. Ten of the studies were prospective controlled studies; the rest were naturalistic case series. Four studies included sham-ECT in their control groups. Among the neuroleptics used in these trials were: clopenthixol, chlorpromazine (Thorazine), fluphenazine (Prolixin), haloperidol, flupenthixol, loxapine (Loxitane), perphenazine (Etrafon), trifluoperazine (Stelazine) and thiothixene (Navane). Fewer patients were treated with ECT and atypical antipsychotics: clozapine (n=13) and olanzapine (n=6). This review found that all studies attest to the safety of the combined treatment. There were no reports of neuroleptics interfering with ECT safety and efficacy. Most studies found combined neuroleptic therapy/ECT more rapidly effective in relieving psychotic symptoms than monotherapy in the acute phase … read more »

Response:

spam.

– Hide quoted text — Show quoted text –

Response:

this is not being passed through AOL, send full message with headers to your own ISP regarding Altopia’s practice of allowing their customers to stalk and abuse with impunity.

Response:

ACNP Focuses on Recent Treatment Advances by Frank Ayd Jr., M.D Psychiatric TimesApril 1999Vol. XVIIssue 4 (This is the second in a series of articles summarizing presentations at the American College of Neuropsychopharmacology-Ed.) Recent advances in the treatment of mental and addictive disorders, along with research findings in basic neuroscience, molecular genetics and molecular biology that contribute to the understanding of such disorders, were discussed at the American College of Neuropsychopharmacology’s 37th annual meeting in Puerto Rico. The following are brief reports from selected presentations. Predictive Value of Early Response to Sertraline for Panic Disorder To examine the relationship of early treatment response to sertraline (Zoloft) for panic disorder (PD), with outcome at 12 weeks, a multicenter, fixed-dose study (n=178) of PD patients, with or without agoraphobia, on sertraline 50 mg/day, 100 mg/day, or 200 mg/day, or placebo, was conducted by Massachusetts General Hospital investigators. Sertraline in the dose range of 50 mg/day to 200 mg/day was more effective than placebo in panic attack reduction; overall response rates were equal for each of the three active medication groups. Of the subjects responding at week 1, 23 of 29 (79%) were in remission by week 12. Of those with less than 50% reduction in panic attacks at week 1, 12 of 38 (32%) met remission criteria by week 12. These study findings support the conclusion that early response to treatment is strongly associated with eventual outcome to sertraline therapy at 12 weeks. Patients having at least a 50% reduction in panic attacks by week 2 of a 50 mg/day sertraline trial are likely to show a full response at 12 weeks of acute treatment. Also, patients with less than a 50% drop in panic attacks by week 2 are relatively unlikely to respond to current treatment; however, they may benefit from a dose increase or additional interventions. Olanzapine’s Effect on Neurocognitive Functioning To assess the efficacy of olanzapine (Zyprexa) on neurological soft signs and neurocognitive functioning in chronic treatment-refractory schizophrenics, New York University Medical School and Manhattan Psychiatric Center investigators conducted a double-blind study of olanzapine and haloperidol (Haldol). Assessment included a variety of neurocognitive tests, neurological soft signs and quantitative clinical scales at baseline and at several time points during the trial. Preliminary results from a sample of 23 patients indicate that, compared to haloperidol, olanzapine significantly improved performance on the Wisconsin Card Sorting Test at the end of the double-blind trial compared to baseline testing. There were no significant changes in neurological soft signs produced by either olanzapine or haloperidol. The lack of significant correlations between the effects of olanzapine on neurocognitive and clinical improvements suggest that these may be separate domains of clinical effects. Clozapine’s Effects on Schizophrenia and Alcoholism Preliminary data from two studies, one naturalistic and one retrospective, of clozapine’s effects in patients with schizophrenia and comorbid alcoholism were presented by researchers from Harvard Medical School, Dartmouth Medical School and the New Hampshire-Dartmouth Psychiatric Research Center. The first study involved 151 patients, 36 of whom were treated with clozapine (Clozaril) and the remainder with conventional neuroleptics. All patients were followed for up to three years. Clozapine-treated patients had significant reductions in severity of alcohol abuse and days of alcohol use compared to those treated with typical neuroleptics. Reductions in alcohol use were not significantly correlated with changes in thought disorder, but were strongly correlated with improvements in negative symptoms as measured by the Brief Psychiatric Rating Scale (BPRS). In the retrospective study of 34 clozapine-treated patients, more than 85% experienced a decrease in alcohol use and 71% achieved abstinence. These results led the investigators to suggest that this could be a potential new use for clozapine that could have important public health implications. Risperidone Treatment for Borderline Personality Disorder Case Western Reserve University investigators reported on 27 patients who have completed an ongoing double-blind, placebo-controlled study of low-dose risperidone (Risperdal) therapy for patients with borderline personality disorder (BPD). Study patients included only BPD patients with no history of schizophrenia or bipolar disorder. They were blindly and randomly assigned to either placebo or risperidone beginning with 1 mg/day. The dose was increased, if necessary, to 4 mg/day by the end of four weeks. The dose at four weeks was kept constant until the end of the eight-week study. Assessments were done with the Hopkins Symptom Checklist 90, the BPRS, and aggression and impulsivity scales. Of the 27 patients who, to date, have completed this ongoing, still-blind trial, all have been found to have had a marked decrease in suspiciousness, impulsivity and aggression. Thus far, no trial participants have dropped out because of side effects. These preliminary data indicate that low-dose risperidone therapy may benefit some BPD patients. Quetiapine’s Effects on Hostility in Elderly Patients with Psychosis The results of an open-label trial of quetiapine (Seroquel) in 169 elderly patients (mean age 76) with psychosis due to Alzheimer’s disease (n=78), Parkinson’s disease (n=40) or schizophrenia (n=36) were reported by investigators from the University of Southern California School of Medicine. Study patients received a median dose of 100 mg/day of quetiapine, dosed according to clinical response and tolerability for up to one year. Various rating scales (e.g., BPRS) were used to measure hostility, suspiciousness and the like. Positive symptoms were assessed by the BPRS symptom cluster score (mean of conceptual disorganization, hallucinatory behavior, suspiciousness and unusual thought content). Improvements detected by test scores suggested that quetiapine treatment may reduce hostility in patients with psychosis related to disorders such as Alzheimer’s disease. Long-Term Fluoxetine Therapy for Bulimia Nervosa The results of a study designed to evaluate the efficacy of fluoxetine (Prozac) therapy versus placebo treatment in preventing relapse of bulimia was reported by Eli Lilly and Company investigators. Subjects for this trial were 150 patients who met acute response criteria (a decrease of 50% from baseline in the frequency of vomiting episodes during the first of two preceding weeks). These responders were randomized to fluoxetine 60 mg/day or to placebo and were monitored for relapse for up to 52 weeks. Patients met relapse criteria if they experienced a return to baseline vomiting frequency that persisted for two consecutive weeks. Following acute response to 60 mg/day, bulimia patients who continued treatment with fluoxetine 60 mg/day had a statistically significantly lower relapse rate than patients switched to placebo. Posttreatment Discontinuation and Residual Fluoxetine Plasma Levels Because of the potential for serious adverse interactions between fluoxetine, a selective serotonin reuptake inhibitor (SSRI), and a monoamine oxidase inhibitor (MAOI), clinicians need to know when it is safe to start MAOI therapy for a patient following fluoxetine treatment. Presently, a five-week interval between stopping fluoxetine and starting an MAOI is suggested. However, the results of a multicenter study in which residual plasma fluoxetine and norfluoxetine levels were measured indicated that a five-week interval may not be safe. In this study, plasma levels were determined, double-blind, five weeks after stopping fluoxetine therapy. Fluoxetine had been taken as follows: 1) 20 mg/day for 50 weeks; 2) 20 mg/day for 38 weeks, followed by placebo for 12 weeks; or 3) 20 mg/day for 14 weeks, followed by placebo for 36 weeks. These were compared against placebo for 50 weeks. Residual plasma fluoxetine and norfluoxetine levels were available from 161 patients, 113 of whom had previously taken fluoxetine for three to nine months. Residual fluoxetine and norfluoxetine 5 ng/mL were found in 6.2% and 14.5% of patients, respectively. The average elapsed time off fluoxetine was 83 days (35 to 260 days). Fluoxetine and norfluoxetine levels ranged from 0 ng/mL to 36 ng/mL and 5 ng/mL to 106 ng/mL, respectively. These findings indicate that some patients taking fluoxetine may be extremely slow metabolizers. Before starting treatment with an MAOI, they require plasma level monitoring even after an extended drug-free period. Concurrent Neuroleptic Therapy/ ECT for Schizophrenia A review of modern literature on studies of concurrent use of electroconvulsive therapy (ECT) and neuroleptics in schizophrenia identified 19 reports published since 1980. The studies include 989 patients with varying degrees of chronicity and treatment resistance. Ten of the studies were prospective controlled studies; the rest were naturalistic case series. Four studies included sham-ECT in their control groups. Among the neuroleptics used in these trials were: clopenthixol, chlorpromazine (Thorazine), fluphenazine (Prolixin), haloperidol, flupenthixol, loxapine (Loxitane), perphenazine (Etrafon), trifluoperazine (Stelazine) and thiothixene (Navane). Fewer patients were treated with ECT and atypical antipsychotics: clozapine (n=13) and olanzapine (n=6). This review found that all studies attest to the safety of the combined treatment. There were no reports of neuroleptics interfering with ECT safety and efficacy. Most studies found combined neuroleptic therapy/ECT more rapidly effective in relieving psychotic symptoms than monotherapy in the acute phase … read more »

