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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Geezer on February 18, 2002, at 14:54:51
To make a very long and miserable story short here are the stats:
1) Incorrectly DXed and treated for Unipolar Major Depression/Recurrent for 30 years.
2) Noncompliance with TCAs and MAOIs due to side effects.
3) Hospitalized 8 times between 1973 and 1985 for major depression (one time detoxed from benzo abuse, one time detoxed from amphetamine abuse).
4) Put on disability 1997 by pdoc due to major depression.
5) Good response to Prozac 20mg. until 1998 then poop-out (no full remission). Pushed Prozac no result. Tried Wellbutrin, Celexa, Zoloft, Klonopin, and Ambien - no response.NEW DX OCT. 2001 - Bipolar II Disorder/Depressed/Moderate/Melancholic & Refractory.
1) Began Valproate increased to 1000mg.
2) Decreased and eventually D/Ced Well., Celexa, Klonopin, with no adverse side affects.
3) Pushed Zoloft to 200mg. with bad insomnia and some agitation. (the above occurred from Nov. 1 - Feb. 12.
4) Added Remeron 15mg. Feb. 14 and this AM Feb. 18 the depression began to lift.Thank heaven for the differential DX of Bipolar II, Depakote, Remeron & a couple of University Based pdocs that knew what the hell they were doing. All comments welcome, including titration of Remeron - Pbabble figured into this imporvement in a big way but I am getting too long here.
Geezer
Posted by Roo on February 18, 2002, at 15:07:58
In reply to Early Success With Dep. Remeron - Long, posted by Geezer on February 18, 2002, at 14:54:51
Geezer--Congrats on finding the right mix...
please keep us informed on how remeron is working
for you--it's one I've thought of trying myself (but
haven't b/c of the weight gain fear)...but it's nice
to hear you are having a good experience with it. I still
may try it.
Posted by JohnX2 on February 18, 2002, at 15:22:18
In reply to Early Success With Dep. Remeron - Long, posted by Geezer on February 18, 2002, at 14:54:51
Congratulations.I'm so sorry your misdiagnosis cost you so many
years. I'm starting to think if I had a dime for
every medication trial for Major Depression that
should have been Bipolar II I would have a lot of
money to donate to charity (including a lot from
my own experience). Its so sad.I'm glad you are hitting pay dirt.
Best of continued luck with your medicines.
-John
> To make a very long and miserable story short here are the stats:
> 1) Incorrectly DXed and treated for Unipolar Major Depression/Recurrent for 30 years.
> 2) Noncompliance with TCAs and MAOIs due to side effects.
> 3) Hospitalized 8 times between 1973 and 1985 for major depression (one time detoxed from benzo abuse, one time detoxed from amphetamine abuse).
> 4) Put on disability 1997 by pdoc due to major depression.
> 5) Good response to Prozac 20mg. until 1998 then poop-out (no full remission). Pushed Prozac no result. Tried Wellbutrin, Celexa, Zoloft, Klonopin, and Ambien - no response.
>
> NEW DX OCT. 2001 - Bipolar II Disorder/Depressed/Moderate/Melancholic & Refractory.
> 1) Began Valproate increased to 1000mg.
> 2) Decreased and eventually D/Ced Well., Celexa, Klonopin, with no adverse side affects.
> 3) Pushed Zoloft to 200mg. with bad insomnia and some agitation. (the above occurred from Nov. 1 - Feb. 12.
> 4) Added Remeron 15mg. Feb. 14 and this AM Feb. 18 the depression began to lift.
>
> Thank heaven for the differential DX of Bipolar II, Depakote, Remeron & a couple of University Based pdocs that knew what the hell they were doing. All comments welcome, including titration of Remeron - Pbabble figured into this imporvement in a big way but I am getting too long here.
