Some background:

I’m using an AD (Cipramil) for 2 and half years now. Before this I used it for 8 months, but the depression returned and now I’m using it chronically. There is a genetic disorder and tendency towards depression etc. on both sides of my family, but I've developed OCD, depression & anxiety only during and after my involvement with FOM. I did experience some mild depression & anxiety from time to time while I was growing up, but it was never of such a nature that I needed to take medication for it. Therefore it seems my involvement with FOM “triggered” these disorders in such a way that it get out of control.

To those of you who have experience or knowledge about mental disorders and A/D’s, I have the following questions. I just want some opinions and others experience on this:

1. Do you think and/or have experienced that people who have a genetic tendency in the family towards mental disorders and have started to use medication because of a “trigger” (negative life experience) can return to their original state (as they were before the disorder) and stop using the medication without the disorder(s) returning again? Or is it in the best interest of the patient to take this medication on a chronic (ongoing) basis? How about stop using the medication for some time to ‘test’ and see how things goes? Will “weaning” off and start using it again if the disorders return, not have a negative impact (physically & mentally) on the long turn? Is it safe to “wean it off” from time to time to see how it goes or can such experimentation further "disturb" the chemical balances in the brain?

2. To those who have used this medication themselves (or still using it): Have you experienced that the effectiveness of the medication stays the same over a long period of time (say more than 2 years) or did you need to increase the dose after a period of time?

3. Did you experience any negative side effects over the long turn - such as a decrease in libido etc.? Do you sometimes feel that the medication “numb” out your feelings and prevent you from experiencing all the emotional highs and lows – in other words, do you feel that the medication sometimes makes you feel TOO stable emotionally?

Thanks in advance for any input.

That was a lot of questions. Depression runs in my family. We have all kinds of crazy relatives. I knew something was wrong at a young age, about 8. I also had OCD.

I didn't take meds until I broke up with my fiance at 20. I went into a horrible year long depression.

My sister never seemed to have problems until she broke up with a lover. She ended up hospitalized. She has been on anti-D's for 10 years, and was able to turn her life around and graduate from Harvard law school. But she feels that she needs to take them for life, and occasionally has the prescription changed.

I took AD's after D-day, and took them for over a year. Then I felt good, so tapered off according to doctors instructions. I've been doing fine without them for over a year.

The only side effect that I noticed was a difficulty in having an orgasm, which was not a huge problem, since my husband is gone.

HAve you spoken with your MD about switching to a different AD med?

My estranged W has all the disorders as you do. She developed them from childhood and have not gone away since. I think she is on about 4 to 5 different meds for all of these. One to help with depression, one to help with OCD, one to help her sleep at night, one for migraines, and others I can't recall. It is herditary - her dad has some symptoms and her sister has gone through depression.

So to answer you specific questions, this is what I have gone through second hand with my W:

1) I'm pretty sure she will be on it for life. She doesn't want this and thinks she can stop talking them one day but it hasn't proven otherwise. You just never know when I trigger will be. Weaning is never a good idea because you don't know what will happen. Never change your meds without your doctor's consent. It is true that these meds will mess with you brain's chemistry over long term use and doctors really don't know the long term side effects.

2) My W has had her dosage increased many times. At one point she asked for an increase in dosage and her doc refused because it would be unhealthy to do so. She has also changed drugs due to different side effects and sometimes the drugs just didn't help.

3) My wife had a very low libido to start with and it went to zero on her meds. She had no desire whatsoever. She also became very lethargic and had to sleep all the time. However, she never reallt became "stable", she would still obsess about work and letting people down.

This is from my experience with my W but I have not gone through this. I hope this helps or gives you some food for thought.

Believer and CambridgeMan, thanks for the responses, it was very helpful.

CambridgeMan, especially the sharing of your experience on your W’s disorders and use of AD’s was very insightful and gave me some things to consider and think about for the future.

Bigwave, recently I haven’t spoken with my MD about switching to a different AD.

The AD I’m currently using falls in the SSRI category and keep my OCD, depression and anxiety under control. I prefer taking one tablet which helps for all of these than using 2 or 3 different types of medicine. I tried the other AD’s in the SRRI group before, but the side effects was terrible and so far Cipramil works the best for me and according to the MD, safe to use on long term.

I can’t really complain about side-effects from it, except that I sometimes feel “numb”, have a lower sex drive than usual and recently I also have difficulty in having orgasm. I didn’t had a problem with the orgasm thing before (while using Cipramil), so this is why I was wondering if this is due to the long term use of it. However, on the other SSRI AD’s my sex drive was non-existent, so comparing to that, I can’t really complain about Cipramil at all. I guess any medicine have its pros and cons.

