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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 39. Go back in thread:
Posted by Judy on October 31, 1999, at 10:10:09
In reply to Re: Viagra - Bob, posted by Bob on October 31, 1999, at 1:06:25
> So, I've been giving considerable thought to the contemplative life lately....
Bob,I checked the Boston Globe Help Wanted's for you today. There was one opening for a monk in the Himalayas...
I've given a lot of thought to Karma. Was I such a screw-up in a previous life that I'm saddled with such cruel irony this time around? Not just in matters sexual, but that's one of the most glaring examples. For the past 15 years, I've either had an "appetite" for intimacy but been unable to respond physically, or vice versa, as an AD side effect or depression sypmtom. One of my most unnerving experiences was when I took Lithium to augment an MAOI and found it to be a magical, mystical aphrodisiac of biblical proportion (all my erogenous zones were keening!); BUT, the lithium also made me too catonic mentally to act on it! How's that for a slap in the face? Almost reminds me of the horror stories I've read about people being anesthetized for surgery and being unable to communicate that they are conscious and feeling the pain of the surgery! (Okay - not that bad - but you get the drift.)
So what do we try next?
Judy
Posted by Bob on October 31, 1999, at 15:11:42
In reply to Re: Viagra - Bob, posted by Judy on October 31, 1999, at 10:10:09
> > So, I've been giving considerable thought to the contemplative life lately....
> I checked the Boston Globe Help Wanted's for you today. There was one opening for a monk in the Himalayas...
Not bad ... i might ask you for that. Was thinking more recently about New Skete (the German Shepard Monks), but they're orthodox christian ... I'm closer to the Society of Friends (in terms of organized religions) than anything else.
> So what do we try next?
I vote for sensory deprivation tanks. If we think we're numb, maybe its time to retrain our bodies and minds as to what no response (since there'd be nothing external to respond to) really means.
The serious question:
For those out there who *have* been in the "able body, unwilling spirit" situation -- absolutely no desire for sex -- have you been able to escape? If so, how?
Kicking my Z habit will, I hope, improve this issue considerably, but I wonder how much of the problem, when it comes to no desire, can truly be chalked up to medication alone, and not some psychological issues.
Bob
Posted by dove on November 3, 1999, at 12:25:13
In reply to Re: What next? (with a serious inquiry...), posted by Bob on October 31, 1999, at 15:11:42
Hey Bob, you still around? I was thinking quite a bit about your question and didn't really find any concrete answers. I do have some pretty basic ideas though. My husband struggles with down periods, very harsh and hopeless and detached, I don't know if it qualifies as depression in comparison to say *me* but it is really a dark mood that he gets into.
To encourage him to reach out and get his brain back into the living, I touch him a lot. And no, not that kind of touching, just letting him know that I notice him, walking past him and giving him a hug or touching his arm with a squeeze. All touch is nonsexual, nondemanding, nonaggressive and purely aimed at his deep nonsexual feelings. I also put my troubles on the backburner and attend to his feelings, thoughts ect.. I try not to add my garbage to his garbage at that point.
I think it's really important not to emphasize or pressurize performance at this point. This same approach is reciprocated when I'm the one under the dark moon.
After 1-4 days of this, there is almost always a positive response of some kind. Very often we realize that we are feeding the same demon so to speak. Taking time to put the other person first helps both of us. The demand free touching and nonjudgemental listening (including no fix-it like this advice) really opens the love-lines and enables us both to reconnect on a visceral level. It's not a cure-all or a perfect approach but it has it's merits in our relationship.
Just some thoughts, and hope the kicking of Z ain't hurtin' ya' too much.
dove
Posted by Bruce on November 3, 1999, at 14:25:23
In reply to Re: Reboxetine-Judy, posted by Bob on October 30, 1999, at 16:48:43
Luke -
Hows it going? I am curious as to any other side effects
you may be experiencing, other than the big 'I'.Bruce
Posted by Bob on November 3, 1999, at 14:30:50
In reply to What next? (rambling/non-technical), posted by dove on November 3, 1999, at 12:25:13
> Hey Bob, you still around?