Response:

Question:

Does anyone know of / have any experience with drugs that suppress REM sleep? I know I fall into the category of those depressed who benefit from sleep deprivation. Sleeping less usually guarantees a happier, more centered and energetic mood the next day for me. I understand from the last time I poked around in medline that it’s the reduction in REM sleep that is thought to be therapeutic, and not necessarily sleep as a whole. I’ve gone through various SSRI’s (now on sertraline) and they didn’t have a noticeable difference on my mood. If anything they made me more lethargic. I’ve tried changing my sleeping patterns but the problem is that when waking up at the hour I want to it just seems insurmountable to get out of bed. I end up laying there and then waking up 4 hours later, feeling drained. Things that screw with sleeping patterns (i.e. alcohol) typically have a positive benefit on my mood the day after. Sleeping more usually leaves me feeling worse. If anyone can offer any help, insight or experience, I’d appreciate it. Thanks.

Response:

I’m taking 40mgs daily of Paxil, which made me very sleepy, so I started to take Mirapex, a Parkinson’s drug that is only being used recently to treat depression. I started on .25 mgs daily, went up to .5, then .75, then 1. The more I took, the more it lessened the effect of Paxil, but the more energy I had. When I hit .75 and 1 mgs a day, I was sleeping about 4 hours a night and was less tired, but my anxiety came back. I also had nightmares. I took Wellbutrin SR for a week, and I was sleeping 6 hours a night and had more energy. KC

Response:

Question:

