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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Ron Hill on April 22, 2002, at 14:52:09
... you may come out and play now (provided you play nice, otherwise it will be back to timeout for you).
You have unanswered mail in the following threads:
http://www.dr-bob.org/babble/20020402/msgs/102320.html
http://www.dr-bob.org/babble/20020402/msgs/101790.html
Did you receive the care packages we sent while you were in e-jail?
-- Ron
Posted by johnj on April 22, 2002, at 18:27:01
In reply to Paging Mr. Colin Wallace. Your timeout is over ..., posted by Ron Hill on April 22, 2002, at 14:52:09
and since I cut the remeron down to 15 I feel a lot better. The remeron was definately causing the spacey and zoned out feeling. I bought some sam-e but have not taken any yet. I see my pdoc around the 5th of May and will see what he has to say, even thought I will give it a try no matter what he says. The aerobic excercise was, without a shadow of a doubt, causing the bizarre side effects, but lifting weights doesn't have any detrimental effects at all. Also, I noticed in a thread that you were an environmental engineer? That is what I do, and I have only been at it about 8 months. take care
johnj
Posted by colin wallace on April 23, 2002, at 10:49:00
In reply to Paging Mr. Colin Wallace. Your timeout is over ..., posted by Ron Hill on April 22, 2002, at 14:52:09
Aaah, the bitter-sweet taste of freedom!
Got that red-cross parcel you sent there Ron- the magazine you sent was scarcely readable though- must have been the oldest one in your archive- very well thumbed.Jean Paul Satre really kept me going!?Still, I wish you'd consulted me before you went ahead and included your own portrait on the new Sam-e packaging.I mean , sure, you look okay in the leotard, but is this the image we really want to portray?I think Beardy may have been a better choice, but as sales director, it's your call.Seeya back at the office,
Col...
(redirect is imminent..)
Posted by Ron Hill on April 23, 2002, at 12:02:07
In reply to Re: Paging Mr. Colin Wallace. Ron Hill, posted by colin wallace on April 23, 2002, at 10:49:00
Posted by johnj on April 23, 2002, at 18:20:47
In reply to Paging Mr. Colin Wallace. Your timeout is over ..., posted by Ron Hill on April 22, 2002, at 14:52:09
I appreciate the answers and it at least makes me feel better since my pdoc said it was just my brain "adjusting". I never bought that since I could see the direct correlation to excercise. I used to be an excercise fanatic and had a mild depression my first year in college and then nothing until the panic attack when I was 27 followed by a severe depression. I was living living abroad at the time and ran out of vitamins, planning a move home, had a girlfriend, etc, etc. I have felt pretty good for about the last 8 years, but last fall the running set me back. I am trying to get that post excercise high back along with the sleep it always gave me, and I think it is possible if I move slowly.
I have no idea if the lithium interferes, but I do think the pamelor does cause things to go awry. I lifted heavy on Sunday and had some trouble sleeping and then did legs and back on Monday and had a terrible night. It seems if I push and stress my body hard even the lifting is causing me to lose sleep. I am a skinny guy, more of an aerobic type build, but I thought if I couldn't run I could at least do some lifting. I didn't feel too depressed today, but was just beat because of the lack of sleep. My pdoc wants to get me on something else stable and then wean off the pamelor. I want to give the sam-e a try too. I bought some 200 mg tablets, but have not taken any yet. I do take a multi in the morning along with some extra B after dinner.
Could you tell me what AD you take? Dose? What is your sam-e dose? What helped you make the transition from the "evil" mother of pamelor? I shouldn't bitch too much since it did help pull me out of the depression I first had. I switched professions last year after I finished my masters and am a new engineer so I need to tread lightly with med switching. But, I can see that getting that excercise is going to help me help myself. Thanks and sorry for the ramblings.
