![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by atreyu on February 21, 2007, at 20:53:26
RECIPE FOR CALM CLARITY: Provigil (400mg), Aricept(5mg), Lamictal(200mg), Seroquel(12.5mg), Klonopin(.5mg),Alpha GPC, CDP Choline, ALCAR, excercise, good eats, sleep
I'm a 2nd year medical student. After many years of trial and error, I’ve discovered a unique yet excellent blend of medications that cater to my particular brain chemistry. I've been on the combination above for a solid year now and have experienced negligible side effects (zero essentially). I've been clinically diagnosed with ADD mixed, bipolar mixed, social anxiety and OCD(a nasty combo). School has been a great challenge for me ever since I was a child. In high school, I managed to succeed via tutors, working extra hours after school with teachers, and unlimited parental support. My college experience was another story. I began drinking heavily and taking stimulants. I first discovered caffeine as a study drug and began consuming it in lethal doses(18 shots daily)…then I found ephedrine HCL (75mg daily), then adderall(30mg daily) and finally cocaine. I've also experimented with a slew of neurotropics (aka. smart drugs). As a result of all this self-medicating, my genetic predispositions began to show their ugly faces. I did manage to graduate with a double major in Human Biology and Visual Arts and my GPA was fairly high(3.8). Nevertheless, all these CNS stimulants(including the smart drugs) did more harm than good and left me in a manic, suicidal mess last December. Who knows how much brain damage they caused? I had to take a year off school to heal my brain and that is exactly what I have done. I would like to share my success story with you and how I've changed my life for the better:
MEDS:
1)PROVIGIL(400mg x2 1 year): Initially hated this on 100 mg, pumped it up to 200mg and concentration improved; finally at 400 mills, this drug kicked in like no other. I'm a study machine w/ boosted confidence and verbal ability(no more word salads). This is the 2nd best drug on the planet. Downside: expensive as hell, and takes about 2 months to take full effect)
2)ARICEPT(5mg x1 for 1 year): This is my number one drug as it is truly a brain steroid for healthy people or for someone that may have caused brain damage from substance abuse. It's prescribed for Alzheimer’s but regardless, it jacks your acetylcholine levels through the roof. My memory and creativity have been greatly enhanced. My critical thinking skills have also improved. Aricept has also helped tremendously with social anxiety. Downside: Expensive
3)LAMICTAL:(200mg x1 for 1 year): This drug was a life saver. That's all I can say. Increased my ability to focus, no more rapid cycling, no more hypomania(although initially it triggered this) depression is nonexistent. Downside: Expensive
4)SEROQUEL:(12.5mg before bed): I was hesitant about this drug initially but 12.5 mg is nothing and I sleep like a rock. Getting a good nights rest is probably the most important aspect of combating anxiety, add and bipolar. There may be some cognitive dulling/sedation from the Seroquel but this is easily outweighed by the sleep factor. Sleep is key. SIDE EFFECTS: At this dose, I experienced none...only increased libido and a Viagra like effect which has been great for my sex life.
5) KLONOPIN :(.25 mg x 2) this is the miracle drug for social anxiety folks but it also has some downsides. My main concern is its ability to interfere with memory consolidation and to cause cognitive dulling over time. Nevertheless, this drug is essential and at such a low dose, my cognitive concerns are minor. Klonopin helps to promote a calm alertness in combination with everything else. Good drug. Addiction can apparently be a problem with benzos yet I've yet to experience this. I have severe substance abuse issues and have never abused my Klonopin. I don’t simply out of fear that I might be damaging my memory and won’t be able to perform as well on exams. NOTE: XANAX and ATIVAN do not work for me. They’re too strong to start off with and their half-life is too short so they end up creating more anxiety.
6)LUNESTA(as needed): I rarely use this anymore after being introduced to Seroquel but if you're going to take a sleeping pill, this is the one.
SUPPLEMENTS: (Supps are not worth it if you’re not willing to fork out the dough to buy the high quality stuff. You can’t just go to Longs and buy a choline supplement and expect results. That’s ridiculous. Below are quality supps that I use:
1)JARROW ALPHA GPC (amazing stuff..boosts
Ach)
2)JARROW CDP CHOLINE (boosts Ach)
3)NORDIC LIQUID OMEGA 3,6,9 (my skin never
looked better)
4)ALCAR (don’t know but I take it anyways)
5)MULTIVITAMINNOTE: If you have any bipolar tendencies, stay away from anything with DMAE, Tyrosine, and Vinopectine…these supps along with Piracetam and Hydergine induce hypomania in me.
