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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by fayeroe on December 17, 2008, at 9:10:29
Someone posted about using a med that started with a D..Deplin? Deylin? Delyin? The poster said it would help with depression and I've come to the end of the road now. Thanks, Pat
Posted by Phillipa on December 17, 2008, at 10:37:36
In reply to Med name? Deylin? Deplin?, posted by fayeroe on December 17, 2008, at 9:10:29
It's Deplin. There is an official website. It's a form of methyl folate. I think Scott was the first to try it. I also tried it. It's kind of a medical food but it's not. Know that confusing. I'd either google the old threads with lots of discussion. And definitely go to official website. It's expensive. Don't know if your insurance covers it mine didn't. All I do know is my pdoc said it can't hurt you. Maybe Scott or someone else will chime in. Phillipa
Posted by Phillipa on December 17, 2008, at 12:31:45
In reply to Med name? Deylin? Deplin?, posted by fayeroe on December 17, 2008, at 9:10:29
Link to official website hope this helps if you haven't done it yet. Phillipa
Posted by fayeroe on December 17, 2008, at 12:43:44
In reply to Re: Med name? Deylin? Deplin? » fayeroe, posted by Phillipa on December 17, 2008, at 12:31:45
Thank you!
Posted by Phillipa on December 17, 2008, at 13:02:31
In reply to Re: Med name? Deylin? Deplin? » Phillipa, posted by fayeroe on December 17, 2008, at 12:43:44
You're welcome hope you let me know if you try it. I wanted so much for it to work for me. Had the three day mark where felt better. Then zip. Oh well there is a poster doing extremly well on it with lamictal. Go for it!!!!!!!! And good luck seriously. Love Phillipa
Posted by JadeKelly on December 17, 2008, at 16:03:49
In reply to Med name? Deylin? Deplin?, posted by fayeroe on December 17, 2008, at 9:10:29
> Someone posted about using a med that started with a D..Deplin? Deylin? Delyin? The poster said it would help with depression and I've come to the end of the road now. Thanks, Pat
There was a recent thread about it, I think Scott started it. Good luck!
~Jade
Posted by fayeroe on December 17, 2008, at 16:15:50
In reply to Re: Med name? Deylin? Deplin?, posted by JadeKelly on December 17, 2008, at 16:03:49
Posted by SLS on December 18, 2008, at 7:02:17
In reply to Med name? Deylin? Deplin?, posted by fayeroe on December 17, 2008, at 9:10:29
Probably Deplin. Deplin was approved for use as an add-on treatment to antidepressants to treat depression early this year. It worked for me, but only for a short-while. That is not to say that you will respond the same way. Maybe you will find it a more stable treatment than I did. The stuff is, for the most part, harmless. L-methylfolate (Deplin) is a naturally occurring vitamin substance that is synthesized in the body from folic acid. It basically allows the body to skip this slow process in forming L-methylfolate.
> ...and I've come to the end of the road now.
I am sure that it feels that way. I doubt you have much reason to think otherwise. It always seems that one has tried everything by the point you have reached. However, this is probably not the case.
Here is an example of polypharmacy in action:
My current treatment regime:
Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mgI have proven methodically that I need each of these drugs at the dosages indicated. If I attempt to remove any one of them or reduce their dosage, I relapse.
There is sometimes no such thing as being "close enough" when evaluating a drug combination. I guess what I am trying to say is that if you have already tried the first three drugs in combination, you are still leaving out the fourth drug that may act to unlock the door and allow for recovery.
To further my case for you not to give up, I challenge you to report that you combined the first two drugs. Remember, as you consider combinations of even three different drugs, the number of permutations seems limitless.
- Scott
Posted by fayeroe on December 18, 2008, at 9:17:17
In reply to Re: Med name? Deylin? Deplin? » fayeroe, posted by SLS on December 18, 2008, at 7:02:17
"My current treatment regime:
Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mgI have proven methodically that I need each of these drugs at the dosages indicated. If I attempt to remove any one of them or reduce their dosage, I relapse.
There is sometimes no such thing as being "close enough" when evaluating a drug combination. I guess what I am trying to say is that if you have already tried the first three drugs in combination, you are still leaving out the fourth drug that may act to unlock the door and allow for recovery.
To further my case for you not to give up, I challenge you to report that you combined the first two drugs. Remember, as you consider combinations of even three different drugs, the number of permutations seems limitless."
Scott, right now I am on Lamictal and Wellbutrin with Trazadone for sleep.
When I was first diagnosed with "depression", I was put on amitriptyline and it worked for years. Is it similiar to nortriptyline 150mg. I'm sorry that I'm asking you to explain this but I have to go to the dentist and then I have my Pdoc at 1:00 p.m.
I'll try any combination. If you know me well, you know that I won't give up immediately on a drug. I wait a reasonable amount of time to see if it will work for me.
I'm taking your list with me to Pdoc. Lately he has been impatient with me...I can't help it if I am still depressed. I'd rather be playing in the street than feeling as I do now. :-(
Thanks for your advice and encouragement. I gotta to to Bastrop.
Pat
Posted by SLS on December 18, 2008, at 10:01:28
In reply to Re: Med name? Deylin? Deplin? » SLS, posted by fayeroe on December 18, 2008, at 9:17:17
> Scott, right now I am on Lamictal and Wellbutrin with Trazadone for sleep.
