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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 34 to 58 of 95. Go back in thread:
Posted by floatingbridge on April 18, 2011, at 17:33:46
In reply to Re: the only way out » poser938, posted by SLS on April 18, 2011, at 5:52:41
> You are right about cyproheptadine. It is considered an anti-serotonergic that blocks 5-HT2a and 5-HT2b receptors. This in turn increases dopaminergic activity in various regions of the brain, including the prefrontal cortex - an area important for cognition and mood. Interestingly, 5-HT2a receptor binding is increased in suicide victims. This upregulation might indicate a decrease of serotoninergic activity in the PFC. This is in contrast to the mood-lifting properties of antipsychotics that block 5-HT2a receptors.
>Scott, I'm having difficulty parsing this information out and applying to my own situation, one in which AP's (limited experience) make me feel worse.
So a 5-HT2a receptor binding agent is the same way of saying anti-serotegenic agents in the above paragraph? Obviously I'm not following. (It's me.)
And remeron? I haven't tried it. A friend considers it a cornerstone in her sustained recovery.
Thanks
> Linkadge is very capable.
Yes! :D
fb
He is an amazing resource for information. I'm sure he will correct my errors and expand upon what I have said.
>
> Have you ever tried Remeron?
>
> I'm glad you are now in a more positive and constructive state of mind. This is a heroic effort in view of the frustration and pain you must endure. Keep it up and continue to think creatively.
>
> Suicide is a way out for which there is no way back in.
>
> There is actually a neurobiology for suicidality. Anger and anxiety make it worse. In other words, there is the possibility that you are currently wired biologically to *feel* suicidal. When this is combined with having to manage a depressing situation, things get dangerous. You might need to start looking at this feeling of suicidality to be artificially produced by a dysfunction brain. Self-talk that recognizes these false fellings might help. It has helped me, especially when I have had bad reactions to medications. I avoid making decisions while in this state.
>
>
>
> - Scott
>
>
>
>
>
> > i stopped going to one because he said there was nothinng else he could do.. and my new one prescribed me celexa(ssr) which is the 1st thing thats usually tried im sure you know. its the only ssri i havent taken and the other ones numbed me to different extents. ive tried wellbutrin and it has a different numbing effect on me than SSRI's.
> > Well i'll tell you a bit of my psych history.
> > in 2005 when i 1st saw a psych he prescribed me cymbalta and adderall. after about a month my tolerance grew to adderall completely to 20mgs XR so i tried taking 2 of them and i still could not feel it one bit. usually people can up their dose and get and effect but i got nothing. i also ended up with anhedonia/extreme anxiety from that combo.. i suffered for a year and then gave and tried effexor and it made me sooooo NUMB! so i tried adderall again and still got no effect from it at all even tho it had been a year.
> > a few days later i asked my doc for cyproheptadine to help with effexor side effects. so i took it, slowly increasing the dose week for about a month..and then all the sudden my anhedonia had gone away. i could feel adderall again, and i was much less numb... but still pretty numb.
> >
> > 2 years went by and then i finally went to a medical doc to see if anything could take away all the numbness and thats when i was given mirapex. after a month and a half i ended up with anhedonia from it. thats when i realized adderall had caused my anhedonia in the past. so i tried cyproheptadine again, it helped quite a bit again, but i ended having to take too high a dose of it this time and had to stop taking it, unfortuanately.. and ive slowly gotten worse since i stopped taking it in december 2010. im going to get some more of the cyproheptadine tuesday to see if my tolerance has gone down to it yet. i storngly believe cyproheptadine affects dopamine receptors by upregulating them/ sensitiziing them in some way. and that increases the release of dopamine. i dont get how, im just positive it does.
> >
> > sorry if some of this sounds unclear, i can seriously not think straight .
>
>
Posted by linkadge on April 18, 2011, at 18:32:58
In reply to Re: the only way out » linkadge, posted by floatingbridge on April 18, 2011, at 17:18:31
I'm not saying its true for everbody, but it just stands to reason that if your brain is more f'd up before meds, it will probably be f'd up (to some degree) after stopping.
Linkadge
Posted by linkadge on April 18, 2011, at 18:38:14
In reply to question, Re: the only way out » SLS, posted by floatingbridge on April 18, 2011, at 17:33:46
Cortisol (stress?) increases the expression of excitory 5-ht2a receptors and decreases the expression of inhibitory 1a receptors. As a result, there is excessive glutamatergic activity in the cerebral / prefrontal corticies.
