Psycho-Babble Medication Thread 994620

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Re: 40% down to 25%

Posted by morgan miller on September 19, 2011, at 22:21:29

In reply to Re: 40% down to 25% morgan miller, posted by floatingbridge on September 19, 2011, at 20:56:36

Hey FB, I don't think methylene blue is going to be a problem at a 60 to 100 microgram dose when mixed with SSRIs or other serotonergic antidepressants. It's definitely worth trying for those of us who are more stabilized but still suffering cognitive and energy issues.

Hope you are doing better!

Morgan

 

Re: 40% down to 25% SLS

Posted by floatingbridge on September 20, 2011, at 15:44:15

In reply to Re: 40% down to 25%, posted by SLS on September 17, 2011, at 10:08:52

Scott, I hope the wash is going alright today. Thinking of you.

 

Re: 40% down to 25% floatingbridge

Posted by SLS on September 20, 2011, at 16:27:42

In reply to Re: 40% down to 25% SLS, posted by floatingbridge on September 20, 2011, at 15:44:15

> Scott, I hope the wash is going alright today. Thinking of you.

Thanks, FB.

My depression is somewhat worse, but tolerable. I am still experiencing sensations in my head that remind me of the brain-zaps seen with SRI withdrawal. My appetite has decreased dramatically, and I have lost 7 pounds. Only 50 pounds more to go.


- Scott

 

Re: 40% down to 25% SLS

Posted by Phillipa on September 20, 2011, at 19:40:52

In reply to Re: 40% down to 25% floatingbridge, posted by SLS on September 20, 2011, at 16:27:42

Scott that is said on a light note hoping. Phillipa

 

Re: 40% down to 25% SLS

Posted by Conundrum on September 21, 2011, at 13:40:19

In reply to Re: 40% down to 25% floatingbridge, posted by SLS on September 20, 2011, at 16:27:42

> > Scott, I hope the wash is going alright today. Thinking of you.
>
> Thanks, FB.
>
> My depression is somewhat worse, but tolerable. I am still experiencing sensations in my head that remind me of the brain-zaps seen with SRI withdrawal. My appetite has decreased dramatically, and I have lost 7 pounds. Only 50 pounds more to go.
>
>
> - Scott

This is weight that you gained after starting nardil that you are losing now?

 

Re: 40% down to 25% Conundrum

Posted by SLS on September 21, 2011, at 15:00:08

In reply to Re: 40% down to 25% SLS, posted by Conundrum on September 21, 2011, at 13:40:19

> > > Scott, I hope the wash is going alright today. Thinking of you.
> >
> > Thanks, FB.
> >
> > My depression is somewhat worse, but tolerable. I am still experiencing sensations in my head that remind me of the brain-zaps seen with SRI withdrawal. My appetite has decreased dramatically, and I have lost 7 pounds. Only 50 pounds more to go.
> >
> >
> > - Scott
>
> This is weight that you gained after starting nardil that you are losing now?


Actually, most of the weight was gained over a period of three years while taking Abilify. The addition of Nardil made my weight jump another 17 pounds over the course of a few weeks. I had been 157 lbs or so before Abilify. I looked pretty good. I was as heavy as 227 lbs with Abilify and Nardil. I looked pretty disgusting. Now, I look just short of being pretty disgusting. I'm about 210 lbs.


- Scott

 

Re: 40% down to 25% SLS

Posted by Phillipa on September 21, 2011, at 21:29:12

In reply to Re: 40% down to 25% Conundrum, posted by SLS on September 21, 2011, at 15:00:08

Scott you should post the pic from your web page you had of you flexing. What a hunk of real man!!!!

 

Re: 40% down to 25% Phillipa

Posted by SLS on September 21, 2011, at 21:37:11

In reply to Re: 40% down to 25% SLS, posted by Phillipa on September 21, 2011, at 21:29:12

> Scott you should post the pic from your web page you had of you flexing. What a hunk of real man!!!!
>

Is there an emoticon for blushing?


- Scott

 

Re: 40% down to 25% -- Viibryd trial question SLS

Posted by zonked on September 21, 2011, at 22:03:53

In reply to Re: 40% down to 25% Conundrum, posted by SLS on September 21, 2011, at 15:00:08

In another post, you mentioned a good question:

Since both Viibryd and Abilify are partial 5HT1A agonists, how would this affect receptor occupancy?

