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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 56. This is the beginning of the thread.
Posted by SLS on November 13, 2018, at 9:57:20
The last five months have been agonizing.
I discontinued Parnate five months ago because the improvement it produced was inadequate and well below 50%. Parnate seemed to be a dead end. I remained unemployable. Reading and memory impairments continued. I haven't read a book since 2001. I was taking Effexor 300 mg/day at the time. The last book previous to that was in 1987 while taking Parnate + desipramine. I rarely read anything at all.
I experienced a horrendous rebound depression after discontinuing Parnate. Unfortunately, my impatience caused me to taper from 80 mg/day in only two weeks. Did this damage my brain? I don't know. After waiting two weeks, I began taking Trintellix. My depression lifted a bit, but then I began to feel weird. I was in a fog and didn't feel like myself. So, I moved on to Effexor. I reacted to it in a similar fashion at only 37.5 mg/day, even though I had been okay at 300 mg/day previously. I then went to my backup plan - Nardil. A few years back, I was taking 90 mg/day. My response was only partial, though. I again started taking Nardil a few weeks ago at 7.5 mg/day. By the time I arrived at 60 mg/day, I was again hit with weird cognitive effects that left me feeling incoherent and depressed.
My doctor agreed that it made sense for me to return to Parnate and then go for TMS magnetic treatments. I am very scared. What if my brain has been affected by these drug exposures in such a way that I will be unable to tolerate Parnate? Will Parnate now produce a severe brain-fog? What then? Suicide?
I have run out of ideas.
Thanks for reading.
- Scott
Posted by beckett2 on November 13, 2018, at 14:47:36
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
We're getting older, and our rebound time has slowed down. I say we because I think we're the same age. You've been through a lot of med changes in five months, something maybe taken for granted because you've always been such a beast. Parnate may take longer to reach your previous baseline (which I know you were unsatisfied with). TMS could be very helpful-- but be patient! You might want extra treatment for anxiety while you steady yourself. Counseling, short term and focused because you are in a crisis. Don't despair. Keep the faith.
Posted by linkadge on November 13, 2018, at 17:48:46
In reply to Re: I feel like I am brain damaged. Please read. » SLS, posted by beckett2 on November 13, 2018, at 14:47:36
Hey SLS,
Med changes can cause a whole host of fluctuations in brain chemistry. When you change one system, you can throw everything else off.
The MAOIS are very powerful and can have profound effects on many aspects of brain function. Coming off them, you may have a rebound in other systems which could cause cognitive difficulties.
I have, in the past, felt, as you do, that I have experienced some form of irreversible brain damage as a result of illness, stress and / or med changes. However, in most cases, with time and recovery, my cognition generally returns to a baseline. I would venture to say, that unless you have suffered a stroke, your cognition should improve as your mood improves.
Make sure to include things like socialization and some degree of exercise (even walking with music) as these can help facilitate cognative recovery.
Hopefully you can get your meds sorted out.
Posted by Roslynn on November 13, 2018, at 18:30:01
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
Scott,
I'm so sorry. Please go easy on yourself. You've had a lot of med changes in a short amount of time and your brain is probably catching up, I think.
I know you'll be busy with TMS, but following what beckett2 said, do you have a counselor/therapist in addition to your pdoc? Maybe just for a while to help you get over this rough period?
Posted by Hugh on November 13, 2018, at 22:38:19
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
You were doing quite a bit better until your appendix ruptured last year, weren't you? Did you recover fully and then start declining five months ago, or have you never felt the same since your hospitalization?
Posted by Lamdage22 on November 14, 2018, at 6:19:51
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
What if my brain has been affected by these drug exposures in such a way that I will be unable to tolerate Parnate? Will Parnate now produce a severe brain-fog? What then? Suicide?
>
> I have run out of ideasI havent. Testosterone and Human Growth Hormone replacement?
Blueberries or frankincense. These wont bring you to remission but they may help! Hormone replacement might bring remission though. See an endocrinologist.
Keep an open mind when thinking about what might help you. You may be suprised.
Posted by SLS on November 14, 2018, at 6:37:45
In reply to Re: I feel like I am brain damaged. Please read., posted by Roslynn on November 13, 2018, at 18:30:01
Hi.
> I know you'll be busy with TMS, but following what beckett2 said, do you have a counselor/therapist in addition to your pdoc? Maybe just for a while to help you get over this rough period?I don't currently have a counselor. I have used them in the past, though. Right now, I am too depressed to pursue getting additional help. I'm not sure that I could pay for it, anyway.
Thanks, Roslynn.
- Scott
Posted by SLS on November 14, 2018, at 6:56:45
In reply to Re: I feel like I am brain damaged. Please read., posted by Hugh on November 13, 2018, at 22:38:19
Hi, Hugh.
