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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 51. Go back in thread:
Posted by SteelyDan on April 3, 2008, at 14:12:06
In reply to Please help. No med at all is helping me!, posted by alexa35 on April 2, 2008, at 20:08:33
> I've battled depression for years. I'm in CBT therapy 1-2 times each week. The past 5 months the depression is feeling unbearable. Some of this is due to personal things going on and the fact that the company I work for is insane. Past 2 years I have tried Zoloft, Prozac, Effexor and Cymbalta. Then gave up for 9 months and was on nothing. Found exercise to be effective.
> Then 2 months ago the depression became unbearable - can't get out of bed in the morning, can hardly function, 12 hours of sleep a night and all weekend.
> Dr. put me on Adderall. This seemed to work for a week...Then nothing and still nothing. He added Wellbutrin, which in the past was the one AD that might have worked a bit for me. I am up to 400 mg a day and nothing!! I am exhausted, moody and feel even more depressed. How can this be????
> Is there anything else to try?
> My dr. advised against trying an SSRI or SNRI ever again since they make me zombie-like.
> He also advised against Lamictal.
> This is the 5th psychiatrist I have seen and he is supposed to be very good.
> I have no idea where to go next. Do any of these drugs work???
> Provigil maybe?
> Anyone know of natural supplements? I really felt the most improvement from 1 hour of cardio a day but now feel too tired to do even 5 minutes.
>
> Thanks. Am at a loss. I don't wish depression on anybody....First of all..I am so sorry you are suffering so badly..i've been there and i know it's horrible!
Okay, let me tell you what FINALLY worked for me. I have the same story that you tell, nothing, i mean nothing was working for me! Finally my pdoc put me on 60 mgs. of remeron, 40 mgs. of prozac, and here's what finally did it... he added Lithium as an augmentation agent 300 mgs. bid...and in about 3 week..BAM, i'm no longer depressed! So i say try adding Lithium to your cocktail, as it works great at making your other meds work. I hope this has been helpful. God bless you!
-Dan
Posted by star008 on April 3, 2008, at 18:19:19
In reply to Please help. No med at all is helping me!, posted by alexa35 on April 2, 2008, at 20:08:33
don't give up yet.. there are alot more meds to try.. I hve been on almost all of them.. Efexor worked for a couple of years for me.. I am at the point now where nothing works anymore but you haven't been on that many meds.. Provigl might break the cycle.. Give it a try.. It might get you out of bed long enough to get you miving again.. hang in there
Posted by 4WD on April 3, 2008, at 21:00:10
In reply to Please help. No med at all is helping me!, posted by alexa35 on April 2, 2008, at 20:08:33
Have you considered an MAOI like Nardil? They are supposed to be very effective when all other meds fail. I went through the same merry go round as you with drug after drug and none of them working. I finally got so bad I asked my pdoc to put me on Nardil. I am slowly improving now - not well or anywhwere close to it but I have only been on it for four weeks and 10 weeks is supposed to be a good trial to see whether it will work for you.
Lots of pdoc won't prescribe MAIOs but it never hurts to ask. If all else fails, maybe he/she will consider it for you.
Marsha
Posted by undopaminergic on April 3, 2008, at 21:38:30
In reply to Please help. No med at all is helping me!, posted by alexa35 on April 2, 2008, at 20:08:33
> I've battled depression for years. I'm in CBT therapy 1-2 times each week. The past 5 months the depression is feeling unbearable. Some of this is due to personal things going on and the fact that the company I work for is insane. Past 2 years I have tried Zoloft, Prozac, Effexor and Cymbalta. Then gave up for 9 months and was on nothing. Found exercise to be effective.
> Then 2 months ago the depression became unbearable - can't get out of bed in the morning, can hardly function, 12 hours of sleep a night and all weekend.
> Dr. put me on Adderall. This seemed to work for a week...Then nothing and still nothing. He added Wellbutrin, which in the past was the one AD that might have worked a bit for me. I am up to 400 mg a day and nothing!! I am exhausted, moody and feel even more depressed. How can this be????