>
> Geezer
Posted by Geezer on February 18, 2002, at 16:28:12
In reply to Re: Early Success With Dep. Remeron - Long » Geezer, posted by JohnX2 on February 18, 2002, at 15:22:18
Roo and JohnX2,
Thanks for the kind words - the results are very early so I am not counting on too much yet. I don't post often but you have both been kind enough to respond in the past and I thank you. IMHO drugs are the only thing that matter in the treatment of this illness - stay the course. Remeron was my next to last choice (the last being Effexor) I am still concerned about the wait gain and the withdrawal when the Remeron poops out (they all do you know - surprisingly the somulance wasn't bad, but I had not slept much lately) hope something new is available when the time comes. All in all this was better than a gun in my ear.Geezer
Posted by spike4848 on February 18, 2002, at 18:16:43
In reply to Early Success With Dep. Remeron - Long, posted by Geezer on February 18, 2002, at 14:54:51
Hey Geezer,
I am glad to hear you are better. Sounds like you have been through quite an ordeal.
May I ask if you had any episodes of hypomania or mania over the past 30 years? What were they like if you did? I have been treatment resistant depressed except to nardil, which may or may not give me hypomania. I have a family history of bipolar-father and unipolar-mother ... so it is hard to tell. My pdoc say I am TR depressed.
Thanks
Spike
Posted by Geezer on February 19, 2002, at 10:09:07
In reply to You story sounds like mine! » Geezer, posted by spike4848 on February 18, 2002, at 18:16:43
Hey Spike,
Thanks for the good wishes. First let me answer your question because this is the point that had me comfused for a very long time. I NEVER had a manic esisode. In HINDSIGHT I did have some hypomania but it felt absolutely NORMAL. Looking back, I believe, this was the order of events:
1) Present to pdoc with major depression (with or without hospital stay).
2) Given TCAs or MAOIs (in the 70s & 80s then SSRIs in the 90s).
3) Hypomania - mild would set in, this felt normal and I felt recovered so I would stop drugs so I could "function at a very high level" ( I had one of those 24/7 jobs-cardiac pacemakers-on call 24 hours-only vacationed when incapacitated with depression-spent my life in surgery).
4) Gradually depression would emerge and grow worse-I would again present to the old pdoc and again be treated for Recurrent Major Depression thus starting the cycle over again.Here is the point. I don't think it is worth wasting anymore time trying to decide if you have hypomania or not. A trial with mood stabilizers won't do any harm regardless of the DX. If you get proper results with the mood stabilizers you may not need anything further. I do read your posts often but, forgive me, I do not remember if you have tried them. In any case I wouldn't accept a DX of TRD until you do so.
WOW! - Strong family history. My mother is Bipolar II-somatic delusion with depression-takes Dep. & Trilofon, my sister is Bipolar II-persecutory delusion with depression, she is in denial and not treated. My very best to you and your family. Hope to hear from you.
Geezer......This is all IMHO
Posted by JohnX2 on February 19, 2002, at 17:15:02
In reply to Re: Early Success With Dep. Remeron - Long, posted by Geezer on February 18, 2002, at 16:28:12
Geezer,I was quite shocked that Remeron did not make
me drowsy during the day. It also didn't affect
my weight. Most other meds with history of weight
gain/drowsiness would hit me as such. I'll keep
my fingers crossed for you.-John
> Roo and JohnX2,
> Thanks for the kind words - the results are very early so I am not counting on too much yet. I don't post often but you have both been kind enough to respond in the past and I thank you. IMHO drugs are the only thing that matter in the treatment of this illness - stay the course. Remeron was my next to last choice (the last being Effexor) I am still concerned about the wait gain and the withdrawal when the Remeron poops out (they all do you know - surprisingly the somulance wasn't bad, but I had not slept much lately) hope something new is available when the time comes. All in all this was better than a gun in my ear.
>
> Geezer
Posted by Geezer on February 19, 2002, at 18:08:29
In reply to Re: Early Success With Dep. Remeron - Long » Geezer, posted by JohnX2 on February 19, 2002, at 17:15:02
John,
Thanks for the info. on weight gain/sleepyness re: Remeron. I've been on 1000mg. Dep, up to 200mg Zoloft (now DCed), and quit a two pack a day cig habit since June. In that time I have lost 3 lbs. (giving up the cigs after 38 years caused the current depression - dopamine effect I think). I have had complete Medical check with no physical illness found. The only AD I ever gained weight on was Prozac = 20 lbs. Lilly claimed no weight gain for that one. I am at 30mg Remeron now-please keep me posted on how you are doing.
