My Psychiatrist has banned me from SSRI's.

[TillySm]

Hey folks,

Hope everyone is doing well. I saw my psychiatrist today for the first time in years and just broke down crying in front of her. I explained what had happened on Zoloft. I told her I wanted to try Prozac because it worked for me years ago and after much thought she has told me I can never go on an SSRI again. She has confirmed the activation syndrome and told me it is not worth risking that again on another SSRI. I am one of the rare people that have grown intolerant to anti-depressants. Instead if my anxiety and OCD gets disabling I must take a tiny dose of Zyprexa at night to help me sleep for a week and then go off the Zyprexa until I get another bad attack. So to kind of use it like a xanax. I trust the antipsychotic way more than bloody anti-depresants after what happened to me. SSRI's are over prescribed for every minor mental problem there is. They are not as safe as people once thought.

I have learnt there is no such thing as a pill that can fix ALL your mental problems. When they worked for me though it 'took the edge off' so to speak which made it easier to cope but I must have grown intolerant to them. She said next time I see her she will talk to me about going to see a psychologist and starting extensive cognitive behavioral therapy and exposure response to stop the health anxieties.

My question is, has anyone ever done cognitive behavioral therapy or exposure response? Did it help you? How does it work?

-Tilly

[LAURA48]

Hi - sorry you have not been well - couldn't your psychiatrist have put you on another type of antidepressant? Nor the SSRI family?

Regards Laura

[rock chick]

I was wondering about the same thing, an antidepressant that isn't an SSRI but I gather since all of them as far as I know affect serotonin levels she probably didn't want to risk it. However Zyprexa affects both dopamine and serotonin, so I'm a bit confused myself.

Yes, I do agree with their over prescription to a point. It's not uncommon in Australia for GPs to be more willing to prescribe them far more often than even Pandedine Forte (basically pills with 30mg of codeine and 500mg of paracetamol in them and only have 20 in each pack) for example. I'm not saying GPs shouldn't be able to prescribe them, however they should be a bit more sparing with them and be more proactive in suggesting the patient sees a psychiatrist who honestly knows far more about mental illness medications (and of course they do offer actual therapy).

For me I am more the opposite, I don't trust anti-psychotic drugs for myself but that's merely because each time I was on them I got side effects that were nasty.

I've had lots of therapy throughout the years and some involved CBT and exposure therapy. This was for my OCD but might have been with others issues (can't remember). It did help a bit, I wasn't as committed to it and there were some other problems but I've never had it done intensely so I suspect I'm not a good source for whether it's very successful, although I've read many others say they are. I've mostly done my own exposure therapy of sorts myself and it made things easier.

As for how they work. Well, the CBT works on changing your mindset and thought process from negative to positive, although each person will be handling different aspects of their lives that they need help with. The exposure therapy is basically slowly introducing a person to anxiety provoking situations to overcome them (it can be assisted, as in your therapist is there with you) or unassisted, usually it involves a bit of both.

The CBT process is considered to be a somewhat intense form of therapy but that's important as you can't hardly just easily change your mindset and thought patterns overnight (well some could and I'd love to have some of that action please!). Both CBT and exposure therapy involve a fair amount of work, patience & commitment on the patients part to get workable results. This was something I wasn't so good at but hope to improve.

[TillySm]

Hi Laura,

thank you for your kind words :), I feel like I am slowly coming out of this day by day. I did not ask her about the older types? Maybe I shall bring it up next time. She wants to stabilize me first she said and then try CBT. I hope you feel better soon. I feel for you and know what you are going through. I wouldn't wish any kind of mental illness upon anyone.

Hi Rock Chick,

I was totally afraid of antipsychotics too. I was petrified about the side effects and stigmatism but my psychiatrist explained to me that in OCD/anxiety and chronic depression they are absolutely brilliant in micro doses. Like a 1/4 of the minimum dose (min dose being 2.5mg) at 6pm every night to help sleep - until the crisis is over. I must admit that in 2006 I went through something like I just went through when upping my prozac dose and I did not want to try Zyprexa. The Prozac and xanax were just making things worse. I got to the point where I didn't care and took a 1/4 of the minimum dose at 6pm for a week. It knocked me out like a light till morning and I woke up refreshed and anxiety free. After a week my pdoc took me of them and I didn't have any mental health problems till 2010. My psych says that sleep is often the key in getting better from mental health problems and is a great believer in this method for conditions like mine. I can't explain what the zyprexa did but I think it was subtle enough to slightly adjust my brain chemicals back to normal in the micro dose, clear the anxiety and deal with the crazy OCD thoughts while it helped me sleep at night. How much Zyprexa did your doc try you on? I hear it only helps in OCD and depression in really small doses. More is not always best for some people.