There is a new product on the market (Cymbalta) which is slightly different than the products in the SRRI group and with fewer side-effects. I asked my MD about this at the beginning of the year and the possibility to try out this product, but he advised me to stay on my current medication since it works well with me. He said I can try Cymbalta, but the research on it is very new and although this product is very good, is not to say that it will work better than Cipramil.

Although it feels like my OCD and depression is totally under control, I still have a tendency to obsess, feel anxious and ‘worry’ about things too much from time to time. Recently I have also started to feel “numb”. I don’t know how to describe it, but it’s like an “empty” feeling inside of me – I don’t feel unhappy and depressed, but I don’t feel happy or alive either...

I ask myself if this is due to the long term use of the medication or due to the unemployment and infertility problems me and my H experience for some time now. Or maybe it is a combination of both. I don’t know... I do know now will not be a good time to wean off the meds while me and H have this external problems and stres, but I do know I don’t want to use these meds for the rest of my life if not necessary. If I have to, no problem and I will accept it, but if I can do without it some day I will be very glad. I don't like the idea of being dependant on a tablet for the rest of my life.

Further feedback and/or opinions will be greatly appreciated.

Most of the women on my mothers side suffer with depression.
I started with lexipro, but gained 25 pounds in 6 weeks which made me even more depressed, Zoloft made a zombie, but Effexxor TRC made a huge difference win my life.
I am off of it now, but it helped so much, plus no weight gain, or sexual side effects.
I ended up taking Clonopin for anxiety disorder.
Once H rekindled his friendship with OW, and his plan was to make me believe that i was insane, I began to have panic attacks. I almost ended up hospitalized as I couldn't eat, sleep, or function, just shook alot and cried.
It has only been 12 days of NC with OW but I have not had any anxiety for the last 3 days or so, have not had to take meds,and am feeling a little better.
That may change when H comes home next week!

Suzet,

I had the same problems when I was taking SSRI's. I felt completely numb. I wasn't sad, but I also wasn't happy. It felt like I couldn't feel.

My doc switched me to Wellbutrin, as it works on the dopamine receptors as opposed to seratonin. It's working for me (I have some sad days, but they are not unbearable, and I have some really good days). Often, a doc will prescribe Wellbutrin in combination with an SSRI.

Cymbalta and Effexor are both SSRI's that work on seratonin and norepinephrine receptors. The difference is that Cymbalta is faster acting (gets both levels to their peak quicker), and reportedly has fewer side effects.

Unfortunately, it is up to you whether you want to try something new. I remember when I had to decide if I wanted to get off Lexapro and try Wellbutrin, I was really frightened. My psychiatrist also wanted me to stay off for a while so that we could get a 'baseline' on my moods.

The good thing about if you do decide to switch, is that if your moods fall, then at least you are aware of why....so you don't have that helpless feeling. Plus, your hubby will be there to help <img src="/ubbt/images/graemlins/grin.gif" alt="" />.

Good luck!

L.I.T.

Do you take Wellbutrin only for depression/mood disorder or do you have related stuff with it like anxiety or OCD? The reason I’m asking is because I want to know if a product like Wellbutrin (which only work on the dopamine receptors) will have the same effectiveness for my specific disorder (OCD with associated depression and anxiety). I know OCD and anxiety disorder is related to a serotonin imbalance and this is the reason why the psychiatrist prescribed me a SSRI which only have an effect on the serotinin level.

Wellbutrin sound like a good product, so I will do some research on the internet. You said doctors often prescribe Wellbutrin in combination with an SSRI. Can you please tell me more about this? If taking Wellbutrin and a SSRI in combination, do you think it will cancel out some of the side-effects of SSRI’s like sexual side effects and tendency to feel numb?

I think I’m a doctor’s worst nightmare because I always want to know things in detail and exactly how it works. I think I have too many questions. That’s why I posted it here and do research on the internet so I can just approach the doctor with the basic questions. <img src="/ubbt/images/graemlins/grin.gif" alt="" />

Suzet,
If you have a family history of depression, anxiety, etc, then more than likely the symptoms will always return after being off medication for a period of time. At least that has been my experience. It's one thing if you have gone through something traumatic and you need medication to cope, but when genetics are the cause the problem generally returns once the seratonin starts to deplete over a period of time.