Johnj
Posted by colin wallace on April 24, 2002, at 4:14:30
In reply to Thanks Colin, and a few more questions..., posted by johnj on April 23, 2002, at 18:20:47
Hi John,
Funnily enough, my most severe bout of depression started when I was living abroad (Taiwan), and was due for the most part to being unable to take regular, outdoor exercise-and generally not taking care of myself.
Anyway, I mentioned previously that Remeron is not usually associated with discontinuation problems, but Amitryptaline/Pamelor have been known to cause them.Especially if you're on a 'fair' dose of the stuff, you'll need to taper here, to be safe.I tapered it and stopped within a week or two, introducing Sam-e simultaneously.
To be cautious, perhaps you could introduce sam-e when you get down to say, 25mg or less?? Difficult to say, but the beauty of Sammy is that the effects can be fairly rapid, so you could try it on a weekend for instance, and if you didn't like it or experienced anything untoward, the noticable effects would be gone before you went back to work.Also , sam-e's therapeutic range is very wide, seemingly; I only take 200mg, along with 25mg zoloft as I'm med.sensitive, and this suits me fine.Bags of energy, plenty of stamina again, and a clear head afterwards!Gotta dash, off biking,
Col.
Posted by johnj on April 24, 2002, at 10:40:20
In reply to Re: Thanks Colin, and a few more questions.john J, posted by colin wallace on April 24, 2002, at 4:14:30
Well, we were not too far apart as I was living in Okinawa, Japan at the time. I was working for the Japanese goverment on a program and was not taking care of myself as I should have been doing. I had started working out a month before the depression (Okinawan karate) and my body was just not recovering and something had to give. The Japanese like to drink and that did not help my body either.
Thanks for the advice on the med tapering. I really want to start the sam-e as soon as possible and will talk to the doc about tapering the nortryptline slowly and adding the sam-e. I really like the type of combination you are currently on and hope I may achieve something similiar.
Did you have any sleep disturbance with your depression? How about any agitation? It is hard to know for sure if sleep disturbances lead to depression or if the reverse it true for me. All I know is that I do push myself hard and like the motor to run quite fast. I love the feeling a good workout gives me and miss it. I slept great last night so today is fine (I think my body has recovered from the workout??). I appreciate the info you and Ron have passed on to me. Is there anything I should watch for when purchasing sam-e? Take care!
Johnj
Posted by colin wallace on April 24, 2002, at 13:53:34
In reply to Nice to have you back Colin! (nm) » colin wallace, posted by Ron Hill on April 23, 2002, at 12:02:07
Howdy Ron,
I'd missed your thread where you mentioned you were experiencing transient rage symptoms( can't get those yellow 'new' tags back on my computer).
I get those same abrupt mood crashes, particularly if my ssri dosage is even a fraction too high.(still managing on 200mg sammy, and upped to 25 mg zoloft- that's my limit, and it took a month to get used to it-feels better than 12.5 though, so it was worth it in the end).
When I was experimenting with 300mg sammy doses, I bought a pill-splitter, which manages to accomplish the near impossible feat of halfing one pill, fairly accurately.Although this goes against established truths, I found that if I put the other half in an air tight polythene 'pill-bag' overnight, it would still work just fine the next morning.Just a thought, as I know you're thinking of going back down to 1oomg.Also, one of those links I posted previously was for the GNC brand (100mg), and this product is actually manufactured in Italy by the same company that produce Nature Made-so you know they're tried 'n tested.
Hope your progress continues.Keep battling,
Col.
Posted by Ron Hill on April 24, 2002, at 16:27:04
In reply to Sammy update....Ron Hill, posted by colin wallace on April 24, 2002, at 13:53:34
> I'd missed your thread where you mentioned you were experiencing transient rage symptoms( can't get those yellow 'new' tags back on my computer).
