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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by mav27 on March 19, 2009, at 23:30:25
Ok sorry but this is a general rant post. I'm really reaching my limit on what i can put up with. lately It's been my body more than my mind that has been the problem, just no energy and it feels like i've always just finished a 10 hour heavy weightlifting session.
Anyways for some stupid reason ssri's don't do anything anymore.. and i mean nothing... not even side effects, not the initial neusea, insomnia.. or sexual dysfunction ect which i used to get even on the smallest dose possoble. Today i took a heap of luvox and parnate and still nothing what so ever.. i can't get any feeling from anti-depressants anymore... it's beyond a joke.
Posted by Phillipa on March 20, 2009, at 0:08:32
In reply to Why the hell does nothing work the same anymore, posted by mav27 on March 19, 2009, at 23:30:25
Mav please don't combine an Maoi with SSRI's that's very dangerous. Seriously I care. Love Phillipa
Posted by mav27 on March 20, 2009, at 0:56:02
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by Phillipa on March 20, 2009, at 0:08:32
> Mav please don't combine an Maoi with SSRI's that's very dangerous. Seriously I care. Love Phillipa
Don't worry, i'm not lucky enough for anything bad to happen. i've tried everything... for some reason god is keeping me alive to torture me some more.
Posted by SLS on March 20, 2009, at 7:16:41
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by Phillipa on March 20, 2009, at 0:08:32
> Mav please don't combine an Maoi with SSRI's that's very dangerous. Seriously I care. Love Phillipa
Agreed.
If you are endowed with any kind of luck, combining Parnate with a SRI is certainly pushing it. You probably haven't yet reached significant MAO inhibition from Parnate to have had much effect. This would temporarily allow you to combine it with Luvox without adverse events.
Serotonin Syndrome. Almost guaranteed to occur when combining MAOI + SRI. Can be fatal. No kidding.
- Scott
Posted by JadeKelly on March 20, 2009, at 11:12:09
In reply to Re: Why the hell does nothing work the same anymore » Phillipa, posted by mav27 on March 20, 2009, at 0:56:02
Hi Mav,
>
>"Don't worry, i'm not lucky enough for anything bad to happen. i've tried everything... for some reason god is keeping me alive to torture me some more."I hope thats a joke. My brother and I used to say the same thing. We've decided were really cockroaches and when all is destroyed and gone, we will still be here crawling out of the rubble. Darn resilience!
I was wondering what dose Parnate, how long, have you been on it before (how long and did it work), and what current meds you are on. Any augments yet with the Parnate?
And please, don't go mixing stuff just because you've been lucky thus far! Luck runs out and could be just before you find the right thing.
Don't be irony's victim ;-)
Would really like to hear what's up with current meds! Hope you'll post back.
~Jade
Posted by Phillipa on March 20, 2009, at 12:42:54
In reply to Re: Why the hell does nothing work the same anymore » Phillipa, posted by mav27 on March 20, 2009, at 0:56:02
Mav I know you will be posting back understand the frustration when you've been on so many meds and they don't work. Can you name them. Sorry if you've done this before. We're you on nardil and parnate for quite a while? Hard to remember. Love Phillipa
Posted by mav27 on March 20, 2009, at 12:50:07
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by JadeKelly on March 20, 2009, at 11:12:09
I've never ben able to take abonve 40mg of parnate before because i just faint non stop from low blood pressure.. 10 and 20mg knocks me out to sleep forhours which is the opposite to wha i need, i'm currently sleeping around 21hours without meds. I've had 3 attempts on parnate and 3 on nardil but theyboth caused too many problemswith m blood pressure so i had to give up.
Right now i'm on luvox, just 100mg a day so far. I've had enough of feeling so crap though so right now i feel dead anyway.
I recently talked to my gp i've known for 8 years, i hadn't seen him for a couple years now because he moved away... he agreed with me that stimulants sound perfect for my condition and was upset as well when i explained how i had bought it up to the pdoc's before and even they have aggreed but thanks for sate law they just don't get prescribed to people over 18 :(
They also won't allow anything to be prescribed to augment maoi's.. in fact 90%of the doctor in the hospital here didn't even know how to spell phelenzine let alone anything else about it.. the medical system sucks balls where i live but i don't have a choice to move away so i'm stuck with it.
Posted by mav27 on March 20, 2009, at 15:03:15
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by Phillipa on March 20, 2009, at 12:42:54
> Mav I know you will be posting back understand the frustration when you've been on so many meds and they don't work. Can you name them. Sorry if you've done this before. We're you on nardil and parnate for quite a while? Hard to remember. Love Phillipa
Yeah i had many attempts at nardil and parnate over a few years, my body just couldn;t handle it though, my blood pressure would be so low that i just couldnt remain standing.
