5 months into Luvox. Looking for advice

[Kobayashi]

Hi all,

So, I've been on 150mg of Luvox for about 5 months and have been weening off of cipralex per my docs instructions. I felt quite a bit of releif at first, but lately its been a roller coaster. One week feeling good, the next very agitated and down with increased ocd and anxiety. The Doc now suggests biting the bullet and coming off oc cipralex completely and slowing adding more Luvox in the am - starting with 50mg. Started today. I think the thought is that if it worked at first, an increased dose might give me some benefit. If this doesn't work after a month or so, we'll try something else like Prozac.

Any thoughts?

 

[David Baxter PhD]

I can't recall: Are you having regular therapy sessions? or are you just taking the medication?

 

[Kobayashi]

I've been through a lot of therapy and its helped tremendously with my OCD and depression. I've also taken a course on mindfulness which has helped a great deal. I am now at the point where I still have obsessive thoughts etc, but they do not scare me and I can deal with them. I feel that therapy has helped a great deal and has allowed me to rationalize things.

What I am experiencing now feels purely like a chemical imbalance. Perhaps caused by medication? Its like an up and down pendulum. I feel fine for several weeks, then just feel awful - like I'm a space cadet, foggy, depressed, headaches, like a bag of rusted hammers....But the frequency and severity of these down times is increasing, thus the decision to up the Luvox. Another way to describe the feeling I have would be that its similar to SSRI withdrawal, (even though I am not withdrawing from an ssri).

I feel the same way now as I did when my cipralex stopped working. Very up and down. The ups are not manic in any way at all - just what I would describe as baseline normal..content..comfortable in my own skin.

I am very curious to see how I would feel off meds. I know this is risky, but to be honest I have never done well on medication.

Put it this way: Two years ago when I first started having issues I went through a series of meds that made things worse than my initial symptoms of OCD/depression: celexa and cymbalta. I found releif for 8 months with cipralex. If I'd had the skills I've learned through CBT two years ago I highly doubt I would have needed medication.

The problem is now, coming off these meds feels worse than the original condition, so I feel stuck. Almost like I need to go to detox for a month or something.

---------- Post added at 02:56 PM ---------- Previous post was at 02:50 PM ----------

Here is the other problem: I'm seeing a GP for these prescriptions, who I can tell is somewhat baffled by my lack of response to them. She seems quite frustrated, while at the same time sympathetic. I have seen a local Psychiatrist, but wont do that again as it was a terrible experience - zero empathy, didn't care what I had to say, has a reputation for drugging his patients into zombie land.

I am at the point right now where I am willing to pay money to fly down to a private clinic in the US if I can find a psychiatrist I can work with and who I don't need to wait 4 months to see. I'm in the Barrie area, and the MH system is just awful here. That comes from my GP and other friends in the medical field.

 

[Daniel E.]

What about taking non-SSRIs as well? For example: Have you tried other anti-anxiety meds like Klonopin (clonazepam) or Busprar (buspirone)? Have you tried the antidepressant Wellbutrin?

 

[Kobayashi]

Hi Daniel,

I do take ativan PRN. I didn't need it for 8 months while on Cipralex as this wiped out all anxiety and OCD - Its very unfortunate that it stopped working. I do take it now during my "low" periods, but only until I really need it. I'm frightened of addiction and have take quite a bit this past month, perhaps 12-13 times which is way out of the ordinary.

But I guess one should do what one needs to do. My GP doesn't mind writing me a script for 20 or so at a time because she knows how conscious I am of the addiction risk. She actually thinks that's overblown and usually just a risk among patients that use it heavily and multiple times a day.

I've not heard of Buspar - can you enlighten me?

I suppose giving welbutrin a shot couldn't hurt, though I've heard those of us with OCD don't react to it very well as it speeds up the brain a little. I do also take risperidone .5mg which does help me sleep and slows my mind down a bit. It truly is amazing to me that I am taking these medications - I feel like a walking pharmacy.

 

[Daniel E.]

I don't know that much about Buspar either (besides that it is approved for GAD), but it's something that helps some people with OCD:

BuSpar (buspirone) looked quite good in initial case series but did not outperform placebo in two double-blind trials. Nonetheless, my clinical experience is that BuSpar augmentation works well in about one out of five patients. I think that the biological heterogeneity of the disease
defeats attempts to find augmentation strategies that are effective for large proportions.

http://www.google.com/url?sa=t&source=web&cd=3&ved=0CBwQFjAC&url=https%3A%2F%2Fwww.portsidetechnologies.com%2Fthecarlatreport%2Fdocuments%2Fgeneral%2FTCR_2004_08b_interview.pdf&ei=OogeTMLoH4H-8Aa4j6mDDA&usg=AFQjCNHHtKHRu9WJ22DDyUNeNfSvqE9sRQ&sig2=hG7rMskdiSV_SkjH8Ma6vg

What about trying other SSRIs that you haven't tried before? There's a boatload of SSRIs available it seems

Also:

Current trends in drug treatment of OCD

 

[Kobayashi]

Yeah - if the increased dose of Luvox doesn't do the trick, I'm thinking about trying Prozac.