Depression and anxiety exist as reflections of each other. A person who first becomes depressed and stays that way for a period of time will eventually find themselves anxious because of their depression. Similarly a persion who has anxiety for a long period of time will eventually find themselves depressed because they are unable to cope with the anxiety. So depression and anxiety overlap, it just depends which comes first.

OCD is a special type of anxiety. The obcessions and compulsions are a way of dealing with the anxiety. For those who have OCD it usually takes "HIGHER LEVELS OF MEDICATIONS" to raise the seratonin. This is something family doctors don't always understand about OCD anxiety and it requires a psychiatrist who knows how to treat OCD.

If you can find a psychiatrist willing to work with you on your medications and you are willing to go through some ups and downs for a bit you might be able to find the right medication that is right for you. Although the one you are on has some of the least side effects. Another possibility is Lexapro, which is an isomer of cipramil and may have even less side effects.

Other possibilities are SNRI's such as Effexor or Cymbalta. Those work on Seratonin and Neopinephrine. Because they affect the neopinephrine they are more stimulating, they don't tend to make you feel as numb, and don't have some of the sexual side effects. They may be less effective for OCD, but then it depends on how bad your OCD is. If it's mild they may work well.

The Wellbutrin is mainly for depression and not anxiety. Great for helping to stop smoking. It does affect dopamine and neopinephrine. Neopinephrine again will give you more of a feeling of alertness and make take away some of the numb feeling. It's why they think it helps some with the sexual side effects in women. It's not always a help for men.

I currently am taking Cymbalta for OCD anxiety, although it is designated only for depression. For me there have been no side effects.

Art,

Lots of great info. Thanks so much! <img src="/ubbt/images/graemlins/smile.gif" alt="" />

Art, I hear what you are saying and I have started to accept the fact that I will probably have to use medication for the rest of my life (or at least from time to time as needed). Apart from the fact that I have a family history of psychiatric disorders, physical and sexual child abuse has contributed hugely to my mental problems. I have received the necessary IC for these internal issues a few years ago, but I have done some research on the subject and discovered that disorders such as depression and anxiety are common amongst women who have been abused as children. From the research I have also discovered that women who were physically and/or sexually abused as children, may have alterations in their brain chemistry that make them prone to depression and anxiety. In the study where I have found these info, it was also discovered that the increased hormonal responses to stress may explain why women who were abused as children are at high risk of major depression and anxiety disorders.

In my case the anxiety definitely came first. I felt unable to cope with the increasing anxiety and as a result I became depressed. I didn’t know what was going on with me and felt like a failure and a “freak”. And the more depressed I become - the more the anxiousness and obsession increased. It was like a vicious cycle – a downward spiral.

Art, My OCD is/was not so bad in the sense that I mainly struggle(d) with the obsessive part of the disorder and not the compulsive part. I have some compulsions, but it’s not practical things like hand washing, door checking etc. When I have obsessive thoughts about something, I tend to do stuff which feed these thoughts and increase the obsession. And then I find it diffucult to focus my attention on something else.

According to what you’ve posted and the information you have supplied me with, I think Cymbalta might me a good alternative choice for me. I like the fact that it might take away some of the numb feeling and it’s good to hear that you’ve not experienced any side effects from it. I know two person who also use Cymbalta and so far they have used it without any problems.

Thanks again for sharing.

Blessings,
Suzet

Suzet,

TheRealArt layed it out very well. Unfortuately, I don't know much about OCD or long term anxiety....I wish I did.

But here's how one of the neurologists described the combination of an SSRI with Welbutrin:

"The Lexapro takes the clouds away, and the Welbutrin brightens the day."

He takes both. I only have short periods of anxiety, to which I just tell myself they will be over in a few days. Of course, I'm beginning to question that because I have been waking up in the middle of the night or morning with my heart POUNDING fast. I do get a little scared.

I have tried Lexapro and Effexor. The Lexapro made me feel less numb than the Effexor (the numb feeling is good just at the beginning of d-day....allows one to think with their cognitive abilities rather than with their feelings). But I still had trouble feeling.

I would definitely suggest seeing a psychiatrist who will work with you. My IC suggested one for me who is really nice, and extremely helpful. You don't happen to live in Dallas, do you? <img src="/ubbt/images/graemlins/pfft.gif" alt="" />

L.I.T.

