![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 47. Go back in thread:
Posted by garnet71 on February 26, 2009, at 10:53:50
In reply to Re: Being Med-Sensitive. » SLS, posted by raisinb on February 26, 2009, at 10:29:38
"I say I'm "sensitive" because nobody else I've talked to has had such an extreme reaction to WB. I was only on 100 mg when this happened."
Wow, I would agree that's pretty sensitive. It didn't do all that for me even at 450 mg. From what you wrote, however, I can say I had your effect but maybe 1/10 of the intensity you described; in other words, it made me feel normal again.
What I find very interesting about your situation is that you didn't display amplified negative side effects (such as severe anxiety and agtitation), but amplified positive effects of Wellbutrin.
Posted by raisinb on February 26, 2009, at 16:14:17
In reply to Re: Being Med-Sensitive. » raisinb, posted by garnet71 on February 26, 2009, at 10:53:50
In a way, I was lucky, because it rocketed me out of a suicidal depression in about three days, but it definitely wasn't workable for more than a few weeks.
The doctor added Zoloft, and all the excessive side effects went away. I felt good, but much more normal.
When I describe what it was like to people who know, they say, "sounds just like cocaine!" Makes sense. Both are about a lot of extra dopamine.
Posted by bleauberry on February 26, 2009, at 17:50:01
In reply to Re: Being Med-Sensitive., posted by NewQuestions on February 26, 2009, at 8:16:40
> Do you think you should just stop taking everything and let the body heal?
Well, actually I'm not taking anything, so there is nothing to stop. And except for short little attempts at things in the last 2 years, I have basically not been taking anything.
Do I believe the body can heal? No. If you think about it, we were sick before we ever started on the road of medications, right? That is the place we would probably return to, not a place of being healed.
I feel as if my body is stuck in a place of illness that is too strong to break out of, and that it will take force by way of medication or supplement to break the cycle. That will require tiny starting doses, trying many things to find what is tolerable, and looking at a titrating journey and a healing journey much longer than the average person.
But then again, when someone is med sensitive, it doesn't require normal therapeutic doses to work. Tiny doses can work very well. We are sensitive not only to the bad, but the good also.
I saw at another forum a woman who is very sensitive. She is completely well on 3mg Lexapro. That's right, 3 (three) mg. She takes it in liquid drops to measure it that accurately. She says 4mg makes her more depressed, and 2mg isn't enough to work. 3mg is her magic dose.
THAT is med sensitivity.
Posted by bleauberry on February 26, 2009, at 17:54:20
In reply to Being Med-Sensitive., posted by SLS on February 22, 2009, at 13:31:50
Hi Scott,
I shared some thoughts on sensitivity in a couple other posts in this thread. To kind of highlight it all, I wanted to re-share this example.
A woman at another forum does very well on her Lexapro. 3mg Lexapro. Liquid form, taken in drops. 4mg makes her a lot more depressed. 2mg isn't enough to work. 3mg she is depression free. Heck, 3mg, most people wouldn't even hardly feel that at all any more than a sugar pill.
Now THAT is med sensitivity. :-)
I'm the same way.
Posted by NewQuestions on February 27, 2009, at 9:29:05
In reply to Re: Being Med-Sensitive. » SLS, posted by bleauberry on February 26, 2009, at 17:54:20
Anything your NOT sensitive to?
Posted by SLS on February 27, 2009, at 9:44:54
In reply to Re: Being Med-Sensitive. » SLS, posted by bleauberry on February 26, 2009, at 17:54:20
Hi Bleauberry.
When you first departed on your odyssey of treatment with antidepressants, were you med-sensitive?
Do you have an example of a drug that you were once able to take in large amounts for which you cannot take now?
Thanks.
- Scott
Posted by bleauberry on February 27, 2009, at 17:17:59
In reply to Re: Being Med-Sensitive. » bleauberry, posted by SLS on February 27, 2009, at 9:44:54
> Hi Bleauberry.
>
> When you first departed on your odyssey of treatment with antidepressants, were you med-sensitive?
>
> Do you have an example of a drug that you were once able to take in large amounts for which you cannot take now?
>
> Thanks.
>
>
> - ScottWell, let's see, the first ever was Paxil at 10mg for a week and then 20mg after that and then 30mg. Except for the obvious sexual problems, piece of cake.
