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TheNeil

AS and ADs - What Works?

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Ok, need some advice on this one as I'm struggling.

 

My GP put me on Sertraline (50mg) five and a half weeks ago to combat post traumatic stress disorder (PTSD). At first I was OK on them (the usual side-effects as mentioned in the little leaflet, but they passed in a couple of days). Since then I've been fine, but in the past week I've been really struggling. I'm finding it hard to concentrate, feel drowsy a lot of the time (want to put my head on the desk and fall asleep - not good in front of my boss), and just 'drift off' at the drop of a hat (to the point where I just stop working and stare into nothingness with whatever song my brain selects from its personal iPod - Burning Bridges (from Kelly's Heroes) and the soundtrack to Pirates of The Caribean seem to be its favourites) and become like a zombie. I'm also getting lethargic, demotivated and can feel my brain fighting the lethargy.

 

This would be bad enough but it's causing insomnia (down to about 3 hours sleep a night) which is causing stomach cramps (imagine jet lag multiplied by 1000 or your stomach feeling as though it's constantly in a vice) and everything has been getting worse since last weekend. Phoned up the GPs yesterday to go in and see her but as the first appointment wasn't until next Wednesday (hooray) I got them to ask her and phone me back. As I'm already on the lowest dose though, they can't reduce them any further so they've said that I have to stay on them for another week. Just in case, I made an appointment this morning...for next Thursday (first available slot).

 

In myself I feel fine but the exhaustion is doing me in and the pain is, naturally, making things hard.

 

Now you're probably thinking 'and?' but I've been through this before with ADs (this is the third type I've been put on in the past three years (can't remember the names of the other two) - I deliberately made sure that GP didn't put me back on the anything that had screwed me up before) and, every time, they leave me feeling the same (these just seemed to have taken longer to kick in this time). I know that different pills affect different people differently but does anybody have any suggestions as to whether certain ADs are more 'AS friendly' than others (if such a thing even exists)? Is what I'm experiencing 'normal' (given that it's happened with three different types of medication then I'm worrying if something in my head just can't handle ADs)? Anybody got any advice?

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I would say that it would be worth phoning the NHS helpline and asking their advice, if only to see if these symptoms are likely side effects from the drugs or not.

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From my own experience, none of them work. I've tried sertraline, cymbalta, citalopram, seroxat... I can't remember the rest. Diazepam or oxazepam are excellent for anxiety though.

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You probably need to ask for a referral to a psychiatrist. This is not the field of expertise for a GP, you need someone more specialised.

 

People with ASD often don't react well to antidepressants at normal doses, but get the best results from very low doses, lower than the normal recommended starting dose. It's worth asking if trying a very low dose might be worth a try. You might need to cut tablets in half or use the medication in liquid form to get the low dose you need.

 

Some of the older antidepressants (tricyclics or MAOIs) can work well for some people where SSRIs have not helped.

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I've had pretty much the same result with ADs at even the lowest 'normal' dose. I've tried many types, and GP is looking at putting me back at half the lowest 'normal' dose (half a pill).

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What I meant by myearlier post is that I don't feel that long term ADS have helped me. If one suffers from anxiety attacks I have found that diazepam type pills can staop them in their tracks.

 

I'm very sceptical about all of the long-term meds I've been prescribed.

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If one suffers from anxiety attacks I have found that diazepam type pills can staop them in their tracks.

 

I've had diazepam before and it was good for making my brain quiet and slow it down a bit, but it also had the unfortunate side effect of sending me to sleep. :blink:

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Probably best give an update on this as I managed to get it sorted out.

 

I'm still on the lowest dose of Sertraline (despite the GPs best efforts to get me to increase it) but to keep everything else in check I needed to be on sleeping pills for a week to get some sleep into me, and have been on IBS tablets to combat the stomach cramps. Touch wood everything seems to be fine at the moment and now that I'm not in pain, I've managed to get my sleep patterns re-adjusted and this has led to something of a 'positive circle' - more sleep equals less pain and less pain equals more sleep.

 

That said, it was my decision to stay on the pills (I had a review just before Christmas) as I didn't want to go into the 'wonderful' Christmas season and the typically 'low' period post-Christmas rocking my little boat. Got about six weeks left until the next review and, depending on how things go of course, I'll be pushing to come off them.

 

The moral of the story? Well these worked with me but (I won't say 'for' as I've tried so many different things that giving credit to just one thing would be impossible) it took a lot of messing about and, what felt like, trial and error on the part of the GP. As for anything beyond the GP...well I'm still waiting to hear about the counselling that I was refered for at the start of October (never mind a psychiatrist) - the NHS certainly seems like a slow moving beast here in the wilds of the north. :shame:

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Glad youre on the mend, I had sleeping tablets at the beginning of last year when I was going through that appalling time with DS, The relief of a nights sleep is not to be underestimated! >:D<<'> Enid

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. As for anything beyond the GP...well I'm still waiting to hear about the counselling that I was refered for at the start of October (never mind a psychiatrist) - the NHS certainly seems like a slow moving beast here in the wilds of the north. :shame:

 

Just to say there are offten long waiting lists for counselling and many practices don't have their own and as people need a course it can take a long time as offten they only see 3 or 4 people a day due to paperwork etc so I would as for a referal to a psychiatrist will probably be quicker as it is a hospital service and more supported.

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Just to say there are offten long waiting lists for counselling and many practices don't have their own and as people need a course it can take a long time as offten they only see 3 or 4 people a day due to paperwork etc so I would as for a referal to a psychiatrist will probably be quicker as it is a hospital service and more supported.

They tried this. The counsellor was reluctant to see me so I was sent off to see the psychiatric assessment team. They (well the social worker who interviewed me) deemed me 'not mad enough' and sent me back to the counsellor...and I've not heard anything since. It was at this point that I realised that they'd be of no use (as I needed help then and not in six month's time) so went and got help myself. If the counselling ever happens I'll still go along just to see if they have any other ideas, perspectives etc. but just getting sleep and having time to explore my own head, think things through etc. seems to have gotten me back on track :thumbs:

 

TBH if I wasn't insane before then I would be now :wacko:

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Being a newish and rather occasional visitor (sorry!), I've only just worked through this helpful thread.

 

I was diagnosed with depression and anxiety even before my ASD diagnosis a year ago: over 18 months we did a tour of the drugs available, with no real result. Last autumn my GP was recommended to try me with Clomipramine. I stepped off from the SSRIs, and as soon as I had taken the last one the depression totally disappeared!

 

The anxiety and agitation remained a huge problem, so after a month I gave in and tried the Clomipramine. This took some getting used to, but was really effective at a very low dose in dealing with the a & a. Unfortunately I became more and more prone to sudden episodes of drowsiness - this really interfered with work, so I went off them again.

 

I seem to be in some kind of a crunch again: this time the GP has put me off work (he thinks my job is extremely damaging for someone with AS anyway), and put me on Imipramine. He's told me I have to put up with the side-effects this time: that's OK for him, but he clearly hasn't the imagination to picture what constipation is like when you have a colostomy! I start the new medication tonight - we'll see how it goes!

 

 

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