Life

[Roderick]

(Miffy's youngest son.)

[Roderick]

Sorry for the double post: I just made a picture of my custom-ordered, crocheted necktie based on the My Little Pony character of Rainbow Dash. This way I can go into meetings and still carry out my outrageous nerdhood.

You can't tell me what to do!

[toblix]

[miffy495]

Awesome. So glad that I (apparently, by popular opinion) posted that.

[subbes]

I laughed when I saw the zoom ins, but apparently toblix was focusing on something different, so it's my turn to comment.

Why the hell do you have an electric toothbrush, romantic candles and a jar of Vaseline next to your monitor?

()

[Lu]

The heat of the candle wax dries out his skin, obviously. Ha ha! Sadomasochism.

[miffy495]

Why the hell do you have an electric toothbrush, romantic candles and a jar of Vaseline next to your monitor?

He's getting ready for the full release of DotA2.

[Orv]

Man Rodi, why must you rollercoaster my respect for you all the time.

(I say this as the man who wore Jayne's hat to a wedding, so I can't talk.)

[ThunderPeel2001]

OKAY now that's done, let's discuss Thunderpeel's doctor problem.

YES! Let's...

OK, I'll skip straight to the part that's made three medical practitioners look at me in a weird way, and apparently dump me in the crank file.

I took 25mg of Sertraline (that's half the therapeutic dose -- and shouldn't be enough to cheer up a fruit fly) and got a ton of SSRI side-effects. My plan was to build up to the normal dose in the softest possible way for my system... but I side-effects abounded: My skin felt weird, my lips tingled, I felt spaced out, and this all lasted for approx 36 hours.

I don't know how that's possible, and the side-effects weren't unbearable (although I did have to explain to the person I was with that I wasn't feeling my usual self), but it certainly made me think twice about taking the normal dose!

I have previous experience with the side-effects of SSRIs (including Sertraline) and they are what they are. Nothing horrendous (although Citalopram certainly didn't agree with me -- I got far fewer side effects from Escitalopram), but I recognized them immediately.

I'd like to know why. Everyone seems to want to pin it on a nocebo effect, despite the fact that mentally I felt good -- in fact I totally gave myself a placebo effect: That wonderful feeling that you've taken care of a problem, and so can devote your brain to other things.

I kept waiting for the SSRI side-effects to dissipate, but when I woke up in the morning and they were still there, I decided not to continue with my plan of building up to a normal dose... as I just couldn't understand why I should get so many side-effects from such a minuscule one.

So Doctor Thumbs (any who care to take on this case), can you explain it? Is there a physical reason for this? Or, because it doesn't sound like anything you've ever heard before, did it not take place (other than in my mind)?

One possible solution that nobody has suggested: By breaking the tablet in two I destroyed the coating and so made the tablet hit me "all at once". I'm a total layman, so I have no idea if this makes sense, but it's better than this most recent doctor's assertion that millions of people take SSRIs and she's never heard of anything like it -- so it can't be true.

[subbes]

When I was changing up my antidepressants before we found a good one that worked or my rumination as well as getting my depress on, I repeatedly found that I got worse side effects while the medication was building up to a steady state than I did once it had taken effect, i.e. I got side effects in the first 4-6 weeks that then went away.

This does not apply to Lexapro (Escitalopram) which did not give me any side effects at all, apart from the ludicrous price because it isn't available in generic form yet.

[Roderick]

Why the hell do you have an electric toothbrush, romantic candles and a jar of Vaseline next to your monitor?

It's for stress relief, and Shy Guy is there to watch

I'll spoil your surely delightful fantasies by pointing out that when the weather is cold, the skin on my hands gets dry to point of cracking and bleeding at the knuckles. Vaseline is a godsend in preventing that. The romantic candles; I have no explanation.

Thunder, shit to hear you have weird side effects. Can our resident doctor come in for some primo advice?

[Lu]

Dr. Poo reporting for duty! I say we amputate at the legs!

[toblix]

Dr. Poo reporting for duty! I say we amputate at the legs!

Which end do we keep?

[ThunderPeel2001]

I'll take the legs.

Edited February 26, 2012 by ThunderPeel2001

[Lu]

Which end do we keep?

The right end.

[ThunderPeel2001]

When I was changing up my antidepressants before we found a good one that worked or my rumination as well as getting my depress on, I repeatedly found that I got worse side effects while the medication was building up to a steady state than I did once it had taken effect, i.e. I got side effects in the first 4-6 weeks that then went away.

Yep, that's true, it's just that these side-effects were so pronounced... for such a miniscule dose. I wish someone could give me a reason why.