I see we have almost posted at the same time (I responded to Art just before you posted to me!). Yes, Art’s post was very helpful and he indeed laid things out very well... I don’t think the two psychiatrists in my immediate town will be patient enough to answer all my questions and explains things so well as the helpfull people on here… <img src="/ubbt/images/graemlins/wink.gif" alt="" /> And unfortunately I don’t live in Dallas. (I live on the Southern part of Africa). <img src="/ubbt/images/graemlins/grin.gif" alt="" />

Just to share with you, my OCD dealt more with obcessive thinking. I would get locked in on a thought and it would be hard to let it go. The thought could go on and on in my mind for hours. My compulsions usually took the form of extreme house cleaning. When my anxiety was high I felt I had to have order and cleaning house until it was perfect was the best way to obtain order. My wife loved it on those days because she would come home to a very clean home. Just to say how exteme I would clean, I would even take down the light fixtures and put them in the dish washer.

I take 120mg of Cymbalta for my OCD. 60mg is the max dosage usually given for depression. It would a psychiatrist who understands OCD to give anything higher than 60mg and they would probably stop at the 120mg, which was just right for me. Some people may even require lower, it all depends on how your body functions.

Ha ha! Well, git yer butt on over to Texas, girl! We dun got a lot 'o those psychiatric-type people over here! <img src="/ubbt/images/graemlins/tongue.gif" alt="" />

<img src="/ubbt/images/graemlins/grin.gif" alt="" />

This was exactly the same with me. As I’ve explained yesterday, my OCD also dealt more with obsessive thinking than compulsions. Especially during withdrawal from FOM the obsessive thinking was severe and became worse. It went on like this for 6 months. The withdrawal & obsessiveness only became better after I started to took the medication.

From what you told me our OCD problems sound very similar. Before I started the medication, I was obsessed with a clean and orderly house. I would not really do extreme house cleaning like you, but I couldn’t stand it when the house started to become disorderly and/or unclean. During such instances I would start to feel overwhelmed and very irritated/“moody”. I don’t like it if things lay around in the house or feels unclean. In the past me and my H fought about this a lot because he is no concerned about an ultra clean and orderly house like me and often let things lay around in the house. Since I’m on the medication, I have learned to “let go” in some ways and I don’t feel so uptight about it anymore, but I still have issues about this and the perfectionistic & obsessive traits are still there - it's just more under control.

I can just imagine how happy & surprised your W was to return to such a clean home! <img src="/ubbt/images/graemlins/wink.gif" alt="" />

Update:

I visited my doctor yesterday and he advised me to stay on my current medication (Cipramil). However, I received a testosterone injection too see if it will help for sexual “numbness” and difficulty in achieving an orgasm I experience for the last couple of months (which is a side effect of the medication). The injection will only last for 4 weeks but if it helps, the doctor will give me a testosterone implant which will last for 6 months. My doctor further advised me to wait until after our circumstances have stabilized (until my H’s court case is finished and he is employed again) before I can slowly start to wean off the medication and see how I feel without the medication (Cipramil).

Now a question: Have any of you women ever received a testosterone injection/implant for sexual related problems/issues where the sexual issues were a result of antidepressant medication? And if you did, has it worked for you and was the change subtle or drastic? I would like to hear any experiences (or opinions) on this. I will also appreciate if someone knows of a good website link where I can get more information on this issue.

Thanks in advance,
Suzet

I have read a lot of articles on testosterone for women. If you search google with just "testosterone women" you will find a lot of the articles. There are some side effects you have to watch out for: excessive hair growth, acne, hair loss, deepening of the voice, clitoris enlargement. The benefits are definitely increased libido and hightened orgasms.

Oh, my gosh!!! <img src="/ubbt/images/graemlins/eek.gif" alt="" />

Thanks AskMe, I will do a google search... The amount of testosterone the docter injected me with was a small amount, so hopefully the women who have that type of side effects are the ones who took it excessively or too big amounts and/or over a very long period of time... But I will read up on it anyway. Maybe I shouldn't have taken the injection so readily and had to read up on it on the internet first. <img src="/ubbt/images/graemlins/frown.gif" alt="" /> Yesterday I asked the doctor about hair growth (because I already struggle with much hair growth on certain parts) and he assured me that one or two injections won't have that type of effect but over a long period of time (injection after injection) it possibly will. That's why he will rather put in an implant if it works for me. For one or other reason implants don't give the side effects of injections. Maybe because and implant allows the body to only absorb very small amounts of the hormone. I guess I have to do a search on that too...

Suzet* hope I didn't scare you.....I guess I should have been more careful in what I put, but I wanted you to be informed too. I'm sure your doctor is using doses of medication that is appropriate for you.