Dear Sarah — Welcome to the group. . . it certainly sounds like you have been going through a rough bit for the past while. I must say that your choice of Erik Satie and the tea sounds like a perfect way to get some relaxation for the spirit … Satie’s music is full of wondrous creativity. It is ironic that he went completely mad at the end of his life due to a brain tumour that caused a tremendous amount of inter-cranial pressure … he is know by many classical musicians as the master of the absurd for his inventiveness and creative ingenuity. Much of what you describe "sounds familiar" as being classic behaviour of mania, mania with psychosis, or, in extreme cases, even hypo-mania (I have done some of what you described and I have never been fully manic. . . as far as I know <grin>). This is definitely a group where you will fit in — as well, compulsive disorders are often things that accompany bipolar affective disorder. Some of the anti-depressants, specifically those in the SSRI’s target obsessive behaviour (sertraline is one — Zoloft, fluoxitine is another — Paxil) — however, before taking an SSRI be sure that you are on a mood stabilizer as these drugs can also precipitate manic episodes and be very destabilizing for people with bipolar disorder. As to your question regarding addiction — it is often found, and I have found this true in my life, that people with bipolar disorder have "addictive disorders" and can easily fall into the traps that are out there. I know many bp’s who are recovering addicts and recovering alcoholics. There is no shame in this — it is something to overcome on the road to stability. Self-medication is often the first-course of treatment, and sometimes the only line of treatment that many bp’s will experience. Hemingway used alcohol — and eventually took his life. . . so, is medication better? Many will argue against it — but it has saved many lives, and many people are living lives with a much better level of quality to it because of medication than if they were going untreated. Anyway, welcome again to our little corner of craziness. . . and watch out for the trolls — Phoenix, Fred, SSRIHater. . . they are pretty easy to spot after a few minutes. Take care, Peter — Amsel The ingeniously CrazyComposer They say that genius and insanity are closely related. . . . So, who are "they" anyway?

Response:

You sound manic-depressive, Sarah, with some OCD symptomatology — not uncommon in bipolars (actually up to a 35% comorbidity rate).  You also sound like you’re getting your head back together, but you need to achieve stability. Keep up the good work, and keep posting.  It’s nice to hear from someone coherent once in a while.  =) Viscount – Hide quoted text — Show quoted text – >Hey its just started softly snowing here, I’m trying to listening to Erik >Satie drinking Jasmine Green Tea while trying to stay calm after 4 weeks >with no proper sleep and rapid cycling oh yeah and a mere week of complete >psychosis…unfortunately during the week joined AA and NA and decided  to >take all the twelve steps in one week with lots of different sponsors!!!, >Made lots of new friends with compulsive acting out behaviour… I can >recommend it!–Started driving lessons and bought myself a book learn to >drive in two weeks …!!!! scared to go out or to pick up the phone… as >God knows what I’ll next start joining… taking second Master’s degree >(Why?) became obsessed with texting everyone I know!!! Hundreds of times >during day and night even when they were at work or sleeping…just to say >sorry for keep texting them!!!! Sort of stalking by text. Started lots of >new really heavy intense relationships and even managed to resurrected a few >old ones!!!! Became obsessed with spirituality although previously being an >atheist, became a vegetarian boarding on being a vegan….Rang all my family >to apologise for pissing them off ,then got pissed off with them all again >and fell out with them all in my head!!!! The only hope of not being >sectioned is if I get snowed in and all my means of communication all fail >at once so I can’t keep getting high on People, Places and Things!!!! >Does any of this sound at all familiar to anyone or am I in the wrong >newsgroup!!!??? >Does anyone else here worry if they have drug or alcohol problems? Self >abuse through debt, relationships, food in fact everything you can get your >hands on!!!!!Does anyone ever try to self medicate and then abuse their >meds???? >Am I an addict or MD or both???? Where do I belong????? >Does anyone here have uncontrollable compulsive behaviour? Compulsive >washing, tidying, talking, eating not eating,,,, you name it I can never >just be!!!! >Apart from that everything’s fine!!!!!

"Fex urbis, lex orbis" [Dregs of the city, law of the world] — St. Jerome

Response:

Hey its just started softly snowing here, I’m trying to listening to Erik Satie drinking Jasmine Green Tea while trying to stay calm after 4 weeks with no proper sleep and rapid cycling oh yeah and a mere week of complete psychosis…unfortunately during the week joined AA and NA and decided  to take all the twelve steps in one week with lots of different sponsors!!!, Made lots of new friends with compulsive acting out behaviour… I can recommend it!–Started driving lessons and bought myself a book learn to drive in two weeks …!!!! scared to go out or to pick up the phone… as God knows what I’ll next start joining… taking second Master’s degree (Why?) became obsessed with texting everyone I know!!! Hundreds of times during day and night even when they were at work or sleeping…just to say sorry for keep texting them!!!! Sort of stalking by text. Started lots of new really heavy intense relationships and even managed to resurrected a few old ones!!!! Became obsessed with spirituality although previously being an atheist, became a vegetarian boarding on being a vegan….Rang all my family to apologise for pissing them off ,then got pissed off with them all again and fell out with them all in my head!!!! The only hope of not being sectioned is if I get snowed in and all my means of communication all fail at once so I can’t keep getting high on People, Places and Things!!!! Does any of this sound at all familiar to anyone or am I in the wrong newsgroup!!!??? Does anyone else here worry if they have drug or alcohol problems? Self abuse through debt, relationships, food in fact everything you can get your hands on!!!!!Does anyone ever try to self medicate and then abuse their meds???? Am I an addict or MD or both???? Where do I belong????? Does anyone here have uncontrollable compulsive behaviour? Compulsive washing, tidying, talking, eating not eating,,,, you name it I can never just be!!!! Apart from that everything’s fine!!!!!