Yeah, just super super busy the last three days and, as for today, busy putting on my steel-toed boots and sharpening my whupass-sized can opener ... yep, another meeting at work and the absolute last straw. My boss and HR director have demonstrated that there is no hope for a reasonable, internal solution, so they're about to get hit with what should be a world full of administrative pain. But enough about workplace discrimination, I'll start a new thread once the action begins....
I really do appreciate your thoughts and suggestions, dove. I wish to God that they'd work. But what you mentioned is what I've tried and it's what she rejects. She focuses on the biggest issues, ignoring the fact that it's the small stuff (contrary to popular self-help book titles) that really matters. Who is it that's in the details? The devil or God? Well, for us its the devil because it is those little things, that casual closeness -- in, of, and for itself -- that our relationship has failed in achieving. They mean a lot to me and nothing to her.
> Just some thoughts, and hope the kicking of Z ain't hurtin' ya' too much.
Thanks for that, too! =^) Actually, I'm in week 2 of the taper. Monday 10/25 I dropped from 200 to 100mg of Z per day ... Friday I was a bit jittery, but this weekend I've felt great ... kind of anti-withrawal. I dropped to 50mg this Monday and its still smooth sailing. Maybe it was such a shit to me while I was trying to get my body to cooperate with it that now that I'm going off, my system is sending me a "Thank You" card ... ;^)
Cheers,
Bob
Posted by Phil on November 3, 1999, at 17:04:44
In reply to thanks, dove (and kicking various targets), posted by Bob on November 3, 1999, at 14:30:50
> > Hey Bob, you still around?
>
> Yeah, just super super busy the last three days and, as for today, busy putting on my steel-toed boots and sharpening my whupass-sized can opener ... yep, another meeting at work and the absolute last straw. My boss and HR director have demonstrated that there is no hope for a reasonable, internal solution, so they're about
to get hit with what should be a world full of administrative pain. But enough about workplace discrimination, I'll start a new thread once the action begins....
>
> >
> > Good luck on this shouldn't have to be happnin' stuff. I wouldn't want to be on their side of the desk!Phil
Posted by Luke on November 3, 1999, at 18:07:59
In reply to Re: Reboxetine-Judy, posted by Bruce on November 3, 1999, at 14:25:23
Bruce-
Other side effects
For the first few days I was unusually irratable. That has passed, but I am only just beginning to notice a change for the better in mood.
At first I would find myself spacing out - not real bad, but enough to notice. That seems to be passing.
One thing that really surprised me - for the first few days I felt quite anti-social. I was quiet, didn't have any desire to participate in conversation, etc. That is passing.
Sometimes for an hour or two after a dose I get cold, which is unusual because I am very hot natured.
That's really the only things I have noticed, other than the problems below the waist, which have improved. What about you?I think I am beginning to notice the increase in drive, motivation and the desire to be social that the manufaturer boasts about. I am a journalist, so self-motivation and the ability to do a of interacting with people is important.
Posted by Bob on November 4, 1999, at 8:49:42
In reply to Go get em, Bob, posted by Phil on November 3, 1999, at 17:04:44
> > > Good luck on this shouldn't have to be happnin' stuff. I wouldn't want to be on their side of the desk!
Damn straight about that, Phil, and thank you for your support (whatever happened to the Bartles & James mascots anyway?). Boss and HR have managed to make me considerably angrier ... and I thought I'd already hit my peak. The anger odometer has just rolled over for the second time on this one. grrrrrrrrrrrrrr
Bob
Posted by Bruce on November 5, 1999, at 7:01:06
In reply to Re: Reboxetine side effects-Bruce, posted by Luke on November 3, 1999, at 18:07:59
> Bruce-
>
> Other side effects
> For the first few days I was unusually irratable. That has passed, but I am only just beginning to notice a change for the better in mood.
> At first I would find myself spacing out - not real bad, but enough to notice. That seems to be passing.
> One thing that really surprised me - for the first few days I felt quite anti-social. I was quiet, didn't have any desire to participate in conversation, etc. That is passing.
> Sometimes for an hour or two after a dose I get cold, which is unusual because I am very hot natured.
> That's really the only things I have noticed, other than the problems below the waist, which have improved. What about you?
