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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by SLS on July 8, 2006, at 7:37:01
I'll probably give this drug a whirl after giving Topamax a few more weeks.
- Scott
Posted by willyee on July 8, 2006, at 11:17:18
In reply to Any comments regarding sibutramine (Meridia)?, posted by SLS on July 8, 2006, at 7:37:01
> I'll probably give this drug a whirl after giving Topamax a few more weeks.
>
>
> - ScottHas the topamax provided any benifit for you?If im not mistaken you long ago stopped parnate correct?
So i assume you were taking topamax in conjunction with the tca (cant remeber)you are still using?
Posted by SLS on July 8, 2006, at 13:05:31
In reply to Re: Any comments regarding sibutramine (Meridia)?, posted by willyee on July 8, 2006, at 11:17:18
> > I'll probably give this drug a whirl after giving Topamax a few more weeks.
> >
> >
> > - Scott
>
> Has the topamax provided any benifit for you?If im not mistaken you long ago stopped parnate correct?
>
> So i assume you were taking topamax in conjunction with the tca (cant remeber)you are still using?
You have a better memory than I do. I can't remember what I take from one day to the next!I am currently taking:
nortriptyline 100mg
Lamictal 150mg
Topamax 75mg
Abilify 10mgRight now, I can't really feel any difference for having added the Topamax. I raised the dosage from 50mg to 75mg only yesterday, so I should not be expecting much. I guess I need to wait until I've been on 200mg for awhile before passing judgment. I just hope I don't get kidney stones. So far, I don't feel any dumber. That would be a pretty hard thing to do, though. This illness makes me into a moron.
- Scott
Posted by med_empowered on July 8, 2006, at 16:31:27
In reply to Any comments regarding sibutramine (Meridia)?, posted by SLS on July 8, 2006, at 7:37:01
Are you trying it for weight loss, or as an AD? For weight loss, I think its considered OK--after a year, most people who stay on the drug lose a bit more weight than those taking a placebo. There are some risks, though, like cardio problems and serotonin syndrome, so do watch for those.
Posted by willyee on July 8, 2006, at 20:39:24
In reply to Re: Any comments regarding sibutramine (Meridia)?, posted by med_empowered on July 8, 2006, at 16:31:27
> Are you trying it for weight loss, or as an AD? For weight loss, I think its considered OK--after a year, most people who stay on the drug lose a bit more weight than those taking a placebo. There are some risks, though, like cardio problems and serotonin syndrome, so do watch for those.
>
>Are you auggesting it isnt much good for AD augmentation or mood stablization......i also considered this at one point until i came to the conclusion not too based on so many people on Remedyfind labeling it "Dopamax" which kinda scared me.
Do you believe it doesent hold much weight in the psych department? I never pursued it really and still havent come up with enough reason too.
Posted by SLS on July 8, 2006, at 20:46:45
In reply to Re: Any comments regarding sibutramine (Meridia)?, posted by med_empowered on July 8, 2006, at 16:31:27
> Are you trying it for weight loss, or as an AD? For weight loss, I think its considered OK--after a year, most people who stay on the drug lose a bit more weight than those taking a placebo. There are some risks, though, like cardio problems and serotonin syndrome, so do watch for those.
I was thinking of taking sibutramine for its antidepressant properties. The net effect of it and its metabolites is that of triple monoamine uptake inhibition (NE, 5-HT, and DA). It might also act to quickly downregulate NE alpha-2 receptors.
I read an article recently that challenged the assumptions made that sibutramine would be cardiotoxic or produce hypertension. I would still feel more comfortable monitoring blood pressure just the same.
- Scott
Posted by med_empowered on July 8, 2006, at 22:10:50
In reply to Re: Any comments regarding sibutramine (Meridia)? » med_empowered, posted by SLS on July 8, 2006, at 20:46:45
the assertion that meridia can/does cause problems is based on reports to the fda so...even if its chemical profile doesn't seem likely to cause problems, I think experience has demonstrated it could cause issues in certain people (Public Citizen called for Meridia's removal from the market)
Posted by SLS on July 9, 2006, at 7:36:50
In reply to Re: Any comments regarding sibutramine (Meridia)?, posted by med_empowered on July 8, 2006, at 22:10:50
> the assertion that meridia can/does cause problems is based on reports to the fda so...even if its chemical profile doesn't seem likely to cause problems, I think experience has demonstrated it could cause issues in certain people (Public Citizen called for Meridia's removal from the market)
If they had their way, they would have distilled water removed from store shelves.
:-)
Thanks for the warning. I'll take it under serious advisement. Of course, once you reach my position in life, one is much more apt to overlook such trivial side effects as premature death.
This illness really sucks, you know?
How are you doing bye the way? You are always so generous to give advice.
Where can I find the FDA reports regarding Meridia and other drugs? It sounds like an invaluable resource.
Take care.
- Scott
Posted by med_empowered on July 9, 2006, at 12:09:24
In reply to Re: Any comments regarding sibutramine (Meridia)? » med_empowered, posted by SLS on July 9, 2006, at 7:36:50
hey man..sorry you feel so bad. I've never been able to come across the actual reports from the FDA; the best you can do is news reports or occasionally FDA reports that say "there have been XXX reports of adverse events," and sometimes there's additional info, like if some of the reports involved people on multiple meds or some other factors.
I'm doing OK. I'm actually not on anything, which is interesting. I do take fish oil (10Grams daily) and exercise, etc. but aside from that...I'm not taking anything. I am meditating, though. I'd say I'm doing better than I was, but w/o meds life does have a new intensity that can be quite hard to take sometimes.
