Which medication to use?

[msf]

I have a question in regards to my wife.  She has suffered from depression for a long time but has never been on an antidepressant drug.  She is considering it now, but we are not sure which one would work for her.

She is a very shy, very sensitive person who feels things, including other people's pain, very very keenly.  In many ways, it is her extreme depth of feeling that causes the most concern.  So we are thinking a drug that would "take the edge off things" would be most beneficial.

However, there are concerns.  We would not want to have her take a drug that helps "take the edge off" her feelings only to worsen her depression or make her listless.  Since she is depressed, she does not need something that will, in effect, make her more depressed.  Is there something out there that can help "take the edge off" intense feelings without being something of a depressant in itself?

She does not want to be "zoned out" and not feel like herself, either.  We are looking for something to help her, not make her a zombie.  This is also important.  

She would not want to take anything that causes weight gain, either.  Is there anything out there with minimal side-effects that can do the sort of thing we are looking for?

My wife will be seeing her doctor soon and would like to have some idea in mind beforehand which drug is best for her.

Again, she would like something to take the sting out of her incredibly keen emotions and feelings and sensitivities but not at the expense of making her a zoned out zombie or worsening her depression, and without significant side effects.

Any suggestions you have would be most welcome.

[medic25]

I feel for your wife and everybody is different, but just to let you know, I am coming off effexor and it's terrible.  It helped so much, but about a year after everything went down hill.  Of all the drugs, effexor helped, but with what I am going through getting off it, it just wasn't worth it to me.I am starting Wellbutrin and am having great luck with minimum side effects, I have to have my brain when I work, with alot of the others that wasn't an option. Hope everything works out.

[newbaby02]

Any suggestions would be greatly appreciated. I'm 29 with a 5yr old and 15 month and suffering from panic attacks, some ocd and depression. I have tried Paxil which withdrawl was horrible,amitryptiline, now i'm on Zoloft which worked in the beginning and I lost 15 lbs, but now panic attacks are worse so is the depression, so weight loss has slowed down. We are thinking about starting Effexor maybe this will help? I am  also on ambien at night because I can't sleep. I have lost 59 lbs altogether since I had  my second child and do exercise regularly
my diet is so so. Any body now what helps? What med/diet?

[blue3E]

I have to say that being a compassionate, feeling, caring human being is not a problem that needs to be fixed.  The world needs more people like your wife and then maybe we wouldn't all have so many problems.  I understand the need to "take the edge off" of the intense feelings that she goes through but there are so many ways other than medication.  If she does get put on a psychotropic med. she may not be the caring, feeling person anymore.  She may not feel anything.  If you find a good therapist, she/he will help her "take the edge off" just by retraining the mind with "substitute mental chatter."  There is no "miracle drug" and it takes a great deal of work, including bringing up pain that may be hiding.  It always gets worse before it gets better, but IT DOES GET BETTER if you work at it.  Wherever You Go There You Are by Jon Kabat-Zinn is an excellent book to help her work through these things.  Books have always helped me keep the "edge off" and this was one that changed my life.  If you feel that she needs medicine while learning how to not be so tormented by herself, I would suggest a benzodiazepine.  It won't effect the brain but will relax her.  I have taken Klonapin and Propanol which have been amazing without taking away "me."  Klonapin is like Xanax except you don't feel it coming and leaving so you feel like the edge isn't being taken off just because you are on meds.  Propanol will keep heart rate from soaring and you can't feel it at all but it is helpful.  I urge you no matter what you do to stay away from anti-depressants. She may feel worse than before and they are what our society is selling as a "quick fix."  There is no "quick fix" and there is NOTHING wrong with being a sensitive, caring person.  Being able to put herself in someone else's shoes and feel their pain means she is more creative, intuitive, and intelligent than most.  It would be a crime for her to lose that. Get a good therapist. Good Luck.

[chadster]

msf, i have been around and around with the meds.  i've read all your posts and with my past experience and psychiatric nursing education, i would suggest your wife try a small dose of xanax.  by small, she might try 0.25 mg twice a day.  if she doesn't notice a difference with this dosage, she could titrate up to 0.5 mg xanax twice a day.  these are very low doses and the possibility of addiction would be minimal.  let me know how things work out.  good luck.