> You were doing quite a bit better until your appendix ruptured last year, weren't you? Did you recover fully and then start declining five months ago, or have you never felt the same since your hospitalization?
Immediately after recovering from the appendix rupture, I was still partially improved while taking Parnate. This was about a year ago. It wasn't until I discontinued Parnate five months ago that I suffered a complete relapse.
My doctor and I thought that it was worth trying Latuda again. I tried it several years ago, but complained of negative effects on my mood. However, I was taking Abilify at the time, and I thought that perhaps these effects were due to taking too much antipsychotic. I took 20 mg of Latuda yesterday morning. The first half of the day was better. Of course, I don't know why. I woke up today feeling slowed-down and with depressed mood and thoughts of suicide. I took another 20 mg of Latuda this morning. It didn't occur to me that these things might be due to Latuda until after I took it. I am afraid that I might suffer more over the next few days. The half-life of Latuda is 18-40 hours.
- Scott
Posted by SLS on November 14, 2018, at 7:01:54
In reply to Re: I feel like I am brain damaged. Please read., posted by Lamdage22 on November 14, 2018, at 6:19:51
Hi, Lamdage.
> What if my brain has been affected by these drug exposures in such a way that I will be unable to tolerate Parnate? Will Parnate now produce a severe brain-fog? What then? Suicide?
> >
> > I have run out of ideas
>
> I havent. Testosterone and Human Growth Hormone replacement?
>
> Blueberries or frankincense. These wont bring you to remission but they may help! Hormone replacement might bring remission though. See an endocrinologist.
>
> Keep an open mind when thinking about what might help you. You may be suprised.I appreciate your suggestions, and will try to keep an open mind. Right now, I am too depressed to pursue them. I'll be lucky if I can go out and buy food today.
- Scott
Posted by Lamdage22 on November 14, 2018, at 7:10:55
In reply to Re: I feel like I am brain damaged. Please read. » Lamdage22, posted by SLS on November 14, 2018, at 7:01:54
Okay. Thats not good. Can you get some help at home like a social worker?
Posted by Lamdage22 on November 14, 2018, at 7:16:54
In reply to Re: I feel like I am brain damaged. Please read., posted by Lamdage22 on November 14, 2018, at 7:10:55
Overthinking wont help Parnate work. Maybe Parnate will get you able to pursue the suggestions!
Posted by SLS on November 14, 2018, at 7:34:23
In reply to Re: I feel like I am brain damaged. Please read., posted by Lamdage22 on November 14, 2018, at 7:16:54
> Overthinking wont help Parnate work. Maybe Parnate will get you able to pursue the suggestions!
That's what I'm hoping.
It is hard not to over-think things. I have suffered too much for too long. My agonizing through five months of negative reactions to multiple drugs has me very fearful of having more.
- Scott
Posted by Lamdage22 on November 14, 2018, at 8:01:04
In reply to Re: I feel like I am brain damaged. Please read. » Lamdage22, posted by SLS on November 14, 2018, at 7:34:23
You are not alone. Im also a terrible overthinker.
Posted by Lamdage22 on November 14, 2018, at 14:10:39
In reply to Re: I feel like I am brain damaged. Please read. » Lamdage22, posted by SLS on November 14, 2018, at 7:34:23
I am rooting for you. I think that Parnate is the best shot you got. The remaining 50% of depression symptoms may be tackled by things other than Antidepressants. For example the ones i mentioned.
You are running out of ideas because you have a pessimistic mindset. It doesnt mean that there is nothing out there for you anymore.
Posted by PeterMartin on November 14, 2018, at 17:18:44
In reply to Re: I feel like I am brain damaged. Please read. » Lamdage22, posted by SLS on November 14, 2018, at 7:34:23
Give it time Scott.
One question I had a few weeks ago that I wanted to ask you is that I saw you listed that you were taking 300mg of Lamictal. I always remember you saying 200 was the best for you and any more started to cause cognitive problems.
Are you still taking Lamictal? If so at what dose and if possible what is the generic maker of the Lamictal you have. Teva stopped making it and many people have had bad reactions to the other generics pharmacies have switched them to.
I'd also check on the generic Parnate you received. Rosyln below mentioned she can't get activas brand now but only par. I truly believe different generics can have seriously different effects ranging from being ineffective to downright terrible side effects.
One thing to consider.
Books are overrated in the internet age btw :)
Posted by baseball55 on November 14, 2018, at 18:00:20
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
Scott - I am so sorry you are feeling so low. I know that feeling when all the helpful suggestions in the world don't help because you don't have the energy to carry them out.