My other concern is that I'm apparently fine for 90% of the week, and then I'll take a sudden horrible dive for a day (at worst, two), and then be fine again. What's that all about? It feels almost like a physical complaint, like something in my body is dipping, and then returning. But then, looking through my calendar, maybe it just coincides with upcoming stressful events...? Hmm.

Edited February 26, 2012 by ThunderPeel2001

[Armchair General]

YES! Let's...

1) My skin felt weird, my lips tingled, I felt spaced out, and this all lasted for approx 36 hours.

2) I kept waiting for the SSRI side-effects to dissipate, but when I woke up in the morning and they were still there

3) So Doctor Thumbs (any who care to take on this case), can you explain it?

4) One possible solution that nobody has suggested: By breaking the tablet in two I destroyed the coating and so made the tablet hit me "all at once"

It's very difficult for me to make any meaningful interpretation not having taken a full history or examination or having access to previous medical records but... ALSO: YOU SHOULD ALWAYS TALK TO YOUR OWN DOCTOR BEFORE FOLLOWING ANY ADVICE OR ACTING ON MY WORDS IN ANY WAY.

1) The symptoms you listed are symptoms found in those with panic attacks and are common recognised ssri side effects which clouds the picture. A possible explanation is that you were experiencing a worsening of your anxiety (another common effect in early stages of taking ssri) this may well have been a transient effect if you had continued with medication for the recommended 4 weeks or so to achieve maximum effect. See 4.8 http://www.medicines.org.uk/EMC/medicine/25806/SPC/Sertraline+50mg+Film+coated+Tablets/

2) This may or may not be of relevance in that usually if someone is able to sleep reasonably well and they wake up* with the problem - it probably suggests that it's more anxiety -i.e they are awake and then thinking about the things that trouble them. What I'm trying to say here (badly) is that it may have been more your anxiety than ssri side effect, but hard to tell (see below)

*Unless you are waking at 0200, then again at 0400 thinking about it.

3) I'm trying but it's difficult from all the way over here with not much info!

4) Unlikely to be what caused your side effects - in fact, if you were given sertraline to treat panic disorder, what you describe, is well recognised - from the pharmaceutical data -

"Panic Disorder, PTSD, and Social Anxiety Disorder

Therapy should be initiated at 25 mg/day. After one week, the dose should be increased to 50 mg once daily. This dosage regimen has been shown to reduce the frequency of early treatment emergent side effects characteristic of panic disorder."

From the same source as linked above

In summary: My tentative, ill informed, advice would be to persevere with treatment and commit yourself to around 2-3 months of treatment, come what may. Only stop if the symptoms are so unbearable that they seriously interfere with daily functioning - you could do this in the knowledge that your symptoms are unlikely to get worse, infact, they are much more likely to recede in time. YOU SHOULD ALWAYS TALK TO YOUR OWN DOCTOR BEFORE FOLLOWING ANY ADVICE OR ACTING ON MY WORDS IN ANY WAY.

EDIT: Normally, I would have PM'd the poster to check they were ok with talking about it on the forums in this way, but as TP has mentioned his troubles many times before on the forums and I have spoken to him in the past, I thought he'd be ok with it. If you want me to remove it at anytime TP, just let me know.

[Armchair General]

I gleaned the above after talking with PiratePoo by the way, I have limited medical knowledge...

ALWAYS TALK TO PIRATEPOO BEFORE FOLLOWING WHAT ANYONE SAYS EVER

[ThunderPeel2001]

Thanks, doctor(s)

Don't worry: I fully appreciate the limitations of your advice giving via the internet, and will take everything you say with that in mind.

I can categorically state that the symptoms I had were not due to anxiety. As I said, mentally, emotionally, I felt good. Anxiety is a very common beast to me. That cold feeling in my stomach. I recognize it immediately. I felt largely calm and happy because I honestly felt I'd taken a step forwards (I even caught myself believing that they'd worked so quickly -- another impossibility, and undoubtedly a placebo).

These side-effects were very recognisable to me, as I'm sure they would be to most people who have taken SSRIs. Not something necessarily to be worried about, but certainly a lot more than I was expecting.

FWIW: Looking at the packaging, the tablets ARE film coated, and it does say "Do not crush or chew your tablet". You're probably right, though, and that's not it. (I've certainly halved SSRI's when I've been coming off them in the past, but it would have been a neat explanation.)

Anyways, I remember looking through the booklet the following day and ticking off what I felt. It was: Dry mouth, shaky feeling, tingling, and reduced ability to react normally to every day situations. None of them were overwhelming, but they were pronounced.

Let me ask you, point blank: Is there any way I could have gotten these symptoms from the tablets?

