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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by linkadge on June 26, 2010, at 12:24:51
With some medications, it seems like there are so many difficult tradeoffs. The clean meds, don't much work for me, and the dirty meds are, well...,too dirty.
Amitriptyline works great for depression, but there are just so many tradeoffs, feeling drowsy and out of it all the time, rubber brain, eating all the time, perceptual disturbances etc. As soon as you start feeling well, you wonder what kind of idiot ingests this toxic crap.
Sometimes I'd rather just be depressed. There are so many unmet needs, and I am an idealist in that I don't believe the sick should have to make such nasty tradeoffs.
Remission should be just that, remission. I believe that there is a way to get there without all the crap that we put up with.
Theres got to be a simpler, cleaner way to just turn off depression.
Linkadge
Posted by SLS on June 26, 2010, at 12:34:23
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
> Theres got to be a simpler, cleaner way to just turn off depression.
Make sure that you post when you find it.
It is so frustrating to be stuck and without options.
Depression is a tomb.
- Scott
Posted by Phillipa on June 26, 2010, at 12:42:37
In reply to Re: costs and benefits, posted by SLS on June 26, 2010, at 12:34:23
As far as anxiety the same and what's the tie in with them. Yes there has to be a way. Phillipa
Posted by europerep on June 26, 2010, at 13:39:28
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
> Theres got to be a simpler, cleaner way to just turn off depression.
>
there is, probably, one would only need a time machine to be able to do, not do, prevent, etc. certain things..as for amitriptyline though, I liked it until the end, i.e. until it stopped working. maybe after 6 or 7 years you're just used to it, but even at 300mg/d I felt fine, could get up early and be fit throughout the day, etc..
I wonder whether the fact that it worked doesn't actually prove it's largely about 5HT/NE in my case, and whether the dysfonction in these circuits now is just simply too serious to get cured by no matter which med... sometimes I wonder whether I do not wanna take a look into "real" drugs, you know, illicit ones.. have a good couple of years and then that was it.. I'm not about to do it, but it seems so much more tempting than to just wait while everyone around me has what they will later refer to as "the best time of their lifes"!
Posted by jade k on June 26, 2010, at 13:54:56
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
> Remission should be just that, remission. I believe that there is a way to get there without all the crap that we put up with.
>
> Theres got to be a simpler, cleaner way to just turn off depression.
>
> Linkadge
>
>
>
>A big Amen to that...
~Jade
Posted by linkadge on June 26, 2010, at 13:57:03
In reply to Re: costs and benefits, posted by europerep on June 26, 2010, at 13:39:28
I have often wondered about the same things. Mind you, many people who do illicit drugs are not mentally ill. I don't know if there is any long term beneifit to using street drugs. Perhaps low dose ketamine, or pot wouldn't do too much harm.
Linkadge
Posted by zonked on June 26, 2010, at 14:41:54
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
> With some medications, it seems like there are so many difficult tradeoffs. The clean meds, don't much work for me, and the dirty meds are, well...,too dirty.
I think many of us in here have felt like this. I used to wonder, with some degree of distress, if I had never started with Zoloft for what now seems like moderately severe depression, and tried to make lifestyle adjustments instead, if I never would have needed to get on the med-merry-go-round, and unintentionally started a process I cannot escape from... Not altogether unlike the spice melange in the novel Dune.
I wish I was still able to just take Zoloft or another SSRI--when it worked, Zoloft really worked WELL until it pooped out. I proceeded to try every SSRI on the market except Luvox with no antidepressant effect. I know lots of folks on SSRI/SNRI monotherapy and sometimes envy them--wish they still worked on me!
I no longer care (and also, I look at my folks--Dad with severe, caffeine-and-nicotine (4pks/day) self-medicated ADD, possibly a unipolar hypomanic; and Mom with diagnosed and treated cyclothymic disorder)--yeah, the meds suck. They also keep me alive, even when they're not perfect. Alive is better than dead.
I also look back on times when meds were working really well and side effects were tolerable--and know I can get "there" again. It's not knowing how long or what it's going to take that is frustrating.