I will give you one suggestion, though you may feel too overwhelmed to do it and I know also how frustrating it can be to have people say - do this, do that.
Maybe if you tried to do just one little thing a day - buying food or showering or any other thing you need to do but just can't seem to do - and try to do it mindfully (i.e., just focusing on the action, not on your feelings at the moment), you would feel just a little better for just a little time. But that might be enough to inspire you to try just a little bit more.
Do you have anyone who can help you? A friend or family who can visit and help you with daily tasks? Maybe make appointments for you? Do you need to be in the hospital? If so and you can't find the motivation to get yourself there, can you call 911? Sometimes just feeling safe for a bit can at least give you some relief and maybe some hope.
I just got out of the hospital. It does suck - mostly because there are not enough psych beds and so you have to wait in the ER for a long time. In the ER, they just kept me somewhat zoned out on ativan so I didn't go nuts and could doze despite the constant noise.
Posted by Roslynn on November 14, 2018, at 18:06:50
In reply to Re: I feel like I am brain damaged. Please read., posted by PeterMartin on November 14, 2018, at 17:18:44
> I'd also check on the generic Parnate you received. Rosyln below mentioned she can't get activas brand now but only par. I truly believe different generics can have seriously different effects ranging from being ineffective to downright terrible side effects.
>
Just wanted to clarify :) --I think they're still making the Actavis, it's just that my particular pharmacy switched generics on me (or their warehouse did) while I'm still working on reaching my target dose. And they're not too concerned about keeping the med in stock for me.But that's me, my pharmacy and where I live, etc.
If Scott is in or near a major city he might not have these problems. At least I hope not.
Posted by PeterMartin on November 14, 2018, at 21:30:50
In reply to Re: I feel like I am brain damaged. Please read., posted by Roslynn on November 14, 2018, at 18:06:50
>
>
> > I'd also check on the generic Parnate you received. Rosyln below mentioned she can't get activas brand now but only par. I truly believe different generics can have seriously different effects ranging from being ineffective to downright terrible side effects.
> >
> Just wanted to clarify :) --I think they're still making the Actavis, it's just that my particular pharmacy switched generics on me (or their warehouse did) while I'm still working on reaching my target dose. And they're not too concerned about keeping the med in stock for me.
>
> But that's me, my pharmacy and where I live, etc.
> If Scott is in or near a major city he might not have these problems. At least I hope not.
>
>Gotcha!
I'm just saying it's important to consider the brand of generic meds you're taking in particular lamictal. The most common (and best) generic for Lamictal was discontinued by Teva in July. Many people suddenly having major problems when they didn't realize their pharmacy switched them to another brand or that a different brand could have vastly different effects. I'm not sure why Lamictal has so many "bad" generics but if you read through this thread you'll see many people had issues when they had to switch from Teva to another brand: https://www.medschat.com/Discuss/What-Is-The-Best-Generic-Of-Lamictal-244558_p4.htm
TARO Lamictal is the only one I've found to work for me as Teva (and brand) did since I started taking it in 2008. Alembic and Cipla both had me rapid cycling and depressed.
I always stick w/ the same manufacturers now. If meds I think are going to work don't for some reason I'll try another generic brand to confirm it's the drug and not the maker (Most in India or China).
Posted by rjlockhart37 on November 15, 2018, at 1:45:29
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
i'm not expert, am not, but maybe this is period when you withdrew from parnate and withdraw from MAO-B neurotransmitters caused cognitive difficulties, because trillitex is serotonin med, effexor is stimulating ... but it's not as parnate. A quick suggestion is memantine because it stimulating to help improve memory, and mental functions. I don't know about MAOI's all i know is basic, but maybe parnate MAO-B and withdrawing from that caused cognitive effects.
I posted about DLPA, what happened was i was taking so much of DLPA, -Phenylalanine it was at a toxic dose and i did not know it. I started having haze-fog and couldnt think correctly, then after it was discontinued i had problems with remembering things, simple things. I don't want to sound silly, but i've gotten on prayer lines. If you google DLPA it's maximum dose is 3000mg, i thought that was in one dose....so i was taking 3 doses of it, it worked well, then started having those symptoms. But...im slowly bein able to remember things. For a while, i would sit at a laptop and could not think of anything to type into google, it was like ... only would check Facebook, and other main websites, i could not browse or be spontaneous. Having to sit in silent suffering and doing memory tasks to help improve.