[frecklesag29]

I have had some anxiety problems off and on my entire life.  My therapist believes that some people and people from certain cultures are more "wired" for these problems.  He thinks we get used to a pattern of reasoning and can't break free.  I have tried diet and exercise both and neither have seem to help me much.  What has helped me is relaxation breathing and listening to calming music.  At times this doesn't work, he (therapist) suggested that I try Luvox.  This is mainly for OCD and also is an anti-depressent.  I haven't heard anyone on this form talk about this med much.  Has anybody tried it?  What are the worst side effects from it?  Any more lack of sex drive will probably drive my husband crazy.

Thanks for any input I get.

[DJW]

I still say the best way is through diet if one is reasonably strong and determined enough to tackle it that way as you do have to give up a lot of things. Problem with drugs is that they take so long to get over again once you come off them it seems. For help with a lot of health problems, including depression, there is a very good nutritional doctor's web site (he lives in the US) which I find very helpful and informative. It would be well worth you having a look at it on www.mercola.com
All the best again and happy searching.

[angel813]

Hi...Although this is a tuff question to answer I hope I can try and be of some help. I don't know the age of your wife...that can be a factor. In my experience, everything that has been posted here is correct. I have been on all the new antidepressants. Paxil was the longest...about 2 years. The main problem I have found with them is that doctors will tell you if you also have anxiety disorder that certain drugs are better for that. Paxil and Zoloft and Prozac are often prescribed for it. They mad the anxiety worse for me and so I have had to take xanax for years (tranquilizer). Unfortunately depression seems to be catchy. I have 5 kids 26,25,23,15,9 and a husband. # out of 5 of my kids and now my husband are being treated for depression also. If the depression is without anxiety then I would guess Effexor or Paxil would be the best route. Prozac if she can handle it. Wellbutrin I could not take but I do know several people who are successful with it. It seems to have an uplifting, speedy effect with weight loss and smoking cessation as a benefit. I did not realize the awful effect that my depression/anxiety had on my loved ones until they started becomming afflicted one by one a few years later. Besides being a 30 year survivor of a rare cancer and survivor of 2 time rape, 2 time abusive marriages, 2 time deadly auto accidents, I am also in my menopausal phase at 45 and type 2 diabetes.  I know some folks can take the meds for a few months to get out of the depression cycle...others are on a permanent course of treatment.Doctors had tried to put me on antidepressants for 10 years before I agreed to them and have been on for about 6 now. A person gets " maxed" out on the dosage...that is taking the maximum amount and has to have another one added or changed. Humans have a built-in survival mode but sometimes it gets lost and we need some help. There is no shame in that....we live in a very chaotic world filled with unhealthy chemicals and habits. I  wish you and your wife mountains of success. By the way. Currently I have maxed out on effexor and my dr. added paxil...so I am on both...still breathing...not crying...can get out of bed and function at a medium level. Peace all.....

[Wish_I_Never_Started]

I started on anti-depressants after being in the L.A. earthquake in '94.(Paxil) Since that time, my life is no longer in my control. Each time I try to come off of the drugs, I go into a deeper depression.  Has anyone out there experienced this?  I was always a high-energy, fun-loving, adventurous, self-confident personality. I should mention that at the time I started anti-depressants I was 44.  After the earthquake in January of '94, I was a neighbor of Nicole Brown-Simpson. I lived 1 block away. These 2 incidences were a defining factor in the 4 years I lived in Los Angeles...a very negative place for me.  I moved from L.A. to Orlando, FL to be near family (my brother).  Not a good move but it seemed a bit more relaxed. I continued with the Paxil because I became physically ill if I did not.  In '96 I was diagnosed with breast cancer.  At that time I was put on Effexor...did that for a while. Since breast cancer and a few other life altering experiences that have not been in my control, I have been "advised" to continue on anti-depressants. I know the person I WAS is inside me.  I think the drugs have killed who I really am.  I greive for my old personality. Now I am on Lexapro (20 mgs) and Provigil (200mgs) and my Dr. wants to put on an additional  5 mgs of Adderal and 25 mgs of Seroquel because I still suffer from anxiety  and now I am becoming agoraphobia. (I will add that I am in menapause and my mother did suffer from the latter but has never taken any drugs for any of her "problems") I don't know what to do.  I never (and no one else who ever knew me) thought I would be in this state of mind.  I am so fearful of becoming "crazy" I am beside myself.  can someone help me...give me advice...I don't trust doctors anymore...and I have been to many to try and "fix" this.  HELP...anyone...please!!  Thank you.