ALSO NOTE: THE ABOVE MEDS ARE ALL BRAND NAME AND UNFORTUNATLEY RIDICULOUSLY EXPENSIVE. The combo above is roughly $2000/month. I get everything in samples so I don't pay this and it's also wise not to use your insurance for BP meds(despite HIPAA protection) as they trigger a red flag for anyone wanting to practice Medicine, especially surgery.
LIFE CHANGES(the most important component):
1)EAT A BUNDLE OF PROTEIN, FISH, CHICKEN,
WHEY PROTEIN SHAKES
2)VEGGIES
3)FIBER(this has been huge for reducing
anxiety as the constipation was putting
pressure on my lungs and preventing me from
breathing fully)
EXCERCISE : run 4miles in morning, 2 miles eveningSLEEP: 8 hours (no more, no less) varies for people. If you find yourself sleeping less and less and feeling more alert…you probably on the verge of manic, hypomanic state. It may feel good temporarily but you undoubtedly crash.
SO THAT'S MY PIECE. MY BRAIN WORKS BETTER THAN EVER. MY SOCIAL ANXIETY IS 98% GONE, ATTENTION PROBLEMS HAVE DIMINISHED MARKEDLY, and MOOD STABILITY IS ON LOCK DOWN. I'M AT THE TOP OF MY MED SCHOOL CLASS AT ONE THE BEST MED SCHOOLS IN THE COUNTRY. THERE IS HOPE FOR EVERYONE. SOME OF THE PEOPLE WITH THE MOST MENTAL ISSUES HAPPEN TO BE THE HIGHEST ACHIEVERS. WE'RE ALL IN THE SAME BOAT AND NOT A SINGLE ONE OF US IS PERFECT. EVERYONE HAS PROBLEMS BUT WITH THE RIGHT MEDS AND LIFESTYLE CHANGES, THE QUALITY OF YOUR LIFE CAN BE IMPROVED TREMENDOUSLY. Thanks for reading--Atreyu
Posted by Edwin Ransom on February 21, 2007, at 21:02:15
In reply to Brain Steroids: Cocktail for Calm Clarity, posted by atreyu on February 21, 2007, at 20:53:26
Haha. This is the great post ever.
You are a piece of cake Dr. Healed-Thyself.
Posted by stargazer on February 22, 2007, at 9:38:26
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by Edwin Ransom on February 21, 2007, at 21:02:15
Way to go, only downside to your story is you are going into surgery, not psychiatry, where you can really help since you are so knowledgable with the meds based on your personal history.
How on earth did you find the combination you are on? through your pdoc, your own research a bit of both?
That's the thing, I believe there is a right combination for everyone but finding it is the problem. You are lucky in that you have the educational background and understanding to be able to help yourself, but the majority of people with these conditions are at the mercy of the medical field and there are so many doctors that have limited knowledge of many of these combinations, maybe one or two together, but nothing like you are on.
I feel like the rest of us have no chance to get the best results, because the drugs that are used are usually ineffective and don't correct the underlying deficiencies, only mask some of the symptoms but give us intolerable side effects.
How long did it take to find the combination you are on? I'm going on 30 years with marginal responses to meds and it's only after taking things into my own hands that things are improving, but it's far from where I want to be.
You are truly lucky you have a chance at a normal functional life that many of us were denied through years of drug trials and poor outcomes.
