Psycho-Babble Medication | about biological treatments | Framed
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Re: hand holding Elizabeth

Posted by Lorraine on July 15, 2001, at 21:11:31

In reply to hand holding Lorraine, posted by Elizabeth on July 15, 2001, at 14:42:39

> > >What's your understanding of the mechanism of action? (By "active ingredients" I really meant the chemical(s), not the name of the plant, BTW.) I looked it up in a few places; it sounds interesting.

I was afraid you'd ask that and, of course, I haven't a clue. I suspect noone does. It was one of those did it on a flyer type of things. I think was where I first heard about it.

> > >I used to be pretty laid-back about tests (like, I took a nap during the SAT), but these days they stress me out a lot.

GABA might help also.

> > It was also effective in another double blind, placebo controlled study, concerning cognitive function, memory and fatigue in adults.*
> > >I always wonder exactly what it is that those research types are talking about when they refer to "cognitive function."

well, you know, some stupid memory test or inventory. I'm sure the tests were nonsense like they normally are. No, actually I think it was students' test results.

> > > Although I don't generally have skin-picking problems, I developed one (temporary, thankfully) when I tried adding Cylert to Nardil (MAOIs can be expected to potentiate psychomotor stimulants).

Good to know. So you tried Nardil with a stimulant? And, I take it has edgy results?

> > >(I later talked to my pdoc, who confirmed that people who take too many amphetamines often have problems of that sort.)

Sounds right to me.

> > > Some people are just sensitive to side effects in general. I'm like that about temperature (I don't tolerate heat or cold very well)

Isn't temperature intolerance tied to thyroid function? Also, I read somewhere about excess dopamine causing this.

> Anxiety with ADD or lethargy can be very hard to treat because anxious people tend to get jittery (to put it mildly) on stimulants (and, often, antidepressants -- my guess is that Serzone, Remeron, or Nardil would probably be the best one for this type of patient). It sucks because a lot of anxious people have problems with fatigue, lethargy, low energy, etc.

Yeah, it really sucks, but I think you have hit it right on the nose here. Serzone put me to sleep--even with Wellbutrin in the am. I hated it. Remeron and Nardil remain to be tried.

> And on the other hand, benzodiazepines can make ADD symptoms and fatigue worse. I've never had a problem with being overly sedated by benzos, personally. I'm just hard to sedate, I guess < g >. Although just 10 mg of Mellaril did the job rather neatly.

So, this is the other piece of bad news. I know--just seems impossible so that probably means back to an all-purpose AD of some sort and your hunch about an MAO may be right.

> Non-cardioselective beta blockers (like propranolol/Inderal) also help

I had a pretty bad reaction to Inderal. I think it worsened my depression, which Jenson says it's prone to do--actually he says that people who take it have a five-fold increase in their AD dosage. Anyway, bad luck for me. But he also mentions long lasting Betaxolol and I'm wondering if that might be your long lasting Beta-blocker.
He notes that Inderal is a Beta 1 & 2 blocker and Betaxolol is a Beta 1 blocker. Given my response to Inderal, I'm wondering if it is worth my while to try or not.

> > >It's pretty weird how I get jittery on opioids. It's not limited to buprenorphine, although it is worse with bup. than it is with pure full agonists (morphine, codeine, hydrocodone, fentanyl, etc.). I've encountered people who weren't so zonked on them, but never anyone who got actively wired the way I do.

Well, that's funny because I think I thought I'd jump out of my skin on them.

> > I'm sorry, what do you mean atypical-like symptoms.
> > >Well, the picture you provided was suggestive of atypical depression, although it didn't include the obvious "reversed vegetative symptoms" (hypersomnia and hyperphagia). Lethargy is a common feature in atypical depression. In particular, the "walking through mud" feeling sounds a bit like what is often described as "leaden paralysis" (yes, this is a real clinical term!). I also think that crying spells and social withdrawal tend to be more common in atypical depression than other types. Panic disorder (or panic-like anxiety symptoms, such as hyperventilating) is definitely more associated with atypical depression than with other types. "Hibernating" is a very common word people with atypical depression use to describe their condition.

Hypersomnia. Well, I'd say unmedicated I sleep a lot, always have and it got worse with depression. Leaden paralysis--that pretty much describes it to a tee.

> Anyway, MAOIs aren't just for atypical depression (and what you described, though suggestive, isn't the textbook picture of atypical depression by any means): they've been touted as being effective for it because tricyclics (which, for a long time, were the main alternative) are so ineffective. TCAs work great for "classic" depression (melancholia) but aren't much help for other types (which really are far more common, IMO).

OK--I'm moving toward MAOs I think. Thanks for really sticking with me on this. It helps immeasurably.

> [re side effect sensitivity]
> > Ain't that a b****. I suspect your right though. Still wish I hadn't opened that particular pandora's box.
> > > Huh. In what sense is it a Pandora's box?

You can't close it.

> > > That's a big problem with pdocs, yeah. A suggestion: try talking to the receptionist at the mood disorders clinic and ask her about the personalities of the doctors there. She (it's usually a she) might not know, but it's worth trying.

Good idea.

> > > Also, LA is a big metro area. If there's a branch of the National Depressive and Manic Depressive Association ( nearby (and I'm guessing there is), start going to support groups and asking around about various pdocs.

Great idea, I'll try that.

> > > Dude, you're *not* stupid. Although I don't have an opinion about how smart you are, I can tell that you're insightful, which is a good sign.

Dudette to you < vbg >

> > > No apologies necessary.

Among friends. Thanx again.




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