Thanks for the advice regarding the CBT, I am going to give it my all. It does not sound like it will be easy from what you said however but I will try my best..

-Tilly

[mandshere2000]

Hi Tilly and rock chick
Where would I find out more about the activation
syndrome to do with Prozac.....i really am at the end of my tether with
taking Prozac have tried different anti ds over the years. It always ended
up back on Prozac been on/off them for over 20 yrs this last time been on them
for 8 yrs and yes I agree anti ds cannot cure everything and I have a lot of baggage
from a bad childhood and bad relationships and also now care for my disabled 14 yr old
son sorry if I'm rambling and not making much sense.
My point is I have these episodes which I can only describe as being depersonalization had one in 2004 and this recent bout has been since August 2011 until now
i also suffer from OCD and bulimia but I'm managing to control the bulimia
at the moment but it's so hard because I used this has a coping mechanism but
The OCD is still really bad and the down days and the
anxiety are getting worse also my sleep is terrible and I know this impacts on
everything else.
I sit here in tears as I write this and I'm going to go see the gp today
and get a referall to a psych doctor have seen a 2 over the yrs but they were awful
even telling me had I considered putting my son in a institution but the path
To getting to see one in the area I live in (Derbyshire uk) is not straight forward anymore
it used to be a referall from your gp and then just waiting but now you get referred to pathfinders who talk to you over the phone and then they decide if they will see you to assess you and they sit with pen and paper and take your history then it's another long wait
to see if they think you should see a psychiatrist it's a nightmare and the reason I've not pursued it any further in the past but I do agree that gp don't know enough about medication etc
I am really interested in the anti phycotics used in small doses
But I just feel so confused at the minute and really down oh and I take 40 MHz
Prozac daily did once go up to 60 mg for the bulimia but didn't do well on this dose
so when back to 40mgs.......I just so want to wake up in the morning and feel glad to be alive and not like this I have a life to live I'm 48 this year and can never remember feeling happy.
Sorry this is such a long post and thank you to anyone who takes the time to read it

Manda xx

[TillySm]

Hi Manda, I am Pming you, please check your inbox in a min

[rock chick]

Actually I've never taken before Zyprexa, the first time was Stelazine (medium potency), I was a foolish teenager and it wasn't mine, anyway it gave me a scary muscular locking movement, hard to explain but my head kept wanting to be in a sidewards position and before that upwards, painful to an extent as well, got an injection to counteract it and never touched it again, I was using it to help me sleep.

Second time was given to me by my shrink at the time Larcagtil (low potency) to help get off Xanax (I was on a low dose of Xanax back then compared to now and usually used it to help me sleep) and about 20- a half an hour after taking it I got up to do something and my legs gave way and I was having trouble even talking. The effect didn't last very long but I hated something having such control over my body so I didn't take it again.

I've nothing again anti-psychotics, I just prefer for myself to avoid them but everyone is different and I'm very glad they helped you as antidepressants have helped me but sadly harmed you.

I say whatever drug works for someone as long as it's not generally harmful & they don't become addicted if it's addictive.

[TillySm]

Hey Rock chick,

I totally agree, some drugs for some people and some for others. That is what annoys me about psychotropic drugs - they are so subjective and different for everyone.

I totally agree about antipsychotics, the ones you mentioned were old generation ones and they are phasing them out because of the horrible side effects. At least they are honest about the side effects in them - it is a horror story. My doc only put me on the new generation antipsychotics like zyprexa and seroquel in a micro dose. The new generation ones have way less severe side effects - zyprexas only major one is desire to eat alot and hence people on high doses STACK the weight on! I like the fact that they are like a xanax, you take it when needed and can just stop when you are well.

They are developing new antipsychotics that work on the glutimate system in the brain. Apparently in the trials they were *slightly* less effective than the new generation antipsychotics but they have pretty much NO side effects at all which is exciting for people who may need them in high doses. Slightly less effective for no side effects is a fair trade off I reckon.

Before my pdoc tried these in me on these I told her no way. I didn't want the terrible side effects but she convinced me that the new generation antipsychotics in micro doses wouldn't have any and so for the week I was on it in 2006. The only side effect I had on a micro dose was no more anxiety. I still had OCD - it did nothing for that but allowed my sleep levels to rise and anxiety to drop which in turn lessened my OCD.

I only took about 7 1/4 tabs back in 2006. I still have the rest of the box and it has gone off! I am someone who reluctantly takes pills these days - even more so with the Zoloft experience, but when I need them I need them.

Urrgh, psych drugs annoy me! If only there was better pills.. one day perhaps.