This is just ... writing not scientific science, but you were on a MAO-B medication, and that is related to dopamine and norepinephrine. When it was discontinued, those nuerotransmitters lowered and you transferred over to serotonin type meds. Which is a big hop. But i don't have the best answer i just hope things work out. Memantine would help cognitive difficulties, but don't give up and work with your doctor. And this could be a totally diffrent problem than this. This was just a thought
Posted by Roslynn on November 15, 2018, at 14:58:08
In reply to Re: I feel like I am brain damaged. Please read., posted by PeterMartin on November 14, 2018, at 21:30:50
> I'm just saying it's important to consider the brand of generic meds you're taking in particular lamictal. The most common (and best) generic for Lamictal was discontinued by Teva in July. Many people suddenly having major problems when they didn't realize their pharmacy switched them to another brand or that a different brand could have vastly different effects. I'm not sure why Lamictal has so many "bad" generics but if you read through this thread you'll see many people had issues when they had to switch from Teva to another brand: https://www.medschat.com/Discuss/What-Is-The-Best-Generic-Of-Lamictal-244558_p4.htm
>
> TARO Lamictal is the only one I've found to work for me as Teva (and brand) did since I started taking it in 2008. Alembic and Cipla both had me rapid cycling and depressed.
>
> I always stick w/ the same manufacturers now. If meds I think are going to work don't for some reason I'll try another generic brand to confirm it's the drug and not the maker (Most in India or China).
>Oh, good point--I'd forgotten that people were having trouble with the lamictal generics. You do want to keep everything as close as possible to what you took before esp. if you are retrying a med or in a crisis situation. Thanks for pointing that out.
Posted by Schlepo on November 15, 2018, at 15:09:20
In reply to I feel like I am brain damaged. Please read., posted by SLS on November 13, 2018, at 9:57:20
you think you've got it bad? I just got a panic attack from Ativan.
Posted by rjlockhart37 on November 15, 2018, at 22:55:09
In reply to Re: I feel like I am brain damaged. Please read., posted by rjlockhart37 on November 15, 2018, at 1:45:29
maybe go back on Parnate, it may help and your doctor may can increase it more than 80mg's, i think when you said you went off parnate, you had a rebound depression, went from dopamine/norepheprhine (mao-b) to serotonin meds
Posted by SLS on November 16, 2018, at 6:46:40
In reply to Re: I feel like I am brain damaged. Please read., posted by PeterMartin on November 14, 2018, at 17:18:44
Hi.
> Give it time Scott.
>
> One question I had a few weeks ago that I wanted to ask you is that I saw you listed that you were taking 300mg of Lamictal. I always remember you saying 200 was the best for you and any more started to cause cognitive problems.I found that I needed 300 mg/day of Lamictal to get the most out of it. When I increased from 200 mg/day to 300 mg/day, I didn't think that I had an increase in cognitive impairments. It is hard to know, though. Things can creep up on you.
I am sad that Teva is no longer making lamotrigine. I found it to be somewhat less effective than Lamictal, but Mylan was much worse.
My depression is bad. I barely take care of myself. My money situation is getting worse. My mother looks like she is developing Alzheimer's Dementia, and I don't know who is going to take care of her. I don't have much drive or energy to get up off the couch. Winter is here, and I am too weak to shovel snow to get my car on the road. I worry about how I will live out my life in a nursing home. There is a lot more.
- Scott
Posted by SLS on November 16, 2018, at 6:49:22
In reply to Re: I feel like I am brain damaged. Please read. » SLS, posted by baseball55 on November 14, 2018, at 18:00:20
> Scott - I am so sorry you are feeling so low. I know that feeling when all the helpful suggestions in the world don't help because you don't have the energy to carry them out.
>
> I will give you one suggestion, though you may feel too overwhelmed to do it and I know also how frustrating it can be to have people say - do this, do that.
>
> Maybe if you tried to do just one little thing a day - buying food or showering or any other thing you need to do but just can't seem to do - and try to do it mindfully (i.e., just focusing on the action, not on your feelings at the moment), you would feel just a little better for just a little time. But that might be enough to inspire you to try just a little bit more.
>
> Do you have anyone who can help you? A friend or family who can visit and help you with daily tasks? Maybe make appointments for you? Do you need to be in the hospital? If so and you can't find the motivation to get yourself there, can you call 911? Sometimes just feeling safe for a bit can at least give you some relief and maybe some hope.
>
> I just got out of the hospital. It does suck - mostly because there are not enough psych beds and so you have to wait in the ER for a long time. In the ER, they just kept me somewhat zoned out on ativan so I didn't go nuts and could doze despite the constant noise.
These are GREAT suggestions!Thank you.
- Scott
Posted by SLS on November 16, 2018, at 6:58:48
In reply to Re: I feel like I am brain damaged. Please read., posted by rjlockhart37 on November 15, 2018, at 1:45:29
Thanks, RJ.
Your post was helpful.
- Scott
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