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Re: Update Lorraine

Posted by Elizabeth on August 11, 2001, at 13:06:14

In reply to Re: Update Elizabeth, posted by Lorraine on August 11, 2001, at 1:34:14

(re Recovery Inc.)
> Mainly, a CBT type group.

But it's a self-help group, there isn't a psychologist or anyone like that involved?

> > (I remain unconvinced that CBT has any specific effect in depression.)
> Have you tried it?

Yes; I was very into it for a while. I was convinced by the research that it was superior to other types of psychotherapy and that I needed to try it. And maybe it was a good idea to try, but in the end it didn't do much good for my depression. I did learn some tricks that have helped a lot with the panic attacks. I was first dx'ed with panic disorder by the psychologist I was seeing for CBT, and just knowing what it was helped a lot; I also learned some relaxation techniques. So I can't say it was completely useless. :-)

> I do think that there are the physical and the mental aspects. Now, when physical is the only issue, I wouldn't expect it to be of too much help. But lots of times, both mental and physical is involved.

What do you mean by all this? It's a little confusing to me.

> Turns out there are people who are insensitive to side effects also--that might be you?

Not especially. I notice them, but I tolerate them. It's just stoicism, nothing more.

> Effexor--I was at 150 XR. It seemed to completely control my depression.

150 is a reasonable dose, not unusually low. Why did you stop taking it?

> The Adderal was in conjunction with Selegiline (Adderal 7.5 mg 2x day; Selegiline 2.5 2x day; Neurontin 300 3x day).

Again, 15 mg/day isn't that unusual a dose of Adderall for an adult, especially with all the other stuff you were using.

> Actually, I'm doing a retrospective mood chart (like the one the NIMH uses) as a project right now. Just finished reviewing my files. If you are interested in the final result (which include my own cool chart in Word Format), Id be willing to share. O/w I will let you know what the results of the side effect/ partial response survey is.

Except for the Word part, I'd like to see that, although charting retrospectively isn't ideal. (I've seen too many viruses that are transmitted through Word to be willing to open a .doc attachment. < g >)

> Oh. Well, I've found some of my most useful therapy in CBT. I've also found regular talk therapy useful. I think it depends on what you are trying to address.

That's probably true. As I mentioned, I found some of the things I learned in CBT helpful for panic disorder.

> It's one thing to not be interested in hanging out with the other kids; it's another to not fit in and hunger for it. I was the latter. It sounds like you were the former.

Not generally, but when I was depressed I was. I usually (when not depressed) come out right in the middle when I take those tests that are supposed to rate how extroverted or introverted you are. I have friends, I like to party and so forth, but I also need quite a lot of time to myself, and a lot of my interests and hobbies are pretty solitary.

> That is a stroke of luck--genetic luck--to have found been inner directed rather than outer directed. That's great.

How so?

> No, all the investment brokers take off in August and the therapists are forced to go on holiday out of boredom;-)

< G > (I thought a joke like that needed to be made there!)

> > Klonopin is usually effective for treating antidepressant-induced bruxism, I think. It also might help you sleep.
> Thanks, it's on my list.

Benzos, Klonopin in particular, seem to be good for a variety of sleep disorders. I take Klonopin for RBD, and it works great.

You and Shelli both agreed that there don't seem to be many successful marriages. I've been seeing that a lot. Seeing the effect that divorce has on children has made me more appreciative of my own parents, who've been together for 27 years.

[re rapid onset of effects]
Parnate has a stimulant-like action that you may notice very shortly after starting it. I think that this should be looked into further; it might be the reason why some people have spontaneous episodes of hypertension on Parnate.

> I asked my pdoc about drug interactions to be careful of with Parnate. He said the major ones were Demmeral and morphene.

Demerol yes, morphine no. Morphine (the main active constituent of opium) is the treatment of choice if a person on MAOIs needs opioids for moderate-severe pain. I've taken morphine with Parnate a couple of times, as well as codeine and hydrocodone. As Shelli's experience demonstrates, oxycodone (which is comparable to morphine in its efficacy but has much better oral bioavailability) is also safe. Demerol and Ultram are the only ones that I know of that are unsafe; you might be cautious of other synthetic ones, like Darvon. The natural (codeine, morphine) and semisynthetic (oxycodone, hydrocodone, oxymorphone (NuMorphan), hydromorphone (Dilaudid), and of course heroin) ones are all okay, as is buprenorphine. I think methadone is too. I'm not sure about Stadol, Talwin, or Nubain. I think that covers most of them. :-)





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