Have you found the answer to this question?

Wikipedia reports the following:

Vilazodone, 5HT1a :
IC50 = 0.5 nM; IA = ~60-70%

Aripiprazole, 5HT1a:
Ki = 1.65 nM

I am more familiar with the units used in the Aripiprazole document and don't know what IC50 stands for. Did you ever answer this question yourself? I am curious. If the units were the same, wouldn't a lower Ki value mean higher affinity?

-z

 

Re: 40% down to 25%

Posted by Conundrum on September 22, 2011, at 5:10:33

In reply to Re: 40% down to 25% Conundrum, posted by SLS on September 21, 2011, at 15:00:08

> > > > Scott, I hope the wash is going alright today. Thinking of you.
> > >
> > > Thanks, FB.
> > >
> > > My depression is somewhat worse, but tolerable. I am still experiencing sensations in my head that remind me of the brain-zaps seen with SRI withdrawal. My appetite has decreased dramatically, and I have lost 7 pounds. Only 50 pounds more to go.
> > >
> > >
> > > - Scott
> >
> > This is weight that you gained after starting nardil that you are losing now?
>
>
> Actually, most of the weight was gained over a period of three years while taking Abilify. The addition of Nardil made my weight jump another 17 pounds over the course of a few weeks. I had been 157 lbs or so before Abilify. I looked pretty good. I was as heavy as 227 lbs with Abilify and Nardil. I looked pretty disgusting. Now, I look just short of being pretty disgusting. I'm about 210 lbs.
>
>
> - Scott
>
>
>
>
>
>

I'm around 223 so I know how you feel. I was around 200 before I tried remeron and then nardil and gained a lot of weight. The thing that sucks about Nardil is it makes me sweat profusely when I exercise so I feel less inclined to be bothered with it.

I need to talk to my pdoc soon, I think the Nardil is making my anhedonia worse not better and I hate wasting my time trialing "fat" pills.

 

Re: 40% down to 25% -- Viibryd trial question zonked

Posted by SLS on September 22, 2011, at 7:04:55

In reply to Re: 40% down to 25% -- Viibryd trial question SLS, posted by zonked on September 21, 2011, at 22:03:53

> In another post, you mentioned a good question:
>
> Since both Viibryd and Abilify are partial 5HT1A agonists, how would this affect receptor occupancy?
>
> Have you found the answer to this question?

No. I think IC50 means the concentration at which 50% of the receptors are occupied and inhibited. The answer to the question is deceptively complicated. I've got a model floating around in my head, but it is difficult to explain briefly. One important question is to what degree these two drugs flip conformations to produce 5-HT1a agonism at a given receptor.

Questions like these are sometimes more esoteric than applicable. I think I would rather try Viibryd in ignorance and without predicting its potential to improve my condition. I might have an easier time suggesting answers to the questions asked once I establish how Viibryd affects me. I might even try removing Abilify if I respond well to the addition of Viibryd. Is D2 partial agonism important to the ability of Abilify to provide improvements in depression? Is 5-HT1a partial agonism sufficient? Remember, the most ubuquitous serotonin receptor in the brain is 5-HT1a. They populate numerous different regions and have different functions. Do Abilify and Viibryd mirror one another in the agonism of 5-HT1a receptor populations? I think Abilify is limited to somato-dendrytic autoreceptors. In addition to these receptors, Viibryd effectively acts upon inhibitory presynaptic autoreceptors and excitatory postsynaptic receptors, with it acting selectively on presynaptic autoreceptors, particularly at low dosages.

> Wikipedia reports the following:
>
> Vilazodone, 5HT1a :
> IC50 = 0.5 nM; IA = ~60-70%
>
> Aripiprazole, 5HT1a:
> Ki = 1.65 nM

Apples to oranges. I don't know how one would use these numbers to compare the two drugs.

Good morning.


- Scott

 

Re: 40% down to 25% -- Viibryd trial question SLS

Posted by Phillipa on September 22, 2011, at 19:47:14

In reply to Re: 40% down to 25% -- Viibryd trial question zonked, posted by SLS on September 22, 2011, at 7:04:55

Scott if you are even a bit like me in my case a little knowledge is dangerous. Always done better when knew nothing and just did it!!!! Phillipa

 

Viibryd SLS

Posted by floatingbridge on September 23, 2011, at 16:08:55

In reply to Re: 40% down to 25%, posted by SLS on September 17, 2011, at 10:08:52

Do you start next week? (I track time pretty poorly.....)