------------------Colin,
Thanks for taking time to inquire about this issue. The irritability thing (that can turn into flash rage) went away. I skipped one day of vitamins and I felt a lot better. Therefore, I think I'm on the trail of the irritability inducing culprit. I'm in the process, via trial and error, of finding out which vitamin(s)I'm taking too much of. Also, I plan to experiment with the SAM-e dose. I have a feeling that 100 mg/day might be better for me. I may try your slice and dice methodology, but like you say, it violates basic SAM-e 101 protocol.
Aside from the irritability, that has since subsided, I feel absolutely GREAT. Motivated, energetic, optimistic, level headed, good kinda feeling. SAM-e sure fixed me up compared to where I was six months ago.
Colin, I think I may have lost the link you sent me for the GNC 100 mg SAM-e tablets. I have the other one you sent bookmarked, but I can't find the GNC. Do you still have it? If so, will you post it again? If not, don't worry about it, I can dig it out of the achrives.
How's the training going? Do you have your eye on a particular race (triathlon) or are you merely training for training's sake at this point in time?
-- Ron
Posted by colin wallace on April 25, 2002, at 12:59:16
In reply to Re: Sammy update... » colin wallace, posted by Ron Hill on April 24, 2002, at 16:27:04
Ron
These are half-price (roughly) 100mg sam-e pills.
Also, drugstore.com do the gnc brand (expensive)at 100mg, but I can't find the link right now.
This brand seems okay; would't be surprised if they're made by Actimet too.Ps.Training right now consists of stomping up and down mountains/trails for hours on end- love being outdoors, especially in the hills etc.
Col.
Posted by Ron Hill on April 25, 2002, at 13:43:22
In reply to Re: Sammy update...Ron Hill, posted by colin wallace on April 25, 2002, at 12:59:16
Posted by johnj on April 25, 2002, at 17:33:39
In reply to Thanks Colin (nm) » colin wallace, posted by Ron Hill on April 25, 2002, at 13:43:22
Well, we were not too far apart as I was living in Okinawa, Japan at the time. I was working for the Japanese goverment on a program and was not taking care of myself as I should have been doing. I had started working out a month before the depression (Okinawan karate) and my body was just not recovering and something had to give. The Japanese like to drink and that did not help my body either.
Thanks for the advice on the med tapering. I really want to start the sam-e as soon as possible and will talk to the doc about tapering the nortryptline slowly and adding the sam-e. I really like the type of combination you are currently on and hope I may achieve something similiar.
Did you have any sleep disturbance with your depression? How about any agitation? It is hard to know for sure if sleep disturbances lead to depression or if the reverse it true for me. All I know is that I do push myself hard and like the motor to run quite fast. I love the feeling a good workout gives me and miss it. I still do not feel as good since those two hard workouts. I like the sleep that remeron gives, but I think I need something that isn't going to leave me as groggy. I was wondering why the nortryptline would cause the problems it does and it may be due to the warning I have seen about some cardiovascular problems?? Guess I will never know. I am also considering serzone or maybe effexor, but may stick to remeron until I am weaned off nortryptline. Have you had any decline in cognizant functioning with zoloft? Take care and thanks.
Johnj
Posted by colin wallace on April 26, 2002, at 4:00:31
In reply to Colin, a few more questions, posted by johnj on April 25, 2002, at 17:33:39
Hi John,
Sorry I missed your post (above)- still can't get my yellow 'new' flags back up, even though I know exactly what's causing the problem!
Would you believe I just spent a while typing out a response to you, and lost the ****** entire page when trying to post it!!Boy, that makes me furious!
I'll get back to you soon,Take care,
Col.
Posted by johnj on April 26, 2002, at 11:48:40
In reply to Re: Colin, a few more questionsJohn J, posted by colin wallace on April 26, 2002, at 4:00:31
I use to lose my emails when I used a microsoft account, one little click and POOF the whole thing would disappear. Today was a holiday so I slept in and probably should have gotten up earlier but sometimes a person has to say what the hell.