Other things ive tried is all the ssri's, the snri's, reboxetine, mirtazapine, moclobemide all the TCA's (except desipramine because you cant get it in australia) umm seroquel, risperdal, zyprexa, stelazine, melleril, haldol, ziprasidone, aripiprazole, all the benzos avail in australia, sodium valproate, wellbutrin, betaloc (beta blocker) clonadine (as an experiment)
So far i've learnt that anything that touches noradrenaline lowers my bp and leaves me lethargic and sore, seratonin makes me feel like an emotionless zombie, antipsychotics makes me want to dril open my head and suck the stuff out of my brain and benzos seem to have little effect.
My dx's are depression, and social phobia and what could be either atypical depression or borderline personality disorder. i don't have any psychotic symptomns of any kind though thankfully.
Recently had a cat scan as well as a billion blood tests to check it wasn't something else causingmy problems, everything was fine other than the kidney results but they wern't serious, my thyroid levels are fine but twice now in the last 6 years i have returned results of low levels (enough for the results to show a red warning about being too low) but they always return to normal a week later. Unfortunatly T3 augmentation isn't done here which is something i would have ovd to have tried.
Posted by linkadge on March 20, 2009, at 18:42:31
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by JadeKelly on March 20, 2009, at 11:12:09
Maybe a 'harder' combo is not what you need. Perhaps a smarter combo would be effective.
Linkadge
Posted by bleauberry on March 20, 2009, at 20:22:49
In reply to Re: Why the hell does nothing work the same anymore, posted by SLS on March 20, 2009, at 7:16:41
Serious stuff here. I think it deserves mention that the proper term for the deadly surprise attack you have flirted with is Serotonin Toxicity, not Serotonin Syndrome. It is not a syndrome. It is a toxic poisoning.
Symptoms come on very rapidly without warning. All can seem fine, and then all of a sudden. And if you don't get to a hospital fast, and they don't recognize what is happening, you're dead.
To get a full education on the topic, go to PsychoTropical Research. Dr Gillman gives details on the causes, symptoms, seriousness, and treatment of Serotonin Toxicity. Combination of Parnate with any SSRI is the most common and the most powerful cause of it.
To your original topic...What have you not tried? How about that route? A TCA like Amitriptyline or Nortriptyline or Desipramine in combination with Zoloft for example? I mean, if serotonin alone isn't doing anything, then get some Norepinephrine involved. If Parnate alone hasn't done it, then reconsider the dose. Some people need unususally large doses of it. Wait a week though to let all the Luvox be completely gone.
> > Mav please don't combine an Maoi with SSRI's that's very dangerous. Seriously I care. Love Phillipa
>
> Agreed.
>
> If you are endowed with any kind of luck, combining Parnate with a SRI is certainly pushing it. You probably haven't yet reached significant MAO inhibition from Parnate to have had much effect. This would temporarily allow you to combine it with Luvox without adverse events.
>
> Serotonin Syndrome. Almost guaranteed to occur when combining MAOI + SRI. Can be fatal. No kidding.
>
>
> - Scott
Posted by mav27 on March 20, 2009, at 20:38:23
In reply to Re: Why the hell does nothing work the same anymore, posted by bleauberry on March 20, 2009, at 20:22:49
> Serious stuff here. I think it deserves mention that the proper term for the deadly surprise attack you have flirted with is Serotonin Toxicity, not Serotonin Syndrome. It is not a syndrome. It is a toxic poisoning.
>
> Symptoms come on very rapidly without warning. All can seem fine, and then all of a sudden. And if you don't get to a hospital fast, and they don't recognize what is happening, you're dead.
>
> To get a full education on the topic, go to PsychoTropical Research. Dr Gillman gives details on the causes, symptoms, seriousness, and treatment of Serotonin Toxicity. Combination of Parnate with any SSRI is the most common and the most powerful cause of it.
>
> To your original topic...What have you not tried? How about that route? A TCA like Amitriptyline or Nortriptyline or Desipramine in combination with Zoloft for example? I mean, if serotonin alone isn't doing anything, then get some Norepinephrine involved. If Parnate alone hasn't done it, then reconsider the dose. Some people need unususally large doses of it. Wait a week though to let all the Luvox be completely gone.
>
>I can't handle anything with noradrenaline.. it makes me agitated, angry , lowers BP seriously, causing fainting spells and causes sexual dysfunction where it feels like someone stabbing me through the prostate with a knife. It also takes away all my energy making me very lethargic even though it's generally considered to be involved in giving energy rather than taking it.