How is your day going so far?

fb

 

Re: Viibryd floatingbridge

Posted by SLS on September 23, 2011, at 16:20:58

In reply to Viibryd SLS, posted by floatingbridge on September 23, 2011, at 16:08:55

> Do you start next week? (I track time pretty poorly.....)

Monday.

> How is your day going so far?

Not too bad. I haven't relapsed to my untreated baseline. Perhaps there is an inertia that will allow me to function for a few weeks.

Who knows?


- Scott

 

Re: Viibryd

Posted by floatingbridge on September 23, 2011, at 16:36:32

In reply to Re: Viibryd floatingbridge, posted by SLS on September 23, 2011, at 16:20:58

> > Do you start next week? (I track time pretty poorly.....)
>
> Monday.
>
> > How is your day going so far?
>
> Not too bad. I haven't relapsed to my untreated baseline. Perhaps there is an inertia that will allow me to function for a few weeks.
>

> Who knows?
>
>
> - Scott

That would be wonderful. I hope so :-)

 

Re: Viibryd SLS

Posted by zonked on September 23, 2011, at 16:59:54

In reply to Re: Viibryd floatingbridge, posted by SLS on September 23, 2011, at 16:20:58

> > Do you start next week? (I track time pretty poorly.....)
>
> Monday.

Were you able to secure samples or did you decide to go Effexor XR?

> > How is your day going so far?
>
> Not too bad. I haven't relapsed to my untreated baseline. Perhaps there is an inertia that will allow me to function for a few weeks.
>
> Who knows?
>
>
> - Scott

I saw my (brilliant) doctor today and we usually spend most of the session just talking pharma/neuroscience - especially since I fixed my insurance problem and will maintain on my current regimen. I forgot to ask him what he makes of Viibryd.

We did make a little joke about Oleptra (he said when the drug rep came in to promote it, "we were so mean to them they never came back.") He laughed when I said "the first thing I thought when I heard about Oleptra was, hangover XR."

Anyway, I hope you were able to work something out. This is truly the most novel antidepressant to come to market in a long time.

(Please, Forest. When you launch your DTC campaign, nothing as disturbing as the Pristiq ladies and their wind-up-doll Avatars. Thanks!)

Best,

-z

 

Re: Viibryd zonked

Posted by SLS on September 23, 2011, at 19:53:59

In reply to Re: Viibryd SLS, posted by zonked on September 23, 2011, at 16:59:54

> I saw my (brilliant) doctor today and we usually spend most of the session just talking pharma/neuroscience - especially since I fixed my insurance problem and will maintain on my current regimen. I forgot to ask him what he makes of Viibryd.

I would be very interested to know what your doctor thinks of Viibryd.

No word back from my insurance company. I will have my doctor's office send another fax on Monday.


- Scott

 

Re: Viibryd

Posted by SLS on September 27, 2011, at 15:10:15

In reply to Re: Viibryd zonked, posted by SLS on September 23, 2011, at 19:53:59

> No word back from my insurance company. I will have my doctor's office send another fax on Monday.

Got it!

I should be up to 40mg by the end of week 2. I am only on day 2. However, I feel it in my brain already. I am slightly improved. I have more energy and can process information faster. These are infrequent occurrences for me. It's just a blip, I guess. I wouldn't expect anything substantial until week 4.


- Scott

 

Re: Viibryd SLS

Posted by floatingbridge on September 27, 2011, at 21:02:36

In reply to Re: Viibryd, posted by SLS on September 27, 2011, at 15:10:15

Excellent news on the insurance. That makes things easier.

Steady on in the face of blips or dips.

:-)

Very best wishes, Scott.

 

Re: Viibryd SLS

Posted by Phillipa on September 27, 2011, at 21:05:58

In reply to Re: Viibryd, posted by SLS on September 27, 2011, at 15:10:15

Scott sorry no more blips allowed. This time this med will permantly cause remission. Now that is an order from me. Phillipa!!!!

 

:-) Everyone

Posted by SLS on September 27, 2011, at 21:37:46

In reply to Re: Viibryd SLS, posted by Phillipa on September 27, 2011, at 21:05:58

Thanks!


