Believe Me Im A Docter

Hello all...to be frank ive being quite depressed of late..just that feeling of who cares..lethargic,negative thoughts,lack of motivation.So i go see my G.P..his prognosis was a chemical imbalance..out comes the scprit...45mg.Zispin&5mg Zyprexa..then he wanted to give me a benzo for sleep..as its been v.irregular..for an age. a dilemma..o.k for the anti,depressant&even the zyprexa..but i had to say no to the..temazepam..coz i know the month script for them would gone in a wk.Its just a rant..but it was a real potetial trigger for me..so soon after my benzo binge 2wks.ago.Also folks if anyone has any knowledge about the first 2 meds..i would app.it..i ony want to be on the meds for as short a time aspossAlso guys have any of you in a low,negetive state of mind after being off gear..i dont mean the 1st few wk.but maybe 6mnth.down the line as i am.Or can anyone recommend an anti.deppresant..that that has a good response from ex.addicts.Just to top it off..i have doubts in myself..am i just reaching for a tablet..even if its non addictive..to cure my mental ills real or imaginary.
Hi Davey, I figured you were pretty down and out from your last posts. I'm very sorry to hear that. I don't know anything about what you were prescribed, but you could search google on it. Good on you in turning down the benzos. It would most certainly turn on you in a very short time. 6 months is so awesome. It would be madness to jeapordize that for anything. I do think that depression is common at this stage of the process. We spend so much time thinking that if we could just get clean, we'd be so happy. Everything would be wonderful. But life still has problems and stresses and now we don't have drugs to smooth them out.
I've been worried about you Dave. Look the meds up and see what you think about it. It might be a real help. I think your job is pretty physical (welder?) but I find long walks to help. Helps with sleep as well. I wish your computer prob was worked out so we could support you more. I'm always pulling for you, even when you're not around. Hang in there Dave. What you've accomplished is awesome. Truly!!
xxoo, Beck
Davey......Here are some facts on the first:

Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. Although Mirtazapine has a tetracyclic chemical structure the pharmaceutical company have chosen to promote the drug using the acronym noradrenergic and specific serotonergic antidepressant (NaSSA), although there is only modest evidence from their research department to support its claimed effects. Indeed, recent work by researchers independent of Organon International has failed to replicate much of the original data. Also the difference in receptor profile from the 'parent' drug, mianserin, appears to be non-existent, at least in respect of those properties that are hypothesised to be relevant. So the rationale for supposing it to be different to mianserin rests on poor, or non-existent, evidence. Due to its unique pharmacologic profile, mirtazapine is virtually devoid of anticholinergic effects, serotonin-related side effects, and adrenolytic effects (orthostatic hypotension and sexual dysfunction). As such it may be preferable to SSRIs. Mirtazapine is relatively safe if an overdose is taken.



Trade Names
Mirtazapine is marketed under the tradenames Remeron in the U.S. and Finland, Avanza and Axit in Australia, Zispin in the UK & Ireland, Norset in France, Remergon in Belgium, Remergil in Germany and Mirtabene in Austria

Mechanism of action
It is thought to work by blocking presynaptic alpha-2 adrenergic receptors that normally inhibit the release of the neurotransmitters norepinephrine (noradrenaline) and serotonin, thereby increasing active levels in the synapse. Mirtazapine also blocks post-synaptic 5-HT2 and 5-HT3 receptorsan action which is thought to enhance serotonergic neurotransmission while causing a low incidence of side effects.

Side effects
Interestingly, its side effect profile can be used for benefit in certain clinical situations. The drowsiness, increased appetite, and weight gain it causes are useful in patients with depressive disorders with prominent sleep and appetite disturbances. In addition, it is quite useful in inpatient situations in which patients suffer from nausea since it also antagonizes the 5-HT3 receptor, the target of the popular anti-emetic ondansetron (Zofran).

At lower dosages, such as 7.5 mg, mirtazapine is primarily antihistaminergic, causing sedation, which can be beneficial in depressed patients who have difficulty falling asleep. At doses higher than 15 mg, its effect is primarily in blocking reuptake of norepinephrine, and is thus less sedating.