>
> I think I am beginning to notice the increase in drive, motivation and the desire to be social that the manufaturer boasts about. I am a journalist, so self-motivation and the ability to do a of interacting with people is important.Luke -
Hope all is getting better for you. I too have been a little on the cold side, probably because an increase in norepinephrine constricts peripheral blood vessels. That plays a part in the impotence thing as well.
Mostly, I have all the anti-cholinergic side effects that I feared I would, although it's not too bad. Most irksome is the inability to pee normally. It just kinda sl-o-o-o-wly comes out.
My energy is definitely improving, a bit of insomnia. I am only on day 9, so any mood effects are likely still in the future.
Keep posting!
Bruce
Posted by Tom on November 8, 1999, at 14:12:41
In reply to Re: Reboxetine side effects-Bruce, posted by Bruce on November 5, 1999, at 7:01:06
> > Bruce-
> >
> > Other side effects
> > For the first few days I was unusually irratable. That has passed, but I am only just beginning to notice a change for the better in mood.
> > At first I would find myself spacing out - not real bad, but enough to notice. That seems to be passing.
> > One thing that really surprised me - for the first few days I felt quite anti-social. I was quiet, didn't have any desire to participate in conversation, etc. That is passing.
> > Sometimes for an hour or two after a dose I get cold, which is unusual because I am very hot natured.
> > That's really the only things I have noticed, other than the problems below the waist, which have improved. What about you?
> >
> > I think I am beginning to notice the increase in drive, motivation and the desire to be social that the manufaturer boasts about. I am a journalist, so self-motivation and the ability to do a of interacting with people is important.
>
> Luke -
>
> Hope all is getting better for you. I too have been a little on the cold side, probably because an increase in norepinephrine constricts peripheral blood vessels. That plays a part in the impotence thing as well.
>
> Mostly, I have all the anti-cholinergic side effects that I feared I would, although it's not too bad. Most irksome is the inability to pee normally. It just kinda sl-o-o-o-wly comes out.
>
> My energy is definitely improving, a bit of insomnia. I am only on day 9, so any mood effects are likely still in the future.
>
> Keep posting!
>
> Bruce
I saw a AD commercial last night made by Glaxo and they were touting their AD which had fewer sexual side effects than others. It never gave the name of the drug, but a phone # to call for info. Do they make reboxetine? Are they getting ready for a marketing blitz?
Posted by Bruce on November 8, 1999, at 14:36:25
In reply to Glaxo Welcome commercial, posted by Tom on November 8, 1999, at 14:12:41
> I saw a AD commercial last night made by Glaxo and they were touting their AD which had fewer sexual side effects than others. It never gave the name of the drug, but a phone # to call for info. Do they make reboxetine? Are they getting ready for a marketing blitz?Tom -
Glaxo Wellcome makes Wellbutrin, which does indeed have fewer sexual side effects.
Bruce
Posted by Bob on November 9, 1999, at 8:14:39
In reply to Re: Glaxo Welcome commercial, posted by Bruce on November 8, 1999, at 14:36:25
The true source of scientific information on the web and radio, here's the gold star question from the good Dr. today that, I believe, applies equally to medications for depression, etc.:
Gold Star Question:
All the medicines I've seen say they're for pain; I need something
that's against pain. Do you have any suggestions?
-- Carl Wold from Los Angeles, CA
Posted by Scott L. Schofield on November 9, 1999, at 15:59:17
In reply to Re: Reboxetine, posted by Luke on October 29, 1999, at 10:28:47
> I got the rebox just 13 days after emailing IAS. Somehow it made it to me very quickly, even though they had the wrong state, but correct zip code, on the package.
----------------------------------
What is IAS?
I would be grateful if you could post some information describing how to go about getting European drugs.
Thanks,
Scott
Posted by Luke on November 9, 1999, at 19:19:00
In reply to Re: Reboxetine, posted by Scott L. Schofield on November 9, 1999, at 15:59:17
IAS's website is:
http://www.smart-drugs.com/price.html
it opens up to the extensive price list.