Seratonin just kills all emotions and makes me very sleepy as well as the usual sexual dysfunction (impossible to reach orgasm) It relieves depression but also kills any happiness iam able to feel which meansno more smiling or laughing which iam at least able to do when not on AD's even if iam suicidal.
I know all abut seratonin syndrome... to be perfectly honest i was hoping it would kill me, i knew it wuldn;t though because iam not that lucky.
Also nothing is allowed to be combined with MAOIS's here, and TCA's can't be mixed with SSRI's (or similar). We are quite backwards here in AUS.
Posted by JadeKelly on March 20, 2009, at 21:00:11
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by mav27 on March 20, 2009, at 12:50:07
> I've never ben able to take abonve 40mg of parnate before because i just faint non stop from low blood pressure.. 10 and 20mg knocks me out to sleep forhours which is the opposite to wha i need, i'm currently sleeping around 21hours without meds. I've had 3 attempts on parnate and 3 on nardil but theyboth caused too many problemswith m blood pressure so i had to give up.
>
> Right now i'm on luvox, just 100mg a day so far. I've had enough of feeling so crap though so right now i feel dead anyway.
>
> I recently talked to my gp i've known for 8 years, i hadn't seen him for a couple years now because he moved away... he agreed with me that stimulants sound perfect for my condition and was upset as well when i explained how i had bought it up to the pdoc's before and even they have aggreed but thanks for sate law they just don't get prescribed to people over 18 :(
>
> They also won't allow anything to be prescribed to augment maoi's.. in fact 90%of the doctor in the hospital here didn't even know how to spell phelenzine let alone anything else about it.. the medical system sucks balls where i live but i don't have a choice to move away so i'm stuck with it.I see. Mav I know you are in misery but may I say that I actually did laugh out loud when I read your post. Very colorful.
Okay. I've never heard of a state that "can't" prescribe ritalin to an adult. I was just like you sound Mav. I couldn't get out of bed, my limbs felt like I had cement blocks attached, and I didn't want to leave my room or see anyone. Sound familiar? The low BP you are experiencing will disappear with Ritalin as an augmentor. There's another argument for the need. What state are you in? Ritalin is a whole lot easier to get prescribed than Parnate from what I've seen, so if you can find the right PDoc. Well, Mav, not if, you have to. You can't continiue the way you are. I know because I was there too. Okay?!
This is your mission: Find a PDoc to augment that Parnate with a stim (I recommend Ritalin) your BP will come up and you will be in remission soon after, Okay? You may have to tweak things with your PDoc, but get it started. If you have to visit a relative out of state to get it, so be it. Just get the attention you deserve. And no more playing russian roulette with meds.
Post back with your progress....
~Jade
Posted by JadeKelly on March 20, 2009, at 21:14:37
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by JadeKelly on March 20, 2009, at 21:00:11
Actually I thought you were in the US. What about desipramine? Would they let you add that to Parnate? Sounds like no, but thought I'd ask. Also, a lot of the really good hospitals here (not psych) psychiatrists who ARE experienced MAOI's and combos. What about calling around to those and the Teaching hospitals as well. Also, did you know Ace? I know he's from Australia and did really well on a MAOI, I'm betting he augmented it. Do a search. He called himself Nardil king or some such thing. If he could do it so can you.
Let us know!!!
~Jade
Posted by Phillipa on March 20, 2009, at 21:30:22
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by JadeKelly on March 20, 2009, at 21:14:37
Australia is quite different from the states and different type of medicines and system. Nationalized or Socialized can never remember. Phillipa
Posted by mav27 on March 20, 2009, at 23:41:35
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by JadeKelly on March 20, 2009, at 21:14:37
Unfortunatly Desipramine isn't available in Australia, and we can't legally import prescription drugs even with a prescription. I tried adding nortriptyline to the nardil and parnate but in both cases it lowered my blood pressure even more so badly that i ended up in hospital.
Ritalin and dexamphetamine (the 2 stims we have here) are only prescribable by a paediotrician to people aged 6 to 18. After 18 years old you have next to zero chance of getting them. The only thing i was able to find out about the laws in my state is for adults it takes 5 pdocs to agree you need a stim in order for one to be prescribed... i even presented them with 10 pages of everything from controlled studies, to anacdotal evidence ect that i could find on the use in america of stims to augment MAOI's but they still didn't go for it :(
> Actually I thought you were in the US. What about desipramine? Would they let you add that to Parnate? Sounds like no, but thought I'd ask. Also, a lot of the really good hospitals here (not psych) psychiatrists who ARE experienced MAOI's and combos. What about calling around to those and the Teaching hospitals as well. Also, did you know Ace? I know he's from Australia and did really well on a MAOI, I'm betting he augmented it. Do a search. He called himself Nardil king or some such thing. If he could do it so can you.