> Is there anything else to try?
> My dr. advised against trying an SSRI or SNRI ever again since they make me zombie-like.
> He also advised against Lamictal.
> This is the 5th psychiatrist I have seen and he is supposed to be very good.
> I have no idea where to go next. Do any of these drugs work???
> Provigil maybe?
> Anyone know of natural supplements? I really felt the most improvement from 1 hour of cardio a day but now feel too tired to do even 5 minutes.
>
> Thanks. Am at a loss. I don't wish depression on anybody....
>Amphetamines, and stimulants in general, often stop working due to tolerance. Quitting them for a week or so tends to restore efficacy, but only until tolerance returns. If you're lucky, about 20-30 mg of memantine (Ebixa, Namenda) may be helpful to avoid the tolerance, and allow the stimulant to work more reliably.
Alternatively, a monoamine oxidase inhibitor (MAOI) may be useful. The selegiline transdermal system EMSAM or tranylcypromine (or possibly even rasagiline) are best tried first, before phenelzine, as the latter is associated with several additional side effects (such as weight gain and fatigue) that rarely occur with the other (non-hydrazine) MAOIs.
Addition of a mood stabiliser to an antidepressant regiment - or possibly as monotherapy - is sometimes helpful. Low doses of lithium (up to 300 mg) may be sufficient - high doses tend to be associated with complications (tremor, hypothyroidism, etc.). Lamotrigine and oxcarbazepine are other choices.
Modafinil (Provigil) is probably not useful at this time, since even amphetamines (Adderall) are failing.
Posted by Fivefires on April 4, 2008, at 11:08:55
In reply to Re: Please help. No med at all is helping me!, posted by undopaminergic on April 3, 2008, at 21:38:30
Hi Alexa35.
It sounds like we have the same doc and same problems, although I think I've probably tried a few more meds. I haven't tried lithium, Nardil, or ENSAM. Then, there is mention of a combo w/ Remeron which I've never tried. Frankly, I'm a little scared to try some of the suggested meds.
As psych doc doesn't want me on any AD, to my family doc I posed the question 'What zones in on dopamine?'; he said Wellbutrin and I've been on Wellbutrin-XL 150 a couple wks. Have only noticed a tad bit of feeling 'more grounded'. I'm still very unhappy and spend most of my day in bed.
I read all the followups to your post and you've received A LOT of really good info!
If you care to share, are you confused about what you'd like to try, or, have you made a decision?
I'm so sorry you are suffering; know it is horrible.
bestwishes, 5f
Posted by Jeroen on April 4, 2008, at 19:32:18
In reply to Please help. No med at all is helping me!, posted by alexa35 on April 2, 2008, at 20:08:33
hi, try low dose seroquel its an anti psychotic, but it once worked for me after 2 weeks
my depression was gonem psychosis too, but it pooped out after 2 months and never came back to me
maybe it helps you
if you decide to take twice 100 mg a day AM and PM
Posted by alexa35 on April 4, 2008, at 21:29:10
In reply to Re: Please help. No med at all is helping me!, posted by Fivefires on April 4, 2008, at 11:08:55
Thank you for your message. I'm glad you find at least a little lift from the Wellbutrin.
I am feeling worse and worse and today physically worse as well and like I've gained weight!To be honest, I am scared to try the lithium and those MAO of whatever they are called drugs. My dr. didn't think I would benefit from the older class of drugs. And huge weight gain potential with the Lithium as he knows we need to avoid since I had a bit of an eating disorder once and I did gain weight from SSRIs.
I am really at a loss. This psychiatrist told me many of his patients didn't respond to any antidepressants.
I was thinking Provigil next but someone posted that probably wouldn't help either.I just don't know. I'd do anything to get rid of this depression. Even cardio exercise for 1 hour isn't giving me much relief.
Thanks again and I am sorry you are suffering as well and hope with a couple more weeks the rx will kick in even more and you're able to get up and out. Take care...
Posted by alexa35 on April 4, 2008, at 21:32:21
In reply to Re: Please help. No med at all is helping me!, posted by alexa35 on April 2, 2008, at 20:37:37
I have been given some very good advice on here. Thank you. Unfortunately I have 5 more days to wait to see psychiatrist. This depression is feeling worse. I am not sure if I should just stop the Wellbutrin and Adderall on my own.
I am going to ask about Provigil. Dr. didn't think I would benefit from the older class of antidep's but I'm going to ask him again about others.
Could be I have treatment-resistant depression and no med will really help .:(
Thanks again.
Posted by Phillipa on April 4, 2008, at 21:42:04
In reply to Re: Please help. No med works. Thanks to everyone, posted by alexa35 on April 4, 2008, at 21:32:21
I feel the same way and I have stuck with a lot of ad's for required time. At a loss myself. Yes your doc is honest at least about the fact that some are not helped by antidepressant. Although others on this board might diagree I am not going to play doc on my own. So no excuse but with thyroid disease and history of chronic lymes. Maybe theraphy is all that will help and benzos at least let me sleep some nights. Can't afford weight gain either 62 years old and heart attacks and strokes are what killed all relatives. Also my whole small family consists of people on benzos and some the ad's do something but they don't have the lymes and most not the thyroid. So far my old kids grown seem okay health wise and mentally. Love Phillipa. Hey if you should find answer babblemail me please. Best of luck to you.
Posted by SteelyDan on April 4, 2008, at 23:17:47
In reply to Re: Please help. No med works. Thanks to everyone, posted by alexa35 on April 4, 2008, at 21:32:21
> I have been given some very good advice on here. Thank you. Unfortunately I have 5 more days to wait to see psychiatrist. This depression is feeling worse. I am not sure if I should just stop the Wellbutrin and Adderall on my own.
>
> I am going to ask about Provigil. Dr. didn't think I would benefit from the older class of antidep's but I'm going to ask him again about others.
> Could be I have treatment-resistant depression and no med will really help .:(
> Thanks again.
>Please ask about Lithium. It can make a non responder a responder, by augmenting an antidepressant medication. It also is an antidepressant on it's own. Best wishes.
-Dan
Posted by Jedi on April 5, 2008, at 0:04:39
In reply to Re: Please help. No med works. Thanks to everyone, posted by alexa35 on April 4, 2008, at 21:32:21
Hi again,
I hate to sound like a broken record, but there is a school of thought that if you have atypical depression, and you have not had an adequate trial of Parnate, Nardil or Marplan, then you can not be termed treatment resistant.
Good Luck,
Jedihttp://www.ijpm.org/content/pdf/173/treatmentresistantdep.pdf
...
> Could be I have treatment-resistant depression and no med will really help .:(
> Thanks again.
>
Posted by star008 on April 5, 2008, at 8:02:55
In reply to Re: Please help. No med works. Thanks to everyone, posted by alexa35 on April 4, 2008, at 21:32:21
don't give up yet.. it is way too soon to think u are treatment resistant.. when u have been on almost of of them without a response then you can start thinking that way but try to stay positive right now.. most people can be treated
Posted by alexa35 on April 5, 2008, at 8:10:15
In reply to Re: Please help. No med works. Thanks to everyone » alexa35, posted by Jedi on April 5, 2008, at 0:04:39
Thanks Dan and Jedi-
I do understand what you are suggesting.
I recovered from an eating disorder last year and am *extremely* sensitive to weight gain. Since lithium and the other drugs are known to cause significant weight gain, especially in women, my dr. advised against it. I know gaining weight would just make me feel worse. :(
Posted by Fivefires on April 5, 2008, at 15:56:01
In reply to Re: Please help. No med works. Thanks to everyone, posted by alexa35 on April 4, 2008, at 21:32:21
Alexa, I think I'm experiencing a little increase in my anxiety since beginning Wellbutrin. There have been some IRL issues occur, but still I am curious.
I don't know if this is a side effect; just got on to google it.
Anyway .. I may d.c. it if I find this to be true re: google or maybe others here who have experienced increased anxiety w/ Wellbutrin-XL.
justFYI, 5f
Posted by Fivefires on April 5, 2008, at 16:04:28
In reply to Re: Please help. No med works. Thanks to everyone » alexa35, posted by SteelyDan on April 4, 2008, at 23:17:47
I was hoping someone w/ a prior suggestion would again suggest it here .. way to go SteelyDan.
I don't know if this is an answer for us. I don't know if I've enough courage to try lithium.
If you are saying lithium alongside an AD, I can't recall which AD you suggested, or if I am correct in getting this is what you are saying, SD.
I've got this dang dial-up service so never get to stay online too long, but if you've not time to answer this ?, I'll go up and re-read.
Again, if anyone above is reading this and saying to themselves 'she should listen to me', I think it's real nice to re-post your thoughts.
5f
Posted by alexa35 on April 5, 2008, at 16:18:00
In reply to Re: Please help. No med works. Thanks to everyone, posted by Fivefires on April 5, 2008, at 16:04:28
I went to see my therapist (talk) and she agrees this is probably the worst off I have been with the depression. Psychiatrist can't see me until Tuesday. I stopped the Adderall. On 300 of Wellbutrin. Almost 4 weeks now. I am feeling the MOST depressed I ever have in my life and I have had major depression before. This actually feels scary and I'm anxious about being alone all weekend.
Could tihs drug be making me worse?? I have a message into my drs office but I am not sure he checks on weekends. If anyone can offer advice, please- I don't know why I am spiraling downward like this to the lowest I've ever felt......
Posted by Fivefires on April 5, 2008, at 16:34:32
In reply to Re: Please help. Help - I'm even worse today, posted by alexa35 on April 5, 2008, at 16:18:00
Oh dear.
I think we may be in the same boat alexa35.
I don't think I'm doing better on Wellbutrin-XL 150. It's been two weeks and I'm still pretty much bedridden! There, I said it. I'm admitting to being deeply depressed, probably for one of the first times here.
I do have anxiety medication though. Think already said I felt there's been an increase in this since starting the Wellbutrin-XL.
I want to help you alexa35, but am not sure what to say. Are you having a lot of anxiety, and if so, do you have anxiety medication?
Yesterday I had a 'panic attack' (crushing chest pain) which must have lasted 5+ minutes.
Sure as luck would have it, it's Saturday.
Do you have a call line, a nurse line? I often call mine here.
I'm not a nurse, but if you're experiencing hyperventilating, weakness, or uncontrollable crying, I'd say go to an ER. (I know. I hate 'em too!) Is there any way you can bypass the former where you are?
Pls do what you must to keep yourself comfortable and warm, and try not to panic, and make anyone involved in your healthcare aware of your situation by phone, as well as, maybe calling a nurse line where you can either speak w/ someone clinical, or just someone for listening and talking support.
I'll check back later.
thinkingofu, 5f
Posted by Fivefires on April 5, 2008, at 16:39:28
In reply to Re: Please help. No med works. Thanks to everyone, posted by alexa35 on April 5, 2008, at 8:10:15
Hell!
I'm gonna' end up breaking a rule here pretty soon (three post rule blah blah blah).
Did I tell you I am on Provigil (modafinal)?
I'm following two different posts. o_o
Anyway, I am on this and it is probably the only reason I'm able to post today.
I can't really say any more about being on Provigil right now because it is kind of a sensitive subject and you do have to treat a stimulant w/ respect, but for now it's helping.
I'm not sure it's any 'significant long-term answer', at all.
5f
Posted by alexa35 on April 5, 2008, at 18:11:21
In reply to Re: Please help. Help - I'm even worse today, posted by Fivefires on April 5, 2008, at 16:34:32
Thank you for helping me. I'm glad you admitted it. That's a good step. I had to also to others when I started the rx last month.