Response:

Question:

That’s very white of you, Keith.  I’d say magnaminous, but I’d offered to send you .pdf files from several psychiatry journals over the past two years or so and you never expressed any interest.  Looks like Julez is in a "sharing" mood for a change. While you’re at it, why don’t you have dysphoric, retentive/explosive Agileflower send you what I sent her — the special Sept. 15 2000 _Biological Psychiatry_ issue on bipolar disorder.  I won’t post waste five minutes on feeding the dregzz *anything* from my extensive collection.  They’re unworthy – period. Viscount of ASDManic  ~~ Let them eat cake.. – Hide quoted text — Show quoted text – > The Journal of Clinical Psychiatry….catch up on your reading…your > doctor doesn’t have the time to keep up! > Alright, request your issues by the month and I’ll email the .pdf file > to you. If you don’t want to post your email then send your request to > Consult the table of contents below…I have July through November > available… > Keith sez knowledge should be free and thanks to those who made it so. > Volume 61 November 2000 Number 11 > Brainstorms > 813 The New Cholinesterase Inhibitors for Alzheimer’s Disease, Part 2: > Illustrating Their Mechanisms of Action. Stephen M. Stahl > Original Articles > 815 Adverse Neuropsychiatric Reactions to Herbal and Over-the-Counter > "Antidepressants." Ronald Pies > 821 Treatment of Dysthymia With Sertraline: A Double-Blind, > Placebo-Controlled Trial in Dysthymic Patients Without Major > Depression. Arun V. Ravindran, Julien D. Guelfi, Roger M. Lane, and > Giovanni B. Cassano > 828 Paroxetine Levels in Postpartum Depressed Women, Breast Milk, and > Infant Serum. Shaila Misri, John Kim, K. Wayne Riggs, and Xanthoula > Kostaras > 833 Strategies for Switching From Conventional Antipsychotic Drugs or > Risperidone to Olanzapine. Bruce J. Kinon, Bruce R. Basson, Julie A. > Gilmore, Sandra Malcolm, and Virginia L. Stauffer > 841 A Double-Blind, Placebo-Controlled, Prophylaxis Study of > Lamotrigine in Rapid-Cycling Bipolar Disorder. Joseph R. Calabrese, > Trisha Suppes, Charles L. Bowden, Gary S. Sachs, Alan C. Swann, Susan > L. McElroy, Vivek Kusumakar, John A. Ascher, Nancy L. Earl, Paul L. > Greene, and Eileen T. Monaghan, for the Lamictal 614 Study Group > 851 The Efficacy and Safety of a New Enteric-Coated Formulation of > Fluoxetine Given Once Weekly During the Continuation Treatment of > Major Depressive Disorder. Mark E. Schmidt, Maurizio Fava, James M. > Robinson, and Rajinder Judge > 858 Bupropion SR Reduces Periodic Limb Movements Associated With > Arousals From Sleep in Depressed Patients With Periodic Limb Movement > Disorder. Eric A. Nofzinger, Amy Fasiczka, Susan Berman, and Michael > E. Thase > 863 Fluoxetine Versus Sertraline and Paroxetine in Major Depressive > Disorder: Changes in Weight With Long-Term Treatment. Maurizio Fava, > Rajinder Judge, Sharon L. Hoog, Mary E. Nilsson, and Stephanie C. Koke > 868 Schizophrenia-Associated Idiopathic Unconjugated > Hyperbilirubinemia (Gilbert’s Syndrome). Tsuyoshi Miyaoka, Haruo Seno, > Motoi Itoga, Masaaki Iijima, Takuji Inagaki,and Jun Horiguchi > CME Article 879 > 880 Differences in Quality of Life Domains and Psychopathologic and > Psychosocial Factors in Psychiatric Patients. Michael Ritsner, Ilan > Modai, Jean Endicott, Olga Rivkin, Yakov Nechamkin, Peretz Barak, > Vladimir Goldin, and Alexander Ponizovsky > Letters to the Editor > 872 Reboxetine Treatment of Depression in Parkinson’s Disease. > Matthias R. Lemke > 872 Olanzapine-Induced Neutropenia in Patients With History of > Clozapine Treatment: Two Case Reports From a State Psychiatric > Institution. Christian J. Teter, John J. Early, and Richard J. > Frachtling > 873 Venlafaxine Versus Sertraline for Major Depressive Disorder. > Thomas N. Wise and Michael J. Sheridan > 874 Adverse Events of Fluoxetine: Postmarketing Compared With > Premarketing Clinical Trials. Mahmoud N. Musa and James M. Staneluis > 874 Diagnosing Melancholia. Iwona Chelminski, Mark Zimmerman, and Jill > I. Mattia > Volume 61 October 2000 Number 10 > Brainstorms > 710 The New Cholinesterase Inhibitors for Alzheimer’s Disease, Part 1: > Their Similarities Are Different. Stephen M. Stahl > Original Articles > 712 How Fast Are Antidepressants? Alan J. Gelenberg and Chelsea L. > Chesen > 722 Efficacy, Adverse Events, and Treatment Discontinuations in > Fluoxetine Clinical Studies of Major Depression: A Meta-Analysis of > the 20-mg/day Dose.Charles M. Beasley, Jr., Mary E. Nilsson, Stephanie > C. Koke, and Jill S. Gonzales > 729 Prodromal Symptoms of Relapse in a Sample of Egyptian > Schizophrenic Patients. Ahmed Okasha, Zeinab Bishry, Mohamed Rifaat El > Fiki, Aida Seif El Dawla, and Amany Haroun El Rasheed > 737 Restlessness of Respiration as a Manifestation of Akathisia: Five > Case