>
> Let us know!!!
>
> ~Jade
Posted by desolationrower on March 20, 2009, at 23:50:20
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by mav27 on March 20, 2009, at 23:41:35
have you got bupropion (including "for smoking sessation") in australia? or attomoxitine or reboxetine?
-d/r
Posted by mav27 on March 21, 2009, at 0:36:08
In reply to Re: Why the hell does nothing work the same anymore, posted by desolationrower on March 20, 2009, at 23:50:20
> have you got bupropion (including "for smoking sessation") in australia? or attomoxitine or reboxetine?
>
> -d/ryeah we have the SR version for smoking.. i tried it but it made me very agitated and would yell at anyone that tried to talk to me... it also made me very drowsy.. again drowsiness not being what you'd usually expect from it but nothing works like it should with me.
Reboxetine lowers my blood pressure badly as well, it does give me a nice calming feeling though, it also causes a side effect where it feels like somoene is sticking needles into my prostate... not a plesent experiance i assure you :)
Posted by rjlockhart04-08 on March 21, 2009, at 1:21:54
In reply to Why the hell does nothing work the same anymore, posted by mav27 on March 19, 2009, at 23:30:25
the brain changes after a long term effect from anti-depressants. I studied this, Prozac used to make life, "Livable" "Enjoyable".....after 2 years, i just started not caring about life, some effects are, go away and come back.
Sexual stuff...prozac does not effect one bit. At 80mg, you dont feel the desire at all.
Ex: Dextroamphetamine.....there is always a tolerance, and it's been known since Amphetamine was released and used for medical use. You have to know about, if it taken at larger doses, it will not cause the "intrest" the "motivation" to get something done. There's an effect, that's why "don't take it on the weekends" is a good rule. Because it gives the mind, to get back, polarized. Amphetamine stimulates desire, feeling, because of release of dopamine and norephinephrine.
Mmm just depends really on what the substance action's are, another: xanax never produced tolerance, GABA receptor's is what it goes after to inhibity firing, 2mg for anxiety "nucs", sweat, make really harsh sarcatic comments to anyone, freindly or wicked, i get "off the charts", think it's more energy waves from the 3rd eye. It's because the mind is discusted with life itself, more than rude, but i feel like crap after humilating someone, if they needed it or not.Anyways
Erosion....you know when "water" shapes, the grand canyon's thousands of years back..? - that is how some medications can "reshape" the mind. It just depends on what they are. Coninuted flow of whatever substance, can change the first shape of the brain, than current.You just have to be aware of your mind, not to even discuss, i've put myself horrid experience, where, my head would keep spinning, until it changed it's personality. PSTD, DID, trama can cause change or even "split" in how it work, so that part of the mind is "quarantined", such as from memories of abuse, or an event that was life-altering.
Later
rj
Posted by bleauberry on March 21, 2009, at 12:04:37
In reply to Re: Why the hell does nothing work the same anymore » bleauberry, posted by mav27 on March 20, 2009, at 20:38:23
> I can't handle anything with noradrenaline.. it makes me agitated, angry , lowers BP seriously, causing fainting spells and causes sexual dysfunction where it feels like someone stabbing me through the prostate with a knife. It also takes away all my energy making me very lethargic even though it's generally considered to be involved in giving energy rather than taking it.
>
> Seratonin just kills all emotions and makes me very sleepy as well as the usual sexual dysfunction (impossible to reach orgasm) It relieves depression but also kills any happiness iam able to feel which meansno more smiling or laughing which iam at least able to do when not on AD's even if iam suicidal.
>> Also nothing is allowed to be combined with MAOIS's here, and TCA's can't be mixed with SSRI's (or similar). We are quite backwards here in AUS.
Yikes. Ok. Got the picture. AUS does make things a bit more limited. I understand the NE and SERT effects you feel. Both somewhat common and make sense. I've experienced them too.
Well, AUS doesn't allow MAOIs and SSRIs combined, do they? But you did it anyway. So what is to stop you from mixing things they don't usually mix? Well, I know the answer, just wanted to make a point. That is, when there is a will, there is a way.
Meds. Ok, so maybe the NE meds you tried were too strong of a dose, and/or not balanced out with an appropriate amount of SERT? What about a low to medium dose of your favorite SSRI (relatively speaking), and a much smaller dose of something like Nortriptyline or Amitriptyline? Or how about Clomipramine by itself? I mean, side by side with Parnate or maybe even a little better than Parnate, Clomipramine is generall still king of the hill. In 50 years nothing yet has been invented that beats it. It is an equal mix of NE and SERT, and maybe all you need is a low dose.
