Thursday, January 26, 2006
I went to see my Doc today. Seems like I am nowhere near as good as I thought. The appointment took twice as long as I expected. He asked me a lot of questions he has not asked before. He also pointed out things I am doing, that I didn't even KNOW I was doing. Like flicking my fingernails, twisting my hair, twitching, losing the thread of a conversation in the middle of a sentence, and screwing up my face. Now he has pointed them out to me, I can see when I am doing them, some of the time. Anyway, after a hugely long list of questions, he decided to switch my medication. He thinks I had adapted to the Effexor too well. and That it was as good as useless now. He has prescribed me a drug I have never heard of before. Or at least, I dont remember having used it before. My memory is so bad these days. I can't remember anything for more then a few minutes any more. He has given me Mirtazapine (Zispin). Starting off at 30mg daily. I checked up a little on it. This is what I found. I also noticed it mentioned Venlafaxine (Effexor)
The efficacy of each antidepressant available has been found equal to that of amitriptyline in double-blind studies as far as mild to moderate depression is involved. However, it seems that some antidepressants are more effective than others in the treatment of severe types of depression (i.e., delusional depression and refractory depression). Following studies regarding the antinociceptive mechanisms of various antidepressants, we speculate that the involvement of the opioid system in the antidepressants' mechanism of action may be necessary, in order to prove effective in the treatment of severe depression. Among the antidepressants of the newer generations, that involvement occurs only with venlafaxine (a presynaptic drug which blocks the synaptosomal uptake of noradrenaline and serotonin and, to a lesser degree, of dopamine) and with mirtazapine (a postsynaptic drug which enhances noradrenergic and 5-HT1A-mediated serotonergic neurotransmission via antagonism of central alpha-auto- and hetero-adrenoreceptors). When mice were tested with a hotplate analgesia meter, both venlafaxine and mirtazapine induced a dose-dependent, naloxone-reversible antinociceptive effect following ip administration. Summing up the various interactions of venlafaxine and mirtazapine with opioid, noradrenergic and serotonergic agonists and antagonists, we found that the antinociceptive effect of venlafaxine is influenced by opioid receptor subtypes (mu-, kappa1- kappa3- and delta-opioid receptor subtypes) combined with the alpha2-adrenergic receptor, whereas the antinociceptive effect of mirtazapine mainly involves mu- and kappa3-opioid mechanisms. This opioid profile of the two drugs may be one of the explanations to their efficacy in severe depression, unlike the SSRIs and other antidepressants which lack opioid activity.
The big problem to me, is that I dont understand one single word of that. I found some other stuff, but it made even less sense then that I posted above.
I was reading the info sheet that came with this med. The list of side effects is HUGE!! I phoned the surgery and asked Andrew, the doc, about the side effects. He said that he believed the good this drug could do ME outweighed the side effects. I asked him what he meant. He said thought that this was one of the few drugs that was going to work on me for a while. It was also one of the few types of drug I hadn't tried. I dont trust most docs, but I do trust Andrew. But I am really scared. I dont know exactly why.I keep asking myself why he totally changed my depression meds. Such a total change. I dont understand. Clive did say that Andrew had explained some stuff, but that I had seemed, to use HIS words, OUT OF IT. Why am I scared? What is happening to me? I haven't felt this bad for a long time. I WAS feeling okay, but Andrew said that my brain had sort of shut off a little to try to make me feel okay.
I wish I was aware enough to actually find more stuff on this drug. But I am not sure what I am doing any more. I'm not even sure if what I am typing is making sense. I dont feel like I have any control any more. Not over me, over my surroundings, anything. I am scared. I am scared. I want to take this new drug. I dont want to. I need something to help me. I know that. But I dont like the sudden TOTAL change.
The doc has changed some of Clives meds too. But he has left him on Effexor. 75mg daily. He's put him on Tamazam too. Which I DONT like him being on. Its WAY too addictive to someone like Clive. I am going to have to try to persuade Clive not to take them every day.
Am I rambling? I dont even really know what I have said. And I am not going back to read it now. I dont want to get myself upset over something. What I typed is what I was thinking at that moment. I must have had a reason. Even if I dont know what that reason is.
posted by tazfan at 8:03 pm comment(s) made:
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