 

[Daniel E.]

Oh, yes. I forgot you mentioned that.

I feel fine for several weeks, then just feel awful - like I'm a space cadet, foggy, depressed, headaches, like a bag of rusted hammers...

Have you thought about keeping a mood log? I've used MoodTracker.com, which is free, but, honestly, I got bored of it after the first week and gave up. (I think if I had used an iPhone app, it would be more interesting.)

 

[David Baxter PhD]

My GP doesn't mind writing me a script for 20 or so at a time because she knows how conscious I am of the addiction risk. She actually thinks that's overblown and usually just a risk among patients that use it heavily and multiple times a day.

I agree with her.

I've not heard of Buspar - can you enlighten me?

Buspar (Buspirone) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList

BuSpar (buspirone hydrochloride tablets, USP) is an antianxiety agent that is not chemically or pharmacologically related to the benzodiazepines, barbiturates, or other sedative/anxiolytic drugs.

In other words, buspar avoids the concerns about addiction with benzodiazepines like Ativan (lorazepam). However, by the same token it may not be as effective in reducing anxiety in some individuals.

I suppose giving welbutrin a shot couldn't hurt, though I've heard those of us with OCD don't react to it very well as it speeds up the brain a little. I do also take risperidone .5mg which does help me sleep and slows my mind down a bit.

Wellbutrin can induce symptoms/feelings of anxiety in some people, especially those with anxiety disorders, including OCD.

 

[Kobayashi]

Hi All,

I've been on 250mg of Luvox for over 3 weeks now and off the cipralex completely. I wish I had good news. I'm feeling more depressed than ever. Its not a horrible deep dark depression, just a general malaise and I feel like there is molasses running through my veins. My OCD is still there, but this depression is becoming unbearable and it seems to be getting worse.

I'm getting very frustrated and stating to lose hope. I have been doing lots of CBT and practicing mindfulness as best I can. The problem is that I'm just worn out.

I had quite a bit of success on cipralex for 8 months or so last year. It was very effective for that time, to the point where I almost forgot why I was taking it. Unfortunately, it just stopped working. My Dr. has suggested that if the Luvox doesn't work that I should go back on the cipralex. I'm not so sure as there are plenty of other alternatives out there.

I know you guys can't give medication advice, but do you think you may be able to advise on a med that I could at least ask her about? I'm thinking Prozac or Zolof? (Never tried those before).

My fear is that I'm immune to antidepressants. If this is the case, what is the alternative? I've read the ECT is effective for some people, although the thought of it is rather frightening. I'd hate to think I don't have any other alternatives.

Trouble is - I'm exhausted. I need some releif. I'm functioning ok at work and at home etc, but the struggle going on inside me is getting more intense as the days go by.

Any advice?

 

[David Baxter PhD]

Prozac would certainly be worth trying. It is also know to have some anti-obsessional properties.

 

[Kobayashi]

Thanks as always David.

What I don't understand is this: If all SSRI's basically do the same thing, (inhibit serotonin reabsorbtion), why do some work and others don't? I guess the fact that I took cipralex last year and it worked wonders for eights months makes me think that I may end up with the same scenario with another SSRI....works for a period of time, then poops out. Or, doesn't work at all. If thats the case, what alternatives are there?

 

[David Baxter PhD]

There are actually lots of alternatives, including using combinations of medications to boost the effect or changing to one of the older style antidepressants or antiobsessionals.

 

[stringbean]

i can completely empathize with how you are feeling the up and down, not manic but just normal when you are up but when down - terrible feeling not able to do anything only on half cylinders, trying to remain calm and sane on the outside but terrified and thinking inwardly!

I also do not tolerate medications well and have tried prozac but find it makes me much worse before i get better! and to be honest cannot always handle that. I have been on cipralex for a few years but once i get to the dose i need 20mg i then feel better and cut down and bam 6 months later back to the start. you mentioned that it worked for 8 months, what dose was it and did you lower it?

I am at the stage you are now, a week good then a week bad ( i am currently on 15mg) but hopeful that sometimes this is the cycle of the medication???? I have only been on this dose three weeks so think its too early to tell. Take heart that there are others feeling this way and that you are not alone