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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 50. Go back in thread:
Posted by floatingbridge on May 2, 2010, at 23:32:06
In reply to Re: Just took hydrocodone(percocet)... » floatingbridge, posted by conundrum on May 2, 2010, at 22:11:07
Well, taking a break from babble could be really good.
Are you working with a doc fairly closely? I'm concerned that if you do start prozac, you won't know what's what. Then, you know more about meds.... And I'm wondering about returning to prozac only because you trace your onset to it's discontinuation.
Glad the opoid wore off.
Oh, and I guess I ignore many of the creativity discussions because I have issues--so it's much better for my mental health. Frankly, the best stuff I ever wrote was after depression treatment.
Posted by SLS on May 3, 2010, at 8:05:47
In reply to Re: Just took hydrocodone(percocet)... » floatingbridge, posted by conundrum on May 2, 2010, at 22:11:07
> I was optimistic at first then I read some negative things in the creativity thread about lamictal and now I'm affraid it will just cause blunting and be a waste of time.
I doubt that Lamictal will affect creativity. Not everyone develops cognitive side effects, either. Hopefully, you will respond to a dosage that is no higher than 200mg. That seems to be the dosage that is most often arrived at. Cognitive side effects seem to be dosage dependent.
Good luck with it.
- Scott
Posted by conundrum on May 3, 2010, at 11:55:51
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by SLS on May 3, 2010, at 8:05:47
> > I was optimistic at first then I read some negative things in the creativity thread about lamictal and now I'm affraid it will just cause blunting and be a waste of time.
>
> I doubt that Lamictal will affect creativity. Not everyone develops cognitive side effects, either. Hopefully, you will respond to a dosage that is no higher than 200mg. That seems to be the dosage that is most often arrived at. Cognitive side effects seem to be dosage dependent.
>
> Good luck with it.
>
>
> - Scott
Yeh I hope it helps. I put a lot of pressure on feeling better before my girlfriend comes to visit me this summer. I don't need to be 100% but atleast a little more energetic and motivated. She tells me not to worry about when she comes and just focus on getting better and she is right.Also I feel like I could be more of a benefit than a burden to my grandparents if I was on a small dose of prozac right now since it makes me get things done and be more productive. My grandmom just got out of rehab hospital so I want to be able to help my grandpop taking care of her, but sometimes I just go sit up in my room and waste time and just avoid doing work. In a way its like ADHD, even when I'm trying to do something I get distracted and start doing something else. I guess I'm just fed up with myself and I have no drive to get things done everything just feels like a burden and I get no reward from doing things like say cleaning my room. There is an obvious benefit to cleaning my room, I can walk through it without tripping , but I get no satisfaction or feeling like I did something good when I clean it, then it just gets messy again. I also have to register to go back to school and I see no way I'm gonna get that done right now.
Last fall I tried prozac at a low dose with a little bit of buspar. After some weeks I noticed I was just doing more things around the house and planning for my future. I didn't even attribute it to the drug. I thought it wasn't doing anything so I increased the dose to 5mg every day instead of just 5 mg every other day. Soon after the increase I felt even more blunted than I had before.
The ammount of benefit was noticable though not huge maybe 3 out of 10 in how close to normal I felt, but it was something. Now I wonder if I had stayed at the lower dose if the benefits would have increased? I took my GPs advice and tried something else since there isn't much room for dosage change if 2.5 mg a day is all the gives a benefit. Also I side effects like diarrhrea and headaches which seem to indicate too much serotonin. I believe the benefits of prozac came from its antagonistic effects at the 5 HT2 receptors.
It was interesting because I was able to even enjoy music slightly more like it made me be able to concentrate and remeber it better. I listen to some complex music now and it does nothing and just seems to blend together.
I guess I'm worried lamictal won't help with my types of symptoms and wish I had something with more noradrenergic support that would kick in sooner than 6-8 weeks. Of course I want to try give lamictal a real trial where I can see if this drug on its own can make me feel better, but I don't feel I have that luxury at this time.
I might call her and see what she thinks about adding the prozac. I think I'd be able to discriminate the effects of prozac from the effects of lamictal but I'm not sure.
Posted by bulldog2 on May 3, 2010, at 12:16:26
In reply to Re: Just took hydrocodone(percocet)... » floatingbridge, posted by conundrum on May 2, 2010, at 22:11:07
> Only stim I've tried is ritalin IR and it doesn't do anything for me. I definitely felt better when the drug wore off this evening. It makes me feel a little more blunted as well.
>
> Right now I'm trialing lamictal, but I'm not very patient I have to titrate up to atleast 100mgs i guess and then wait 6-8 weeks.