Reports of Respiratory Akathisia. Shigehiro Hirose > 742 Elevated Levels of Insulin, Leptin, and Blood Lipids in > Olanzapine-Treated Patients With Schizophrenia or Related Psychoses. > Kristina I. Melkersson, Anna-Lena Hulting, and Kerstin E. Brismar > 750 Treatment of Depression With Methylphenidate in Patients Difficult > to Wean From Mechanical Ventilation in the Intensive Care Unit. > Hans-Bernd Rothenhausler, Sigrid Ehrentraut, Georges von Degenfeld, > Michael Weis, Monika Tichy, Erich Kilger, Christian Stoll, Gustav > Schelling, and Hans-Peter Kapfhammer > 756 Genetic Studies of Panic Disorder: A Review. Odile A. van den > Heuvel, Ben J. M. van de Wetering, Dick J. Veltman, and David L. Pauls > 767 An Algorithm for the Treatment of Schizophrenia in the > Correctional Setting: The Forensic Algorithm Project. Charles A. > Buscema, Qamar A. Abbasi, David J. Barry, and Timothy H. Lauve > Academic Highlights > 791 Alzheimer’s Disease: Translating Neurochemical Insights Into > Clinical Benefits. > CME Article 803 > 804 Diagnosing Bipolar Disorder and the Effect of Antidepressants: A > Naturalistic Study. S. Nassir Ghaemi, Erica E. Boiman, and Frederick > K. Goodwin > Letters to the Editor > 784 EMDR for Treatment of PTSD. -Gary Peterson****-Nancy J. Smyth, > Ricky Greenwald, Ad de Jongh, and Christopher Lee > Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances > 785 Further Discussion of EMDR for Treatment of PTSD. Charles R. > Figley, Andrew M. Leeds, Sandra A. TinkerWilson, and Bessel A. van der > Kolk > Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances > 786 Omission of Bupropion as a Recommended Treatment for PTSD. Ralph > M. Reeves > Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances > 787 Psychodynamic Psychotherapy for PTSD. -Jose A. Saporta****-Eric M. > Plakun and Edward R. Shapiro > Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances > Book Reviews 789 > Volume 61 September 2000 Number 9 > Brainstorms > 628 Paying Attention to Your Acetylcholine, Part 2: The Function of > Nicotinic Receptors. Stephen M. Stahl > Original Articles > 630 The Implications of Genetic Studies of Major Mood Disorders for > Clinical Practice. Anne Duffy, Paul Grof, Carrie Robertson, and Martin > Alda > 638 A Naturalistic Comparison of Clozapine, Risperidone, and > Olanzapine in the Treatment of Bipolar Disorder. Constance Guille, > Gary S. Sachs, and S. Nassir Ghaemi > 643 A Randomized, Double-Blind, Placebo-Controlled Trial of > Moclobemide in Patients With Chronic Fatigue Syndrome. Ian B. Hickie, > Andrew J. Wilson, J. Murray Wright, Barbara K. Bennett, Denis > Wakefield, and Andrew R. Lloyd > 649 Possible Induction of Mania and Hypomania by Olanzapine or > Risperidone: A Critical Review of Reported Cases. Jean-Michel Aubry, > Andor E. Simon, and Gilles Bertschy > 656 Mirtazapine Compared With Paroxetine in Major Depression. Otto > Benkert, Armin Szegedi, and Ralf Kohnen > 664 Psychostimulant Augmentation During Treatment With Selective > Serotonin Reuptake Inhibitors in Men With Paraphilias and > Paraphilia-Related Disorders: A Case Series. Martin P. Kafka and John > Hennen > 671 Clinical and Psychopharmacologic Factors Influencing Family Burden > in Refractory Schizophrenia. Robert Rosenheck, Joyce Cramer, George > Jurgis, Deborah Perlick, Weichun Xu, Jonathan Thomas, William > Henderson, and Dennis Charney, for the Department of Veterans Affairs > Cooperative Study Group on Clozapine in Refractory Schizophrenia > Academic Highlights > 686 Novel Antidepressant Strategies to Optimize Outcome. > CME Article 697 > 698 Psychiatric Care of Patients With Depression and Comorbid > Substance Use Disorders. Ivan D. Montoya, Dace Svikis, Steven C. > Marcus, Ana Suarez, Terri Tanielian, and Harold Alan Pincus > Letters to the Editor > 677 Association Between Premenstrual Syndrome and Depression. Claudio > N. Soares and Lee S. Cohen > Reply by Catherine A. Roca, Peter J. Schmidt, and David R. Rubinow > 678 Is Antipsychotic Drug-Induced Weight Gain Associated With a > Favorable Clinical Response? J. Steven Lamberti > Reply by Rohan Ganguli > 678 Polypharmacy of 2 Atypical Antipsychotics. Edward Rhoads > Reply by Stephen M. Stahl > 680 Clarification of Anticholinergic Effects of Quetiapine. Jeffrey M. > Goldstein and Martin Brecher > 680 Side Effect Profile of Enteric-Coated Divalproex Sodium Versus > Valproic Acid. Joseph Levine, K. N. Roy Chengappa, and Haranath > Parepally > 681 Correction. Gelenberg AJ, McGahuey C, Laukes C, Okayli G, Moreno > F, Zentner L, and Delgado P. Mirtazapine substitution in SSRI-induced > sexual dysfunction (J Clin Psychiatry 2000;61:356-360) > Book Reviews 682 > Volume 61 August 2000 Number 8 > Brainstorms > 547 Paying Attention to Your Acetylcholine, Part 1: Structural > Organization of Nicotinic Receptors. Stephen M. Stahl > Original