- Scott

 

TRD advocacy

Posted by zonked on September 27, 2011, at 23:26:11

In reply to :-) Everyone, posted by SLS on September 27, 2011, at 21:37:46

There are advocacy group for most conditions, but none that I am aware of for treatment-resistant depression (unipolar or bipolar.)

Depression robs one of energy, so perhaps that's a reason.

I don't think we are so few in number so as to not warrant an advocacy group of our own. No, NAMI doesn't count.

It's something I've been thinking about off and on. Unfortunately, of the many things I do graphic design and website design aren't among them.

I wonder if having such a group would get any attention (press perhaps?) or pressure pharma to consider us a distinct group to study in trials.

As far as I know, the only drugs with FDA *indications* for TRD are Symbyax (Zyprexa with Prozac) and Marplan.

Just an idea. Maybe if I return to full functioning (including occupational) this is a cause I could devote some time to.

I think if big pharma pursued indications for TRD as well as MDD for novel compound they might sell more product. Having said that, the product would have to be effective for TRD. TRD-ers are often excluded from trials for various reasons (previous suicide attempts, I believe, being one of them.)

What do you guys think?

-z

 

Re: TRD advocacy zonked

Posted by SLS on September 28, 2011, at 5:55:06

In reply to TRD advocacy, posted by zonked on September 27, 2011, at 23:26:11

Hi Z.

You offer very cogent arguments for greater recognition of TRD.

> There are advocacy group for most conditions, but none that I am aware of for treatment-resistant depression (unipolar or bipolar.)

As you suggest, people with severe depression have trouble getting out of bed and taking a shower. How could such a condition allow for that kind of active advocacy?

> I don't think we are so few in number so as to not warrant an advocacy group of our own. No, NAMI doesn't count.

Why not?

What about DBSA?

http://www.dbsalliance.org/site/PageServer?pagename=home

I didn't know that Marplan was indicated for TRD.

It is wonderful that you now have the resources to consider and act upon such issues.

Stay well.


- Scott

 

Re: TRD advocacy SLS

Posted by zonked on September 28, 2011, at 8:31:11

In reply to Re: TRD advocacy zonked, posted by SLS on September 28, 2011, at 5:55:06

> Hi Z.
>
> You offer very cogent arguments for greater recognition of TRD.
>
> > I don't think we are so few in number so as to not warrant an advocacy group of our own. No, NAMI doesn't count.
>
> Why not?
NAMI *seems* to be focused more on other mental disorders perceived as more chronic and disabling.
Also, I don't have time to look at it now; someone once told me they had accepted donations from pharmaceutical companies. I can't say that's blanket good or bad...

> What about DBSA?
>
> http://www.dbsalliance.org/site/PageServer?pagename=home

Good for support groups, but I was thinking more along the lines of, like, how The American Cancer Society is for Cancer.

> I didn't know that Marplan was indicated for TRD.

If you look at the advertising on their website, it's for "treatment resistant depression." US rules only allow advertising for approved indications. I think this supplemental indication is why it was brought back from the dead after Roche didn't seem to care that it pre-dated DESI and never bothered to implement it; and why the third party (Validus?) was interested in it.

> It is wonderful that you now have the resources to consider and act upon such issues.
>
> Stay well.
>
>
> - Scott

Scott, be patient, and your brain will feel like you remember again. Me, telling you to be patient, that's rich. Some of my own patience has been influenced by watching you over the years. I should say, one day you will feel like yourself - consistently - again. And you have the writing skills to write a novel about your experiences should you ever wish to.

I hope it's Viibryd that does the trick for you. BTW, how easily is the Nardil weight coming off? I am not going to mess with my regime, just curious.

BEST of luck always,
-z

 

Re: TRD advocacy zonked

Posted by SLS on September 28, 2011, at 9:10:11

In reply to Re: TRD advocacy SLS, posted by zonked on September 28, 2011, at 8:31:11

> Scott, be patient, and your brain will feel like you remember again.

From your mouth to God's ears...

Thank you for the words of encouragement and everything else you have to say.

It has been 17 days since I took my last dose of Nardil.

Before: 220 pounds
Now: 207 pounds

I have also changed my eating habits, so it is difficult to ascribe discontinuing Nardil for all 13 pounds. However, prior to coming off Nardil, the same eating habits yielded no weight loss.

Thank God for leptin! Burn that white adipose!


- Scott


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