Stargazer
Posted by TheMeanReds on February 22, 2007, at 10:53:43
In reply to Brain Steroids: Cocktail for Calm Clarity, posted by atreyu on February 21, 2007, at 20:53:26
> RECIPE FOR CALM CLARITY: Provigil (400mg), Aricept(5mg), Lamictal(200mg), Seroquel(12.5mg), Klonopin(.5mg),Alpha GPC, CDP Choline, ALCAR, excercise, good eats, sleep
>
> I'm a 2nd year medical student. After many years of trial and error, I’ve discovered a unique yet excellent blend of medications that cater to my particular brain chemistry. I've been on the combination above for a solid year now and have experienced negligible side effects (zero essentially). I've been clinically diagnosed with ADD mixed, bipolar mixed, social anxiety and OCD(a nasty combo). School has been a great challenge for me ever since I was a child. In high school, I managed to succeed via tutors, working extra hours after school with teachers, and unlimited parental support. My college experience was another story. I began drinking heavily and taking stimulants. I first discovered caffeine as a study drug and began consuming it in lethal doses(18 shots daily)…then I found ephedrine HCL (75mg daily), then adderall(30mg daily) and finally cocaine. I've also experimented with a slew of neurotropics (aka. smart drugs). As a result of all this self-medicating, my genetic predispositions began to show their ugly faces. I did manage to graduate with a double major in Human Biology and Visual Arts and my GPA was fairly high(3.8). Nevertheless, all these CNS stimulants(including the smart drugs) did more harm than good and left me in a manic, suicidal mess last December. Who knows how much brain damage they caused? I had to take a year off school to heal my brain and that is exactly what I have done. I would like to share my success story with you and how I've changed my life for the better:
>
> MEDS:
>
> 1)PROVIGIL(400mg x2 1 year): Initially hated this on 100 mg, pumped it up to 200mg and concentration improved; finally at 400 mills, this drug kicked in like no other. I'm a study machine w/ boosted confidence and verbal ability(no more word salads). This is the 2nd best drug on the planet. Downside: expensive as hell, and takes about 2 months to take full effect)
>
> 2)ARICEPT(5mg x1 for 1 year): This is my number one drug as it is truly a brain steroid for healthy people or for someone that may have caused brain damage from substance abuse. It's prescribed for Alzheimer’s but regardless, it jacks your acetylcholine levels through the roof. My memory and creativity have been greatly enhanced. My critical thinking skills have also improved. Aricept has also helped tremendously with social anxiety. Downside: Expensive
>
> 3)LAMICTAL:(200mg x1 for 1 year): This drug was a life saver. That's all I can say. Increased my ability to focus, no more rapid cycling, no more hypomania(although initially it triggered this) depression is nonexistent. Downside: Expensive
>
> 4)SEROQUEL:(12.5mg before bed): I was hesitant about this drug initially but 12.5 mg is nothing and I sleep like a rock. Getting a good nights rest is probably the most important aspect of combating anxiety, add and bipolar. There may be some cognitive dulling/sedation from the Seroquel but this is easily outweighed by the sleep factor. Sleep is key. SIDE EFFECTS: At this dose, I experienced none...only increased libido and a Viagra like effect which has been great for my sex life.
>
> 5) KLONOPIN :(.25 mg x 2) this is the miracle drug for social anxiety folks but it also has some downsides. My main concern is its ability to interfere with memory consolidation and to cause cognitive dulling over time. Nevertheless, this drug is essential and at such a low dose, my cognitive concerns are minor. Klonopin helps to promote a calm alertness in combination with everything else. Good drug. Addiction can apparently be a problem with benzos yet I've yet to experience this. I have severe substance abuse issues and have never abused my Klonopin. I don’t simply out of fear that I might be damaging my memory and won’t be able to perform as well on exams. NOTE: XANAX and ATIVAN do not work for me. They’re too strong to start off with and their half-life is too short so they end up creating more anxiety.
>
> 6)LUNESTA(as needed): I rarely use this anymore after being introduced to Seroquel but if you're going to take a sleeping pill, this is the one.
>
> SUPPLEMENTS: (Supps are not worth it if you’re not willing to fork out the dough to buy the high quality stuff. You can’t just go to Longs and buy a choline supplement and expect results. That’s ridiculous. Below are quality supps that I use:
> 1)JARROW ALPHA GPC (amazing stuff..boosts
> Ach)
> 2)JARROW CDP CHOLINE (boosts Ach)
> 3)NORDIC LIQUID OMEGA 3,6,9 (my skin never
> looked better)
> 4)ALCAR (don’t know but I take it anyways)
> 5)MULTIVITAMIN
>
> NOTE: If you have any bipolar tendencies, stay away from anything with DMAE, Tyrosine, and Vinopectine…these supps along with Piracetam and Hydergine induce hypomania in me.
>
> ALSO NOTE: THE ABOVE MEDS ARE ALL BRAND NAME AND UNFORTUNATLEY RIDICULOUSLY EXPENSIVE. The combo above is roughly $2000/month. I get everything in samples so I don't pay this and it's also wise not to use your insurance for BP meds(despite HIPAA protection) as they trigger a red flag for anyone wanting to practice Medicine, especially surgery.
