Lofepramine anyone?

[lebonvin]

I never read all the posts so somebody may have mentioned this already. My shrink at the time said that benzos ultimately make you more depressed and interfere with the efficacy of the AD

[panic_down_under]

i said i felt i was letting the dr down

...I dont feel that with my shrink. very much feel passive and vulnerable with my shrink.

Don't be. You're numero uno in the relationship. While medico's all too often have delusions of being worthy of a place in the pantheon of minor, and sometimes not so minor gods, they are in fact merely hired hands, someone you employ, directly, or indirectly via taxes, to fix what ails you. Do not under any circumstances pander to their delusion.

And don't think for a minute you've let your doctors down, much less say so. They seem to have been doing a comprehensively thorough job of letting you down very badly. IMunHO, neither your GP, psychiatrist, or CPN are worth feeding. A very p*** poor effort by all three of them!!

[panic_down_under]

My shrink at the time said that benzos ultimately make you more depressed and interfere with the efficacy of the AD

He/she seems to be one of the few worth feeding.

There is considerable evidence benzodiazepines and other antiepileptics drugs block the mechanism by which ADs work. It's hardly new info with the earliest studies going back a decade, but maybe one in a thousand shrinks and far fewer GPs/PCPs seem to be aware of this.

Boldrini M, Butt TH, Santiago AN, et al. (2014)
Benzodiazepines and the potential trophic effect of antidepressants on dentate gyrus cells in mood disorders.
Int J Neuropsychopharmacol. Dec;17(12):1923-33 (Abstract | Full text)

Nochi R, Kaneko J, Okada N, et al. (2013)
Diazepam treatment blocks the elevation of hippocampal activity and the accelerated proliferation of hippocampal neural stem cells after focal cerebral ischemia in mice.
J Neurosci Res. Nov;91(11):1429-39 (Abstract)

Sun Y, Evans J, Russell B, et al (2013)
A benzodiazepine impairs the neurogenic and behavioural effects of fluoxetine in a rodent model of chronic stress.
Neuropharmacology. Sep;72:20-8 (Abstract)

Song J, Zhong C, Bonaguidi MA, et al (2012)
Neuronal circuitry mechanism regulating adult quiescent neural stem-cell fate decision.
Nature. Sep 6;489(7414):150-4 (Article | Study full text)

Chen J, Cai F, Cao J, et al. (2009)
Long-term antiepileptic drug administration during early life inhibits hippocampal neurogenesis in the developing brain.
J Neurosci Res. Oct;87(13):2898-907 (Abstract)

Wu X, Castren E. (2009)
Co-treatment with diazepam prevents the effects of fluoxetine on the proliferation and survival of hippocampal dentate granule cells.
Biol Psychiatry. Jul 1;66(1):5-8 (Abstract)

Stefovska VG, Uckermann O, Czuczwar M, et al (2008)
Sedative and anticonvulsant drugs suppress postnatal neurogenesis
Ann Neurol. 2008 Oct;64(4):434-45 (Abstract)

[pulisa]

Why on earth are psychiatrists not aware of this? It's basic stuff. Or are they just using long term benzos as a chemical cosh?

[Sober2000june]

The problem, for me you see, is where does that leave me, been on lorazepam daily since 22nd april, and valium about 5 -10 mg daily between jan and april.