I just get the hunch that even though you have specific effects from either NE or SERT, I can't help but wonder if that picture would change if they were combined. I think they would. It would not be like adding one to the other. It would change the whole flavor of the soup.
5ht2 antagonism. That could be a missing link. That would ptentially counter some of the bad effects you feel and simultaneously enhance the good ones. Something like Clomipramine by itself, or anything else combined with low dose Zyprexa.
If you have not tried the antipsychotics, Zyprexa or Abilify deserve a good look in combination with anything else you try. Their multi-dirty receptor blocking properties can to wonders. These days we have it all backwards...the cleaner a med is the better it works. NOT. In reality, the dirtier a med is, the better it works. That's why SSRIs still have not been able to beat TCAs or MAOIs or Atypical Antipsychotics.
So think dirty! Mix things up. Do a lot of stuff. Don't focus on NE or SERT issues alone. Mess with a bunch of stuff. And instead of just looking at ways to increase concentrations of NE or SERT, look at ways to block receptors and affect dopamine as well. That's where antipsychotics and some of the TCAs come into play.
Sorry, just thinking out loud.
I know, this stuff is wicked hard. I'm just trying to help with some ideas.
Posted by desolationrower on March 21, 2009, at 14:02:37
In reply to Re: Why the hell does nothing work the same anymore » mav27, posted by bleauberry on March 21, 2009, at 12:04:37
Well if i were to try a neuroleptic the best is amisulpride, not here in the states, have you got that? also, do you have ephedrine or yohimbine/yohimbe? those increase blood pressure a lot. not 'safe' choices or anything, but maybe with an ssri which they would be safe with you might be improved
-d/r
Posted by mav27 on March 21, 2009, at 16:51:39
In reply to Re: Why the hell does nothing work the same anymore, posted by desolationrower on March 21, 2009, at 14:02:37
> Well if i were to try a neuroleptic the best is amisulpride, not here in the states, have you got that? also, do you have ephedrine or yohimbine/yohimbe? those increase blood pressure a lot. not 'safe' choices or anything, but maybe with an ssri which they would be safe with you might be improved
>
> -d/rAmisulpride is great but it oly lasts a couple weeks and then stops having any good effect,, that's at low dose. If itake anything above 100mg i get the usual anti-psychotic feling that makes me want to take a shotgun to my head because it would feel better than the feeling of the AP in my brain.
Can't get ephedrine or yohimbine.
Posted by metric on March 22, 2009, at 14:39:25
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by mav27 on March 20, 2009, at 23:41:35
> Ritalin and dexamphetamine (the 2 stims we have here) are only prescribable by a paediotrician to people aged 6 to 18. After 18 years old you have next to zero chance of getting them. The only thing i was able to find out about the laws in my state is for adults it takes 5 pdocs to agree you need a stim in order for one to be prescribed...Aren't they prescribed to adults with sleep disorders? Perhaps you might have better luck by faking a sleep disorder. Hell, if you're sleeping 21 hours/day, you might not even have to fake it...
What about modafinil? What it's legal status in Australia? If you can't get it prescribed, you might be able to import it from abroad (but know your laws before attempting this).
Posted by desolationrower on March 22, 2009, at 16:05:58
In reply to Re: Why the hell does nothing work the same anymor » mav27, posted by metric on March 22, 2009, at 14:39:25
how about phenelethylamine? or you might be able to find a strong chocolate extract that has enough if you consume in large quantities. on an MAOI you should be able to get some effect.
-d/r
Posted by Sigismund on March 24, 2009, at 0:10:06
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by mav27 on March 20, 2009, at 12:50:07
>he agreed with me that stimulants sound perfect for my condition and was upset as well when i explained how i had bought it up to the pdoc's before and even they have aggreed but thanks for sate law they just don't get prescribed to people over 18 :(
You are in Australia, right?
My psychdr told me that he has, on occasion, provided a diagnosis of ADHD where he felt that was appropriate. There must be doctors who recognise Adult ADHD as a condition in the same way my psych does ie as a useful tool.
Or maybe sleep disorder. Depression's a sleep disorder. Trouble getting to sleep, trouble with being awake.
Posted by Sigismund on March 24, 2009, at 0:13:19
In reply to Re: Why the hell does nothing work the same anymore » JadeKelly, posted by mav27 on March 20, 2009, at 23:41:35
>and we can't legally import prescription drugs even with a prescription
I've done it without one.
I think they draw the line at drugs of dependence ie just below benzos.
This is the end of the thread.
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