>
> I gotta stop reading forums like this unfortunately. I was optimistic at first then I read some negative things in the creativity thread about lamictal and now I'm affraid it will just cause blunting and be a waste of time.
>
> I want to go back to school but I know I won't be able to do a master's until my motivation comes back. I'm considering asking about taking 2.5 mg prozac with this to help with motivation. I just don't know what to do. I have a temp job thats ending soon and I'll just sit around at home bored out of my mind ugh. I would like to add prozac, but if it starts working how do i know if its the prozac or lamictal? I guess I would know if it was just the prozac since I have taken that alone before and know how it makes me feel.Talked to my doctor about this today and he tends to be very open when I ask him about sides.Your comment about forums like this giving you a negative spin on a med is unfortunate. I started a thread about forums like this.
1. People who have had positive experiences with meds don't seek out forums like this.
2. People who achieve remission tend to leave forums such as this one.
3. So that leaves treatment resistant people who have had bad experience and med failures here.
4. So be aware that the amount of actual negative experiences will be far less in reality than what is being reported here.
5. Almost any drug that you come here for info will give you a much skewed report on negative incidents.
6. Maybe you need to find a p-doc who you trust and is talanted and follow him/her for med advice. I can assure you that 10 minutes after looking up a drug here you will be deflated and think everyone who tried the drug either failed on it or almost died from sides.
7. I myself have made the same mistake. Find a good doc and take the meds they prescribe and see how things work out. You can always stop a med trial. I know how you feel as I have made the same mistake.
Posted by bulldog2 on May 3, 2010, at 12:23:40
In reply to Re: Just took hydrocodone(percocet)..., posted by floatingbridge on May 2, 2010, at 20:53:43
> Conundrum,
>
> that sound's pretty cr*ppy-- I'm sorry this is on-going for you.
>
> I don't think opoids help most people, and you probably took too much anyways as others posted.
>
> I'm still considering tramadol but have much different thoughts about it now than before. So I've been taking hydrocodine (sp?) for over a month now. I don't think I'm less depressed (I know our conditions are different).
>
> In fact, when I have breakthrough pain and take more, I feel muffled and dull.
>
> I know I've asked--stims don't work?
>
>
>Stims are like opiates in my opinion. They tend to work for awhile and than tolerance sets in and you need more and than they stop working.
I have found that at least for me opiates at best can be a good on. But for me it cannot be the main ad. Right now I am on clomipramine and it seems to be helping. When I take my pain meds I get a small blip of mood improvement. But the opiate could never function as an ad by itself for me.
When neurontin worked it actually was a good ad for me and it worked for a couple of years. But I don't think most people get that result.
As far as tramadol goes it a unique drug because of the se and ne reuptake.
I think most people need a good ad as the foundation of their med program.
Posted by SLS on May 3, 2010, at 13:53:02
In reply to Re: Frustration » SLS, posted by conundrum on May 3, 2010, at 11:55:51
> I might call her and see what she thinks about adding the prozac. I think I'd be able to discriminate the effects of prozac from the effects of lamictal but I'm not sure.
How does Wellbutrin affect you?
- Scott
Posted by ed_uk2010 on May 3, 2010, at 16:51:53
In reply to Re: Just took hydrocodone(percocet)..., posted by bulldog2 on May 2, 2010, at 17:52:00
>Well we do know that heroin addicts are maintained on methadone for years. Apparently it sustains their mood enough to keep them off heroin.
I don't think it sustains their mood but it does prevent withdrawal symptoms. Depression is very common during methadone maintenance therapy, but there are of course multiple reasons for this.
Posted by ed_uk2010 on May 3, 2010, at 16:56:25
In reply to Re: Just took hydrocodone(percocet)... » ed_uk2010, posted by floatingbridge on May 2, 2010, at 21:00:08
>Ed, is there any antidepressant treatment that creates sustainable improvement? I don't understand....
Most commonly prescribed antidepressants have the potential to produce sustained improvement (although not after they have been stopped). They don't always poop out, you know :) Still have good days and bad days of course.
Posted by conundrum on May 3, 2010, at 17:59:15
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by bulldog2 on May 3, 2010, at 12:16:26
Thanks for the tip. I thought number 6 was pretty funny. I think you are right. I was feeling good until I read too much. I looked at askapatient.com and lamictal has pretty high ratings. So I'll try to be hopeful. Did you ultimately find things that help at all? Do you just post here for support?
Posted by conundrum on May 3, 2010, at 17:59:51
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by bulldog2 on May 3, 2010, at 12:16:26
I think my pdoc is good but its hard to trust when I know a lot of what they do is guess work.
