Chapter 35: FEELING SOME RELIEF! Antidepressant Medications

It has been 9 months since I went to the Amen Clinic in Newport Beach, California.  It has taken this long to make all of the medication changes recommended by my doctor at the clinic.  I am starting to feel better, FEELING SOME RELIEF!  I have an atypical depression that needed to be treated in layers.  The anxiety symptoms needed to be treated first, and I talk more about this in Chapter 9 of my blog.  There is a detailed treatment plan from the Amen Clinic in Chapter 10.

I am now taking 150 mg of Effexor XR in the morning with breakfast.  I have come down from 300 mg because I was not feeling any improvement of depression symptoms, and side effects were not going away.  The higher dose was causing insomnia and anxiety, flushing several times a day, and constipation.  These are the only side effects I have experienced with Effexor XR, and they are just about gone on 150 mg.

 




 

I am also taking generic Luvox, fluvoxamine.  I take 50 mg in the morning and 50 mg in the afternoon.  I was already on this drug when I went to the Amen Clinic and my brain scans showed it was helping to quiet the activity in the deep limbic system; but it was not completely effective.  Depression symptoms originate in the deep limbic system.  I am using fluvoxamine for depression, and I do not have any side effects strong enough to notice.  I have been on fluvoxamine for over a year, and a pharmacist told me the brand Luvox is no longer made. The extended-release capsule is a new medication.

Information on generic Luvox, fluvoxamine from:  PubMed Health - Fluvoxamine

 

Why is this medication prescribed?

Fluvoxamine is used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over) and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Fluvoxamine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs).

 

How should this medicine be used?

Fluvoxamine comes as a tablet and an extended-release capsule to take by mouth. The tablet is usually taken either once daily at bedtime or twice daily, once in the morning and once at bedtime. The extended-release capsule is usually taken, with or without food , once daily at bedtime. Swallow the extended-release capsules whole; do not crush or chew them.

Your doctor may start you on a low dose of fluvoxamine and gradually increase your dose, not more often than once every week, depending on how well the medication works for you and the side effects you experience.  It may take several weeks or longer for you to feel the full benefit of fluvoxamine. Continue to take fluvoxamine even if you feel well. Do not stop taking fluvoxamine without talking to your doctor.

If you suddenly stop taking fluvoxamine, you may experience withdrawal symptoms such as irritability; agitation; dizziness; extreme worry; uneasiness; confusion; headache; tiredness; mood changes; difficulty falling asleep or staying asleep; or pain, burning, numbness, tingling or 'electric shock' sensations in the hands or feet. Your doctor will probably decrease your dose gradually.

 

Other uses for this medicine

*Fluvoxamine is also sometimes used to treat depression. Talk with your doctor about the possible risks of using this medication for your condition.  This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

 

What side effects can this medication cause?

Fluvoxamine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:  drowsiness, difficulty concentrating, dry mouth, headache, nausea, vomiting, diarrhea, stomach pain, constipation, indigestion, gas, change in taste, decreased appetite, weight loss, nervousness, weakness, unsteadiness, and changes in sex drive or ability.

I am taking generic Neurontin, gabapentin, to help calm the activity in the basal ganglia where anxiety begins.  I take a 300 mg capsule four times a day,1,200 mg total.  Neurontin is an anticonvulsant medication the Amen Clinic has found to be effective for anxiety.  I started on this drug as soon as I got home from the clinic to help me get off the drug clonazepam.  I have written quite a bit about clonazepam in Chapter 12 - I Hate Clonazepam and Chapter 15 - Clonazepam The Beast.  (I have been off The Beast for 7 months! =)  My doctor at the clinic chose gabapentin for me because of its low side effect profile, but you will see there are many side effects listed for this drug in the following article.  I did not experience any of these side effects.

Information on generic Neurontin, gabapentin from: PubMed Health - Gabapentin

 

Why is this medication prescribed?

Gabapentin is used to help control certain types of seizures in patients who have epilepsy. Gabapentin is also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain.

 

How should this medicine be used?

Gabapentin comes as a capsule, a tablet, and an oral solution (liquid) to take by mouth. It is usually taken with a full glass of water (8 ounces [240 milliliters]) three times a day. Gabapentin may be taken with or without food. Take this medication at evenly spaced times throughout the day and night; do not let more than 12 hours pass between doses.

If your doctor tells you to take one-half of a tablet as part of your dose, carefully split the tablet along the score mark. Use the other half-tablet as part of your next dose. Properly throw away any half-tablets that you have not used within several days of breaking them.

Your doctor will probably start you on a low dose of gabapentin and gradually increase your dose as needed to treat your condition. If you are taking gabapentin to treat PHN, tell your doctor if your symptoms do not improve during your treatment.

 

Other uses for this medicine

Gabapentin is also sometimes used to relieve the pain of diabetic neuropathy (numbness or tingling due to nerve damage in people who have diabetes), and to treat and prevent hot flashes (sudden strong feelings of heat and sweating) in women who are being treated for breast cancer or who have experienced menopause (''change of life'', the end of monthly menstrual periods). Talk to your doctor about the risks of using this medication for your condition.  This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

   

What side effects can this medication cause?

Gabapentin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:  drowsiness, tiredness or weakness, dizziness, headache, shaking of a part of your body you cannot control, double or blurred vision, unsteadiness, anxiety, memory problems, strange or unusual thoughts, unwanted eye movements, nausea, vomiting, heartburn, diarrhea, dry mouth, constipation, weight gain, swelling of the hands, feet, ankles, or lower legs, back or joint pain, fever, runny nose, sneezing, cough, sore throat, or flu-like symptoms, ear pain, and red, itchy eyes.

My favorite website to learn about medications is Crazy Meds! The Good, The Bad, and The Funny.  It will tell you about uses, pros and cons, effects, side effects, and stuff your doctor usually won't tell you.  "Crazy Meds Suck Donkey Dong"  If that quote is offensive to you, you may not like this site.

I hope you are FEELING SOME RELIEF from your antidepressant medication, or will be soon!!