… read more »

Response:

The Journal of Clinical Psychiatry….catch up on your reading…your doctor doesn’t have the time to keep up! Alright, request your issues by the month and I’ll email the .pdf file to you. If you don’t want to post your email then send your request to Consult the table of contents below…I have July through November available… Keith sez knowledge should be free and thanks to those who made it so. Volume 61 November 2000 Number 11 Brainstorms 813 The New Cholinesterase Inhibitors for Alzheimer’s Disease, Part 2: Illustrating Their Mechanisms of Action. Stephen M. Stahl Original Articles 815 Adverse Neuropsychiatric Reactions to Herbal and Over-the-Counter "Antidepressants." Ronald Pies 821 Treatment of Dysthymia With Sertraline: A Double-Blind, Placebo-Controlled Trial in Dysthymic Patients Without Major Depression. Arun V. Ravindran, Julien D. Guelfi, Roger M. Lane, and Giovanni B. Cassano 828 Paroxetine Levels in Postpartum Depressed Women, Breast Milk, and Infant Serum. Shaila Misri, John Kim, K. Wayne Riggs, and Xanthoula Kostaras 833 Strategies for Switching From Conventional Antipsychotic Drugs or Risperidone to Olanzapine. Bruce J. Kinon, Bruce R. Basson, Julie A. Gilmore, Sandra Malcolm, and Virginia L. Stauffer 841 A Double-Blind, Placebo-Controlled, Prophylaxis Study of Lamotrigine in Rapid-Cycling Bipolar Disorder. Joseph R. Calabrese, Trisha Suppes, Charles L. Bowden, Gary S. Sachs, Alan C. Swann, Susan L. McElroy, Vivek Kusumakar, John A. Ascher, Nancy L. Earl, Paul L. Greene, and Eileen T. Monaghan, for the Lamictal 614 Study Group 851 The Efficacy and Safety of a New Enteric-Coated Formulation of Fluoxetine Given Once Weekly During the Continuation Treatment of Major Depressive Disorder. Mark E. Schmidt, Maurizio Fava, James M. Robinson, and Rajinder Judge 858 Bupropion SR Reduces Periodic Limb Movements Associated With Arousals From Sleep in Depressed Patients With Periodic Limb Movement Disorder. Eric A. Nofzinger, Amy Fasiczka, Susan Berman, and Michael E. Thase 863 Fluoxetine Versus Sertraline and Paroxetine in Major Depressive Disorder: Changes in Weight With Long-Term Treatment. Maurizio Fava, Rajinder Judge, Sharon L. Hoog, Mary E. Nilsson, and Stephanie C. Koke 868 Schizophrenia-Associated Idiopathic Unconjugated Hyperbilirubinemia (Gilbert’s Syndrome). Tsuyoshi Miyaoka, Haruo Seno, Motoi Itoga, Masaaki Iijima, Takuji Inagaki,and Jun Horiguchi CME Article 879 880 Differences in Quality of Life Domains and Psychopathologic and Psychosocial Factors in Psychiatric Patients. Michael Ritsner, Ilan Modai, Jean Endicott, Olga Rivkin, Yakov Nechamkin, Peretz Barak, Vladimir Goldin, and Alexander Ponizovsky Letters to the Editor 872 Reboxetine Treatment of Depression in Parkinson’s Disease. Matthias R. Lemke 872 Olanzapine-Induced Neutropenia in Patients With History of Clozapine Treatment: Two Case Reports From a State Psychiatric Institution. Christian J. Teter, John J. Early, and Richard J. Frachtling 873 Venlafaxine Versus Sertraline for Major Depressive Disorder. Thomas N. Wise and Michael J. Sheridan 874 Adverse Events of Fluoxetine: Postmarketing Compared With Premarketing Clinical Trials. Mahmoud N. Musa and James M. Staneluis 874 Diagnosing Melancholia. Iwona Chelminski, Mark Zimmerman, and Jill I. Mattia Volume 61 October 2000 Number 10 Brainstorms 710 The New Cholinesterase Inhibitors for Alzheimer’s Disease, Part 1: Their Similarities Are Different. Stephen M. Stahl Original Articles 712 How Fast Are Antidepressants? Alan J. Gelenberg and Chelsea L. Chesen 722 Efficacy, Adverse Events, and Treatment Discontinuations in Fluoxetine Clinical Studies of Major Depression: A Meta-Analysis of the 20-mg/day Dose.Charles M. Beasley, Jr., Mary E. Nilsson, Stephanie C. Koke, and Jill S. Gonzales 729 Prodromal Symptoms of Relapse in a Sample of Egyptian Schizophrenic Patients. Ahmed Okasha, Zeinab Bishry, Mohamed Rifaat El Fiki, Aida Seif El Dawla, and Amany Haroun El Rasheed 737 Restlessness of Respiration as a Manifestation of Akathisia: Five Case Reports of Respiratory Akathisia. Shigehiro Hirose 742 Elevated Levels of Insulin, Leptin, and Blood Lipids in Olanzapine-Treated Patients With Schizophrenia or Related Psychoses. Kristina I. Melkersson, Anna-Lena Hulting, and Kerstin E. Brismar 750 Treatment of Depression With Methylphenidate in Patients Difficult to Wean From Mechanical Ventilation in the Intensive Care Unit. Hans-Bernd Rothenhausler, Sigrid Ehrentraut, Georges von Degenfeld, Michael Weis, Monika Tichy, Erich Kilger, Christian Stoll, Gustav Schelling, and Hans-Peter Kapfhammer 756 Genetic Studies of Panic Disorder: A Review. Odile A. van den Heuvel, Ben J. M. van de Wetering, Dick J. Veltman, and David L. Pauls 767 An Algorithm for the Treatment of Schizophrenia in the Correctional Setting: The Forensic Algorithm Project. Charles A. Buscema, Qamar