Prozac 10mg for 4 days then 20mg. A slight bit of the prozac jitters for a couple weeks and the sleep problems, but basically a pretty mild introduction to a new med.
In my early psych journey, normal doses of just about anything felt rather benign overall.
Zyprexa 5mg smooth as could be.
3 or 4 large coffees a day no prob.
But after about 8 years, all that changed fairly rapidly within a timeframe of perhaps 6 months. The first I noticed was a progressing intolerability of my usual coffee. After that it just all progressed downhill fast.
What am I NOT sensitive to? Hmmm. That's a tough one. Well, Ibuprofen is fine. Olive Leaf Extract is fine (a potent herbal antimicrobial/anti-inflammatory). I seem ok with modest doses of vitamin D or vitamin E, a modest dose of selenium or zinc, but not at all tolerable of any of the other minerals, and especially not tolerable at all in any way to B vitamin supplementation at any dose. The absolute worst are Bs, magnesium, and lithium. I recently tried SAMe for 2 days at 200mg and it was tolerable just fine other than the headache, and its rapid acute antidepressant and antipain effect was a surprise.
I have no idea if this is more anecdotal suggestive evidence of a longterm ssri syndrome, or perhaps a pathology of Lyme or Lyme-like (my LLMD sees this with nearly all his patients), a pathology of exposure to unusually large amalgams (not that many at chelation forums seem sensitive like me), or a combination of all the above.
It is a very frustrating situation because it seriously limits the ability to try things, regardless if they are vitamins, herbs, or medicines. The only good side is that if there is to be any benefit from a supplement, it is noticed quickly and at a tiny dose. Example, milnacipran at a mere 6mg bid deserved a standing ovation in producing perhaps a 30% improvement from baseline in under 2 weeks. Heck, that is half the starting dose.
Posted by zzzz7 on February 28, 2009, at 18:24:32
In reply to Re: Being Med-Sensitive., posted by SLS on February 23, 2009, at 16:17:59
SLS, this is from a post I made two months ago. I have a case similar to that of NewQuestions'. Right now, I'm off SRIs totally, and when I get depressed .1mg of Requip works immediately.
From 1997 to 2006 I was on large amounts of SRI drugs. At various points, I was on 400mg clomipramine with 100mg Luvox, 110mg Prozac, 100mg Prozac and 400mg ProVigil, and the like.
in 2006 I entered a deep depression after a sporting injury that caused me to go from a high level of physical activity to none at all for several months. To get out of it, I pushed serotonin levels even higher than I had before. I assumed that drugs were pooping out on me. I even added small amounts of 5HTP. All of this seemed to make things even worse. I backed way off when I developed signs of serotonin syndrome. As I backed off, I felt better. The lower I went, the better I felt. I went down to 1mg Lexapro for a while. I felt better, but still slightly depressed. Then, all the way down to two sand-sized grains of Lexapro. Finally relief. I experimented some more by going off SRIs altogether (in this case Lexapro). The depression came back. So, apparently I'm hyper-sensitive to serotonin (and the same turns out to be case for DA; I found this out by decreasing doses of amatadine to lower serotonin levels when I had taken too much of the SRI).
The problem is that something like exercising will increase DA levels such that I get depressed. One grain too much on Lexapro, I get depressed. I sit on this knife's edge between DA and 5HT, and it's tough not to fall off one side.
Posted by zzzz7 on February 28, 2009, at 18:26:36
In reply to Re: Being Med-Sensitive., posted by bleauberry on February 27, 2009, at 17:17:59
beauberry, are you able to see a common thread in terms of effects of various substances on neurotransmitters?
I've not had problems with things that don't affect dopamine or serotonin.
Posted by bleauberry on February 28, 2009, at 19:12:25
In reply to Re: Being Med-Sensitive., posted by zzzz7 on February 28, 2009, at 18:26:36
> beauberry, are you able to see a common thread in terms of effects of various substances on neurotransmitters?
>
> I've not had problems with things that don't affect dopamine or serotonin.Well, actually with me it seems the there are some categories that help...
Milnacipran with its 3:1 norepinephrine to serotonin balance. Even so, I can only take 1/2 of the introductory starting dose.
Antibiotics make me a lot worse for a couple weeks and then a lot better. Definintely a chronic infection going on. Nearly impossible to diagnose these things, but reactions to blind antibiotic challenge trials tell the unseen story.