Sorry you anxiety is so bad but you should get relief from the anti-anxiety med. I did read Wellbutrin can increase anxiety in some.I dont have much of an anxiety issue...I just feel anxious b/c I'm alone all wknd...Ususally my parents are around (and I am 30!) but it helps and they're not so..
I think it is the med. I never cry and I can't stop crying the past hour. I don't know who to call. It's 7:00 and I'm going to go to bed to try to sleep this off..... My God this is beyond terrible.I'm sorry you're in a similar situation. If you feel worse, please call someone. Maybe I will find someone to call tomorrow.....
Posted by Phillipa on April 5, 2008, at 18:22:49
In reply to Re: Please help. Help - I'm even worse today, posted by alexa35 on April 5, 2008, at 18:11:21
Maybe lower the wellbutrin to l50? Some do better on low doses of meds. Phillipa. Guessing you're asleep now . Rest well.
Posted by Phillipa on April 5, 2008, at 18:26:50
In reply to Re: Please help. No med works. Thanks to everyone » alexa35, posted by SteelyDan on April 4, 2008, at 23:17:47
Dan once worked with a pdoc he gave lithium to most of his patients and didn't like to follow levels he said whatever worked. But he did them if high of course cut back. At the time he was using a lot of paxil. Love Phillipa. ps once even said at PMS time to take a little lithium mixed in water and that would help. A long time ago. But didn't know it could be an ad on it's own.
Posted by Phillipa on April 5, 2008, at 19:15:14
In reply to Re: Please help. No med works. Thanks to everyone, posted by Fivefires on April 5, 2008, at 16:39:28
FF it's three threads not posts to a thread. Love Phillipa
Posted by Fivefires on April 5, 2008, at 20:15:11
In reply to Re: Please help. Help - I'm even worse today, posted by alexa35 on April 5, 2008, at 18:11:21
> Thank you for helping me. I'm glad you admitted it. That's a good step. I had to also to others when I started the rx last month.>
> Sorry you anxiety is so bad but you should get relief from the anti-anxiety med. I did read Wellbutrin can increase anxiety in some.>I thought this might be so.
> I dont have much of an anxiety issue...I just feel anxious b/c I'm alone all wknd...Ususally my parents are around (and I am 30!) but it helps and they're not so.. >
Couple days ago my caseworker or someone over there in the office said it sounds like you're 'just lonely'. Yes, I am lonely, but these problems w/ anxiety and depression surfaced at times in my life when I had a lot of people around me. Actually began in the form of PMS. What followed the PMS was my husband at the time disliking the symptoms of PMS and he left me. I reacted with my first panic attack. Rejection has and has since been very difficult for me.
> I think it is the med. I never cry and I can't stop crying the past hour.>
I've been crying a lot as well.
>I don't know who to call.>
I'd be very surprised if there weren't a crisis line for you to call. You don't have to be suicidal to call a crisis line. The one I call has nurses, therapists, and peers.
>It's 7:00 and I'm going to go to bed to try to sleep this off..... My God this is beyond terrible.>
I really don't want to take my Wellbutrin-XL tonight.
> I'm sorry you're in a similar situation. If you feel worse, please call someone. Maybe I will find someone to call tomorrow.....>
I hope you do find a number, and hope you're sleeping now; always good for you. I'm in an earlier time zone, so not even dark here yet.
Are you aware you are not signed up for the babblemail feature. It would allow you to speak privately w/ another poster. Just wondering.
nite, 5f
Posted by Fivefires on April 5, 2008, at 20:17:33
In reply to Re: Please help. No med works. Thanks to everyone » Fivefires, posted by Phillipa on April 5, 2008, at 19:15:14
Oh ... I guess this is correct Phillipa.
tks, 5f
Posted by Phillipa on April 5, 2008, at 20:45:23
In reply to Re: Please help. No med works. Thanks to everyone, posted by Fivefires on April 5, 2008, at 20:17:33
FF I wouldn't take wellbutrin at night too stimulating for me. Love Phillipa
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