>
> LIFE CHANGES(the most important component):
> 1)EAT A BUNDLE OF PROTEIN, FISH, CHICKEN,
> WHEY PROTEIN SHAKES
> 2)VEGGIES
> 3)FIBER(this has been huge for reducing
> anxiety as the constipation was putting
> pressure on my lungs and preventing me from
> breathing fully)
>
> EXCERCISE : run 4miles in morning, 2 miles evening
>
> SLEEP: 8 hours (no more, no less) varies for people. If you find yourself sleeping less and less and feeling more alert…you probably on the verge of manic, hypomanic state. It may feel good temporarily but you undoubtedly crash.
>
> SO THAT'S MY PIECE. MY BRAIN WORKS BETTER THAN EVER. MY SOCIAL ANXIETY IS 98% GONE, ATTENTION PROBLEMS HAVE DIMINISHED MARKEDLY, and MOOD STABILITY IS ON LOCK DOWN. I'M AT THE TOP OF MY MED SCHOOL CLASS AT ONE THE BEST MED SCHOOLS IN THE COUNTRY. THERE IS HOPE FOR EVERYONE. SOME OF THE PEOPLE WITH THE MOST MENTAL ISSUES HAPPEN TO BE THE HIGHEST ACHIEVERS. WE'RE ALL IN THE SAME BOAT AND NOT A SINGLE ONE OF US IS PERFECT. EVERYONE HAS PROBLEMS BUT WITH THE RIGHT MEDS AND LIFESTYLE CHANGES, THE QUALITY OF YOUR LIFE CAN BE IMPROVED TREMENDOUSLY. Thanks for reading--Atreyu
>
>Lamictal(200mg), Seroquel(12.5mg), Klonopin(.5mg)
Have to disagree with this one scholar.
Posted by Atreyu on February 22, 2007, at 11:04:39
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by stargazer on February 22, 2007, at 9:38:26
Stargazer,
I've been searching for the perfect blend of meds ever since I was 18. I've been my own test subject and as a result have made some drastic mistakes. Inevitably it was my failures that lead to my success. I eventually concluded that most of my problems were stemming from neurotransmitter deficiencies in my prefrontal cortex (but this took 7 years of trial and error to determine). I had to suffer through the BAD to discover the GOOD. I've read almost every psych book out there (most are written by garbage pdocs trying to make a buck) yet have learned the most from websites like dr.bob. I knew about drugs like Aricept and Provigil 5 years ago (Cephalon's putting out a new Provigil called Nuvigil which is encouraging-since Provigil will go generic and be affordable-but then of course everyone's going to want Nuvigil). I've tried every psych drug on the planet in hopes of discovering something that would help my issues with a minimal side effect profile. What I've discovered is that you have to willing to work with a drug and tweak the doses. I'm extremely sensitive to drugs so 12.5 mg of Seroquel does the trick...most pdocs will slam you on 100mg and of course you're going to hate the drug. The bottom line is that most drugs can be helpful if the drug is titrated to work in cohesion with your brain chemistry. Provigil didn't work for me at 100mg and I figured I'd just wasted 170 bucks. Once I upped the dose to 400mg(which is expensive I know)-it's amazing.My case was particularly difficult since I was searching for a combo to calm my nerves without impairing cognitive function. I really wanted to be on monotherapy but found that a cocktail of multiple meds at low doses can often be a better solution. You're right in your assumption that MOST pdocs are clueless. Most have serious psych issues themselves (which is why they practice psychiatry) and are dabbling in their own meds. I had two pdocs that were clearly alcoholics(or benzo addicts) and I found that my knowledge of psychiatry at age 20 far surpassed theirs. I eventually came to terms with this unfortunate reality: THE ONLY GOOD PDOCS ARE THE ONES THAT DON'T TAKE INSURANCE(you're disillusioned if you think otherwise). My pdoc now is amazing (she has far more knowledge than I could ever hope to have and is the first pdoc that doesn't let me dominate. I actually listen) but she costs an arm and a leg and doesn't take insurance. Why would she? She's the best! You want to find a pdoc that is working at a major University like Stanford, Harvard, etc...B/c they're in a situation that forces them to be on top of their game as they have conferences every week where they get grilled. You're best bet is to find one that is younger(they tend to be more willing to experiment with newer off-label drugs b/c they're all looking to get published...for ex. who would have thought that Aricept would help with social anxiety??) Old pdocs are 'old' and out of touch with all the new brain gear that's about to hit the shelves. Take the years 2010, 2012, and 2014...a slew of new meds for bipolar, ADD, anxiety will hit the market at these stages and will change psychiatry as we know it. If drugs aren't working for you now, just hold out for a few more years(try to focus on healthy living and reducing your stress, mediation, yoga, all that stuff that seems like b.s. but it does help. Reading as much as possible is also key). As for taking drugs now, my advice is "the newer the drug, the better (as far as side effects go)". For ex. Lithium may be a great drug for some but it was discovered nearly a century ago, along with Arsenic. Regardless of whether or not you have side effects on them, it's ridiculous that these drugs are still being used. The same goes for amphetamine-based stimulants and benzos. In 50 years...nothing better has come a long? Well I'm sure you know the answer to that. It wasn't until the US military got involved in psychiatry that psychiatry got the stank pumped back into its tank. There are a bundle of super drugs in the line up with low side effect profiles that will begin to hit the market. The military is dumping crates of cash into the production of drugs that will help their soldiers function longer, better and with zero side effects. This is where Provigil and Aricept got their funding (although you'll find people that will disagree). In the military's pursuit to produce BrainRoids for their super soldiers, they've as a side effect, developed drugs beneficial to the general population. As I said earlier, by 2014 you will see many of these drugs popping up. By 2030, pill popping will have become obsolete and instead you'll just have a little chip implanted into your brain(the military is dumping buckets into this kind of research too-mainly for soldiers suffering traumatic brain injury but of course, benefit to the general public will ensue). There will come a time when drugs will have become so good that ethical concerns will begin to arise. People will be popping drugs like Aricept as a daily multi-vitamin. To compete, you'll need to take these drugs however, will you be able to afford the?? The pursuit for the ultimate BrainRoid will continue to go forward and as usual, only the wealthy will be able to benefit and the poor will be stuck having to wait for the far-inferior generic version. Do a little research into what constitutes a generic drug and you'll begin to understand why you're having so many side effects (if you're on generics). Stick with Brand Name if you can (that's what I'm on and I've yet to experience anything serious...I exercise and eat healthy though which is the most important thing you can do).
PS. A good book to read just for your own psychological awareness is "Ego and Archetype"...by Endinger(nothing to do with drugs but a great read...it's dense but stick with it b/c it may change your life). My motto is, if anything in life is easy, it's probably a waste of your time! Atreyu
Posted by Atreyu on February 22, 2007, at 11:30:42
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by TheMeanReds on February 22, 2007, at 10:53:43
I'm far from being a scholar. I'm not suggesting that my medications will work for anyone but myself b/c my brain chemistry is clearly different than yours. I'm not suggesting that these meds will not poop out on me tomorrow? I don't know? Obviously Klonopin and Seroquel have some anti-cholinergic effects...but this can beneficial for someone with an overactive mind. All I know is that this particular combo has been working for me. My main point is that experimenting with the dosage of the drug(that seems to be working for you) can yield unexpected and often better results. You may hate one drug on a high dose yet find it beneficial on a low low dose. As for Lamictal and Seroquel and Klonopin, I'm not sure what you are referring too? You can't just make a claim with out backing it up with some form of evidence. Build an argument around what you think? Why you think it? Your past experiences? What meds you’re on? Use some form logic to give the readers a chance to weigh what I think vs. what you think. For ex. Do you have bipolar tendencies b/c if not, then clearly there is no need for you to take these meds. I do so they help me focus tremendously and get the sleep I need. There are many different type of bipolar as well. For ex. Abilify is supposed to be a wonder drug yet at 1.5 mg it through me into a full blow manic phase for a month. It felt like cocain x10 (and that is at 1.5 mg). I've never posted on one of these boards and I certainly wouldn't have posted if I didn't believe I had some good advice. It might not be valid for all but could be helpful for some. Regardless, learn to back up your claim otherwise you're just wasting space.-Atreyu
Posted by TheMeanReds on February 22, 2007, at 11:43:05
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by Atreyu on February 22, 2007, at 11:30:42
Sorry if I came off as wasting cyber space. I'm not trying to provoke a fight, or write essay-type responses. Postings on here that seem like 'fights' are the longest conversations it seems. Anyhow best of luck to you. =)
Posted by Phillipa on February 22, 2007, at 12:00:50
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by TheMeanReds on February 22, 2007, at 11:43:05
I don't know about the newest meds being best .I think meds like the benzos have a long track record with minimal side effects. Worse that can happen if you're responsible is tolerance. Now how do you get over this? Love Phillipa
Posted by Joe Bloe on February 22, 2007, at 13:32:35
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by Phillipa on February 22, 2007, at 12:00:50
This is a very interesting post: the whole microchip thing in the brain sounds extremely frightening, I have to say.