Side effects occurring commonly:
Increased appetite
Weight gain
Drowsiness, especially at lower doses and during the first few weeks of treatment
Dizziness
Headache
General or local swelling
Visual hallucinations (when taken during the day)

Side effects occurring rarely:
Mania
Nightmares and vivid dreams
Seizures
Tremor
Muscle twitching and Restless Legs Syndrome
Pins and needles
Rash and skin eruptions
Pain in the joints or muscles
Low blood pressure

Dangerous side effects
If you experience any of these, tell your doctor immediately. You will need to consult your doctor for taper-off instructions. Sudden withdrawal from antidepressants can cause serious symptoms.

An allergic reaction; signs of swelling of the lips, face and tongue, difficulty in breathing, rash or itching (especially affecting the whole body) or feeling faint.
Signs of infection such as fever, sore throat, mouth ulcers or stomach upset.
Jaundice (yellowing of the skin and/or eyes).
Agranulocytosis

Dosage
The usual starting dose for mirtazapine is 7.5 - 15 mg once daily, usually at bedtime (due to its sedative nature and the possibility of disturbed visual perception). Doses may be increased, following medical advice, every 1-2 weeks up to a dose of 45 mg; the maximum daily dose is 90 mg. It may be taken with or without food. Dissolving tablets (SolTab orally disintegrating tablets) can even be taken without water.
....and the second:

Olanzapine (oh-LAN-za-peen, sold as Zyprexa, Zydis, or in combination with fluoxetine, as Symbyax) was the third atypical antipsychotic to gain approval by the Food and Drug Administration (FDA) and has become one of the most commonly used atypical antipsychotics. Olanzapine has been approved by the FDA for the treatment of schizophrenia, acute mania in bipolar disorder, agitation associated with schizophrenia and bipolar disorder, and as maintenance treatment in bipolar disorder and psychotic depression.

It has also been established in treating depression off-label because of its mood-stabilizing properties and its ability to increase the efficacy of antidepressants. Olanzapine is manufactured and marketed by the pharmaceutical company Eli Lilly and Company. It is available as a pill that comes in the strengths of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, and 20 mg and as as Zydis orally disintegrating tablets in the strengths of 5 mg, 10 mg, 15 mg, and 20 mg. It is also available as a rapid-acting intramuscular injection for short term acute use.

Case-reports, open-label, and small pilot studies suggest efficacy of olanzapine for the treatment of some anxiety spectrum disorders (e.g. general anxiety disorder, panic disorder, post-traumatic stress disorder); however, olanzapine has not been rigorously evaluated in randomized, placebo-controlled trials for this use and is not FDA approved for these indications. Other common off-label uses of olanzapine include the treatment of eating disorders (e.g. anorexia nervosa) and as an adjunctive treatment for major depressive disorder with psychotic features.

Pharmacology:
Olanzapine is structurally similar to clozapine, and is classified as a thienobenzodiazepine. Olanzapine has a high affinity for dopamine and serotonin receptors. Like most atypical antipsychotics compared to the older typical ones, Olanzapine has a lower affinity for histamine, cholinergic muscarinic and alpha adrenergic receptors. The mechanism of action of olanzapine is unknown, however it is theorized that olanzapine's antipsychotic activity is mediated primarily by antagonism at dopamine receptors(does not allow dopamine to activate the dopamine receptors), specifically D2. Serotonin antagonism may also play a role in the effectiveness of olanzapine, but the significance of 5-HT2A antagonism is debated among researchers. Antagonism at muscarinic, histaminic and alpha adrenergic receptors likely explains some of the side effects of olanzapine, such as anticholinergic effects, weight gain, sedation and orthostatic hypotension.


Metabolism:
Olanzapine is metabolized by the Cytochrome P450 system isoenzymes 1A2 and 2D6 (minor pathway). Drug metabolism may be increased or decreased by agents that induce (e.g. cigarette smoke) or inhibit (e.g. fluvoxamine or ciprofloxacin) CYP1A2 activity respectively.

