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Re: hanging in there Elizabeth

Posted by shelliR on October 9, 2001, at 23:32:54

In reply to Re: hanging in there shelliR, posted by Elizabeth on October 9, 2001, at 12:36:51

> re bupe:
> > And it still makes you nauseous? And it's a pain to administer. Those are the two side effects for you?
> No, of course it doesn't still make me nauseous. That was the point of starting at a lower dose. The side effects I still get are itching, constipation, and dry mouth, all of which are easily controlled. (They're also side effects that you're liable to get from just about any opioid, although I gather that fentanyl -- which comes in transdermal patch (Duragesic) that most people need to change every 2-3 days -- is generally more tolerable than the others.)

I guess I keep asking because in posts you say quite often that you'd rather find a substitute with less side effects. Itching is pretty bad, nothing to control that? And constipation, I think, has to be managed with so many medications.

> re cost of OxyContin:
> > He said when everything is all stabilized, we could talk about changing, perhaps to a shorter acting generic. I like the long-acting, but it's not worth what I have to pay.
> It might interest you to know that generic MS Contin (slow-release morphine) is available.

I didn't know that. My pharmacy is supposed to automatically substitute generics, and it always has before. Is the generic a new thing?

> And you're comfortable going up to 60 mg of Nardil? What dose were you on previously? (I'm thinking maybe I misunderstood you; it sounded like you were only on 30 mg/day.)

I was on 30mg, then I started 45mg. I am fine, except for the sleep problems which are serious and constipation (already compounded by oxycontin). Magnesium helps that; sleep is going to be a much more complicated issue if 60mg kicks in. Also I could not adjust to changes in light on 45 mgs after several months, so I'll have to see how that goes. It was pretty dangerous--I was "whiting out"--couldn't see anything until I got into a building (from a bus to outside, or from my car to outside.) If it just happened in the car I could see it related to blood pressure changes, but I used to stand on the bus when I worked downtown years ago.
> I like the idea of combining Wellbutrin and Nardil; it seems like the WB might alleviate the appetite increase from Nardil.

So far I have no appetite. My carbo cravings on Nardil are gone, but as I've said before, I don't think it made me gain weight. But I don't remember. When I first started it, I was seriously underweight from the severe depression.

> I know the feeling. Do you find that the oxycodone helps you get started?

I'm okay except when I reach a level when the oxy is not working. And it feels like it's not working at all until I increase it.
I hope the 60mg of nardil makes a difference. I want there to be something backing up the oxy--not relying on that for the whole job, especially in light of the fact that I keep developing tolerances.


> T2? Do you mean T4? What are the generic names on the bottles?
Yes, I guess I do mean t3, t4. It's amour thyroid, a natural thyroid combination.
As far as tricyclics go, I'd stick with the ones that are mainly NE reuptake inhibitors -- desipramine, nortriptyline, amoxapine. (Protriptyline and maprotiline fall into this category too but they have some serious toxicity issues and I think they are best avoided.)

Tried tricyclics years ago and couldn't tolerate several; don't remember which ones.

Hmm...lithium and anticonvulsants can be added to MAOIs. So can BuSpar (you have to monitor your blood pressure closely, though, and I would keep a lookout for signs of serotonin toxicity).

Done both lithium and most anticonvulsives, as well as BuSpar with no success. If I can control water weight I might try lamictal again because it was the only one I was successful one. But I carried 15lbs of pure water (swollen everything), which I dropped immediately when off the drug.
> Something interesting to consider: I had a friend in college (I've long since lost track of her so I don't know how she's doing now) who had problems with dissociation and cutting, and she said that naltrexone (of all things!) really helped her

Tried that also. My last pdoc was hopeful because of the relationship to opiates, but it felt awful. I only did a one day trial, then gave it up.

> > Although I'm surprised he hasn't brought that up because he is big on thinking that stimulents added to any pooped out AD is generally the way to go.
> Which AD pooped out?

Nardil. But he was talking about the success of adding stimulents to any pooped out AD in general.




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