Help please - how long do meds take to work for you?

[kizzie]

Hi Ive been back up a therapeutic dose of anafranil (clomipramine) for the last 10 weeks - 8 weeks back up to 75mg with is the max dose i have taken in the past. (Its a tricyclic)

I had already been on the drug since 2006 (75mg then 50mg then 25mg then 20mg and below for a year) and had been very well for the last3 years. (I cant take more than 75mg because it reduces my blood pressure too much).

I took 7 weeks off work and returned 2 weeks ago. I returned after a similar break from work in 2006 and managed ok. This time i have also reduced my hours and have taken a temporary downgrade to reduce my responsibility. But the depression and anxiety and still extreme and I am crying regularly through the day and feel quite desperate.

My psychiatrist has said that he would expect anafranil to work again (its the third time Ive been on it) and to stick with it for another few weeks - but am i just clutching at straws. If something hasnt worked after 8 weeks at therapeutic dose then is there little chance of improvement after this time?

I would really appreciate any thoughts - finding it very difficult to cope.
x

I'd be absolutely desperate after 8 weeks too, probably begging for something different. Mine all 'work' quite quickly, that is they start to do something, could be placebo effect but have been on enough to know when they are helping and when they are doing nothing.

Apparently my anti-depressant is the least effective ever even at therapeutic doses (I take half the normal
starting dose) but I think it's a miracle drug - reboxetine. I also take an anti-convulsant (for my mood) which is quite a stimulant and kicks in quickly, it is supposed to be quite good for depression, Lamictal. And I take quetiapine which is quite a mild anti-psychotic that is also supposed to help with depression as well as mania, it works quickly in terms of helping with sleep and boosting appetite and alleviating anxiety - within a few days - but am not convinced it does much for my actual moods.

How long before you can see your dr again?

thanks for replying.

Im seeing dr again on the 18th

The weekend was really awful. Just constant anxiety/panic attacks and crying.
And then today just shaking all day and crying.

You wouldnt believe that when im well i run a media business and am responsible for all output/staff/ budget etc.

Im so frightened at the moment that im just not going to get well this time

(btw Mitchy im glad you are feeling stronger x)

I believe you, it just shows how debilitating mental health problems can be. The 18th is thankfully not too far away, would it be catastrophic to take some more time off?

I know that feeling of 'this is the one I won't come out of', it IS the depression talking but feels so real and final at the time. Do you have anything else to help in the short term, or anyone else you can see/call for support?

im seeing a counsellor who ive known for a long time - should be able to see her early next week.

Have done bits and pieces of cbt in the past and was going to go for more - although the psych has said that because he thinks my problem is 'purely' ???? chemical cbt wouldnt be much help.

My consultant told me that, I did find cbt beneficial though - coming to terms with diagnosis (bipolar) recognising symptoms and signs of relapse, but it took a few years to sink in . Lifestyle things help too, in fact are more my mainstay than drugs which I go on and off like a yoyo.

Hope appointment helps, keep posting if that takes the edge off? You will feel better again, it's inevitable, like changes in the seasons. x

thats useful to know about the cbt.

I feel about keep posting because i seem to have been going on about this for so long

if it helps you feel less alone or helps in any way at all then 'go on about it' as much as you like, that's what this board is here for after all!

thank you xx

today has been so hard

I woke up with overwhelming feelings of anxiety and panic(for no apparent reason).

Went for walk to try to reduce the adrenaline and cortisol but when I got back had horrible waves of depression and frightening negative thoughts. Couldnt stop crying and felt really desperate.

Ds's off school today because of election and im so sorry that their mum is in such a state at the moment. They deserve so much better. DH was also off for part of today and he is really losing patience with it/me. i dont blame him - it must be so difficult for him.

Ended up sobbing on the phone to my mum but then i know all im doing is upsetting them.

I think id find it easier if i had something to be depressed about. I know that must sound so horrible to people who really do have problems to worry about but i just inderstand it when theres nothing wrong.

Before this latest bout I was probably the most content, fulfilled and simply happy that Id been in my adult life. And then this just hit.

I dont know why im writing really because i know theres nothing anyone can do but if youve read this thank you for listening

cant atop crying this morning

my RL friend came and sat with me for an hour this morning. She is very understanding.

I just wish this dark cloud and intense anxiety would lift. It ll just seems to have lasted so long this time .

Thanks for replying x unfortunately/fortunately (i dont know which it is) the anxiety isnt based on anything. The dr says I have chemically activated anxiety and depression.

Its 10 days till i see the psychiatrist again now.
Got to just keep putting one foot in fron of the other till then. Although i know there will be no miracle sures on that day.

I keep thinking 'maybe tomorrow 'IT' will have lifted' but no luck so far.

i think its the length of time its gone on as much as anything - at the start I think i had some resilience left and kept telling myself - 'just another few weeks' - but those few weeks have turned into nearly 4 months now (although only 8 weeks on the 75mgs.)

Sorry i know this is so boring for everyone - and its not even post natal so doesnt help others to share the experience. But I cant talk to DH anymore about it - hes had enough. And theres only so much you can load onto other people anyway.

Am sorry I missed these, haven't been here much lately. Do you have a sympathetic gp? Wondering if you could get something to help between now and next appointment with psych, like diazepam or lorazepam or something. Or even some over the counter stuff or rescue remedy?

Gp is ok but sort of 'opts out' when Im seeing the psychiatrist so think i'll probably have to wait for that appointment.

Thanks for replying - it really does help to know someone is reading x

Thank you xx

hey kizzie - am so sorry you are feeling so awful.
Do you have OCD ? I was prescribed anafranil many years ago when first diagnosed with OCD - can't remember how quickly or indeed whether it helped me -I was in a very wretched state. More recently (6 months ago) I started taking venlafaxine which seemed to take a while to kick in - I do think it has helped a lot in the last 4 months - am now having CBT as well (have had it before) and hope that the combination will be helpful.

Hi- i dont have particular OCD but when the depression kicks in i do have obsessive thoughts (if that makes any sense).
Although thats not why they originally gave me anafranil - it was given as a 'different' AD to the SSRI's because id had horrible withdrawal probs from seroxat.

My psychiatrist told me that CBT wont help me because my depression/anxiety are 'chemical' rather than caused by faulty thinking but Im thinking of trying it anyway to see if it can help me deal with the symptoms of depression. Ive read all the books on it but feel that I need someone to actually go through it with me

I do believe that CBT is pretty good for resetting responses to anxiety and stress and even if yours is chemical,I think that the emotional responses can be helped,if that makes sense.

Thanks MAS.
I feel heartbroken today. I know that sounds over dramatic but i miss my mind and my life :-(

for you kizzie

I hope you are ok today kizzie, or at the very least no worse.

It doesn't really matter whether you view your depression as 'chemical' or reactive or whatever, you can benefit from CBT, take control of your thoughts and find ways to improve your mood and so on. You probably need to be getting more from your meds first though?

You will feel better again, sooner rather than later hopefully x