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He Rx'd an antidepressant - A poor decision my neuro and my PCP made

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    He Rx'd an antidepressant - A poor decision my neuro and my PCP made

    It has taken me many years to get to the point where I have realized that my neuro gave me terrible advice when he Rx'd an antidepressant in 2000

    I was in the first year following my first MS event, my wife had been diagnosed with Stage 1 Breast cancer (she has survived 17 years since surgery) and when I mentioned my concerns to Dr. X he whipped out his Rx pad and sent me to the pharmacy.

    As we MS'ers know all too well depression can add to the MS experience.

    Trusting Dr. X I started taking Citalopram, some years later my new GP seeing it on my Rx list switched me to 150 mg of Effexor Rx.

    I knew then that these meds had an impact on my personal and professional life, but busy with home, family and a very demanding job, didn't investigate.

    This was a bad mistake!

    Almost seven years ago I moved to San Francisco and needing a PCP asked my son for a suggestion. He sent me to One Medical (highly recommended though I suggest you carefully review the staff qualifications before choosing your primary). Sometime last year my One Medical physician expressed qualms about my daily use of Zolpidem. She said I should start seeing a psychiatrist, which I did.

    During our first meeting Dr. Z expressed concerns about my anti-depressant use, suggested I cut down the Effexor XR dose, and, months later after I could not go from 37.5 mg/day to 0 Rx'd a very low dose (2 mg) of Citalopram.

    I have finally stopped the med and happy I did, my thinking seems to be a bit clearer, but am watching to see what happens - it has been about a week since my last pill and it should be out of my system.

    I firmly believe I was never depressed though I was definitely unhappy for good reasons, and should not have been given either of these meds.

    This is single person, anecdotal, and should be taken with several large grains of salt!

    I plan on sharing these thoughts with the MDs involved.

    I plan to follow this thread (man plans, G-d laughs, I procrastinate and forget) and eventually update this post. Can't promise, but ...

    G.

    #2
    An SSRI or SNRI prescribed by a PCP isn't usually a problem although prescribing them both together except during a titration process imvho is concerning unless done by a thoughtful, experienced psychiatrist who thoroughly documents the rationale.

    I'm not a fan of the sedative hypnotics for anything more than the briefest sleep correction and really don't like seeing females on higher than the recommended dose which unfortunately is not unusual.

    I hope you continue to feel better as you work with your new psychiatrist.
    He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
    Anonymous

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      #3
      Originally posted by Jules A View Post
      An SSRI or SNRI prescribed by a PCP isn't usually a problem although prescribing them both together except during a titration process imvho is concerning unless done by a thoughtful, experienced psychiatrist who thoroughly documents the rationale.

      I'm not a fan of the sedative hypnotics for anything more than the briefest sleep correction and really don't like seeing females on higher than the recommended dose which unfortunately is not unusual.

      I hope you continue to feel better as you work with your new psychiatrist.
      Jules,

      Thanks for your good wishes and insights - once I am reasonably certain that I have successfully gone off Citalopram I will speak with my psychiatrist about my sleep issues.

      I wasn't as clear as I hoped.

      I never took two antidepressants at the same time though there was an overlap due to the med's half life.

      I am a 68 year old male.

      Aside from a few very strange dreams when taking Ambien (Zolpidem) ER following a recent 24+ hour journey home from Europe starting around 3 AM, I haven't had a bad reaction or gotten out of bed other than the usual quick early morning bathroom visits.

      My ex-wife, a heavy recreational drug (MJ, LSD, mushrooms & more in the 60s and 70s) user in her teens and early adult years, a MSW, took Ambien an hour or more before getting in bed, she'd take a pill and soon drink about a half bottle of Muscat wine along with onion dip, crackers, etc. Results: auto accidents, divorce, being fired from several jobs, and, over a few years, coming close to doubling her weight.

      G
      PS - Lunesta would almost always result in a very strange dream somewhere between 4 and 7 AM.

      Comment


        #4
        Sorry to hear of your experiences. I think for short term or as a maintenance drug, ok for PCP or neuro to prescribe. Just my opinion and experience.But for long term or changing needs, think a psychiatrist should be involved, along with therapy. The psychiatrist is a specialist in these meds. I was on one med after diagnosis for a year or so, did well. About 7 years later, started to have problems again. Neuro gave me same Rx as before while waiting to get in psychiatrist again. It made me worse the second time.Hope you continue to get better. Thanks for sharing your lesson learned.
        Kathy
        DX 01/06, currently on Tysabri

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