That’s including, prozac for 3 weeks in jan when i admitted myself to local mental health hospital(suisidal) and couldn’t get a consultant - it was worse than one flew over cuckoo’s nest. Signed myself out, went private for a week with old consultant i knew. She put me on mirtazapine and said that Prozac would never have been a choice for me as it is too activating. Anyway, the first night on mirt i slept 11 hrs, it was great. I was also allowed to take up to 20mg of diaz. The next day I had to drive down south with family, I had 5 mg of diaz in am felt ok, but as i set off i had pins and needles, full on panic attack; anyway made it to Edinburghand had another 5mg, within half hr. I was chatting away and really enjoying the music. That night I put in my journal almost normal. the next 4 nights away were really promising enjoyed every night, log burner movies stuffing face with carbs(mirt). Anyway came home and had a few good days was only taking 5 mg .Then after 11 days i was wide awake 5 hrs after taking mirt. I had cut my diaz down to 5mg. as i felt it gave me more energy to do stuff. But counsellor told me to go back up to 10(he was liasing with private shrink) to help with sleep. Never really worked; had a few more good days on mirt then gave up after 3 weeks.Looking back gave up too soon cause I had a couple of days just before that where I felt really good. It was just th 5 hrs sleep and low mood that was getting me. The private shrink kinda told me off and said no meds will work as I won’t give them enough time. Anyway i was in limbo now, wish i had come back on here earlier. I went to NHS crisis team and was on just valium and quetiapnie(awful combination insane zombie) until i got my current shrink. She just looked at what i had been on previously and put me on paroxetine was horrifying stuck it for 12 weeks trying twice to stay at 20mg but I was running around jumping up and down. My previous meds (between Sept 2011 until summer of 2015 )- citalopram 20 straight of the bat then up to 30mg after 3 weeks then 40mg(lasted 11 weeks , sertraline ramped up from 25mg to 100mg in a few weeks it was like where i am now. then it was mirtazapine ( same thing fisrt night I took it , it was beautiful my head slowed right down and my mind could breath. However ended ended up manic and aggressive. next was put on venlafaxine and lasted 9 months same again was ramped upto 225mg in a few weeks felt fantastic for 3 days then bang Kinda settled on 150 slow release for longest time, then clomipramine, for few months, then escitalopram for 7 months, then bupropion, then back onto citalopram for 8 months. then gabapentin and finally back onto escitalopram for a few months then i came off and after 3 months started to feel like me. I had also been signed off work at that point long term. Anyway i never had the racing head and felt normal was redeployed into another department start of 2017. Had a great time in the job, then sept 2018 I took a promotion and with a few days collapsed at home anyway kept on until nov19th last year 2 days after getting a dental implant and given amoxicillin and metronidazole? I started to feel a bit funny then by that evening my head took off i ended up at a&e as i thought the dogs of hell were coming for me. Needless to say i have been suffering this depersonalisation obsessive about my condition in my own head since November 19th last year. I have really tried to give the Lofepramine a good go, but it is too much. I was in at gp earlier today and she just said we cant deal with you - So where to now? Termination??

[Sober2000june]

meant to say Ian, you wanted to know my age 47

[panic_down_under]

The problem, for me you see, is where does that leave me, been on lorazepam daily since 22nd april, and valium about 5 -10 mg daily between jan and april.

It probably leaves you dependent on BZDs and in need of careful management when weaning off. Not sure the clown show treating you can pull that off.

She put me on mirtazapine

... I had cut my diaz down to 5mg. as i felt it gave me more energy to do stuff. But counsellor told me to go back up to 10(he was liasing with private shrink) to help with sleep.

Where you having problems sleeping? Not that it matters, BZDs are crap sleeping pills because the sedating effect usually wears off after only a couple of weeks. So poor advice. The mirtazapine would likely have been enough on its own.

Never really worked; had a few more good days on mirt then gave up after 3 weeks.

How much mirtazapine were you on?

She just looked at what i had been on previously and put me on paroxetine was horrifying stuck it for 12 weeks trying twice to stay at 20mg but I was running around jumping up and down.

Paroxetine is usually the most sedating of the SSRIs, though that isn't saying much, plus some have a paradoxical reaction.

citalopram 20 straight of the bat then up to 30mg after 3 weeks then 40mg(lasted 11 weeks

That is nutz. It should have been 10mg for 7-10 days, then 20mg for 6-8 weeks to see whether it was effective only increasing the dose if there was no improvement after 12 weeks from when 20mg was started.

sertraline ramped up from 25mg to 100mg in a few weeks

Same problem as with citalopram, although at least the 25mg was a better starting point, then upping to 50mg for up to 12 weeks, etc, etc.

then it was mirtazapine ( same thing fisrt night I took it , it was beautiful my head slowed right down and my mind could breath. However ended ended up manic and aggressive

Yet you seem to have tolerated it well before, so what changed? How much were you taking when you went manic and aggressive, which is very unusual, and were you taking anything else?

next was put on venlafaxine and lasted 9 months same again was ramped upto 225mg in a few weeks felt fantastic for 3 days then bang Kinda settled on 150 slow release for longest time

So was it working at 150mg, and if so, why did you stop taking it?

then clomipramine, for few months

Can you remember the maximum dose and what was your experience on it?

escitalopram for 7 months, then bupropion, then back onto citalopram for 8 months. then gabapentin and finally back onto escitalopram

It looks like citalopram/escitalopram is the AD you took for the longest time in total (or second longest after venlafaxine 150mg?). Does this mean it was somewhat effective?

I was in at gp earlier today and she just said we cant deal with you - So where to now?

A better GP, psychiatrist and CPN would help!

[Sober2000june]

The mirtazapine wasnt working on ist own and i was on 15mg. It worked great for 10 days. then 6hrs ater taking it vivid dreams bing wide awake

[Sober2000june]

please tell me there is a way forward for me ian, Please for the sake of my wife and three beautiful children?

[Sober2000june]

i dont want to give up but this constant racing brain and all it focuses is on meds and how do i get back to me before nov 19th?