A. Abbasi, David J. Barry, and Timothy H. Lauve Academic Highlights 791 Alzheimer’s Disease: Translating Neurochemical Insights Into Clinical Benefits. CME Article 803 804 Diagnosing Bipolar Disorder and the Effect of Antidepressants: A Naturalistic Study. S. Nassir Ghaemi, Erica E. Boiman, and Frederick K. Goodwin Letters to the Editor 784 EMDR for Treatment of PTSD. -Gary Peterson****-Nancy J. Smyth, Ricky Greenwald, Ad de Jongh, and Christopher Lee Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances 785 Further Discussion of EMDR for Treatment of PTSD. Charles R. Figley, Andrew M. Leeds, Sandra A. TinkerWilson, and Bessel A. van der Kolk Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances 786 Omission of Bupropion as a Recommended Treatment for PTSD. Ralph M. Reeves Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances 787 Psychodynamic Psychotherapy for PTSD. -Jose A. Saporta****-Eric M. Plakun and Edward R. Shapiro Reply by Edna B. Foa, Jonathan R. T. Davidson, and Allen Frances Book Reviews 789 Volume 61 September 2000 Number 9 Brainstorms 628 Paying Attention to Your Acetylcholine, Part 2: The Function of Nicotinic Receptors. Stephen M. Stahl Original Articles 630 The Implications of Genetic Studies of Major Mood Disorders for Clinical Practice. Anne Duffy, Paul Grof, Carrie Robertson, and Martin Alda 638 A Naturalistic Comparison of Clozapine, Risperidone, and Olanzapine in the Treatment of Bipolar Disorder. Constance Guille, Gary S. Sachs, and S. Nassir Ghaemi 643 A Randomized, Double-Blind, Placebo-Controlled Trial of Moclobemide in Patients With Chronic Fatigue Syndrome. Ian B. Hickie, Andrew J. Wilson, J. Murray Wright, Barbara K. Bennett, Denis Wakefield, and Andrew R. Lloyd 649 Possible Induction of Mania and Hypomania by Olanzapine or Risperidone: A Critical Review of Reported Cases. Jean-Michel Aubry, Andor E. Simon, and Gilles Bertschy 656 Mirtazapine Compared With Paroxetine in Major Depression. Otto Benkert, Armin Szegedi, and Ralf Kohnen 664 Psychostimulant Augmentation During Treatment With Selective Serotonin Reuptake Inhibitors in Men With Paraphilias and Paraphilia-Related Disorders: A Case Series. Martin P. Kafka and John Hennen 671 Clinical and Psychopharmacologic Factors Influencing Family Burden in Refractory Schizophrenia. Robert Rosenheck, Joyce Cramer, George Jurgis, Deborah Perlick, Weichun Xu, Jonathan Thomas, William Henderson, and Dennis Charney, for the Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia Academic Highlights 686 Novel Antidepressant Strategies to Optimize Outcome. CME Article 697 698 Psychiatric Care of Patients With Depression and Comorbid Substance Use Disorders. Ivan D. Montoya, Dace Svikis, Steven C. Marcus, Ana Suarez, Terri Tanielian, and Harold Alan Pincus Letters to the Editor 677 Association Between Premenstrual Syndrome and Depression. Claudio N. Soares and Lee S. Cohen Reply by Catherine A. Roca, Peter J. Schmidt, and David R. Rubinow 678 Is Antipsychotic Drug-Induced Weight Gain Associated With a Favorable Clinical Response? J. Steven Lamberti Reply by Rohan Ganguli 678 Polypharmacy of 2 Atypical Antipsychotics. Edward Rhoads Reply by Stephen M. Stahl 680 Clarification of Anticholinergic Effects of Quetiapine. Jeffrey M. Goldstein and Martin Brecher 680 Side Effect Profile of Enteric-Coated Divalproex Sodium Versus Valproic Acid. Joseph Levine, K. N. Roy Chengappa, and Haranath Parepally 681 Correction. Gelenberg AJ, McGahuey C, Laukes C, Okayli G, Moreno F, Zentner L, and Delgado P. Mirtazapine substitution in SSRI-induced sexual dysfunction (J Clin Psychiatry 2000;61:356-360) Book Reviews 682 Volume 61 August 2000 Number 8 Brainstorms 547 Paying Attention to Your Acetylcholine, Part 1: Structural Organization of Nicotinic Receptors. Stephen M. Stahl Original Articles 549 Clinical Factors Associated With Treatment Noncompliance in Euthymic Bipolar Patients. Francesc Colom, Eduard Vieta, Anabel Martinez-Aran, Maria Reinares, Antonio Benabarre, and Cristobal Gasto 556 Is Melatonin Treatment Effective for Tardive Dyskinesia? Eyal Shamir, Yoram Barak, Igor Plopsky, Nava Zisapel, Avner Elizur, and Abraham Weizman 559 A Double-Blind Comparison of Sertraline and Fluoxetine in Depressed Elderly Outpatients. Paul A. Newhouse, K. Ranga Rama Krishnan, P. Murali Doraiswamy, Ellen M. Richter, Evan D. Batzar, and Cathryn M. Clary 569 Pisa Syndrome (Pleurothotonus): Report of a Multicenter Drug Safety Surveillance Project. Susanne Stubner, Frank Padberg, Renate Grohmann, Harald Hampel, Matthias Hollweg, Hanns Hippius, Hans-Jurgen Moller, and Eckart Ruther 575 An Open-Label Trial of St. John’s Wort (Hypericum perforatum) in Obsessive-Compulsive Disorder. Leslie vH. Taylor and Kenneth A. Kobak 579 Predictors of Response to Sertraline Treatment of Severe Premenstrual Syndromes. Ellen W. Freeman, Steven J. Sondheimer, … read more »