At this point I'm more alarmed (although please be aware, I feel very calm right now, I'm not an anxiety ridden mess at all, in fact I'm about to go to the gym once I've finished typing this) that everyone is keen to explain the symptoms as psychological. If one doctor had said to me, "That's common, even for low doses", or something that rang true to what I felt, then I'd probably be on the tablets... But the fact that my experience is met with incredulity is the main thing that concerns -- I honestly thought there'd be an explanation.

Open your mind for a minute to the idea that I may be right. That I know my body, my general state of being, and am familiar with SSRI side-effects. That my symptoms did come from the tablets... Under what circumstances could that possibly be true?

Edited February 26, 2012 by ThunderPeel2001

[Armchair General]

I'm saying: The medication gave you side effects all on it's own (the symptoms you describe are recognised side effects, certainly when treating anxiety disorder - see point 4) but also probably exacerbated your anxiety.

Sorry, it's not clear because it's not a situation to which a definitive answer can be elucidated.

[ThunderPeel2001]

I'm saying: The medication gave you side effects all on it's own (the symptoms you describe are recognised side effects, certainly when treating anxiety disorder - see point 4) but also probably exacerbated your anxiety.

Sorry, it's not clear because it's not a situation to which a definitive answer can be elucidated.

Ah! Hurrah! Thanks for that. My bad for not hearing what you were saying. That makes me feel a lot better. Perhaps I will give them another go.

I guess my body has changed, as I didn't have such a strong reaction to a larger dose 10 years ago. Anyway... If it's perfectly normal for me to have had such a reaction to the tablets, then there's nothing to worry about. (I get what you were saying about 25mg now, and why you quoted that text. Everything else I've seen said 50mg, including my doctor who assured me that I'd probably barely feel anything on that, and 25mg wouldn't be felt at all -- And lo! Thinking about it, that's where my concern started, because I did feel something. Doh.)

Perhaps I could start with a quarter of a tablet, just to placate any remaining fears.

Thanks again!

[Armchair General]

Thanks again!

Don't thank me, thank PiratePoo

I hope it does help you TP, good luck

[Lu]

That'll be about 4000 bucks. And thank you.

[subbes]

do you accept blue cross

[miffy495]

Just as a general update on all kinds of things, here's a rapid-fire account of my last two weeks. Some is new to this thread, some old. Point is, it's been a busy and stressful time, and I'm looking forward to being out the other side of it:

- Quit the job that has been frustrating the hell out of me since a management shake-up 8 months ago

- Got a new job as a shift supervisor at Starbucks. Less cool than indie projectionist, but close to home, only for a year, and with a non-infuriating boss (when he learned I used to manage the games section of an HMV, he just wanted to stop interviewing me right there and talk about Mass Effect. Nice guy, too).

- Gave a 45 minute presentation at the Western Canadian Association of Student Teachers Conference (WestCAST) in front of delegates from over 30 universities. Had some of my professors in attendance as well, which was extra pants-shittingly-terrifying on top of representing my faculty. I noticed two specifically who were sitting next to each other, one obviously super into what I was saying, the other obviously NOT. The fact that the positively responding professor cornered me after for a talk about my idea was encouraging though.

- Feeling guilty about going into English teaching and not being up on current young adult fiction, read The Hunger Games. Pretty fucking good, actually.

- Had two exams.

- Ran tech for a double feature silent movie program with live music. Cops and Sherlock Jr, both starrring Buster Keaton. Not a bad way to spend my second last shift as a projectionist. Still, the joy of the show did not outweigh the way my boss jerked around the people who rented us out to run it. Their vow to never work with him again only helped to strengthen mine. I was CC'd in an email just now telling my boss that the only good part about renting the theatre was working with me, then shitting all over him for letting the place fall apart. That felt nice to read.

- Finally got a beat up old Rav 4 fixed with help from my uncle in Edmonton (with about 3 hours between our cities, he's the closest relative I have, proximity-wise). I now not only have my license, but a viable car to use it with. I just need to practise on back roads for a while before going anywhere real, since I got my license 2 months ago and still have yet to use it. Worried I'm forgetting stuff already and need to remedy this fast.

So yeah, been busy. I'd say I'm looking forward to a break, but starting Wednesday I'm babysitting a hyperactive Scottish Terrier for six weeks (this is actually awesome. I love animals and can't wait to start taking care of Stan and his obese cat sister, Stitch) and in three weeks I'll be doing a month of practicum at an elementary school. I think one of the weeks of that month is the Calgary Board of Education's spring break, so I'm desperately hoping that I actually have that week to myself. I guess we'll see.

EDIT: Oh, and TP, one other thing is that my partner has just finished the 4-ish week wind-up period with a similar medication to yours and is starting to feel much better. It was a rough few weeks being on the supporting side of it, so I can't even imagine what it was like to be her, but it does seem that she's feeling that it was well worth it. I hope it works out as well for you.

Edited February 27, 2012 by miffy495