Posted by Ame Sans Vie on March 3, 2005, at 12:37:13
In reply to Re: Back in the saddle..., posted by katalina on March 2, 2005, at 11:03:18
Hi! It's nice to see your name again too!
> I think he deals mostly with epileptic and parkinsons patients whom don't question anything he prescribes and at first I was a pleasant change for him, coming in armed with information (mostly extracted from psycho babble) and we could have an intelligent exchange about pharmaceuticals, etc. which led him to giving me what I asked for.
Yeah, that's always a nice thing, isn't it? Especially when so many psychiatrists/neurologists/etc. these days fall into one (or more) of three categories -- 1) stuck in the days of TCAs, 2) "staying safe" by sticking with SSRIs and Effexor without exception, or 3) willing to experiment throughout the range of antidepressants, but deathly afraid of benzodiazepines, stimulants, or novel therapies.
> Anyway, he kind of "turned" on me in January, when I lost my bottle of klonopin helping my sister move out of her apt.
Ugh, I've had that happen to me once with the doctor I just ditched... I think that may have been the start of the decline in our good rapport.
> I think it got thrown out. I have never misused any meds in the past or asked for early refills, but when I called his office explaining the situation, the nurse called back and said "Dr. Smith is concerned you may be abusing your meds and suggests you be more careful with them in the future. If you're having withdrawal symptoms he advises you go to the ER" What the ^%&$?? I was so blown away by that, I felt betrayed. I don't know if he was having a bad day or if I was the 10th person that day to call with a "story" about losing pills, but I was furious.
That's ridiculous -- hard to get yourself to the E.R. when you're in the process of enduring a grand mal seizure!
> ANYWAY, I don't know why I'm purging this now in this post, nonetheless, but I just wanted to say that I always enjoyed your posts and advice.
Thank you, I really appreciate that. :-)
> 60 mgs. dexedrine spans (after 3 years of 50 mgs. of Adderall XR)Just curious, how have you found the duration of action of the Spansules to compare to Adderall XR? And are you using the brand or generic? I used the generic dextroamphetamine sulfate SR before I began taking Adderall but was very disappointed with the 4-5 hours each dose seemed to affect me.
> 50 mgs. desipramine (newly added, not sure if it's therapeutic, or even if I need it. I've been anti ssri/snri lately and wanted to try a tca, but I don't know if this has enough (or any for that matter) serotonin in it.
I haven't looked very deeply into the pharmacology lately, but to my knowledge it has very minimal (if any) effect upon serotonin. It's action seems restricted to noradrenaline reuptake inhibition which also results indirectly in increases of dopamine function throughout certain areas of the forebrain in which dopamine and noradrenaline share common pathways. If you *do* end up feeling a definite therapeutic effect from desipramine but still feel you could use that serotonin "kick", perhaps Tofranil (imipramine) would be worth a try? Desipramine is, after all, a metabolite of imipramine -- desmethylimipramine.
> I think I need prozac again to be honest, but I'm afraid to call and ask)
I understand the feeling. I've had positive experiences with Prozac in the past (especially compared with all other SSRIs) and found it to work very well along with amphetamines.
> dexalone (dextromorphan) (one or two caps a day - is that enough? And do you really think it warded off tolerance? So hard to tell what is real and what we think is real sometimes).
I think weight plays a big role in proper dosage, but one or two caps (I believe they're 30mg apiece?) should be sufficient. I personally believe quite strongly that it prevented tolerance in my case, and my psychiatrist used it in other patients taking various amphetamines (Adderall, Dexedrine, DextroStat and Desoxyn) as well as methylphenidate. He mentioned to me that it worked wonderfully in all but one patient taking the amphetamines (who had a bad reaction, possibly consistent with serotonin syndrome) though it didn't help his methylphenidate patients much.
> I also take enough supplements to choke a small horse. Rhodiola, Tyrosine, Taurine, Theanine, NAC, 5-HTP, SAME, PS, multi-vitamin, mineral, antioxidants, etc., etc. I could probably own beach front property if I ditched my vitamin regime. (O.K., slight exaggeration, maybe not owe my soul to mastercard is more accurate). *sigh*lol, I hear you -- I probably should have mentioned my supplement regimen in my above posts. I'm taking acetyl-l-carnitine, phosphatidylserine, phosphatidylcholine, Suntheanine, trimethylglycine, alpha lipoic acid, sublingual B-12/B-6/folic acid, chelated cal-mag tablets, and separate timed-release "green-food" multivitamin/multimineral and B-vitamin supplements.
> Oh well. Nice to have you back, I hope the Parnate is everything you hope it to be. It's always nice to have something new to try to put our hopes into, isn't it? (I don't mean for that to sound sarcastic if it does.) I just mean it's always good to have one in the bank if you know what I mean - just that safety net to know there's something out there that we haven't tried yet, that could be the magic solution.
>
> Sorry for my epic length, somewhat inpertinent post. I wish you the best with the Parnate and hope you keep us posted!Yes, it's very nice indeed, and I have my hopes very high for this one! Keep your fingers crossed for me! :-)
Take care,
~Michael
poster:Ame Sans Vie
thread:465343
URL: http://www.dr-bob.org/babble/20050227/msgs/465958.html