Posted by Scott L. Schofield on November 10, 1999, at 12:04:59
In reply to Re: Reboxetine, posted by Luke on November 9, 1999, at 19:19:00
> IAS's website is:
>
> http://www.smart-drugs.com/price.html
>
> it opens up to the extensive price list.- Tanks
Posted by Peter on November 11, 1999, at 17:41:04
In reply to Re: Reboxetine, posted by Scott L. Schofield on November 10, 1999, at 12:04:59
I just started Reboxetine 1 week ago and the main side effect I've noticed is major constipation. I started at only 4 mgs/day and now have reduced it to 2 mg. I've been drinking lots of prune juice and eating fiber but it helps minimally. Does anyone know if this particular side effect goes away over time? If not I don't think I'm going to last long on this drug. Any suggestions or help would be most appreciated! Peter
Posted by Bruce on November 12, 1999, at 10:24:08
In reply to Help! Reboxetine & Constipation, posted by Peter on November 11, 1999, at 17:41:04
> I just started Reboxetine 1 week ago and the main side effect I've noticed is major constipation. I started at only 4 mgs/day and now have reduced it to 2 mg. I've been drinking lots of prune juice and eating fiber but it helps minimally. Does anyone know if this particular side effect goes away over time? If not I don't think I'm going to last long on this drug. Any suggestions or help would be most appreciated! Peter
Hello !
I am starting my third week on Reboxetine. Constipation has definitely eased up. Most anti-cholinergic side effects have, for me. I still pee slowly, though. You?
Bruce
Posted by Luke on November 12, 1999, at 21:58:25
In reply to Re: Help! Reboxetine & Constipation, posted by Bruce on November 12, 1999, at 10:24:08
Bruce, Peter, I'm coming up on 4 weeks on rebox, and I haven't had the constipation problem at all.
I started out at 4 mg a day, and there were some really intense side effects - slow painful urination, impotence, racing thoughts. I was energized but unfocused, a little disoriented. It was overwhelming.
I cut back to 2 mg a day as soon as I saw Bruce's first posting two weeks ago. (What dose are you doing, Peter?)
The side effects eased up immediately. Like Bruce, I still pee slow, but it's not painful like it was. Sex could be better, but it's not impossible, as it was at 4 mg. I hope all that doesn't return when I go back to 4 mg. I'm thinking another week at 2 mg.
What about you, Bruce? When are you going to 4 mg?
Good luck
Posted by Bruce on November 13, 1999, at 8:35:21
In reply to Re: Help! Reboxetine & Constipation, posted by Luke on November 12, 1999, at 21:58:25
> Bruce, Peter, I'm coming up on 4 weeks on rebox, and I haven't had the constipation problem at all.
>
> I started out at 4 mg a day, and there were some really intense side effects - slow painful urination, impotence, racing thoughts. I was energized but unfocused, a little disoriented. It was overwhelming.
>
> I cut back to 2 mg a day as soon as I saw Bruce's first posting two weeks ago. (What dose are you doing, Peter?)
>
> The side effects eased up immediately. Like Bruce, I still pee slow, but it's not painful like it was. Sex could be better, but it's not impossible, as it was at 4 mg. I hope all that doesn't return when I go back to 4 mg. I'm thinking another week at 2 mg.
>
> What about you, Bruce? When are you going to 4 mg?
>
> Good luck
Good to hear from you, Luke.I doubt that I will go up to 4mg BID. The half dose is plenty energizing for me, and the side effects are tolerable, although I dislike the urinary dysfunction. I also seem to have retrograde ejaculation (it barely flows out). Insomnia once in awhile also occurs.
As for the antidepressant effect, I have noticed that I simply don't dwell on negative thoughts anymore, and I'm not as cynical as before. It is a different feel altogether than Prozac, but effective in it's own right.
I must say, though, the energizing effect is for real.
Posted by Luke on November 13, 1999, at 16:01:02
In reply to Re: Help! Reboxetine & Constipation, posted by Bruce on November 13, 1999, at 8:35:21
Bruce & Peter,
there are a couple of other very mild, odd side effects I forgot to mention.That muscle just above the top lip on either side of the face, the one Elvis used to make his famous snarl - mine twitches, spasms every now and then, two or three times a week for maybe a half hour. Never happened before rebox.
Twice I have been in the middle of a meal and suddenly everything tastes like the reboxetine - you know that weird mint-like smell the pill has. For the rest of the meal, all food - spinach quesadillas, sushi, turnips, barbecue, whatever - has a candied flavor. It's not really bad, but it's not good. It slowly makes me nauseated. But it's only happened twice.
