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Re: jumping in Lorraine

Posted by Elizabeth on August 4, 2001, at 23:06:40

In reply to Re: jumping in Elizabeth, posted by Lorraine on August 4, 2001, at 13:46:56

[re ADHD]
> I don't think it is important that it be an official diagnosis, only that the symptoms be treated.

Yes; but in order for them to get treated, they generally must first be recognised! I don't think most pdocs would be willing to diagnose "adult-onset ADD," but they should be willing to consider the possibility that ADD-like symptoms associated with depression and/or anxiety might be treatable with the same medications that work for ADD (i.e., stimulants).

> > > >FWIW, when I tried Neurontin, the feeling reminded me of Xanax.
> Well, it is anti-anxiety in its effect, although more gentle and less sudden in its effects. I hated Xanax--it made me feel very druggy, but then I was probably on the wrong dose and didn't know enough at the time to experiment with it.

That's too bad. I've found Xanax to be one of the more convenient benzos for my purposes: it works fast enough that I can use it to fend off a panic attack, and it's not too sedating or impairing for me, so I can take the high-end dose that I usually need (2 mg) without getting totally zonked.

> [re MAOI withdrawal]
> So that's the parachute then; Adderal, Neurontin and Ativan as needed. Good--it's nice to know the escape route.

Heh. Yeah, I can see why stimulants would be effective, although I've never tried using them for that purpose myself.

> I think this ends up being an important piece of information. You might find yourself, then, taping lectures in difficult classes to relisten to whereas I'd buy another text book that approached the subject from a different angle.

I've tried taping lectures. It doesn't work for me. I just take copious notes and use the text as a reference rather than as my primary source of information.

> What is the serum level supposed to be? Cutting it in half--isn't that drastic?

Generally accepted therapeutic serum leves for desipramine range from about 125-300 ng/mL. Yes, cutting the dose in half is drastic, but the doctor covering for my pdoc wanted me to stop taking it altogether (to which I said "no way!").

> You had said that if your blood levels were high an ECT was the next logical step

No, I said *ECG*, not ECT! An electrocardiogram, to determine if the high desipramine levels are causing cardiotoxicity.

> This is the problem with invisible chronic diseases. My SIL sees me and I'm fine. See doesn't see, nor would I allow her to see the down times.

Heh. I'm like that: if I'm depressed, I just disappear. I don't find attention or "support" to be useful when I'm depressed (unless it's something concrete like making sure that I don't get dehydrated), so what's the point of seeking people out?

> It's like energy management in a way. I can store it up for special occassions, like family visits, then I collapse afterward--as though my energy supply was depleted.

I do a very poor job of faking it when I try to.

> When I was young, I thought I would never marry and so forth.

I had similarly fatalistic ideas when I was a child; like, I was convinced I wouldn't live past 30.

> He majored in linguistics and went on to become an attorney. But his private time reading is always math and science. In high school, he thought he was headed for a career in math and science. Then he went to Harvard and found his "excellence" was mediocre in the new pool of peers. It's still part of his passion though. That and history.

Harvard, huh? That's kind of funny to me because I've found most Harvard undergrads to be of pretty mediocre intelligence. (Although my dad and my brother went there, so I guess they aren't all bad. :-) ) I took a few science courses there when I decided to go pre-med after I'd already graduated (in case it's not obvious by now, I went to MIT < g >), and I found them really trivial compared to the science and engineering classes I'd taken as an undergrad (even the introductory-level ones).

So, what kind of law does your husband practise? I think it's always useful to have a lawyer as a relative or friend. Plus, I've always found the lawyers I've met to be interesting people to talk to.

> My father used to masturbate in front of me and take pictures of me in sexy nightgowns. Pretty strange--I was paralyzed, unable to move to leave the room (although I'm sure I could)--it was one of those "elephants" in the room that we ignored politely and then, of course, there was the issue of my complicity--but then I think there frequently is in these situations. That's why I refer to it as "mild" and it's also why it probably didn't have much impact on my own sexuality. Years later when my father was dying of lung cancer when I would visit him alone, he would tell me sexually lurid stories. It got to the point where I couldn't visit him alone and it was hard to visit him otherwise. My husband visited him nearly every day for me.

That sounds pretty bad to me; I mean, it could have been worse, but being exposed to that kind of stuff as a child -- it can't be good for you. Did you experience any sort of closure when he died? That must have been hard; I would think that you'd have really mixed emotions about it.

> Well, for instance, the Propanolol made me weak, the Moclobemide gave me muscle cramps in my feet and legs, and the Parnate and Selegiline make me strong.

Propranolol doesn't exert its effects directly on the skeletal muscles: it decreases cardiac output, so your tissues don't get as much oxygen. It's understandable why you'd feel "stronger" on stimulant-like drugs (Parnate and selegiline). The muscle cramps from moclobemide puzzle me, though.

> [re your headaches and Prozac]
> Your headaches were not migraines (which are related to seizure activity)?

No, they weren't migraines. That was the only time in my life that I've ever had headaches frequently.

> I had the stupidity to be off ADs for about a year trying SamE and so forth.

Some of that stuff is actually worth trying. Don't kick yourself for doing it. What else did you try besides SamE?

> Martin Jensen. His book is an informal self-published deal. He gets a lot of criticism for his approach which is basically to "trial" you through many meds very quickly and some people feel his treatment of the science behind mental illness is sloppy. But the book is great for a quick concise run down of the meds, there side effects, the probability of success with certain meds and so forth. You will be happy to note that he does include opiates. I refer to his book a lot as sort of a handbook for where I am because he lists the stimulants and so forth with worksheets as to what has been tried and the effects. His phone number (to order the book) is 949-363-2600.

You're right, it does sound pretty unscientific: some meds work quickly (like within 3 hours after taking them), some take a few days to work, and some can take weeks. You can't generalise about how

On the other hand, with all the antidepressants that have worked for me, I've at least noticed something within two weeks, although it may have taken longer to realise the full therapeutic effect. So I think there is something to the idea of brief trials.

> I'm so sorry to hear this. So you are past the therapuetic dose range and still not in remission?

Oh no, it's definitely working -- didn't I mention that? I just hope that it will still work at the lower dose that I'm taking now!

> Tough timing too with your pdoc being out of town. Did you guys formulate a game plan for this contingency before he left for vacation?

Nope. Neither of us really thought it was likely that there'd be a problem like this; we just thought that it would be a good idea to check the serum level because of some past experiences I've had with medications that suggested I might be deficient in the relevant enzyme.





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