Response:

Question:

– Hide quoted text — Show quoted text -> On the same track – what is the real truth about libido and the sris’ in > my case zoloft.  Will tapering down to a smaller dose help? > any advice much appreciated, > codeee > SSRI’s will often make things worse for men over 45 years of age. At > that point their *FREE* testosterone level drops radically and the > result can manifest itself as depression. SSRI’s will lower it further, > causing more depression – as well as adding severe unhappiness with the > sexual dysfunction. The doctor will often increase the dosage or use > something even stronger, until the mood-altering effects over-ride the > unhappiness – AKA the "happy eunuch". > Zoloft is particularly bad. If you take a dose that’s adequate for the > job, it’ll do a job on you. > From one pharmaceutical database: > During initial clinical trials, sexual dysfunction manifested primarily > as ejaculation dysfunction > (ejaculatory delay ) and orgasm dysfunction (anorgasmia) was observed in > about 16% of men > and 2% of women treated with sertraline. However, post-marketing > experience has suggested > that the frequency of sexual adverse events is actually much higher. In > fact, many physicians report > an incidence of up to 90% based on their clinical experience. The FDA is > considering changing the > labeling of SSRIs to reflect a higher frequency of drug-induced sexual > adverse events. > From another: >   Home   Site Map   Marketplace   My Medscape   CME Center   Feedback > Help Desk > Side effects for Sertraline Hcl >      Incidence more frequent >          Anxiety >          Decreased Sexual Ability <======= >          Decreased Libido <======= >          Dry Mouth >          Impotence <======= >          Drowsiness >          Dizziness >          Insomnia >          Tiredness/Weakness >          Increased Sweating >          Tremors >          Appetite Loss >          Weight Loss >          Headache >          Nausea >          Gas >          Diarrhea >          Stomach Cramps/Pain >      Incidence less frequent >          Agitated States >          Blurred Vision >          Visual Changes >          Constipation >          Flushing >          Increased Appetite >          Palpitations >          Vomiting >          Nervousness >          Hypomania >          Allergic Dermatitis >          Pruritus >          Hives >          Fever >          Skin Rash >          Allergic Reaction

Thanks Alec, to FIX all of these problems?? I give up. codeee Before you buy.

Response:

My pShrink is now ordering the full set of hormone screening on every male patient over 45 and lower if any libido problems are present. I interpret them for him (name whited out on my copy – doctor/patient confidentiality) and you would be shocked at the number of men who need some hormone adjustments! Fortunately, many men only need lifestyle and dietary adjustments to fully recover. – Hide quoted text — Show quoted text -> > On the same track – what is the real truth about libido and the > sris’ in > > my case zoloft.  Will tapering down to a smaller dose help? > > any advice much appreciated, > > codeee > SSRI’s will often make things worse for men over 45 years of age. At > that point their *FREE* testosterone level drops radically and the > result can manifest itself as depression. SSRI’s will lower it > further, > causing more depression – as well as adding severe unhappiness with > the > sexual dysfunction. The doctor will often increase the dosage or use > something even stronger, until the mood-altering effects over-ride the > unhappiness – AKA the "happy eunuch". > Zoloft is particularly bad. If you take a dose that’s adequate for the > job, it’ll do a job on you. > From one pharmaceutical database: > During initial clinical trials, sexual dysfunction manifested > primarily > as ejaculation dysfunction > (ejaculatory delay ) and orgasm dysfunction (anorgasmia) was observed > in > about 16% of men > and 2% of women treated with sertraline. However, post-marketing > experience has suggested > that the frequency of sexual adverse events is actually much higher. > In > fact, many physicians report > an incidence of up to 90% based on their clinical experience. The FDA > is > considering changing the > labeling of SSRIs to reflect a higher frequency of drug-induced sexual > adverse events. > From another: >   Home   Site Map   Marketplace   My Medscape   CME Center   Feedback > Help Desk > Side effects for Sertraline Hcl >      Incidence more frequent >          Anxiety >          Decreased Sexual Ability <======= >          Decreased Libido <======= >          Dry Mouth >          Impotence <======= >          Drowsiness >          Dizziness >          Insomnia >          Tiredness/Weakness >          Increased Sweating >          Tremors >          Appetite Loss >          Weight Loss >          Headache >          Nausea >          Gas >          Diarrhea >          Stomach Cramps/Pain >      Incidence less frequent >          Agitated States >          Blurred Vision >          Visual Changes >          Constipation >          Flushing >          Increased Appetite >          Palpitations >          Vomiting >          Nervousness >          Hypomania >          Allergic Dermatitis >          Pruritus >          Hives >          Fever >          Skin Rash >          Allergic Reaction > Thanks Alec, > to FIX all of these problems?? I give up. > codeee > Before you buy.

Response:

On the same track – what is the real truth about libido and the sris’ in my case zoloft.  Will tapering down to a smaller dose help? any advice much appreciated, codeee Before you buy.

Response:

> On the same track – what is the real truth about libido and the sris’ in > my case zoloft.  Will tapering down to a smaller dose help? > any advice much appreciated, > codeee

SSRI’s will often make things worse for men over 45 years of age. At that point their *FREE* testosterone level drops radically and the result can manifest itself as depression. SSRI’s will lower it further, causing more depression – as well as adding severe unhappiness with the sexual dysfunction. The doctor will often increase the dosage or use something even stronger, until the mood-altering effects over-ride the unhappiness – AKA the "happy eunuch". Zoloft is particularly bad. If you take a dose that’s adequate for the job, it’ll do a job on you. From one pharmaceutical database: During initial clinical trials, sexual dysfunction manifested primarily as ejaculation dysfunction (ejaculatory delay ) and orgasm dysfunction (anorgasmia) was observed in about 16% of men and 2% of women treated with sertraline. However, post-marketing experience has suggested that the frequency of sexual adverse events is actually much higher. In fact, many physicians report an incidence of up to 90% based on their clinical experience. The FDA is considering changing the labeling of SSRIs to reflect a higher frequency of drug-induced sexual adverse events. From another:   Home   Site Map   Marketplace   My Medscape   CME Center   Feedback   Help Desk Side effects for Sertraline Hcl      Incidence more frequent          Anxiety          Decreased Sexual Ability <=======          Decreased Libido <=======          Dry Mouth          Impotence <=======          Drowsiness          Dizziness          Insomnia          Tiredness/Weakness          Increased Sweating          Tremors          Appetite Loss          Weight Loss          Headache          Nausea          Gas          Diarrhea          Stomach Cramps/Pain      Incidence less frequent          Agitated States          Blurred Vision          Visual Changes          Constipation          Flushing          Increased Appetite          Palpitations          Vomiting          Nervousness          Hypomania          Allergic Dermatitis          Pruritus          Hives          Fever          Skin Rash          Allergic Reaction

Response: