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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by markwell on October 12, 2009, at 11:22:32
I am really struggling with depression and feel like ending my life is the only thing that will take away my pain. I thought about going to the hospital but I had a terrible experience last winter. I am on 10 mg of paxil and meds just dont help me. Please if someone could offer advice.
Posted by Maxime on October 12, 2009, at 11:35:43
In reply to suicidal ideation, posted by markwell on October 12, 2009, at 11:22:32
What other meds/combos have you been on?
Posted by markwell on October 12, 2009, at 11:46:18
In reply to Re: suicidal ideation » markwell, posted by Maxime on October 12, 2009, at 11:35:43
I've tried just about everything. I'm bipolar 3 (mania induced by anti-depressant). I was on seroquel which gave me good sleep but I couldn't move in the am. I tried 5 mgs zyprexa which was helpful for awhile but again difficulty moving in the morning. I wouldn't want to put my family through this but I feel I have exhausted all my options.
Posted by Phillipa on October 12, 2009, at 12:08:37
In reply to suicidal ideation, posted by markwell on October 12, 2009, at 11:22:32
Markwell I know how you feel. Not exactly but a good idea. I also don't feel meds help and feel the same thoughts. The paxil isn't giving you hypomania right? Mood stabalizers? Have you called your pdoc? I know they don't always help. Will talking help? Are you sleeping? Know that I care. Phillipa
Posted by markwell on October 12, 2009, at 12:49:20
In reply to Re: suicidal ideation » markwell, posted by Phillipa on October 12, 2009, at 12:08:37
I'm not sleeping much which adds to the problem. I feel if I could sleep I might improve. I'm really desperate and my pdoc is no help at all.
Posted by Maxime on October 12, 2009, at 14:09:03
In reply to Re: suicidal ideation, posted by markwell on October 12, 2009, at 11:46:18
> I've tried just about everything. I'm bipolar 3 (mania induced by anti-depressant). I was on seroquel which gave me good sleep but I couldn't move in the am. I tried 5 mgs zyprexa which was helpful for awhile but again difficulty moving in the morning. I wouldn't want to put my family through this but I feel I have exhausted all my options.
I asked about the meds because right now you are on 10 mg of Paxil and that's it. That's not a very agressive approach to helping you with your mood. I'm sure that there are so many combos of things that you haven't tried. If your pdoc is useless then find another one.
Posted by linkadge on October 12, 2009, at 14:47:08
In reply to Re: suicidal ideation » markwell, posted by Maxime on October 12, 2009, at 14:09:03
I don't know how effective SSRI's are for dealing with a potential bipolar depression. You might want to try some nice strong coffee, perhaps some tyrosine. The herb vitex (chasteberry) lifeted me out of a deep place. It has SSRI + opioid + D2 agonists effects, a very good herb.
You have definately not exhausted all options. You may wish to ask your doctor about mirapex. Its a dopamine agonist with some efficacy in bipolar depression.
Linkadge
Posted by markwell on October 12, 2009, at 15:02:10
In reply to Re: suicidal ideation, posted by linkadge on October 12, 2009, at 14:47:08
Should I go to the hospital or would that be fruitless? Paxil isn't working but I'm afraid of getting off. I'm desperate for answers.
Posted by Maxime on October 12, 2009, at 16:37:58
In reply to Re: suicidal ideation, posted by markwell on October 12, 2009, at 15:02:10
If your pdoc won't do a med change and you are really suicidal, then you should probably go to the hospital.
Posted by bleauberry on October 12, 2009, at 18:38:45
In reply to suicidal ideation, posted by markwell on October 12, 2009, at 11:22:32
If you are making plans that can never be undone once they are carried out, it is imperative to walk into the emergency room or call and amulance. Let them take it from there. A bad experience in the past does not mean it will duplicate again. Mircales do walk out of the hospital.
I wholeheartedly support the approach of Linkadge. That is, think outside the box, utilize some of the great substances on this planet that have been here for centuries doing great things. The only reason we don't get them prescribed is because no one can patent them and make multimillion dollar corporations out of them.
We don't want to rock the boat, which means keep Paxil where it is for now. It can always be weaned off later. The question now is, what can go with it?
Link mentioned Chasteberry. That wasn't the first to come to my mind, but certainly a decent choice. I would add to the list of easily accessible powerful options:
1. Rhodiola Rosea...can be mixed with SSRIs.
2. SAMe...can be mixed with SSRIs.
3. St Johns Wort with Lemon Balm companion...can be mixed with SSRIs, but the SJW dose below 600mg. The synergy of these two is more than either alone.
4. Albizia Julibrissin.
5. Free and Easy Wanderer.
6. An Shen Buxin.
7. Tyrosine and/or DL-phenylalanine.
For sleep, go to hepapro.com and order Herbsom. And old popular Chinese favorite with two herbs in it that give excellent sleep with no hangover and no addiction.
Fast: SAMe, Rhodiola, tyrosine, Albizia. Results noted within 1 to 10 days.
Herbsom: Results in 20 minutes.
Not wanting to make the list any longer, depression can readily respond to things that would seem to have nothing to do with serotonin or neurotransmitters. Explaining in some cases why ADs just don't work. For example a herbal combo called CirculationP that has 10 fantastic herbs in it that reduce brain inflammation and stimulate microcirculation.
If you are inclined to continue in the narrow path of what the psychiatrists have shown you thus far, then this post will be of no value to you.
There is hope. Hang in there! Do something moving forward. Don't sit on it. Don't hesitate. Make a positive move. You were brave enough and trusting enough to pop that first Paxil pill. Be brave enough and trusting enough to try something new.
With your history, I doubt that will come from the psychiatric toolbox. Too narrow. I would pin hopes on adding Nortriptyline or Abilify to the Paxil, or stopping the Paxil completely and starting Parnate. Other than that, I'm not sure.
I could be wrong. Just sharing my heartfelt thoughts to a friend in need.Link is on the right track, in my opinion, and I just wanted to point out the very best, fastest, safest, cheapest options readily available.
Posted by Phillipa on October 12, 2009, at 19:21:00
In reply to Re: suicidal ideation, posted by markwell on October 12, 2009, at 15:02:10
Markwell the hospital can cross you over to another med or help you wean off the paxil. You have so many options. Love Phillipa
Posted by zzzz7 on October 12, 2009, at 19:57:26
In reply to Re: suicidal ideation, posted by markwell on October 12, 2009, at 12:49:20
If you're feeling like you likely will hurt yourself, definitely go to the ER. Stay on the Paxil for now.
When you mean you can't move in the morning, is this due to dystonia?
Posted by emmanuel98 on October 12, 2009, at 20:06:45
In reply to suicidal ideation, posted by markwell on October 12, 2009, at 11:22:32
I had been hospitalized three times in the past two years and was not responding to medications, like you. I finally agreed this summer to try one more hospitalization. They kept me for a while, started me on parnate and I've been great ever since. I can't believe I was so suicidal before this. I have a good life and would have made people I love desperately unhappy if I had killed myself. Try to hold on. There are good hospitals and good meds to try.
> I am really struggling with depression and feel like ending my life is the only thing that will take away my pain. I thought about going to the hospital but I had a terrible experience last winter. I am on 10 mg of paxil and meds just dont help me. Please if someone could offer advice.
Posted by rnny on October 12, 2009, at 22:17:04
In reply to Re: suicidal ideation, posted by markwell on October 12, 2009, at 12:49:20
Now a days quite a few doctors insist that ECT is the best alternative for people who want to die. I should know, I see one who advocates ECT and has even suggested it for me should things not improve.
Posted by Zyprexa on October 13, 2009, at 7:26:40
In reply to Re: suicidal ideation, posted by markwell on October 12, 2009, at 15:02:10
You should give the zyprexa anouther try. Maybe at a lower dose. The paxil might be making you tired too. And it does not sound like its helping. Even if the zyprexa makes you tired, you would be getting sleep! A little tired is better than suicide, and a trip to the hospital.
Posted by markwell on October 13, 2009, at 15:48:41
In reply to Re: suicidal ideation, posted by bleauberry on October 12, 2009, at 18:38:45
Bleauberry, the one concern I have is I have been diagnosed with bipolar 3(antidepressant induced mania). Sam-e states on the box not to use if you are bipolar. I thought about going back to zyprexa but I had increased suicidal thoughts on that. But I was only taking 2.5mgs as it made me like a zombie at 5mgs (with paxil). I took wellbutrin once and if I could have gotten sleep it would have been a good drug, maybe. That's the piece that really gets me is I am an insomniac to begin with and most of these drugs with the exception of seroquell and zyprexa keep me awake. My pdoc gave me dioxine to try to help with sleep but I had a bad experience with elavil which has a similar s.e.profile. I'm trying to find a new dr but there are very good pdocs where i live.
Posted by markwell on October 13, 2009, at 15:51:20
In reply to Re: suicidal ideation, posted by markwell on October 13, 2009, at 15:48:41
Can zyprexa alone act as an antidepressant or does it need an adjunct? What doseage when you say small?