It is becoming painfully obvious that remeron is great for sleep but impairs my ability to concentrate on problem solving tasks. I am preparing for an engineering exam and my memory has been dulled along with my problem solving ability. I am sure it is the remeron even though I felt sharper without the remeron I had little energy to sit still and accomplish a task. I can also tell in my writing where I repeat things, etc.
I will talk to my pdoc about trazodone, serzone, and maybe even effexor to see if I can still get off the nortryptline. Just not sure where to fit the sam-e in my regime. I am going to try to go down to 7.5 mg of remeron tonight and see if that improves my ability think and clears my head somewhat. With me, I can see I have agitation and anxiety with the depression so I need something that gives me energy and motivation, but will still allow me to sleep at night.Could you tell me if you had any other meds that caused you trouble when you trained? Did any other tricyclic work for you before you switched to zoloft? I am a little leary of SSRRi's just because I hear they poop out more often. I have a lot of decisions to make in the coming months and just want to be able to retain some type of workout during the med shift. Take care and thanks for everything.
Johnj
Posted by colin wallace on April 26, 2002, at 17:19:21
In reply to Colin, I know how you feel, posted by johnj on April 26, 2002, at 11:48:40
Let's try again!
John, I sympathise with your current predicament, not least because there are more than a few similarities in our circumstances.
My depression is also marked by co-existing anxiety, sleep disturbances, agitation(in the form of occasional, extreme irritability and mood crashes).I have tried a broad range of antidepressants in the last three years, and have found that unfortunately, many of them actually made matters worse- being acutely med. sensitive hasn't helped matters either.
My full complement med regimen at present is: sam-e, 200mg mornings, diazepam (for 'residual' anxiety, 4mg (very low dose), 25 mg zoloft (juvenile dose!)and occasionally, 10 mg amitriptyline(fractional dose) for insomnia.
I unfortunately had to take myself out of the care of a doctor, do my own research, experiment through trial and...more trial,and buy all my own meds before I reached this happy compromise- I was suicidal previously, and could scarcely read or talk.
Well, it seems you have some trial and(hopefully not too much) error to endure yourself.Your doc. will probably balk at the idea of you trialing sam-e (has he even heard of it?), and this is where you reach a personal crossroads.Serzone, effexor, sam-e??
How severe is your depression John?You see, if you're looking for an enlivening, effective AD, then effexor can be very effective (I took it for a good while, but it made me prone to anger, and was pretty difficult to discontinue...
I haven't tried serzone, but I believe it 's more toward the sedative side- more likely than effexor to impair your exercise or to cause daytime fuzziness perhaps.
If you took effexor, then you may well not need the sam-e, but then again, effexor is quite a strong med. by comparison.
I'd guess your doc will steer you towards effexor, but IMHO (stressing here I'm NO doctor), it would seem to make sense to try sam-e, if you intend trying it at all, before moving up to the big-guns like effexor.If it works for you, you may not need to go any farther.It has completely restored my cognition, and is devoid of side -effects (other than good ones, like inreased alertness and energy).
There would be no reason to drop the low dose remeron, if it helps you sleep-Sammy should counteract that daytime grogginess.Also, remeron really helps with anxiety once you get used to it- some would say it's preferable to being on a benzo if it works for you.
How about discussing your options here with your doc.-maybe he'll run with the sam-e trial for a month or so.If your not in a very severe depressive state, and you value your mental clarity, and need to exercise too, it may well be worth a try.Of course, I have a bias toward it, as it pretty much saved my life where all else had failed miserably, but I'm trying to be objective here.It really depends on how much YOU want to try it, and how receptive your doc. is to non- mainstream meds!! (my new doc. is a big sam-e fan).
Many of us here have been in the sam-e boat(groan)-some have ben helped tremendously, others not a great deal-but I've not heard of anyone being made worse by it!
Well, this is an entirely different post from the one I lost, so forgive any rambling-it's late and I'm about to catch some zzz's.
Hope this is some help at least.
Catchya later,Col.