I forgot your med list but...could you just take a straight up stimulant? There are lots of options; some docs apparently RX the old non-amphetamine diet pills for ADD/ADHD, so I imagine that those pills would be available for depression, too, if your doc wanted to avoid actual amphetamines. (Although..having taken phentermine, I can see why they're considered less addictive than amphetamines: they can be thoroughly unpleasant).
Good luck
Posted by cecilia on July 9, 2006, at 21:08:35
In reply to Re: Any comments regarding sibutramine (Meridia)? » med_empowered, posted by SLS on July 9, 2006, at 7:36:50
LOL, Scott, re your comment that Public Citizen would remove distilled water from the shelves if they could. I can see it now, a big report, distilled water causes hyponatremia. Cecilia
Posted by SLS on July 16, 2006, at 7:11:24
In reply to Re: Any comments regarding sibutramine (Meridia)? » SLS, posted by cecilia on July 9, 2006, at 21:08:35
I watched a video yesterday of Peter Mueller, MD administering sibutramine to patients suffering from either fibromyalgia, reflex sympathetic dystrophy, or Tourettes. All of his patients also suffered mood, energy, and cognitive perturbations that overlapped with depression. The improvements in all aspects of their conditions were quite miraculous. Most were placed on dosages of 15-20mg per day given in divided doses. The only thing that bothered me is that many improved to some degree within a day, although the full effect did take longer. I don't doubt that this occurred, but it doesn't necessarily bode well for sufferers of true MDD or BD because I would expect it to take a minimum of two weeks to see an improvement in these conditions. I guess I still see the response to medication as a compensatory mechanism in the CNS that includes things like receptor reregulation and second messenger-mediated alterations in gene expression. These are things that take awhile to happen. Of course, there is the possibility that there are some psychostimulant properties that engage immediately while these other mechanisms are at work.
I think I am going to try this drug next. I am dismayed at the cost, though. It costs $134 for 30 10mg pills. The active metabolites have half-lives of about 12 hours. My guess is that one would need to take 20mg a day. $270 a month! I guess I'll start at 10mg and see what happens.
- Scott
Posted by Denise190466 on July 19, 2006, at 14:38:54
In reply to Any comments regarding sibutramine (Meridia)?, posted by SLS on July 8, 2006, at 7:37:01
Hi Scott,
I'm sorry I don't know anything about this drug although it sounds very promising.
But I don't understand why you are doubtful if it would work for MDD because of the rapid results?? When I first every took Doxepin (tryclic) I swear to God it worked within 24 hours, it took a while though for me to get passed the drowsiness but it really did work that quick and hand on heart it definately wasn't a placebo effect.
I can't understand why everyone seems to stick with this theory that ADs take at least a couple of weeks to work because this isn't the case with everyone.
Denise
Posted by SLS on July 19, 2006, at 19:10:10
In reply to Re: Any comments regarding sibutramine (Meridia)?, posted by Denise190466 on July 19, 2006, at 14:38:54
> I'm sorry I don't know anything about this drug although it sounds very promising.
>
> But I don't understand why you are doubtful if it would work for MDD because of the rapid results?? When I first every took Doxepin (tryclic) I swear to God it worked within 24 hours, it took a while though for me to get passed the drowsiness but it really did work that quick and hand on heart it definately wasn't a placebo effect.
>
> I can't understand why everyone seems to stick with this theory that ADs take at least a couple of weeks to work because this isn't the case with everyone.
Hi Denise.Thanks for chiming in.
Having participated here on Psycho-Babble for over 5 years, I must say that you are one of many to report experiencing a robust improvement in their depression within the first 3 days of starting treatment with an antidepressant medication. I don't doubt at all that your response was real.
Can you describe the long-term course that your treatment with doxepin followed? I would really appreciate it.
How are you doing now?
- Scott
Posted by SLS on July 23, 2006, at 8:23:22
In reply to Re: Any comments regarding sibutramine (Meridia)? » Denise190466, posted by SLS on July 19, 2006, at 19:10:10
Recently, sibutramine has been studied for the treatment of binge-eating disorder. One of the benefits seen in treatment is a reduction in depressive symptomology.
- Scott
A Randomized, Double-blind, Placebo-Controlled Study of Sibutramine in the Treatment of Binge-Eating Disorder
Appolinario JC, Bacaltchuk J, Sichieri R, et al.
Archives of General Psychiatry. 2003;60(11):1109-1116Binge eating disorder (BED) has been associated with episodes of uncontrolled eating, obesity, and comorbid depressive disorders. Unlike bulimia nervosa, it is not associated with compensatory behaviors such as purging. Antidepressant medications have been the first line of treatment for this disorder. The authors evaluated the efficacy of sibutramine, an antiobesity agent in the treatment of binge eating disorder. They randomly assigned 60 obese outpatients who met the DSM-IV criteria for binge eating disorder to receive either placebo or sibutramine 15 mg/day for 12 weeks. This assignment was done after a 2-week run-in period with placebo, with those patients who maintained 2 or more binge eating episodes during the previous 7 days included in the study. The primary measure of efficacy was the number of days with binge eating episodes during the previous week. Secondary measures included weight, Beck Depression Inventory scores, and Binge Eating Scale scores.
Between baseline and week 2, the sibutramine group showed a sharper reduction in binge eating frequency than the placebo group. This finding was maintained throughout the length of the study. Binge eating days were reduced by 66% in the sibutramine group and 41% in the placebo group. By week 12, those in the sibutramine group experienced a mean weight change of -7.4 kg, while those in the placebo group had a +1.4-kg weight change. Sibutramine also was associated with a significant improvement in depressive symptomatology. In terms of side effects, dry mouth and constipation were significantly higher in the sibutramine group vs the placebo group. The authors concluded that sibutramine is an effective and well-tolerated treatment for binge eating disorder -- for reducing the number of binge days as well as decreasing weight and diminishing comorbid depressive symptomatology.
This is the end of the thread.
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