Antidepressant is it really a answer to my problem?

[GracieBH]

My Physician said at 20mg on Lexapro He said I'm maxed out. He want to put me on Prozac 20mg with no break between quitting the Lexapro and going on the Prozac.

I've had such problems with trying new meds, I'm nervous to change. I'm not sure if they make a higher dose than 20mg on Lexapro, but I have no side effects from it so I hate to change.

The problem is my stress level is out of control, between family, friends, and my MS I want to just run away. My friends, I don't think they understand why I can't always go out in the heat or for hours. I worry constantly about my parents because they are all I have so it's scary for me when I feel like no one is there for me.

I work full time or try to, I'm on intermittent leave because of my fatigue and have found that I just can't fight that when it hits anymore, so I leave. Then I get the "but you look so good" eye roll from a few coworkers and then that just angers me so bad I'm surprised I haven't cussed them out.

I'm going to try and find a counselor hopefully without a 4 week wait, I just have become so overwhelmed, any decision is a process. My neurologist, he's nice but no real help as far as the MS goes, nor is my family doctor.

I don't know what to do anymore!

[Jules A]

Hi GracieBH,
Yeah our neurologists no matter how nice aren't usually much help with this miserable, complicated disease.

I think Prozac is an excellent choice. It doesn't help everyone but it is unlikely to cause you harm. Most often what I hear is people complain of slight stomach upset in the beginning but because you are already on a SSRI it is doubtful you will experience that side effect. It is one of the first SSRIs so there has been a ton of research on it as well as it being FDA approved for certain indications in children.

It can be slow to reach the maximum effect, usually 6 weeks or so, which is likely why he is switching you right from one to the other. The good news about that is that with Prozac there isn't withdrawal symptoms if you decide to discontinue it because the effect takes a while to start it also takes a while to go away. You can also titrate up quite a bit on the dose if you have a partial response.

It should help with both mood and anxiety but you are definitely on the right track with considering therapy in addition to medicine because non-pharmalogic coping skills will be necessary also. Good luck.

[MSer102]

If stress is your major problem an antidepressant isn't the answer. Antidepressants can take the edge off the the point that they numb you so you don't feel much. But they don't do anything about the major problem which is that you aren't able to be proactive enough to make changes in your life to relieve stress, prevent stress in the first place, make changes to your relationships and get out of bad situations. An antidepressant isn't going to fix what's wrong with your life, no matter which one you take or how high a dose.

You are on the right track with getting counseling. If you have a good therapist, therapy can teach you how to solve your problems and prevent some new ones from happening. It can help you change how you deal with things you can't change. It can also help you decide what you want to live with and what you can't. It can help you find the strength to make the changes you might think are impossible right now.

If you don't know what to do, drugs are not the answer even if they're prescription medicines. The answer is to get in touch with yourself, get past your fears and learn how to make good decisions. It is possible to learn how to control fear, anxiety, worry and stress.

An antidepressant can help by raising or stabilizing your mood while you are in therapy so there is definitely a role for medication. And toward that end it might be better to have a psychiatrist decide which medication is best for you. That's their specialty. Family doctors don't have the time to become experts in psychiatric medications so they usually pick a couple that they like and prescribe the same ones for everybody. If you read what psychiatrists say about that it's one of their pet peeves.

So if you want to be on an antidepressant it makes sense to have it prescribed by a specialist who knows them well. I don't think you would expect your family doctor to know all about MS medicines and I don't think it's realistic to expect that your family doctor knows about psychiatric medications either.

Based on what you told us it sounds like depression isn't your major issue. So it sounds like therapy is the best approach with an appropriately prescribed medication to help, not the other way around or medication alone.

[Thinkimjob]

I don't know. All anti-depressants/ anti-anxiety drugs more or less work, but they're probably just masking the real problem.

Me, myself, I have no desire to work through the "issues". I know what they are, and I know exactly what a therapist would say, or encourage me to "express".

If you are young and reasonably perky, then use the drugs to help you work through the other stuff.

I'm happy (ha) enough with the drugs.

[mercadies25]

depression is my issue, I take 3 different kinds of anti-depressants it helps some, some of the time.
I would love to see a therapist but the cost is outrageous and most won't even see me without insurance. I have no insurance and hardly enough money to pay bills much less seek mental help. So if you can get to a therapist GO it can only help. I went for a short time before quiting work and felt better.
Anti-depressants also help but how much can we take?
I just keep trying.

[BigA]

As some have posted, you seem to have an anxiety problem - that's why you're worried about changing meds - not that there is no need for concern, but the extra worry is the Anxiety.

Some antidepressants are better and worse for Anxiety and some will be better and worse for you individually. Here's what I think:

1) Wellbutrin is often added when other ADs are not enough. I take it and it's very energizing. It will help with fatigue, it *may* give more anxiety or may give less - it helps me with anxiety. But it's truly a happy pill. Be sure to get the XL version.

2) If you switch, ask for some tranquilizers for the transition time, just in case. You can take them and feel much relieved within 20 minutes. They're fantastic. Yes, you can get addicted, but not that easily. Your doctor will be cautious, but a few pills are immensely helpful, just knowing you have them in your pocket and can escape is great.

3) Your long-term solution is meditation and exercise. Note that you don't meditate to relax, so don't get stuck when it doesn't "work". In meditation, you build the mental "muscles" to keep the brain focused (and not going wild). You practice regularly. Get a guided meditation or take a course. As for exercise, it helps you MS too.

Good Luck.

[justmsme1012]

OMG

I think I just wrote about the same post......I will read through your post and maybe it will help me also.....I was reading yours and I felt like you were telling my story....