[HardAnxiety]

Boy, I really do wish I could suggest a particular medication.

But the truth is, each medication is a gamble.  I've been on 16 different antipdressant and antipsychotic medications to alleviate anxiety and depression, none of them have had any noticable effect that lasted for more than a few days.

I have had many side effects.  Some medicines worse than others.

I won't tell you which ones I've taken.  The reason is this, each person reacts differently to each medicine.

I've learned this both from personal experience and talking with hundreds of others who have taken the same drugs I have - and each person seems to react differently to the same drug at the same dosage - some are at one end of the spectrum, where they find major relief with little to no side effects, and there are others on the other side of the spectrum who see not only horrible side effects but worsening of their initial symptoms.

So, unfortunately, your wife may (or may not, if she is lucky) be in for a long, long ride of trying medication after medication seeking the one that will give the least side effects for the most relief.  I stress again that just because you hear a few people saying they had great response to a certain medication, don't put much faith in anecdotal stories, because each of our individual bodies has a unique chemical balance and will react in an individual way.

I'll pray for you that you find the right medication the first time.

[onlyopinions]

Please keep in mind that just because something is "natural" doesn't mean it is safe to consume. There are plenty of "natural" plants that are very deadly if ingested. Some of the most beautiful flowers and creatures, are the most poisonous.  Nature also kills the most people, and causes the most destruction in one episode. Think tornadoes, forest fires, floods, etc. Just a thought, to help put in perspective my intention is to ask your doctor, and do your research before taking anything without first consulting your doctor or pharmacist.

While many find relief and benefits using herbal products, no one should use them without understanding that they are drugs and have the potential dangers that over the counter and prescription drugs do. Informed choice is what should be sought.

There are no labels that warn about side effects and allergic reactions. These products have the same or even greater potential in some cases, of interactions and side effects than over the counter and prescription medications do.

Plant products present a special challenge in that the medicinal ingredients vary in potency from plant to plant and season to season. Unless extracted in highly controlled laboratory conditions, this results in tremendous variation in potency in the resulting herbal product. A recent study reported in the American Journal of Health-System Pharmacy on ephedrine products found great variation in the amount of ephedra supposed to be in the products and the actual amount found. The disparity ranged from no ephedra at all to 154% more than the label indicated. This would be intolerable within the pharmaceutical industry.

This nonstandard dosing means that each time you purchase a new bottle of any given herbal product; you are exposed to a new risk. You may have tolerated the last bottle just fine; experiencing no side effects or interactions. However, since there is no guarantee that the next bottle you buy will have exactly the same amount of the active ingredient in the dose, you have a new risk of interaction and side effects.


As for a medication to help with depression or "take the edge off" is different for everyone. The problem is that not one thing works in the same way for everyone who takes a particular drug. Good experiences, on a particular type of medication, can have the opposite with another person.

This has me so frustrated so much. I too want a med like you described. I haven't found it yet. But, others have. What works for one, doesn't work for another. I've had someone say to me how wonderful Prozac was for them, and when I tried it, it made me more depressed. Then the Zoloft, Paxal, etc. Although while on the paxal, I didn't have any bad side-affects. But, I've heard where others had. It's so complicated. :( Same with Wellbutrin. Yet, I have a friend who uses it with GREAT results, and few, if any side-effects. She says it's made her "normal" again. I'm happy for her, very much so. And wished it would have done the same for me, but alas. :p

This has made me more depressed, because I get my hopes up, then ask my Doctor for the medication a friend said worked for her/him, and wouldn't ya know it, it did not have the same effect for me. But, that doesn't mean that the medications mentioned in this forum will not work for your wife.