5-ht2a blocking AD's will reduce some of the enhanced activity at 5-ht2a receptors. But, it might take some time till the receptors actually decrease in expression.
SSRI's take some time to decrease 5-ht2a expression and in the mean time might make anxiety worse by activating these receptors. Combining with a 5-ht2a blocking agent, might have theraputic utlilty by decreasing the effect of the oversensitive receptors untill they decrease in affinity.
Basically, one theory is that its the ballance of 5-ht1a / 2a that is off in heightened anxiety / suicidality especially.
Linkadge
Posted by huxley on April 18, 2011, at 18:42:35
In reply to Re: the only way out, posted by morgan miller on April 18, 2011, at 12:01:08
Wow so many questions. Couldnt be bother answering them all.
I will answer one, Why do I come back here?
Beacause I hope to stop people getting put on drugs such as Risperdal, Zyprexa and Seroquel from casual advise from internet psychiatrists.
Maybe poser938 is one of these people who is suffering heavily from SSRI withdrawal. Something worth looking into.
I am well MM thanks for asking.
Still stuck on Zyprexa but I am getting of it slowly.
Im doing pretty well MM thanks for asking.
Posted by sigismund on April 18, 2011, at 18:49:56
In reply to Re: the only way out » floatingbridge, posted by linkadge on April 18, 2011, at 18:32:58
It makes sense to me that the more you need a drug, the harder it will be to stop, and maybe the more you should avoid it.
Not always, but sometimes.
For example anxious people might be better off avoiding benzos.
They might be better off trying TCM. I would have been.
Posted by SLS on April 18, 2011, at 19:05:37
In reply to Re: the only way out, posted by sigismund on April 18, 2011, at 18:49:56
> It makes sense to me that the more you need a drug, the harder it will be to stop, and maybe the more you should avoid it.
>
> Not always, but sometimes.
>
> For example anxious people might be better off avoiding benzos.
>
> They might be better off trying TCM. I would have been.
What is TCM?
- Scott
Posted by floatingbridge on April 18, 2011, at 20:31:17
In reply to Re: the only way out, posted by huxley on April 18, 2011, at 18:42:35
Well, Huxley, I hear you on that one.
Seroquel ER (or XR or CR) is being advertised as a first line treatment for depression. I find that disturbing.
I can't imagine being given that when walking into a doctor's office right off the bat.
Then there is the big fat socio-economic problem of lots of kids being given ap's in the United States. Without parents being fully aware.
Thanks for answering. And good luck.
fb
Posted by floatingbridge on April 18, 2011, at 20:34:57
In reply to Re: the only way out » sigismund, posted by SLS on April 18, 2011, at 19:05:37
Traditional Chinese Medicine.
Maybe when I was.... No I was 20 when I tried it--but I'm intractable :-P
Or incorrigible.
It helps me though. Some other folks it can really help.
Posted by sigismund on April 18, 2011, at 21:13:39
In reply to Re: the only way out » sigismund, posted by SLS on April 18, 2011, at 19:05:37
Traditional Chinese Medicine.
When I was a kid I was quite frightened, but not badly so, just kind of obviously so. It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
Posted by sigismund on April 18, 2011, at 21:15:41
In reply to Re: the only way out » SLS, posted by floatingbridge on April 18, 2011, at 20:34:57
Best to try it before you are damaged too much by pharmaceuticals.
In my case that is chronic benzo use, so the things they have to calm you down work very gently on me.
Posted by floatingbridge on April 18, 2011, at 21:22:29
In reply to Re: question, Re: the only way out, posted by linkadge on April 18, 2011, at 18:38:14
Link, thanks. Hence the warnings posted about suicidal behavior at the onset of ssri use, yes?
(I wonder why young brains are more susceptible? Perhaps because executive functioning is proposed to mature by 24 or so....)Methinks I'll be thinking some more.
fb
Posted by floatingbridge on April 18, 2011, at 23:37:05
In reply to Re: the only way out » SLS, posted by sigismund on April 18, 2011, at 21:13:39
> Traditional Chinese Medicine.
>
I apologize for answering for you.> When I was a kid I was quite frightened, but not badly so, just kind of obviously so.