Peter, how's your rebox trial going?
Posted by Phil on November 14, 1999, at 8:56:58
In reply to Re: Reboxetine, posted by Scott L. Schofield on November 10, 1999, at 12:04:59
> > IAS's website is:
> >
> > http://www.smart-drugs.com/price.html
> >
> > it opens up to the extensive price list.
>
> - Tanks>>Did you guys have a script or 'note' from your docs as IAS requests?
Phil
Posted by Edronaut on November 14, 1999, at 16:39:19
In reply to Re: Reboxetine-Need script?, posted by Phil on November 14, 1999, at 8:56:58
You don't need a Rx for IAS. They will send it.
Posted by Peter on November 15, 1999, at 13:28:36
In reply to reboxetine, elvis and the tongue, posted by Luke on November 13, 1999, at 16:01:02
> Peter, how's your rebox trial going?
I've decided to go off of it for the time being because of the constipation. I may give it another trial but this time go much slower and start with a lower dose. It's really too bad because Rebox is the last drug in what seems like an endless trial of practically all the drugs on the market. Nothing has worked for very long or I have not been able to tolerate the side effects. The term treatment resistance seems to have been created especially for me! Good luck all.
Peter
Posted by JohnL on November 16, 1999, at 3:21:57
In reply to Re: Ending trial of Rebox, posted by Peter on November 15, 1999, at 13:28:36
> > Peter, how's your rebox trial going?
>
> I've decided to go off of it for the time being because of the constipation. I may give it another trial but this time go much slower and start with a lower dose. It's really too bad because Rebox is the last drug in what seems like an endless trial of practically all the drugs on the market. Nothing has worked for very long or I have not been able to tolerate the side effects. The term treatment resistance seems to have been created especially for me! Good luck all.
> PeterPeter, sorry it didn't work out. I think we can all relate to the frustration. And the question of where to go from here. I don't know your history, but I wanted to comment that 'treatment resistant' isn't really an accurate terminology unless the patient has been at a maximum dose for 3 months on three trials of drugs without 50% improvement of symptoms. Does that apply to you? If not, then you probably fall in a category of 'difficult to treat' rather than 'treatment resistant'. For me, and many of us, getting up to a maximum dose and staying there for 3 months is very difficult due to side effect difficulties. I think most of us (not all) are 'difficult to treat' because of side effects. Side effect intolerance is the primary patient-related cause of antidepressant failure (according to international pdoc/author Hagop Akiskal). The primary physician-related cause of failure is underuse of MAOIs. Either way, side effects sure get in the way for you and me huh? I suspect we're more 'difficult to treat' than 'treatment resistant'.
Anyway, where to go from here? Any ideas what's next? I am curious, what meds have you tried? Why were they discontinued? Maybe there's a pattern that can help figure out where to go from here? I can sure relate to your frustration. Making that decision to discontinue is so sweet & sour. Sweet to say goodbye to the lousy side effects, sour to ponder starting all over with something else and the unknown variables it has in store for us. Hopefully we'll both find a drug that's not sweet & sour, but sweet all the way around. :)
Posted by Bruce on November 16, 1999, at 6:18:27
In reply to Re: Ending trial of Rebox, posted by Peter on November 15, 1999, at 13:28:36
> > Peter, how's your rebox trial going?
>
> I've decided to go off of it for the time being because of the constipation. I may give it another trial but this time go much slower and start with a lower dose. It's really too bad because Rebox is the last drug in what seems like an endless trial of practically all the drugs on the market. Nothing has worked for very long or I have not been able to tolerate the side effects. The term treatment resistance seems to have been created especially for me! Good luck all.
Peter (and All) -I must say, from the posts here and my own experience, the side effects of Reboxetine were unexpectedly harsh.
It's a small N to be sure, but I got quite a wallop at 2mg BID, and Luke got hammered at 4mg BID.
If this is to be a successful drug in the US, docs should prescribe a very small starting dose and ramp up.
I am now about to start my 4th week on the drug, and almost all the side effects are gone except for peeing slowly.
Bruce
Bruce
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