I have confidence that in 10-20 years we'll have better treatments for mental illness...
Hang in there. Look forward to when you're feeling like yourself again (and please post when you do.)
-z
Posted by inanimate peanut on June 26, 2010, at 16:41:36
In reply to Re: costs and benefits, posted by zonked on June 26, 2010, at 14:41:54
I completely agree with you. I feel now like I'm one giant side effect (weight gain, acne, hair falling out, insomnia, etc.) but I would even take a dirty drug right now if it would work!
Posted by Phillipa on June 26, 2010, at 19:22:23
In reply to Re: costs and benefits, posted by zonked on June 26, 2010, at 14:41:54
So you're saying that an SSRI made you treatment resistant? What about all the people in real life they seem to work for year for like my neice and Sister? Phillipa
Posted by Phillipa on June 26, 2010, at 19:24:17
In reply to Re: costs and benefits, posted by inanimate peanut on June 26, 2010, at 16:41:36
I'm sure your thyroid was and is being checked as hair loss is a sign of hypothyroidism? Phillipa
Posted by zonked on June 26, 2010, at 19:50:55
In reply to Re: costs and benefits » zonked, posted by Phillipa on June 26, 2010, at 19:22:23
> So you're saying that an SSRI made you treatment resistant? What about all the people in real life they seem to work for year for like my neice and Sister? Phillipa
Naw. I guess I meant more like I wondered if taking meds--and it could have been something other than Zoloft-- in the first place altered my brain chemistry in such a way as to create a permanent need for them. Notice I use the past tense--wondered. I did not mean to suggest that taking Zoloft made me treatment-resistant or that SSRIs make people treatment resistant.
When Zoloft did work for me, it was an awesome medication! I won't ever know, and I guess my point is that I'm okay with not knowing--I will possibly need to take meds the rest of my life, and I've come to peace with the fact that some of us have our meds stop working and have to hit the drawing board again and endure until we find something that works again. That's all. :-)
I am not anti-SSRI at all, in fact I recommend Zoloft or Lexapro as first line treatment to family and friends if they are considering taking an AD. :-)
-z
Posted by Phillipa on June 26, 2010, at 20:06:47
In reply to Re: costs and benefits » Phillipa, posted by zonked on June 26, 2010, at 19:50:55
One of the reasons I never go up on a med SSRI is cause I feel that it does change your brain chemistry as something changes a doc took me off that tiny 50mg of luvox been on forever and upped benzos so high but didn't sleep for two weeks. ER and went back on original valium low dose and the luvox and slept? Go figure????? Phillipa
Posted by polarbear206 on June 27, 2010, at 10:38:46
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
Just wondering, have you ever tried a low dose of Effexor, say like 37.5 with low dose of depakote and/or Lithium?
Posted by atypical on June 27, 2010, at 20:10:17
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
rTMS (repetitive transcranial magnetic stimulation)? seems pretty clean, few side effects. seems to work for some people.
Posted by Chris O on June 28, 2010, at 16:28:54
In reply to costs and benefits, posted by linkadge on June 26, 2010, at 12:24:51
I completely identify with every word in your post, Link.
Chris
Posted by linkadge on June 28, 2010, at 20:13:58
In reply to Re: costs and benefits, posted by Chris O on June 28, 2010, at 16:28:54
What bothers me is that doctors are so oblivious to how sh*tty these meds can make people feel. They just don't believe what their patients tell them.
They just believe their medical school / FDA / pfizer package insert crap. I think to get the pychiatric licence you have to have ingested two medications from each class of drugs for 4 weeks each. Period.
Linkadge
Posted by zonked on June 28, 2010, at 20:20:29
In reply to Re: costs and benefits, posted by linkadge on June 28, 2010, at 20:13:58
> What bothers me is that doctors are so oblivious to how sh*tty these meds can make people feel. They just don't believe what their patients tell them.
> They just believe their medical school / FDA / pfizer package insert crap.