You were? :( My kid is fearful and anxious at times. I worry. This reminds me that his TCM sessions have lapsed.
>It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
>> If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
I'm still trying to figure this one out. :-/I suppose by 20 I was already on my way to h*ll in a handcart.
Posted by morgan miller on April 19, 2011, at 1:39:20
In reply to Re: the only way out, posted by floatingbridge on April 18, 2011, at 23:37:05
> > Traditional Chinese Medicine.
> >
> I apologize for answering for you.
>
> > When I was a kid I was quite frightened, but not badly so, just kind of obviously so.
>
> You were? :( My kid is fearful and anxious at times. I worry. This reminds me that his TCM sessions have lapsed.
>
>
> >It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
> >
>
> > If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
>
>
> I'm still trying to figure this one out. :-/
>
> I suppose by 20 I was already on my way to h*ll in a handcart.
>
>
>FB, I believe there is a way out for you in the future. Do you think it is possible you may be holding on to things and you've held on to them for so long you no longer know how to let go, and this may be holding you back from healing?
Don't get me wrong, I think the right medication treatment is going to be absolutely necessary, I just think there may be some other deep seated factors largely at play here. I'm thinking of a very integrative approach to healing.
Morgan
Posted by morgan miller on April 19, 2011, at 1:42:06
In reply to Re: the only way out » floatingbridge, posted by sigismund on April 18, 2011, at 21:15:41
> Best to try it before you are damaged too much by pharmaceuticals.
>
> In my case that is chronic benzo use, so the things they have to calm you down work very gently on me.I think chronic benzo use comes second only to chronic antipsychotic use as the most damaging and counter productive treatments for a large part of the mentally ill population.
Ayervedic medicine is probably just as important and effective as TCM is. A combination of the two would be ideal.
Posted by SLS on April 19, 2011, at 5:19:43
In reply to Re: the only way out » SLS, posted by sigismund on April 18, 2011, at 21:13:39
> Traditional Chinese Medicine.
>
> When I was a kid I was quite frightened, but not badly so, just kind of obviously so. It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
>
> If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.Unfortunately, this is true. Most people don't appreciate the unhealthy changes that can occur in a maturing brain when it is subject to unhealthy surroundings. This is especially true when chronic psychosocial stress is present. Of course, some people are wired to be less resilient than others. It is true that depression runs in families. However, so are pathological behaviors. They are often learned and passed on from generation to generation. If the rate of biological predisposition to depression is 10%, perhaps only 1% would develop the illness if everyone were raised in a low-stress, nurturing environment. 1% is probably an exaggeration, but it serves to make the point. The 10% is probably accurate.
- Scott
Posted by poser938 on April 19, 2011, at 8:10:08
In reply to Re: the only way out, posted by morgan miller on April 19, 2011, at 1:39:20
so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
Posted by SLS on April 19, 2011, at 8:29:50
In reply to Re: the only way out, posted by poser938 on April 19, 2011, at 8:10:08
> so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
Perhaps Abilify would stabilize your DA synapses. It is part DA agonist and part DA antagonist. It also may increase DA activity in PFC via 5-HT2a receptor antagonism.http://www.ncbi.nlm.nih.gov/pubmed/11775041
http://altcancerweb.com/bipolar/abilify/abilify-illustrating-their-mechanism-of-action-stahl.pdf
http://www.ncbi.nlm.nih.gov/pubmed/17205315
- Scott
Posted by morgan miller on April 19, 2011, at 12:46:02
In reply to Re: the only way out » sigismund, posted by SLS on April 19, 2011, at 5:19:43
> > Traditional Chinese Medicine.
> >
> > When I was a kid I was quite frightened, but not badly so, just kind of obviously so. It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
> >
> > If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
>
> Unfortunately, this is true. Most people don't appreciate the unhealthy changes that can occur in a maturing brain when it is subject to unhealthy surroundings. This is especially true when chronic psychosocial stress is present. Of course, some people are wired to be less resilient than others. It is true that depression runs in families. However, so are pathological behaviors. They are often learned and passed on from generation to generation. If the rate of biological predisposition to depression is 10%, perhaps only 1% would develop the illness if everyone were raised in a low-stress, nurturing environment. 1% is probably an exaggeration, but it serves to make the point. The 10% is probably accurate.