Posted by sigismund on May 3, 2010, at 18:40:36
In reply to Re: Just took hydrocodone(percocet)... » bulldog2, posted by ed_uk2010 on May 3, 2010, at 16:51:53
>I don't think it sustains their mood but it does prevent withdrawal symptoms. Depression is very common during methadone maintenance therapy, but there are of course multiple reasons for this.
That's right.
Most people on methadone maintenance suffer low grade depression, probably related to methadone toxicity.
Posted by conundrum on May 3, 2010, at 19:07:42
In reply to Re: Frustration » conundrum, posted by SLS on May 3, 2010, at 13:53:02
Doesn't have any positive effect. It gave me tremors and tinnitus. I had to stop taking it at 300mgs before giving it a long enough time because of the tinnitus. I could handle the tremors but thought of hearing loss is too scary. This was the SR generic.
Posted by SLS on May 4, 2010, at 5:48:45
In reply to Re: Frustration » SLS, posted by conundrum on May 3, 2010, at 19:07:42
> Doesn't have any positive effect. It gave me tremors and tinnitus. I had to stop taking it at 300mgs before giving it a long enough time because of the tinnitus. I could handle the tremors but thought of hearing loss is too scary. This was the SR generic.
It was just a thought. My doctor has had good results combining Wellbutrin with Lamictal. Theoretically, both drugs might have pro-dopaminergic effects - Wellbutrin via dopamine reuptake inhibition and Lamictal through disinhibition of dopamine release. In real life, who knows? For me, Wellbutrin makes my depression moderately worse.
- Scott
Posted by SLS on May 4, 2010, at 5:52:13
In reply to Re: Just took hydrocodone(percocet)... » bulldog2, posted by conundrum on May 3, 2010, at 17:59:15
> Thanks for the tip. I thought number 6 was pretty funny. I think you are right. I was feeling good until I read too much. I looked at askapatient.com and lamictal has pretty high ratings. So I'll try to be hopeful. Did you ultimately find things that help at all? Do you just post here for support?
You might consider that Lamictal is probably better as an adjunct than it is as monotherapy. So, if you feel somewhat better with Lamictal monotherapy, you could leave it in place as you try other drugs.
- Scott
Posted by bulldog2 on May 4, 2010, at 7:56:06
In reply to Re: Just took hydrocodone(percocet)... » bulldog2, posted by conundrum on May 3, 2010, at 17:59:51
> I think my pdoc is good but its hard to trust when I know a lot of what they do is guess work.
parnate and clomipramine for depression. High dose neurontin for anxiety and depression.
I like askapatient, because of the ratings you get more balance. But that also may be somewhat skewed towards the negative for reasons mentioned before. But better than other forums.
If you and your doctor have discussed a med and decided to use it don't go all over the internet looking for more info.If you looked up toothpaste,milk,cheese,etc on the internet you would find horrow stories about some disasterous side effect.
If you trust your doc and think he is good than discuss all your issues with him. Make a decision and follow through. If it doesn't work out than stop. He must have had some good results to be prescribing it.
Posted by conundrum on May 4, 2010, at 11:14:18
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by bulldog2 on May 4, 2010, at 7:56:06
I see what you mean even on askapatient there is probably a disproportionate number of negative reviews, claiming the drug almost killed them, but there are also people that have tried a lot of things and finally find something that works they post reviews on sites like that. I think the thing that attracted me to this forum was that I wanted to know about how the drugs worked and what could help my specific symptoms. This is one of the few med forums where people don't say "ask your doctor" for better or for worse.
Well when I started seeing my pdoc I thought she had 38 years experience but its really only 18 years! So she isn't as comfortable with the older drugs although she said she has a patient on atleast one of each of the TCA drugs. Not sure about MAOIs. I think I would try them last after seeing how crazy my grandmom's blood pressure was in surgery. The surgeon believed it dropped because of the Nardil. If I exhaust all other options before trying APs I would consider parnate. I know she prescribes neurotonin, but I don't think I have an anxiety problem.
I think its important to talk to your doc about what kind of side effects would bother you most. Many people hate weight gain but I could handle that. I gained a lot of weight on prozac the first time and it never bothered me. Movement disorders, memory problems, and tinnitus are much more scarey to me.
Anyway, I really appriciate your posts, Bulldog, I feel much more relaxed now about just taking the lamictal and waiting it out. Maybe she'll add something too it like you said and it if it doesn't work you move on. Its like Tom Petty said, "The waiting is the hardest part."
Posted by floatingbridge on May 4, 2010, at 11:33:52
In reply to Re: Just took hydrocodone(percocet)... » bulldog2, posted by conundrum on May 4, 2010, at 11:14:18
By way of encouragement, I know people who have done quite well on lamictal. Good luck!