AMEN!!!!!!>
I think to get the pychiatric licence you have to have ingested two medications from each class of drugs for 4 weeks each. Period.Is that really true, anyone? I hope it is--they really should know what it feels like to take these drugs.
-z
Posted by jade k on June 28, 2010, at 21:18:58
In reply to Re: costs and benefits, posted by linkadge on June 28, 2010, at 20:13:58
> What bothers me is that doctors are so oblivious to how sh*tty these meds can make people feel. They just don't believe what their patients tell them.
>
> They just believe their medical school / FDA / pfizer package insert crap. I think to get the pychiatric licence you have to have ingested two medications from each class of drugs for 4 weeks each. Period.
Concurrently.~Jade
Posted by zonked on June 28, 2010, at 23:05:50
In reply to Re: costs and benefits » linkadge, posted by jade k on June 28, 2010, at 21:18:58
>
I think to get the pychiatric licence you have to have ingested two medications from each class of drugs for 4 weeks each. Period.
>
>
> Concurrently.
>
> ~Jade
There should be a required element for any mental health profession, a class that would consist of the following elements:
Students should all be made to do massive amounts of depressogenic drugs--something that would not carry any risk of being permanent. Perhaps several days of crystal meth (under anasthesia, so they don't get any pleasure out of it), wait until they are in withdrawals from it,
and be told:
Now imagine you felt like this EVERY DAY for months or years at a time--meanwhile trying drugs that didn't help, or made you sleepy, or made you anxious, or made you fat, all the while being told it was only in your head, or that taking walks or yoga or meditation or prayer or diet or journaling or therapy or being in nature or taking a hot bath or knitting or lighting candles or drinking chamomile tea or going to support groups or taking a vacation or watching funny TV would make you feel better. You try these things, but you only grow more frustrated because THEY DON'T WORK. Everywhere you go, everything you do, you're exhausted and STILL feel like this.
You keep on trying these things; people around you even provide some academic proof that they do, in fact, work for some people--you gain a bit of hope. You try them AGAIN with renewed vigor. Again, they don't work. Your doctor grows frustrated, although he tries to hide it, and ignores the research you bring him; you get the sense that he's not up to the challenge of treating you and begin to feel as if no one believes you. Your doctor throws another random "cocktail" of drugs at you. You still don't get any better. You stuggle to make it out of bed every day for months to years. Then, finally, you find SOMETHING that works, perhaps something you mentioned to your doctor because he's not interested enough to do his own homework--and for 6 months, a year, maybe a few years--maybe as long as ten, hell--you feel like your normal self again. You're willing to put up with some side effects (gaining massive amounts of weight, equipment not functioning right, insomnia that requires another pill) because otherwise, you're as good as new. But then it slowly creeps back--and those pills you've been taking gradually stop working. It's back, and your doctor is not happy to see you.THIS is what treatment-resistant, recurrent major depression feels like, class, and you must treat your patients with the utmost care and compassion, and do all you can to get them well--even if that means calling your colleagues, dusting older drugs off the shelves, or trying cutting edge combinations. You must use every tool you have in your arsenal, not just the brand new, patented samples that the Pfizer rep brought when she took you out to lunch at your favorite restaurant. You must continue to read your journals, and never forget why you chose this profession in the first place--to help people in emotional distress.
Wouldn't that be nice?
-z
Posted by jade k on June 29, 2010, at 12:36:33
In reply to Re: costs and benefits, posted by zonked on June 28, 2010, at 23:05:50
> >
> I think to get the pychiatric licence you have to have ingested two medications from each class of drugs for 4 weeks each. Period.
> >
> >
> > Concurrently.
> >
> > ~Jade>
>
. Perhaps several days of crystal meth (under anasthesia, so they don't get any pleasure out of it)hilarious
>
> and be told:
>
>
> Now imagine you felt like this EVERY DAY for months or years at a time--meanwhile trying drugs that didn't help, or made you sleepy, or made you anxious, or made you fat, all the while being told it was only in your head, or that taking walks or yoga or meditation or prayer or diet or journaling or therapy or being in nature or taking a hot bath or knitting or lighting candles or drinking chamomile tea or going to support groups or taking a vacation or watching funny TV would make you feel better. You try these things, but you only grow more frustrated because THEY DON'T WORK. Everywhere you go, everything you do, you're exhausted and STILL feel like this.
z-have you been reading my journal again?