>
>
> - ScottWow Scott we are totally on the same page. I got the impression that when I first joined this site we differed in our beliefs when it came to some topics like nurture versus nature. Maybe I just did not interpret what you were saying accurately. You did direct me to your blog, but I was too impaired at the time to really read it and break it down.
Are you still doing better on the current regimen?
Morgan
Posted by morgan miller on April 19, 2011, at 13:02:57
In reply to Re: the only way out, posted by poser938 on April 19, 2011, at 8:10:08
How about optimal nutrition and proper exercise?
As far as supplements go, I would try high DHA to EPA fish oil omega 3 supplements(maybe a good Cod liver oil, or even better Calamari oil Carlson has one) a good ginger extract(New Chapter's Ginger Force) and Luteolin(Lutimax). If you can afford these, they may be quite helpful.
http://www.ncbi.nlm.nih.gov/pubmed/20971650
http://www.ncbi.nlm.nih.gov/pubmed/19815045
http://www.ncbi.nlm.nih.gov/pubmed/18952146
http://www.livestrong.com/article/400030-can-fish-oil-boost-dopamine/
http://www.ncbi.nlm.nih.gov/pubmed/21109417
Posted by sigismund on April 19, 2011, at 14:07:57
In reply to Re: the only way out, posted by floatingbridge on April 18, 2011, at 23:37:05
>'m still trying to figure this one out. :-/
You are the picture of reasonableness. So you are not well? I don't think children are damaged so much by their parents depression as by confusion and denial around it.
I remember once my son told me that in year 12 he had, at one of those interactive things they have, told the class I guess, certainly the facilitator/teacher that I was depressed. And he told me he said that. He is in good shape. I think most of the problems arise when there is lots of mystification and confusion.
Posted by SLS on April 19, 2011, at 19:41:32
In reply to Re: the only way out, posted by morgan miller on April 19, 2011, at 12:46:02
> > > Traditional Chinese Medicine.
> > >
> > > When I was a kid I was quite frightened, but not badly so, just kind of obviously so. It would have been better for me to be offered TCM formulations than Valium in the 70s. It does the same thing in a more gentle way (at receptor sites), but it didn't really exist here then.
> > >
> > > If parents can be persuaded to do what is necessary to stop tormenting their children, that might be effective too.
> >
> > Unfortunately, this is true. Most people don't appreciate the unhealthy changes that can occur in a maturing brain when it is subject to unhealthy surroundings. This is especially true when chronic psychosocial stress is present. Of course, some people are wired to be less resilient than others. It is true that depression runs in families. However, so are pathological behaviors. They are often learned and passed on from generation to generation. If the rate of biological predisposition to depression is 10%, perhaps only 1% would develop the illness if everyone were raised in a low-stress, nurturing environment. 1% is probably an exaggeration, but it serves to make the point. The 10% is probably accurate.
> >
> >
> > - Scott
>
> Wow Scott we are totally on the same page. I got the impression that when I first joined this site we differed in our beliefs when it came to some topics like nurture versus nature. Maybe I just did not interpret what you were saying accurately. You did direct me to your blog, but I was too impaired at the time to really read it and break it down.
>
> Are you still doing better on the current regimen?
Yes I am. Thanks. I would say that I am about 35% improved. Since adding lithium, my mood is less variable. I am hoping that I will be 50% by the end of summer. I should be able to go back to work with such an improvement. I remain encouraged by the progress I have made since last August. It took about four months for the addition of Nardil to kick in. I am still looking into using vitamins and supplements to provide the building blocks and enzymes to encourage brain tissue growth and functional remodulation.Fish oil and phosphatidylserine are the first two substances I might add. Later, I might try adding N-acetylcysteine, Co-Q10, and other mitochondrial-sparing antioxidants. A bit of magnesium might not be a bad idea.
- Scott
Posted by huxley on April 19, 2011, at 20:08:02
In reply to Re: the only way out » poser938, posted by SLS on April 19, 2011, at 8:29:50
> > so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
>
>
> Perhaps Abilify would stabilize your DA synapses. It is part DA agonist and part DA antagonist. It also may increase DA activity in PFC via 5-HT2a receptor antagonism.
