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takemitsu
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01 Aug 2010, 4:31 pm

Recently, I've been on concerta, provigil, effexor, and prosac. I never took the effexor and prosac together, and neither the provigil and concerta. I go from med to med because I don't like how I am on them, even though, it seems that they initially work. An example is with the effexor and prosac. I've been extremely depressed a few times in my life and effexor seems to be a godsend. But when I don't need it anymore, it's not like I can quit cold turkey, as other users might know of the withdraw one goes through. So I'll take prosac to ween myself from the effexor. During this time, I'll feel really great. I don't know if this is because of the chemical change or because of the prospect of quitting effexor. But after I feel I've taken it long enough, I'll quit the prosac, and I'll feel the same for maybe a month or so. But after that, it all goes downhill again, and I start on the effexor again. It seems I'm on a cycle of meds and being off of them, and it might work. I have yet to ask a doctor what they though about this, and I have no idea what their thoughts would be. Anyone have any similar experiences or a prospective to add?



Wedge
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01 Aug 2010, 6:11 pm

According to what I read even when the symptoms of the depression are gone the patient remain in high risk of relapse (reemergence of depressive symptoms) for the following 4-6 months if the treatment is stopped. That is why to reduce the likelihood of relapse the treatment should be continued 6-12 months after the symptoms are gone. That is called "continuation phase treatment". Also there is the possibility of recurrence of a second episode of depression after the treatment is stopped. So even after the symptoms of depression are gone some people make an assessment of the risks to consider if they will continue to take anti-depressants. That phase is called "maintenance phase treatment".

Hope this helps.



Callista
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01 Aug 2010, 8:26 pm

Uhh... Wow. Get a different doctor! If your first medication is working, why in the world are they switching you to some other medication? And why, with your constant relapse, are you getting taken off meds immediately? I just don't get it. Unless there's some miscommunication, your doctor seems to be botching this.


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Exclavius
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01 Aug 2010, 11:35 pm

Okay, let me get this straight.

You take med 1 for a while, and start to feel good, but after a while you don't like who you are... ie, you feel less good.
So you switch to med 2, and for a while you feel good but then you don't.
So then you take nothing, feel good for a while then you don't.

I think the "feeling good on med 2" and "feeling good on nothing" is because you feel better than you were before, but not "good"

better is a relative term, and needs to be compared to something else. Feeling better than suicidal doesn't say much... it is better, but still not necessarily good. Though your body will likely interpret it as "good" if you had just been suicidal but now aren't.

I've had similar, though not identical issues.
I don't think drugs can fix you though. They can give you the ability to fix yourself. I think you have to take that initiative early in the taking of the drug though, otherwise the window of opportunity is gone, and your body reverts back.
This is just my speculation keep in mind... but when your body senses a hormonal change, which is what these drugs elicit in you, your brain is more open to cognitive changes because the brain is too busy dealing with the hormonal changes. So when you are on the upswing of the drug, say 2 to 3 months in, this is when you need to do the most work in Cognitive Behavior Therapy, changing your actions to meet your beliefs, and working on getting your life together physically. If you just sit back and hope the drug will make you happy for the rest of your life all by itself, you're living in a deluded world of make believe.... And will in no time flat be right back at the bottom of your depression.

Another way to look at this... especially if the depression is of the bipolar aspect, as compared to the dysthymia or chronic side, the drugs like SSRI's and their cousins will induce an upswing, usually a prolonged one.
Some people believe that every person needs to find the right SSRI for them which will keep them on the upswing, others like me believe you have to grab hold of the opportunity when it arises and maintain the crest of that wave and keep on going by use of other non-drug methods (ie, changing your lifestyle, expectations, beliefs etc)



SmallFruitSong
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01 Aug 2010, 11:48 pm

Actually, AFAIK, SSRIs [i.e. prozac] work by soaking your brain with serotonin for longer, hence the uplift in mood. Nothing to do with hormones. SNRIs [i.e. effexor] work in a similar way, although they also affect the intake of norepinephrine as well as serotonin.

Quote:
I go from med to med because I don't like how I am on them


You'll have to elaborate on that - how do you feel when you are on them?

Anyways, it sounds like you're the one who decides to cycle through meds? I can understand that in a way as I've done the same [stopped and started four drugs in over a year, about to start no. 5]. However, jumping on and off doesn't actually help because you may end up destabilising yourself.

You might want to look into therapy if you haven't already done so, because therapy will teach you coping mechanisms and how to recognise your stress triggers. Medication alone isn't the silver bullet. The main role of the meds is to raise your baseline mood to a more functional level, but it's not meant to be the cure for depression.


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Exclavius
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02 Aug 2010, 12:07 am

SmallFruitSong wrote:
Actually, AFAIK, SSRIs [i.e. prozac] work by soaking your brain with serotonin for longer, hence the uplift in mood. Nothing to do with hormones. SNRIs [i.e. effexor] work in a similar way, although they also affect the intake of norepinephrine as well as serotonin.

Quote:
I go from med to med because I don't like how I am on them


You'll have to elaborate on that - how do you feel when you are on them?

Anyways, it sounds like you're the one who decides to cycle through meds? I can understand that in a way as I've done the same [stopped and started four drugs in over a year, about to start no. 5]. However, jumping on and off doesn't actually help because you may end up destabilising yourself.

You might want to look into therapy if you haven't already done so, because therapy will teach you coping mechanisms and how to recognise your stress triggers. Medication alone isn't the silver bullet. The main role of the meds is to raise your baseline mood to a more functional level, but it's not meant to be the cure for depression.


serotonin is a hormone as is norepinephrine.



SmallFruitSong
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02 Aug 2010, 12:25 am

Okay, interesting. I always thought serotonin was a neurotransmitter and therefore different from a hormone.


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Exclavius
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02 Aug 2010, 12:48 am

SmallFruitSong wrote:
Okay, interesting. I always thought serotonin was a neurotransmitter and therefore different from a hormone.


Yes, a neurotransmitter is a specific type or class of hormone. I can understand where you're coming from, and how you've interpreted what I've said, so I'll clarify in case others do the same. When I said "hormonal changes" I wasn't referring to the classical hormonal changes, but specifically to serotonin, norepinophrin and dopamine.



takemitsu
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02 Aug 2010, 12:08 pm

I've been on these meds for years and just got tired of them, they made me feel like I was receiving a chemical lobotomy. I don't like the idea of taking meds for really long stretches of time, it seems like 5 years was an ample amount of time to do what it was supposed to do. I don't have insurance anymore because I lost my job. Before I wasn't paying anything for them, now I have to pay full price, which is why I'm not taking any now. And I'm a sensitive person when it comes to meds, I always took the smallest dose, 37.5mg for effexor. Doctors always said this was a non-therapeutic dose, while it worked for me for awhile.

I never thought depression was my primary problem. I believe it is anxiety first, and depression is the effect of it. I wish the anxiety could be treated but no med has touched that.