So you see, the only way you'll have an idea is to go to a psychiatrist first, so that he/she may prescribe one of the newer meds on the market. Especially the newer ones out now that have good results/less side-effects for lots of people. It's up to you to do what you're doing, reasearch..and bring your list to your doctor to help plan the best route.

Best of luck to you and your wife. :)

That is, if you got this far. ;D Sorry for going on so long.

[health-hope-opportunity]

My best friend tried everything from Effexor Xr, Zoloft, Wellbutrin, Celexa, Prozac, Paxal, and finally she achieved success. She brought her body into balance through diet!
She did this after watching the changes I made in my diet. In my early twenties I was diagnosed with bipolar disorder. I had a prescription for Lithium in the form of Carbolith that I thought would be for life.
Fortunately, the human body is a marvellously designed living organism, with the ability to grow, regulate, repair and defend itself when given natural high quality, full spectrum nutrition.
Over the years and with my doctors supervision my body gradually required less and less medication until several years ago, when I didn

[DJW]

Glad to hear that your wife has been using natural means for so long. Yes, it can get a bit hard to make any headway after a while but I am finding the fasting/cleansing regime helping me at the moment...had got into a vicious cycle of "comfort eating" lately, but am managing to break it again.
Has she tried taking things like St. Johnswort, 5-HTP, Valerian (herbal) or SAM-e? Other than these natural remedies, which I have tried and got a certain amount of relief from, (only take one at a time of course), I wish I could also find what you are looking for as well. Will also be interested if anyone else can come up with something. Here's hoping.

[msf]

Thanks for responding.  I appreciate all and any feedback.  As for natural things, my wife also believes in that very strongly and that's really the main reason she has avoided medication for so long.  Now, we're just wondering if it's time to try medication.

Still wondering about my original question, though.  Does anyone know of a particular medication that is useful in "taking the edge off things" without being a depressant or turning you into a zombie or causing many side effects?

I would very much appreciate hearing from someone who has sought out such a medication and who can share their experience.  Any success stories?  Any suggestions are most welcome.  Thanks.

[Roger Gould, M.D.]

Given all of these very reasonable considerations, your wife should talk to her doctor about Wellbutrin first. There are other good choices, amongst them would be Zoloft, Paxil and Celexa.

[DJW]

To msf:

I can fully understand where you are coming from re. your wife as I am much the same as her in every way and have suffered for many years also. As I do not like medication in any shape or form, am doing my best to stick to "natural measures". As well as exercise and relaxation, these include watching the diet as things like sugar especially, affect my mood and pain levels (also have osteo-arthritis in some joints).Something I am trying to get back to lately is "fasting and cleansing" the system (it really makes a big difference) and then carry on with correct and safe foods again. These foods also help to keep the blood sugar on a more even keel which can help avoid depressive symptoms.(See article on Hypoglycaemia on this Medhelp web site under the heading "Chest Pressure"-jigger 4/12/2003).
Also low thyroid is another cause so plenty of kelp powder and sea foods in the diet are beneficial. So, seek out some good helpful books on nutrition/dietary supplememts. Eat plenty of raw fruits, cooked and raw vegetables, nuts, seeds, some red meat, chicken & fish but keep the starch foods like bread to a minimum. Your wife may also be best to cut down on grains and dairy products.Try and eat organic as much as possible and drink plenty of filtered water. All the best with that.

[techsup]

I had been on Effexor Xr and my sex life with my husband became non-existant.  I talked with my Dr. about that this week and she is starting me on Welbutrin SR...she claims that this does not have the side effect that Effexor XR and Zoloft and all the others have that cause a decrease in the libido.  Zoloft was one that I had tried at first....I had no appetite (which I thought was a good thing), but I also could not sleep.  Then we tried Celexa and I felt like I was hung over all the time.  The Effexor XR worked the best for me other than the sex part.  
The best person to know what is going to work for your wife would be your wife and the Dr.  Most of these medications do not cause you to gain weight....I have quite a few people that I know that are on them and no one had gained weight from them...if anything, they have lost weight.
I hope this helps you at least a little bit and I hope your wofe gets better.