SAMe is a darn good antidepressant and works really fast. While it is claimed it increases serotonin and dopamine, I would strongly bet it does not. If it did, believe me, I would know, same as you. It does something else...changes in gene expression, more fluidity in receptors, more receptiveness of receptors, detoxing unknown bodily contaminants, stuff like that.
DMSA is a lead/mercury chelator. I have done 10 rounds of low dose frequent dose for 4 to 7 days each round. Every single round there have been 2 days of incredible improvement. I cannot figure out if it is because I am clearing out a layer of toxic metals, or if I am responding positively to the addition of a strong sulfur source. Coincidentally, SAMe also is a sulfur source.
So anyway, yeah, any psych drug that is pro-serotonin or pro-dopamine is bad business and tricky business for me. But norepinephrine, antibiotics, metal chelators, and good ole SAMe feel a heck of a lot better than $20,000 worth of what the psych world can offer me.
Kind of makes one wonder why the medical profession doesn't expand depression treatment outside the limited confines of psychiatry. Lots of things mess up the brain that no amount of serotonin will fix and can instead make it worse.
Posted by zzzz7 on February 28, 2009, at 19:19:00
In reply to Re: Being Med-Sensitive. » zzzz7, posted by bleauberry on February 28, 2009, at 19:12:25
That's interesting; NE should affect DA and 5HT levels indirectly.
What about Lamictal?
Are the antibiotics Sulfa? Could they be affecting the levels of another drug you're taking via inhibition of a P450 enzyme? Is your white cell count up in a way that would indicate an infection?
Posted by SLS on March 1, 2009, at 7:14:52
In reply to Re: Being Med-Sensitive. » SLS, posted by zzzz7 on February 28, 2009, at 18:24:32
> when I get depressed .1mg of Requip works immediately.
This might be reaching a bit, but have you tried Abilify? It is a unique drug in that it acts as a dopamine receptor partial agonist at D2 and D3. It is supposed to stabilize the synapse. It would be like effectively mixing Zyprexa and Requip. They do not cancel each other out.
- Scott
Posted by SLS on March 1, 2009, at 7:21:06
In reply to Re: Being Med-Sensitive. » zzzz7, posted by bleauberry on February 28, 2009, at 19:12:25
I asked my doctor what he thought of the development of med-sensitivity. His knee-jerk reaction was to suggest that it might mean that the patient no longer needs a particular drug mechanism of action. Essentially, you wouldn't need an SSRI anymore because the system is already corrected to its capacity. I'm not sure I agree with him on that one, but to be fair, he only had a few seconds to think about it as I was walking out the door.
- Scott
Posted by SLS on March 1, 2009, at 7:22:13
In reply to Re: Being Med-Sensitive. » zzzz7, posted by bleauberry on February 28, 2009, at 19:12:25
Hi Bleauberry.
Are you now sensitive to Stablon (tianeptine)?
- Scott
Posted by zzzz7 on March 1, 2009, at 15:46:31
In reply to Re: Being Med-Sensitive., posted by SLS on March 1, 2009, at 7:21:06
Thanks, Scott. I have tried Abilify; it makes me feel worse. I wish your pdoc were right. I need tiny amounts of these drugs. My brain reacts to them as though it were a normal dose for a normal person. And if I take, say, .05mg rather than .1mg of Lexapro, it's as if someone normal went from 10mg to 5mg.
The one drug that has helped me is Lamictal, though it's pretty side-effect heavy for me on the cognitive side.
Posted by bleauberry on March 1, 2009, at 17:21:30
In reply to Re: Being Med-Sensitive. » bleauberry, posted by SLS on March 1, 2009, at 7:22:13
> Hi Bleauberry.
>
> Are you now sensitive to Stablon (tianeptine)?
>
>
> - ScottInteresting question. Actually, I was able to start with 1 pill first day. Fine. Two pills second day. Fine. And the full dose by day 3. No problem in toleration. No apparent sensitivity with Stablon.
It just didn't do anything good for me is the only problem with it. Each day over a 3 week period I got a little more depressed than the previous day until it was just getting really bad compared to where I had started and really there was no genius needed to say stop. Other than that, it was fairly invisibile in terms of side effects of sensitivity.