Posted by bleauberry on October 13, 2009, at 18:53:37
In reply to Re: suicidal ideation, posted by markwell on October 13, 2009, at 15:48:41
> Bleauberry, the one concern I have is I have been diagnosed with bipolar 3(antidepressant induced mania). Sam-e states on the box not to use if you are bipolar.
I think I mentioned other things besides just SAMe?
They have to say that on the box. It does not mean that someone who has been labeled bipolar is going to have a reaction. I have seen people get calm and relaxed on SAMe, when they should have been hyped up instead. You just never know. If there is a risk of a reaction, no matter how small the risk, they have to say that on the label to protect themselves legally from you sueing them.
Anything that impacts the nervous system in any way carries a risk of a reaction. No matter what it is. No matter whether it is labeled or not. There is always risk. I'm not saying ignore the label and go try SAMe. I am saying that if you do it, approach it gently as you should with any substance. Cut a pill in halves or quarters. Any substance you take...med, herb, food...deserves respect.
You certainly cannot go by what something says on a box. And in my opinion, you certainly can't go solely on a subjective unprovable untestable unexplainable unduplicatable vague thing as a word called "bipolar". That means absolutely nothing to me. It is a term to describe a set of symptoms that could also be something else.
So ok, rule out SAMe. The list has no shortage of other options. You want some natural mood stabilizers to go with your AD? There are some good ones.
Posted by Phillipa on October 13, 2009, at 22:36:49
In reply to Re: suicidal ideation » markwell, posted by bleauberry on October 13, 2009, at 18:53:37
BB please don't tell Markwell to ignore directions on a box as they are placed there for safety and safety first in my opinion. Markwell where are you and how are you tonight? Phillipa
Posted by markwell on October 14, 2009, at 8:31:37
In reply to Re: suicidal ideation » bleauberry, posted by Phillipa on October 13, 2009, at 22:36:49
Phillipa, I'm hanging in there but just barely. I took an ativan for sleep last night and that helped a little but I am depressed this a.m and I feel if I don't keep moving I will fall into the deepest dispair. I have zyprexa here that I can take but it was not the best med for me.
Posted by bleauberry on October 14, 2009, at 16:50:38
In reply to Re: suicidal ideation » bleauberry, posted by Phillipa on October 13, 2009, at 22:36:49
> BB please don't tell Markwell to ignore directions on a box as they are placed there for safety and safety first in my opinion. Markwell where are you and how are you tonight? Phillipa
Phillipa please go read the post again. You inserted your own words into it that I never said.
Posted by Phillipa on October 14, 2009, at 19:51:52
In reply to Re: suicidal ideation » markwell, posted by bleauberry on October 13, 2009, at 18:53:37
BB in last sentence I feel it sounds like a challenge to try it anyway? Phillipa
Posted by Phillipa on October 14, 2009, at 19:53:48
In reply to Re: suicidal ideation, posted by markwell on October 14, 2009, at 8:31:37
Markwell you made it through the day? If so please post. I feel call the doc. Or hospital til passes. Love Phillipa
Posted by Meltingpot on October 15, 2009, at 16:24:07
In reply to suicidal ideation, posted by markwell on October 12, 2009, at 11:22:32
Hi,
I don't suffer from Bipolar I suffer from straight forward depression/anxiety but I do know how it feels to feel suicidal. From what you have said you have tried it looks as though you have got so many other options ahead of you. There are lots of medications that you haven't even tried yet so at least look forward to trying them.
I can think of one particular (very clever and persistant) person on this site who has suffered with very resistant Bipolar (more on the depressive side) and yet he has found some relief with a combination of medications.
Also, as Phillipa says, your dose of Paxil (10mg) seems really low. I had to take at least 40mg to get a response all 20mg did was increase my anxiety and make me feel more suicidal. Some times all low doses do is give you the horrible side affects without the benefits. I know that as you have bipolar then you have to be careful but if the Paxil did send you into a manic state then I'm sure they could try adding a mood stabliser.
I personally think vitamins/herbs etc are a waste of time and money (for me anyway) but who knows they might help you.
Please don't give up hope.
Denise
Posted by jrbecker76 on October 15, 2009, at 23:08:57
In reply to Re: suicidal ideation » markwell, posted by bleauberry on October 13, 2009, at 18:53:37
Have you tried benzodiazepines? Anti-anxiety agents have worked better in the past for suicidal ideation than antidepressants did.
I have also found that any antidepressant with noradrenergic activity can >increase< suicidality. This would includes the SNRIs (Effexor, Cymbalta, Milnacipran), NARI (reboxetine, atomoxetine), and other drugs with strong NE activity (e.g., Seroquel). This has just been my own individual experience.
JB
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