Two questions:
1) How is Nuvigil supposed to be different from Provigil?
2) How do you find the cognitive SE's from Lamictal?
Posted by djmmm on February 22, 2007, at 18:22:44
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by Joe Bloe on February 22, 2007, at 13:32:35
> This is a very interesting post: the whole microchip thing in the brain sounds extremely frightening, I have to say.
>
> Two questions:
>
> 1) How is Nuvigil supposed to be different from Provigil?
>
> 2) How do you find the cognitive SE's from Lamictal?Nuvigil is simply the active isomer of Provigil
Posted by stargazer on February 23, 2007, at 0:24:58
In reply to Re: Brain Steroids: Cocktail for Calm Clarity » stargazer, posted by Atreyu on February 22, 2007, at 11:04:39
Atreyu,
Interestingly, I just asked my pdoc for a second opinion and the pdoc he referred me to did not accept insurance so I guess he was probably a good doc. Too bad I can't afford to see him.
Is this because the people that can afford to go to these docs do not want an insurance trail identifying them as 'psych' patients. It's always the case, the rich get the best treatment and the rest of us get the leftovers.
I'm going to see someone tomorrow who accepts insurance. Probably a pretty mediocre doc.
I am currently on 12 mg Emsam. My depression is in remission for now but I don't feel normal or well enough to accept this feeling. I'm always dizzy and my brain is not sharp or focused in it's functioning. I haven't felt well in a very long time and since I'm not working due to depression, it's hard for me to tell how functional I actually am with little work stress affecting me.
Question-Whats the best way to have a new pdoc evaluate my depression and treat it with the right combination of medications? I don't think they know what's wrong with my brain and therefore they don't seem to have any game plan when they treat me. I don't think any of the typical AD meds do much for me but I have had luck in the past with two MAOs, Nardil (1989), stopped working and Marplan (1994), discontinued by Roche, forced to come off it, retrial in 2006, which failed. A combination of Celexa, Wellbutrin and Adderall worked for a while too, not great but acceptable results.
I still don't have an idea of what brain deficiencies I have and I never feel the pdocs ask the right questions to determine which meds will work. There doesn't seem to be any logic in their choice of meds. They just try anything I haven't been on before and that usually makes me worse. Luckily, this past November Emsam did pull me out of a depression but it has not restored me to a place that feels right.
My depression seems to be triggered mainly by work responsibilities. When I was on Nardil I had the ability to work under pressure and although I felt stress, I didn't cave with it, until it stopped working. It seems when a med works, I can handle stress and be able to accomplish many stressful things. When I'm depressed I become unable to handle even minor stressors, become unable to make any decisions, and lose the ability to multitask and prioritize tasks.
Is this a faulty process having to do with the brain's executive functioning? Are you familiar with what is broken or not working right? Is it a dopamine problem or something else going on?
I have gone from being very accomplished to being quite mentally debilitated. In my past few jobs I try to avoid any situations that will stress me out because I'm so afraid of decompensating and becoming depressed but even with doing this, my brain inevitably starts to fail. I become unable to filter information for relevance and I get overloaded with useless details and become unable to focus on what's important.
Do you see anything here that is a clue to what is going on and what meds might work? I am desparate and that is why I have asked my pdoc for a second opinion. You may be better equipped than them to advise me about this. At least it would give me some ideas to discuss when I see him tomorrow, if I get your response in time.
Thanks for any light you can shed on my situation. Sorry so long, I tired myself out. Also my ability to read and retain info has always been poor. This is why I told my pdoc I thought I had ADD.