Posted by SLS on March 1, 2009, at 19:08:56
In reply to Re: Being Med-Sensitive., posted by zzzz7 on March 1, 2009, at 15:46:31
> Thanks, Scott. I have tried Abilify; it makes me feel worse. I wish your pdoc were right. I need tiny amounts of these drugs. My brain reacts to them as though it were a normal dose for a normal person. And if I take, say, .05mg rather than .1mg of Lexapro, it's as if someone normal went from 10mg to 5mg.
I hate losing.
1. Have you ever tried St. John's Wort (SJW)?
2. How about a tricyclic with mild serotonin effect: nortriptyline.
3. Has ADD ever been mentioned as a diagnosis?
- Scott
Posted by SLS on March 1, 2009, at 19:15:33
In reply to Re: Being Med-Sensitive. » SLS, posted by raisinb on February 26, 2009, at 10:29:38
Hi.
Sorry to not be keeping up with this thread, but my energy and concentration have been lacking.
If you can get Wellbutrin to produce mania, you are half-way there. Depression is generally harder to treat than mania. Here, you would treat the mania rather than remove the antidepressant. For instance, you could try a variety of anticonvulsant mood stabilizers. Depakote would be my first choice of one of these drugs. The other option would be to use an antipsychotic like Abilify or Seroquel to stabilize the mood and squash the mania.
- Scott
Posted by Phillipa on March 1, 2009, at 19:42:05
In reply to Re: Being Med-Sensitive. » raisinb, posted by SLS on March 1, 2009, at 19:15:33
Does that advise also apply to me as manic on 150mg of wellbutrin with benzos? Love Phillipa
Posted by raisinb on March 1, 2009, at 19:54:33
In reply to Re: Being Med-Sensitive. » raisinb, posted by SLS on March 1, 2009, at 19:15:33
That is a very interesting idea--and the exact opposite of the approach my pdoc took. My pdoc was very strongly opposed to me continuing Wellbutrin at all, even though it was working well with Zoloft. She said it was responsible for my insomnia (I have had insomnia for 10 years--I don't think WB was the sole cause).
Anyway, I'm doing fine on a Zoloft/Lexapro combo, but I notice that my happiness level is not what it was when I was taking the Wellbutrin. "Welloft" seemed to be an almost magical combination--weight loss and insomnia aside.
After months of being suicidal, that rush of dopamine with the first couple pills was really something.
Posted by zzzz7 on March 1, 2009, at 23:41:08
In reply to Re: Being Med-Sensitive. » zzzz7, posted by SLS on March 1, 2009, at 19:08:56
Hi Scott,
1. Have you ever tried St. John's Wort (SJW)?
No. I'm afraid of its MAOI properties.
2. How about a tricyclic with mild serotonin effect: nortriptyline.
I've had protryptline to try to get the ACH effects as well the effects on NE. Also, I've tried imipramine. Both depressed me in any amount at all.
3. Has ADD ever been mentioned as a diagnosis?
No. I'm pretty certain I'm not ADD. OCDish, though.
Thanks.
Posted by zzzz7 on March 1, 2009, at 23:46:38
In reply to Re: Being Med-Sensitive. » SLS, posted by raisinb on March 1, 2009, at 19:54:33
Why not cut down on the Wellbutrin or add another dopaminergic drug (Requip or amantadine) in its place? You can do small amounts of regular buproprion, esp. if you're on an anti-convulsant.
Posted by NewQuestions on March 2, 2009, at 8:00:17
In reply to Re: Being Med-Sensitive. » raisinb, posted by zzzz7 on March 1, 2009, at 23:46:38
What about hormones? HGH? Would you be sensitive to that?
Also, how about ldn?
Posted by NewQuestions on March 2, 2009, at 10:02:50
In reply to Re: Being Med-Sensitive-beauberry, posted by NewQuestions on March 2, 2009, at 8:00:17
Have you confirmed you have lyme disease or mecury poisoing or is it just a theory?
Posted by NewQuestions on March 2, 2009, at 10:46:41
In reply to Re: Being Med-Sensitive-beauberry, posted by NewQuestions on March 2, 2009, at 10:02:50
Beauberry--my most distressing symptom right now is major confusion, lack of ability to learn, lack of concentration, memory loss. I feel like my hard drive has been erased--major vacancy.
I think it is either from protracted withdrawal off of a SSRI or a side effect of the benzo I am on (which I am tapering off). Can you relate to this?
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.