> You keep on trying these things; people around you even provide some academic proof that they do, in fact, work for some people--you gain a bit of hope. You try them AGAIN with renewed vigor. Again, they don't work. Your doctor grows frustrated, although he tries to hide it, and ignores the research you bring him; you get the sense that he's not up to the challenge of treating you and begin to feel as if no one believes you. Your doctor throws another random "cocktail" of drugs at you. You still don't get any better. You stuggle to make it out of bed every day for months to years. Then, finally, you find SOMETHING that works, perhaps something you mentioned to your doctor because he's not interested enough to do his own homework--and for 6 months, a year, maybe a few years--maybe as long as ten, hell--you feel like your normal self again. You're willing to put up with some side effects (gaining massive amounts of weight, equipment not functioning right, insomnia that requires another pill) because otherwise, you're as good as new. But then it slowly creeps back--and those pills you've been taking gradually stop working. It's back, and your doctor is not happy to see you.
Wait, something worked for years? Okay, my bad...that wasn't my journal you were reading (what ARE those magic pills, that work for years?!)
>
> THIS is what treatment-resistant, recurrent major depression feels like, class, and you must treat your patients with the utmost care and compassion,They can treat me like sh*t as long as they...
>do all you can to get them well--even if that means calling your colleagues, dusting older drugs off the shelves, or trying cutting edge combinations. You must use every tool you have in your arsenal, not just the brand new, patented samples that the Pfizer rep brought when she took you out to lunch at your favorite restaurant. You must continue to read your journals, and never forget why you chose this profession in the first place--to help people in emotional distress.
>
> Wouldn't that be nice?
>
> -zAnd then we woke up.
~Jade :-)
Posted by zonked on June 29, 2010, at 14:40:42
In reply to Re: costs and benefits » zonked, posted by jade k on June 29, 2010, at 12:36:33
I forgot to mention the part where some of them suggest you electrocute yourself and potentially lose years of memories and what precious brain power you might have left.
Heh.
-z
Posted by jade k on June 29, 2010, at 14:55:52
In reply to Re: costs and benefits » jade k, posted by zonked on June 29, 2010, at 14:40:42
> I forgot to mention the part where some of them suggest you electrocute yourself and potentially lose years of memories and what precious brain power you might have left.
>
> Heh.
>
> -z
Lose the last three years? Awesome!Precious brain power? Yeah, runnin low on that, soooo, yup, I'll trade it for happiness!
Where do I sign up?
~Jade ;-)
Posted by linkadge on July 2, 2010, at 20:28:23
In reply to Re: costs and benefits, posted by zonked on June 28, 2010, at 23:05:50
Very well put!!!!
(Althogh I do like chamomile tea. Mind you I'm a little better ATM)
Linkadge
Posted by linkadge on July 2, 2010, at 20:39:43
In reply to Re: costs and benefits » zonked, posted by jade k on June 29, 2010, at 14:55:52
There should be a depression classification system. Eg. "I've been diagonised with depression, stage G". That way when you talk to depressed (stage A) co-workers they don't start to give you all their lame lexapro sucess stories.
I also wish doctors were moe realistic about your prognosis. If you had cancer, and there was a 1% chance of survival, they'd let you know that.
Linkadge
Posted by jade k on July 2, 2010, at 21:10:09
In reply to Re: costs and benefits, posted by linkadge on July 2, 2010, at 20:39:43
> There should be a depression classification system. Eg. "I've been diagonised with depression, stage G". That way when you talk to depressed (stage A) co-workers they don't start to give you all their lame lexapro sucess stories.
>
>> Linkadge
>
>
Pdocs could stamp a temporary tatoo on our foreheads. And the stage "G" and above depressives get reserved parking spots.~Jade
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