That is actually a very good combination. Not for you, obviously, but it does show that someone knows what they are doing. My doctor has had much success with Wellbutrin 300mg and Lamictal 200mg.
> When I was first diagnosed with "depression", I was put on amitriptyline and it worked for years. Is it similiar to nortriptyline 150mg.
When the body breaks down amitriptyline, the result is nortriptyline. Nortriptyline is the daughter drug, and appears in the blood stream along side the amitriptyline. Nortriptyline is "cleaner" and more forgiving with regard to side effects. I would think that your chances to respond to nortriptyline would be better than to desipramine, given your history. The average dosage for someone is 75mg. Some people metabolize the drug at a higher rate (rapid metabolizers), and must take higher dosages. However, blood tests assaying nortriptyline are well studied and have yielded the observation that the effective range for blood levels are between 50-150 ng/ml. Even so, this is just a guideline. You really do have to titrate the drug clinically, just as you would with any other drug.
Has Wellbutrin 300mg helped at all? If it has, I would leave it in place and try adding Effexor 300mg or Lexapro 40mg to it, so long as you can tolerate the higher dosages.
Stephen Stahl, MD, PhD has had success with combining a TCA with an SSRI or SNRI. The TCAs of choice are nortriptyline and desipramine, as they are the most noradrenergic (NE) and least serotonergic. I have no impression of the effectiveness of combining Wellbutrin with a TCA, but I do not see why it wouldn't be safe to do so. Unless you are susceptible to seizures or are electrolytically comprimised, there should be no contraindication.
Good luck with your appointment today. If you haven't already considered adding an atypical neuroleptic (antpsychotic), it might be time to discuss this with your doctor. Abilify and Geodon are probably the most antidepressant-like of the breed.
- Scott
Posted by fayeroe on December 18, 2008, at 10:19:18
In reply to Re: Med name? Deylin? Deplin? » fayeroe, posted by SLS on December 18, 2008, at 10:01:28
> > Scott, right now I am on Lamictal and Wellbutrin with Trazadone for sleep.
>
> That is actually a very good combination. Not for you, obviously, but it does show that someone knows what they are doing. My doctor has had much success with Wellbutrin 300mg and Lamictal 200mg.
>
> > When I was first diagnosed with "depression", I was put on amitriptyline and it worked for years. Is it similiar to nortriptyline 150mg.
>
> When the body breaks down amitriptyline, the result is nortriptyline. Nortriptyline is the daughter drug, and appears in the blood stream along side the amitriptyline. Nortriptyline is "cleaner" and more forgiving with regard to side effects. I would think that your chances to respond to nortriptyline would be better than to desipramine, given your history. The average dosage for someone is 75mg. Some people metabolize the drug at a higher rate (rapid metabolizers), and must take higher dosages. However, blood tests assaying nortriptyline are well studied and have yielded the observation that the effective range for blood levels are between 50-150 ng/ml. Even so, this is just a guideline. You really do have to titrate the drug clinically, just as you would with any other drug.
>
> Has Wellbutrin 300mg helped at all? If it has, I would leave it in place and try adding Effexor 300mg or Lexapro 40mg to it, so long as you can tolerate the higher dosages.Wellbutrin at 300 almost drove me crazy. My ears rang and I feel like I was on speed. And my depression stayed at the level that I am used to.
>
> Stephen Stahl, MD, PhD has had success with combining a TCA with an SSRI or SNRI. The TCAs of choice are nortriptyline and desipramine, as they are the most noradrenergic (NE) and least serotonergic. I have no impression of the effectiveness of combining Wellbutrin with a TCA, but I do not see why it wouldn't be safe to do so. Unless you are susceptible to seizures or are electrolytically comprimised, there should be no contraindication.
>
> Good luck with your appointment today. If you haven't already considered adding an atypical neuroleptic (antpsychotic), it might be time to discuss this with your doctor. Abilify and Geodon are probably the most antidepressant-like of the breed.I was on Effexor 75 mg, 4 years ago, and I lost 38 lbs. I was only eating about every third day. Getting off of it was hell. I'm 5' and 110 and we have to be very careful with my dosages due to my size.
Thanks, again, Scott. I'm off.
>
>
> - Scott
>
Posted by fayeroe on December 21, 2008, at 18:53:31
In reply to Re: Med name? Deylin? Deplin? » SLS, posted by fayeroe on December 18, 2008, at 10:19:18
Posted by Partlycloudy on December 22, 2008, at 14:43:36
In reply to Pdoc added Buspar... (nm) » fayeroe, posted by fayeroe on December 21, 2008, at 18:53:31
Posted by fayeroe on December 22, 2008, at 14:46:13
In reply to Hope that works for you! (nm) » fayeroe, posted by Partlycloudy on December 22, 2008, at 14:43:36
This is pretty amazing. We talked about my pain causing so much anxiety. How it becomes a vicious circle. Anxiety causes the pain.
The Buspar has lowered my level of anxiety about 90%. My pain has also lowered very much. I don't feel as depressed due to the lack of pain and anxiety.
Cooler than sliced bread, eh?
Posted by Partlycloudy on December 22, 2008, at 17:20:42
In reply to Re: Hope that works for you! » Partlycloudy, posted by fayeroe on December 22, 2008, at 14:46:13
Sounds like that whole mind-body connection thing working the way it's supposedly to, blessedly.
That's wonderful news on both fronts.
pc
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