Posted by johnj on April 26, 2002, at 18:47:04
In reply to Re: Colin, I know how you feelJohn J., posted by colin wallace on April 26, 2002, at 17:19:21
that my case is not totally unique! Although I would not wish depression on any other human being. My current depressive state is not too bad, but that is at a price of being not so sharp and on top of things as I like to be. I probably told you this but I currently take 50 mg of nortryptline, 600 mg of lithobid(AD booster, or so I have been told), tranxene(a benzo) 7.5 mg (low dose) for anxiety, and the recently 15 mg of remeron which was to help me wean off the TCA. I think the lithobid kind of stablizes things. If I stopped working out totally I would most likely settle down and feel better. But, I do have a problem when I am not allowed to help myself. I have always wondered if the AD for me helps a point and then hinders or actually makes the depression worst. My family doctor said he would like to get me off the tranxene since it can cause depression, but my pdoc never mentioned that as a goal. I did sucessfully wean off a morning dose of 7.5 mg because I would just sit there and yawn like a horse. I have not had any panic attacks after starting the tranxene and it is kind of scary thinking I might invite them back by dropping the tranxene.
I am not near as bad as I first was and at that time I, like you, was suicidal, and could barely speak a meaningful phrase. It felt as if my fight or flight mechanism was switched on and wouldn't turn off. Thinking about how I felt at that time is scary. I was really whacked out and thought I was some horrible person. It took 3 months of physical tests over in Japan before I came back to the US and went to a pdoc. I didn't even know what I had experienced was at all common.
I can see that the remeron has made me less prone to snap at people, but dulled parts of me I don't like to be dulled. They say remeron doesn't have any sexual side effects, but it did for me. I have always had a short fuse but the depression made me very irritable at times.
I lifted weights today and hope that doesn't set me back. If I could keep the way I feel right now at this very moment I would be very pleased. But, it is late afternoon and I seem to feel better after a sort of crash after lunch. I wonder if this means less remeron is better?The sam-e sounds like something that I really need to get me going in the morning. I bought some from a company off the net I have used named Swanson's and on the bottle it said it is from Europe. It was pretty cheap so I have a few doubts on it's quality. It was something like 9 US dollars for 30, 200mg tablets.
You mentioned the amitryptline helps you sleep. Is it pretty sedating? The TCA;s, although with more side effects seem to have been tried and tested that is why the new meds, even with less side effects, scare me a little. I may even ask my pdoc about a different TCA that is not related to nortryptline and see what he thinks. I know the effect of it on excercise is not in my head, now I just have to convince him of that! That is why I felt much better after reading someone else has had that type of reaction. This has probably been posted before, but I wonder if anybody else has had excercise problems with their meds? Colin, thanks for all the information I appreciate it. Take care. Johnj
Posted by johnj on April 29, 2002, at 16:28:23
In reply to Re: Colin, I know how you feelJohn J., posted by colin wallace on April 26, 2002, at 17:19:21
Colin you mentioned you had taken lofepramine/imipramine and it did not cause the you to feel like hell post excercise? Also, remeron had the ill effect too? I know you said you tried 90 mg at one time, and did you not get an AD affect from it? I felt pretty good yesterday so I worked out and also did an hour or so of work outside and today I feel terrible and totally spaced.
I tried to go down to 7.5 mg of remeron and it made me really tired all day. I pretty much don't remember dreaming, just knocked out. The confusion has increased after going on remeron. It is strange I can concentrate better, but am lacking in the short term memory area. I like it for anxiety, but I probably need to move on to something else too since I hate to up my current benzo. That is another area I will have to addres since I currently cannot use excercise to combat that.
I guess I need to give up working out until I do some med adjustment. I just can't afford to feel so shity post excercise. Part of me wants to get off everything and focus on food/excercise, but that could be a big roll of the dice. I am thinking maybe another TCA switch first. Did you ever take or look into Celexa? There are so many meds out there it makes my head swim.
Take care.
John
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