Adverse events:
Adverse events reported in the package insert for olanzapine include dry mouth, dizziness, sedation, insomnia, orthostatic hypotension, akathisia, and weight gain. Olanzapine is reported to cause extrapyramidal symptoms, tardive dyskinesia and neuroleptic malignant syndrome, although at a much reduced rate when compared to the classical anti-psychotics. Recently the FDA required the manufacturers of all atypical antipsychotics to include a warning about the risk of hyperglycemia and diabetes with atypical antipsychotics. Additionally there are some case reports of olanzapine-induced diabetic ketoacidosis. There is data showing that olanzapine can decrease insulin sensitivity. In addition, increased triglyceride levels may also be an issue with olanzapine. Impaired glucose metabolism, high triglycerides, and obesity have been shown to be constituents of the metabolic syndrome and may increase the risk of cardiovascular disease. The data suggests that olanzapine may be more likely to cause adverse metabolic effects than some of the other atypical antipsychotics. Citing an increased risk of stroke, in 2004 the Committee for the Safety of Medicines (CSM) in the UK issued a warning that olanzapine and risperidone, both atypical antipsychotic medications, should not be given to elderly patients with dementia. The results of a large, random-design study funded by NIH's National Institute of Mental Health (NIMH) were published in September 2005. The 18-month study, which involved 1,400 participants at 57 sites around the country, found that "patients on olanzapine also experienced substantially more weight gain and metabolic changes associated with an increased risk of diabetes than those participants taking the other drugs." Data from a small, open-label, non-randomized study seems to suggest that taking olanzapine by orally dissolving tablets may not be associated with the same degree of weight gain as conventional tablet formulations (de Haan, et al. Psychopharmacology 2004 Sep;175(3):389-90); however this has not been substantiated in a blinded experimental setting. According to information made available from the U.S. National Library of Medicine the effects of olanzapine on children under the age of eighteen have not been thoroughly researched. Additionally, it is not clearly understood what effect, if any, olanzapine might have on the unborn child of a mother who is being treated with the drug. Laboratory tests have shown that olanzapine can penetrate the placenta in animals. It is also unknown whether or not olanzapine is transferable in human breast-milk. Olanzapine does, however, pass in the breast-milk of laboratory animals. The effects of olanzapine, in conjunction with other drugs has not been fully studied. Alcohol and any other centrally acting drugs should be avoided while taking olanzapine.



Hope they help......the best to you always!
D!

..Davey..
..I second wot beck said..You have come a long way in trying to stay off the pills..you will get times like this where ya feeling like no one cares and that..but we care on here how ya feeling and getting on and your daughter cares how her dads feeling..as bad as it gets..we have to try ride out the storm..walks are good mate..it helps clear ya head (i normally walk by the river..its sumthing about water thats so soothing)..i get days where i feel like im alone in the world and nuffin goes right even 10 months down the line..ya done well mate refusing the pills off ya doctor..life has its ups and downs weather we,re using or not..things can come on top and get stressful..but i think its worse for us addicts cos we always think a little bit of sumthing will make us feel better..but at the end of the day it,ll make it all so much worse..even thou we,re on a pc hundreds of miles away talking to ya..you ain,t alone mate..stay strong and keep ya chin up..good luck mate..Robbie..

Hey Robbie! How're you doing friend? Haven't spoken in quite a bit. Sounds like you've been working a bit. How's that going? I'm doing well. Ha.d a bit of stomach flu but coming out of it. Starting to get cold here. Drove all day in a bizzard on Wednesday.
Hope you're well Robbie. You too Dave.
Beck
HeyDavey

I also have been depressed latey. I try to just roll with the emotions, tell myself its onLY temporary, and try to think positive thoughts.- Much easier said than done.

I do know that some of those anti-depressant drugs the docs give out are dangerous. Be careful
peace,
jack
Thanks..for the replies guys..specially you Darin..with your usual mine of information.Im thinking of only being on the anti,deppresants for 3mnth.max&i know the meds are only a lil kickstart..its me&only me who can get me out of this situation mentally.Alot of me"s basically...also im gonna be starting weekly counselling with a drug add.clinic.So hopefully i will be out of this state of mind..soon ..its entirely up to myself...proactive..maybe the word im looking for.As always take care ...Davey
I didnt mention this to the board ,but 2 weeks ago when Sandy was beginning all her tests for this lump & that lump, her doctor saw my anixiety and wanted to give me a script for colonipin.
Now, I dont even know this guy and he doent know me (never mind my history)-
It was tempting but I figured -Hell Id probably look to sell them rather than take them. I certainly dont need that kind of sh*t going on at this point.
I thanked him for his concern and that was that.- - It is weird how some of these medical doctors are similar to the street doctors.