Posted by conundrum on May 4, 2010, at 11:42:06
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by SLS on May 4, 2010, at 5:52:13
Hmm that could be good, I think my pdoc might have that in mind as she wanted to make sure my mood was stable, for some reason.
Posted by conundrum on May 4, 2010, at 11:46:44
In reply to Re: Frustration » conundrum, posted by SLS on May 4, 2010, at 5:48:45
Yeh I was thinking the brand might be better but then I remember tinnitus was listed as a side effect in the original brand trials, so I'm not sure about that. I didn't even know lamictal increased DA release, thats odd since too much DA causes psychosis doesn't it and its often used as a mood stabilizer for BP. Most drugs for BP like antipsychotics block DA. Thats interesting.
Posted by bulldog2 on May 4, 2010, at 12:16:29
In reply to Re: Just took hydrocodone(percocet)... » bulldog2, posted by conundrum on May 4, 2010, at 11:14:18
For a while I could never pull the trigger on taking meds. So many opinions on wether to take or not to take. Finally realized part of getting better was trusting my judgement on a drug. So I discuss the pros and cons on a particular drug with my p-doc. But now I tend to trust his recommendations.
I'm on 75 mg of clomipramine and the sides are fine. I heard comments like I'd rather be with cobras than take this med or something like that.
People read things on the internet.Once you learn to trust your judgement and a p-doc you trust you have taken a first step in getting better. One day you wake up and say enough. I'm a smart person and can make good judgements. Why am I asking other people about these things. I still enjoy reading the technical aspects of meds.
Posted by conundrum on May 4, 2010, at 12:26:58
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by bulldog2 on May 4, 2010, at 12:16:29
Yeh I've had the same problem about making a decision about what drugs to take and worrying about sides. Ever since I tried pristiq and survived taking it and the withdrawal I put a lot less stock on what I read online since many people claimed it was a horrid experience.
I'm trying not to read too much about lamictal but now I'm curious about how it works. Not sure if I'll look it up or not.
Yes trusting yourself and your p-doc is very important.
Posted by SLS on May 4, 2010, at 15:28:32
In reply to Re: Frustration » SLS, posted by conundrum on May 4, 2010, at 11:46:44
> Yeh I was thinking the brand might be better but then I remember tinnitus was listed as a side effect in the original brand trials, so I'm not sure about that. I didn't even know lamictal increased DA release, thats odd since too much DA causes psychosis doesn't it and its often used as a mood stabilizer for BP. Most drugs for BP like antipsychotics block DA. Thats interesting.
As best as I can recall, glutamatergic circuits efferent from the PFC project into the nucleus accumbens and inhibit dopamine release there. Lamotrigine inhibits glutamate release in the PFC and thus disinhibits (allows) the release of dopamine. Glutamate antagonists can be psychotogenic. I have heard of people having manic reactions to lamotrigine.
- Scott------------------------------------------
Psychopharmacology (Berl). 2008 Dec;201(3):325-38. Epub 2008 Aug 28.
Blockade of NMDA receptors in the prefrontal cortex increases dopamine and acetylcholine release in the nucleus accumbens and motor activity.
Posted by SLS on May 4, 2010, at 15:35:24
In reply to Re: Just took hydrocodone(percocet)... » bulldog2, posted by conundrum on May 4, 2010, at 12:26:58
> I'm trying not to read too much about lamictal but now I'm curious about how it works. Not sure if I'll look it up or not.
I'm not sure that anyone can claim understanding as to how Lamictal works to treat depression. My guess is that it has more to do with its activity at glutamate nerve terminals than at sodium channels. I could be wrong, though.
- Scott
Posted by floatingbridge on May 4, 2010, at 16:25:03
In reply to Re: Just took hydrocodone(percocet)... » conundrum, posted by SLS on May 4, 2010, at 15:35:24
So Lamictal could be someone's main ad? Not just for BP...?
(Excuse the intrusion, conundrum.)
Posted by SLS on May 4, 2010, at 17:54:54
In reply to Re: Just took hydrocodone(percocet)... » SLS, posted by floatingbridge on May 4, 2010, at 16:25:03
> So Lamictal could be someone's main ad? Not just for BP...?
>
> (Excuse the intrusion, conundrum.)
I haven't heard too many stories describing Lamictal monotherapy as being particularly effective in treating unipolar depression. However, some researchers look at unipolar and bipolar disorders as being endpoints along a continuum. Some people who have demonstrated only depression may in fact have a bipolar diathesis. Perhaps these seemingly unipolar people would be responsive to Lamictal. I don't think it is entirely clear what place Lamictal has in the treatmtent of mood disorders. Under what circumstances does it produce long-term robust antidepressant effects?
- Scott
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