Stargazer
Posted by psychobot5000 on February 23, 2007, at 0:57:51
In reply to Help with my treatment,Suggestion for meds/Atreyu, posted by stargazer on February 23, 2007, at 0:24:58
"When I'm depressed I become unable to handle even minor stressors, become unable to make any decisions, and lose the ability to multitask and prioritize tasks."
I know this wasn't directed at me, but I thought this might help. What you've just described is very much like me, and when I described the issues to the best and most knowledgeable psychiatrist I've ever had a chance to deal with, he did indeed identify it as a dopamine problem. ('associated with dopamine pathways' is what he said.)
I do note that all the med combos you mentioned being beneficial seem to involve a dopamine component, as well as dealing with serotonin and probably NA, so maybe there's something to it? MAOis are good for dopamine, of course.
Best,
Pbot
Posted by Declan on February 23, 2007, at 2:14:09
In reply to Brain Steroids: Cocktail for Calm Clarity, posted by atreyu on February 21, 2007, at 20:53:26
Have you found any effect on your mood by changing your acetylcholine levels with Aricept, GPC and ALCAR (if it does that)?
I've been cautious about doing so because any alteration in mine seemed problematic.
Posted by stargazer on February 23, 2007, at 8:08:00
In reply to Re: Help with my treatment,Suggestion for meds » stargazer, posted by psychobot5000 on February 23, 2007, at 0:57:51
Pbot, that's what I was figuring but have yet to have a pdoc confirm the deficiency as being one of dopamine, although I have though that was the issue. All my current pdoc says is he doesn't know. I just accepted this explanation for so long but since the only meds that have helped involve dopamine, why can't he say the defect is in the dopamine system and prescribe meds that involve this pathway? Is that too much to ask from a supposed psychiatric practitioner who has been treating me for 20 years? Depression really makes me complacent and trusting when skepticsim may have had much better results. Although today I'm getting a second opinion, I know the pdoc and I'm not sure of his capabilities either, although Ivy league affilitated means squat. We'll see.
Prior to starting Emsam in Nov., I had a bad reaction to Cymbalta, as it increased my depression. Other meds, mostly SSRI's have done the same, although in comnbination with other meds (Adderall, Wellbutrin) have helped, none as well as Nardil and Marplan when they initially worked. Both eventually stopped working and Marplan failed on retrial.
I think many of the pdocs don't form any conclusions as to what system is involved in the depression. I think my pdoc just randomly hopes to get something to work without any real analysis of what is causing the symptoms. Why is this? Do they want us to suffer forever or just don't care or just don't know what they're doing. It causes me much distress to think there is really no scientific basis to what they are doing, besides causing me more harm than good. And forget them referring you to someone who might know better than them, that never happens. When i asked my doc for a referral he seemed stumped to come up with a name, so it seemed as though the requewst was a foreign one.
I have asked others here for suggestions for expert psychopharmacologists and have searched online without any results. I am trying to find an answer but it has not been easy despite my ongoing attempts to heal thyself, since the docs seem incapable of offering me much long term relief. Lots of bandaids over the years which are short lived and marginally effective.
Hopefully today's appt will be beneficial else I will know there is no help from psychiatric professionals, only PB'ers on-line, who are more of the experts than the docs. Too bad we can't write our own prescriptions and eliminate the costly, inefficient middlemen.
SG
Posted by stargazer on February 23, 2007, at 8:14:03
In reply to Acetylcholine, posted by Declan on February 23, 2007, at 2:14:09
Declan, I wasn't sure who you were posing this question to (I think to our doctor in training) but I wanted to ask what the effects of ACTH are on mood, thinking.
Also, I know about Aricept from working with the elderly...but what are GPC and ALCAR? Never heard of those and what is their availability, OTC, prescription?
So much to learn, so little time...Thanks for your babble message...SG
Posted by notfred on February 23, 2007, at 10:33:10
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by TheMeanReds on February 22, 2007, at 10:53:43
> Lamictal(200mg), Seroquel(12.5mg), Klonopin(.5mg)
> Have to disagree with this one scholar.
>
He posted a treatment program that is working well **for him**. What is there is disagree about ?
Or is this sour grapes ?
Posted by TheMeanReds on February 23, 2007, at 10:52:45
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by notfred on February 23, 2007, at 10:33:10
>
> > Lamictal(200mg), Seroquel(12.5mg), Klonopin(.5mg)
> > Have to disagree with this one scholar.