Sandy did end up taking a script for them and something else for mild depression & anxiety, I would have to go look at the name, its something I never saw before.

It dangerous that they show all these commercials on the TV- ending with"ask your doctor if its OK for you". Years ago the doctor told you> you never asked for anything!

Anyway- happy Sunday
the time change has already messed me up

peace,love,and breakfast
jack
I'm wit da boyzzz on this one, Davey.......yepper.......that black and very sad thing hits ya smack out of nowhere......I looked at it like this......I beat it myself or I take whatever drug they so generously divey out.....pop-pop-pop....here ya go.......have a this for that and that will give ya this so ya need another pill.

No way..........I agree......GYAC hit ya up with some awesome information.
Believe me I'm a Doctor.....LOL....oh, heck NO........yah mean you get a kick back did ya say, Doc?????????????? Oh, oh of course not.....oh, you're dating that very pretty Barbie doll of a professional drug pusher....I mean drug representative......Eh, right??????????...........of course that is very few Doctor's, and we as a society I think when we go for healtcare don't want to leave empty handed.........these Doc's will hit ya up with an antibiotic if they see that look like "Yo, this visit is $70.00.......where's my script??????

Darn gone it...........the Klonopin..........whewie.....had one once and didn't get up for two days, and this is me we're talking about.....the garbage pail pale pill person......LOL.....pale as ale......see ya can rhyme without going on these things....LOL.....creative like.......I think ya done right, Davey......we promise it does go away and it will pass..........unless you are urgently depressed.....I mean then a Doctor is a good thing, but I say you done good.

See all these SSRI things like the Paxil????????? Again this is only my experience and about a bajillion other people worldwide.........you want a wacky drug to kick..........honestly YEARS later ya still get side effects......our youth are drugged from get-go......like in our day if ya had a bad tic.....like ya made a weird noise all the time out of nowhere.....either the parent's ain't had any money to get ya "HELPED"..........or they had no time.......y'ad be sitting in a Doctor's office forever if ya did take all kids for all things odd.

Like my sibling.........JUST IGNORE IT.......that too shall pass as it came on...LOL........that is what my grandmom would say........pay no attention....that'll abruptly stop...........OHOHAHAHA......yeah, you walk in circles and chant, and make a weird noise for a few years......that'll properly put ya in the "I can beat your azzzzz down, son" catergory cause how long ya going to let yourself be teased....especially if your Pop's hit ya head for NOT fighting the people make fun of ya?????????????

Hope you laughed Davey..........hope you can laugh.........and see the absurdity of what we think are normal people......and see just how brilliant and STRONG you are that you JUST SAID NO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Davey,
As have been mentioned above that depression creeps up to bite us in the a$$ at a moments notice but it like all trials will pass so hang in there. No thanks needed....just passing along info. Take care and keep hanging bro!

D!
Thanks folks for all yer good&funny words...ahem..Bryn.Had a long chat with myself&realised the antideppresants etc.are not the l/t answer..so out went the script..but im gonna be attending a counsellor i am cynical bout those type of things...but i aint got nothing to lose.I agree with Bryn the change in seasons&shorter days seem to have an effect on myself,but as Jack said its a matter of rolling with the punches&we"ve all had enough of them.So from a moody but pill free me thanks....Davey
im on a cocktail of lamictal and serequel, mood stabilizer and anti anxiety/tranquilizer, lamictal reacts to dopamine, levels u out balances highs and lows, most effective for mood swings, bipolar disorder, i dont get manic or extremely depressed. the serequel helps my thoughts and allows me to focus. i take a higher dose at night bc it makes u sleepy, the drugs work wonders for me, but i have a psychiatric diordr. u could be depressed bc the nature of heroin addiction supresses many chemicals that help us feel happy one we begin recovery. if u are having post acute withdrawal (depression/anxiey u never had b4 drugs) cymbalta is a good one and wellbutrin too. if u are truly depressed, clinically, u may need to go thru a series of trial meds b4 u find ur right combo. good luck, im just telling u what has worked for me.
Hey, Davey......good for you..........hope you're feeling better today.

Hang in there, buddy.