>
> http://www.ncbi.nlm.nih.gov/pubmed/11775041
>
> http://altcancerweb.com/bipolar/abilify/abilify-illustrating-their-mechanism-of-action-stahl.pdf
>
> http://www.ncbi.nlm.nih.gov/pubmed/17205315
>
>
> - ScottScott perhaps you should also point out some of the side effects and unwanted effects of anti
psychotics.
Posted by SLS on April 19, 2011, at 20:34:48
In reply to Re: the only way out, posted by huxley on April 19, 2011, at 20:08:02
> > > so i guess there are no thoughts on what could fix what the mirapex did to me? i guess what it did was kind of like a tolerance thing. that it stimulated my receptors to where they're not tolerant of dopamine anymore. i know they're not because i tried ritalin and tianeptine in the past hoping they would help, they only made me worse.. ritalin made me worse after just one dose. i've been trying DXM (dextromethorphan) at 60mgs a day lately to see if it would help, but hasnt at all so far. its been a week since i started.
> >
> >
> > Perhaps Abilify would stabilize your DA synapses. It is part DA agonist and part DA antagonist. It also may increase DA activity in PFC via 5-HT2a receptor antagonism.
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/11775041
> >
> > http://altcancerweb.com/bipolar/abilify/abilify-illustrating-their-mechanism-of-action-stahl.pdf
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/17205315
> >
> >
> > - Scott
>
> Scott perhaps you should also point out some of the side effects and unwanted effects of anti
> psychotics.Since you brought up this issue, I think it would be appropriate for you to attend to it yourself. I look forward to your contributions. Your list of unwanted effects should be specific for Abilify, since it is this drug that I chose to speak about. Citations are welcome.
- Scott
Posted by morgan miller on April 19, 2011, at 21:34:05
In reply to Re: the only way out » morgan miller, posted by SLS on April 19, 2011, at 19:41:32
Hey Scott,
Great to hear you continue to do better. I've read some good things about milk thistle and the brain lately, like neuroprotection and increase BDNF. I'm sure you are getting plenty of BDNF with your medication regimen, but a little extra neuroprotection and liver and kidney protection would not hurt.
http://www.stopagingnow.com/liveinthenow/article/this-super-herb-protects-both-liver-and-brain
Hope your journey towards wellness continues in the right direction.
Morgan
Posted by floatingbridge on April 20, 2011, at 0:21:49
In reply to Re: the only way out » floatingbridge, posted by sigismund on April 19, 2011, at 14:07:57
> >'m still trying to figure this one out. :-/
>
> You are the picture of reasonableness.Ask my husband :-) The internet can do wonders for one's personality. (Thanks, though sigi.)
>So you are not well? I don't think children are damaged so much by their parents depression as by confusion and denial around it.
I guess that is probably more accurate. Sigh. It's that depression, well, mine, just takes away so much focus. I can be very self-absorbed. Getting better. Still. Not what I had in mind.
>
> I remember once my son told me that in year 12 he had, at one of those interactive things they have, told the class I guess, certainly the facilitator/teacher that I was depressed. And he
told me he said that. He is in good shape. I think most of the problems arise when there is lots of mystification and confusion.This made me laugh. It really is funny; not in an lol way. But funny beautiful or funny poignant. Are you better now than you were? You strike me as someone with a certain amount of self-acceptance.
My son certainly understands that my
pain level affects my mood and ability to participate or tolerate things like jumping on my back. He calls it my arthritis (even though it's only a little OA). I wonder how I would explain depression in an o.k. way. He's just past seven.He seems like he understands alot--verbal and precocious that way, but his world is still very magical. It's like intermittent rationality.
I suppose the most we've ever touched upon it was when my father died, and
sometimes I would be hit by a wave of saddness. Like clouds over the sun, I would say. I was missing my dad. It's o.k. to be sad.Now I'm making the effort to work on anger. I find that as difficult as
saddness. And my son has a temper. I suppose everyone does, but my son is not mild. The best approach is to
understand and manage my own--or else I'll won't be much help to him with
his.He understands in his way his grandfather's Parkinson's--papa's illness, he calls it. And doesn't take his grandfather bouts of discomfort and intolerance (sensitivity to stimulation--
anvawful disease) personally. It's very moving, actually.But a parent with a MI? I just don't know. For me, that is. Still guilty. Scared. When did you start talking to your son? (About depression.) How did you make it be o.k. for your family?
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