Posted by Eric on March 17, 2001, at 9:30:56
In reply to Which meds for ruminating thoughts?, posted by Margit on March 16, 2001, at 19:05:47
> I was wondering which meds would help with ruminating thoughts. Can't tolerate the SSRIs anymore. Paxil was a great help with that. Would Neurontin help with negative thoughts/ocd? I am currently on Nortriptyline and Xanax - suffering from PAD, depression, and mild OCD. I am terrified of med side effects and that is all I can think about all day. I am going crazy because the Nortrip has made my heart race and also dried out my mouth to the point that my tongue has cracks all over. All I do is imagine the worst, but I can't stop it. I also have acid reflux problems, which were agravated by the SSRIs. So my doc picked Nortrip (has the least anti-cholinergic side effects of the old ADs). Anti-cholinergic side effects make the reflux worse. I really could use some advise or experience somebody could share. I feel like I can't get out of this anymore and this feeling is boxing me in, which makes may inward ruminating thinking even worse. Thanks for any replies. They will be much appriciated.
The usual diagnosis for excess rumination is a dx of psychosis, even if it considered a "small psychosis." Severe, untreated clinical depression can oftentimes distort perception in some people. Thus, usually psychiatrists like to prescribe anti-psychotics for excess rumination. Any anti-psychotic will work for this. Zyprexa, Seroquel, Risperdal, whatever.However, I have found that just plain old antidepressants will usually help rumination. Especially in high dosages. Especially if the rumination is stemming from severe depression or OCD, anxiety, etc. Many times just antidepressants by themselves will go a long long way towards combatting rumination. If it was me and I had ruminating thoughts(which I do) I would start off with an antidepressant. If that didnt get rid of the rumination, Id throw in some low dose anti-psychotics. Probably Seroquel as I personally believe Seroquel has the best overall side effect profile for neuroleptics. 50 mg to 150 mg of Seroquel(low dose) will go a long long ways for most depressives towards combatting excess rumination if antidepressants dont take care of it.
Why cant you tolerate SSRIs anymore? Cause of the GERD? If you cant even tolerate an SSRI or Effexor, you are probably going to have a hard time combatting your problems. Side effects may have to be put up with if your objective is to get out of the hole. What about taking Prilosec or Prevacid everyday to fight off the GERD problem so you can then tolerate SSRIs again? And a daily aerobic exercise program will also help you combat the GERD, as well as help your anxiety and depression a little. Id recommend going back on an SSRI, taking Prilosec/Prevacid everyday for GERD and begin walking a couple miles a day. The walking will greatly help the GERD, trust me as I have the same problem.
Nortrip is a poor choice for rumination and OCD, as Nortrip(Pamelor) is not a serotonergic antidepressant. To effectively combat OCD you really need to be on a strongly serotonergic antidepressant such as an SSRI, Effexor, Remeron, etc. Of the Tricyclics antidepressants(Nortrip is a tricyclic) the only one that is serotonergic enough to really combat OCD is Anafranil.
Overall I would say switch over to a serotonergic antidepressant. Start exercising everyday to fight the GERD, even if it is only something real easy and basic like walking 2 or 3 miles a day! Get some Prevacid or Prilosec to take along with the SSRI.
Figure out a way to fight off the GERD so you can return to an SSRI, as this sounds like it was helping the rumination.
poster:Eric
thread:56699
URL: http://www.dr-bob.org/babble/20010310/msgs/56743.html