> >
>
>
> He posted a treatment program that is working well **for him**. What is there is disagree about ?
> Or is this sour grapes ?Yes notfred it was sour grapes, that is why I aplogised, and wished that person luck. Thank you for your close eye on this matter. Good luck notfred.
Posted by Quintal on February 23, 2007, at 10:54:45
In reply to Re: Help with my treatment/Pbot, posted by stargazer on February 23, 2007, at 8:08:00
>I have asked others here for suggestions for expert psychopharmacologists and have searched online without any results. I am trying to find an answer but it has not been easy despite my ongoing attempts to heal thyself, since the docs seem incapable of offering me much long term relief. Lots of bandaids over the years which are short lived and marginally effective.
http://www.psychotropical.com/question_fees.shtml
You might want to consider giving this guy a try if you're looking for an expert pharmacologist online. He is of the opinion most modern antidepressants aren't as effective as the MAOIs, and that seems to be what you found in your own experiences. I've made a spreadsheet of all the different meds I've taken with doses, duration of treatment, effectiveness, tolerability etc, which I'm planning to forward to any future professional that deals with me. I think it can help them identify patterns more easily and choose the best treatments for you that way.
I'm willing to post mine, but it spreads over nearly two screen widths............
Q
Posted by Declan on February 23, 2007, at 18:54:59
In reply to Re: Acetylcholine, posted by stargazer on February 23, 2007, at 8:14:03
GPC is glycerolphosphatidylcholine.
ALCAR is actetyl-l-carntine.
Both are supplements mentioned in the original post.
GPC is a precurser to Ach, intensified if you take Aricept with it.
ALCAR may mimic Ach or something like that.
Posted by Phillipa on February 23, 2007, at 19:14:21
In reply to Re: Brain Steroids: Cocktail for Calm Clarity, posted by Phillipa on February 22, 2007, at 12:00:50
We have no means but trial and error after ruling out all possible phsical causes to chose a med or combo to the best of my knowledge. But VNS will make a med work better. Love Phillipa
Posted by psychobot5000 on February 23, 2007, at 19:25:55
In reply to Re: Help with my treatment/Pbot, posted by stargazer on February 23, 2007, at 8:08:00
"Do they want us to suffer forever or just don't care or just don't know what they're doing. It causes me much distress to think there is really no scientific basis to what they are doing"
___I think psychiatrists ultimately don't know what they're doing--a lot of psychiatric theory seems too poorly substantiated and poorly understood. Remember that for thousands of years, doctors were basically all quacks--not because they were bad people, but because they simply didn't have enough knowledge about the human body. Seems we're still there, concerning the mind.
Some doctors I've met tell me that, while many advances have been made in mainstream medicine, psychiatry is not entirely out of the dark ages. ...It seemse easy to see--for twenty years much of the psychiatry profession had their panties all in a bunch over serotonin, because SSRIs were somewhat effective for depression. Then, Lamictal seems effective, and a Ketamine test allegedly shows an instant antidepressant response, and suddenly everyone's looking at an almost entirely different system in the brain. Not terribly scientific...and drug companies' meddling doesn't seem to help...
I'm not certain where you live, but have you tried the McKlean hospital outside Boston? They specialize in this stuff--expensive, I believe, but it might help...
Posted by psychobot5000 on February 23, 2007, at 19:30:22
In reply to Re: Acetylcholine, posted by stargazer on February 23, 2007, at 8:14:03
> Also, I know about Aricept from working with the elderly...but what are GPC and ALCAR? Never heard of those and what is their availability, OTC, prescription?
>I read a study that showed equal effectiveness (and better than placebo, I think) between amisulpride and Acetyl-l-carnitine (ALCAR) for moderate depression. Seems it help some people to have a better mood or be more focused or energetic.
It's available at most supplement stores.
Posted by Joe Bloe on February 23, 2007, at 20:29:49
In reply to Re: Acetylcholine, 'AlCAR' » stargazer, posted by psychobot5000 on February 23, 2007, at 19:30:22
I am going to try some out. I will start a new thread when I begin taking it and keep you all updated.
BTW, Linkadge recently reported benefits from choline and caffeine on the Alternative board.
This is the end of the thread.
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