Geezer
Posted by spike4848 on February 19, 2002, at 19:15:35
In reply to Re: You story sounds like mine! SPIKE!, posted by Geezer on February 19, 2002, at 10:09:07
> Here is the point. I don't think it is worth wasting anymore time trying to decide if you have hypomania or not. A trial with mood stabilizers won't do any harm regardless of the DX. If you get proper results with the mood stabilizers you may not need anything further. I do read your posts often but, forgive me, I do not remember if you have tried them. In any case I wouldn't accept a DX of TRD until you do so.
>
> Geezer......This is all IMHOHey Geezer,
Thanks for the response. I may not have mentioned it previously, but back in November I decided to stop my nardil ... partially due to side effects, but *mostly* because I thought I had bipolar II. I tried lithium for 8 week ... no help. I also was on lamictal 350 mg for 8 weeks ... nothing. I was devastated. So I am not unipolar .... not bipolar ..... what am I ???????????????????
So now I am trying to find a combo that will work and with only moderate sexual side effects. Maybe a low dose zoloft/wellbutrin/despiramine with neurontin/depakote. I am probably some unipolar with panic(mother's side)/bipolar II(father's side) hybrid. Now that is tough to treat!
Thanks again. Your story restores my hope.
Spike
Posted by Mr. Scott on February 19, 2002, at 19:31:46
In reply to Not Bipolar/Not Unipolar/What do I have? » Geezer, posted by spike4848 on February 19, 2002, at 19:15:35
I suspect this is why a lot of us originally Diagnosed unipolars have not recovered, because we're just a bit too far over on the spectrum to bipolar.
scott
Posted by Geezer on February 19, 2002, at 20:51:31
In reply to Not Bipolar/Not Unipolar/What do I have? » Geezer, posted by spike4848 on February 19, 2002, at 19:15:35
Hi Spike,
Yes Sir.....You have got me!! You have been thru the protocols I am aware of. Also have to agree you are TRD but your plans for next drug combos may offer some relief. Hang in here - has anyone come up with good suggestions? Sounds like you have a good pdoc - I will save your post - want to think about it.
Geezer
Posted by susan C on February 20, 2002, at 12:32:52
In reply to Not Bipolar/Not Unipolar/What do I have? » Geezer, posted by spike4848 on February 19, 2002, at 19:15:35
>
> > Here is the point. I don't think it is worth wasting anymore time trying to decide if you have hypomania or not. A trial with mood stabilizers won't do any harm regardless of the DX. If you get proper results with the mood stabilizers you may not need anything further. I do read your posts often but, forgive me, I do not remember if you have tried them. In any case I wouldn't accept a DX of TRD until you do so.
> >
> > Geezer......This is all IMHO
>
> Hey Geezer,
>
> Thanks for the response. I may not have mentioned it previously, but back in November I decided to stop my nardil ... partially due to side effects, but *mostly* because I thought I had bipolar II. I tried lithium for 8 week ... no help. I also was on lamictal 350 mg for 8 weeks ... nothing. I was devastated. So I am not unipolar .... not bipolar ..... what am I ???????????????????
>
> So now I am trying to find a combo that will work and with only moderate sexual side effects. Maybe a low dose zoloft/wellbutrin/despiramine with neurontin/depakote. I am probably some unipolar with panic(mother's side)/bipolar II(father's side) hybrid. Now that is tough to treat!
>
> Thanks again. Your story restores my hope.
>
> Spike"Maybe a low dose zoloft/wellbutrin/despiramine with neurontin/depakote"
Ok, if you have had no or bad side effects with single trials of the above, is it possible to asume adding one to another would/could make a difference? Do different pdocs have different attitudes towards mono therapy vs poly therapy?
mouse looking at a chemistry set
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