![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 35 to 59 of 59. Go back in thread:
Posted by SLS on July 12, 2010, at 13:46:57
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!', posted by Brainbeard on July 12, 2010, at 13:14:27
> > I hope you find something that works. Perhaps having confidence in your new doctor will help.
> Thanks. I guess that could help indeed.
With your level of knowledge and understanding, any doctor will certainly be challenged. Respect and confidence in them may not come easily for you. That's okay, though. I think the right doctor will earn your respect and confidence. It just might require an open mind to start with.
My doctor is interested in using magnetic treatments for me. Have you been presented with rTMS as an alternative? I have my doubts, but I will probably pursue it if I don't respond adequately to the addition of Nardil. I've never combined it with lithium before, so we'll see. I really should give it another 4 weeks to see what direction things go in.
Nardil 90mg
nortriptyline 150mg
Lamictal 100mg
Abilify 10mg
lithium 300mg
- Scott
Posted by Brainbeard on July 12, 2010, at 14:24:50
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!', posted by SLS on July 12, 2010, at 13:46:57
> With your level of knowledge and understanding, any doctor will certainly be challenged. Respect and confidence in them may not come easily for you. That's okay, though. I think the right doctor will earn your respect and confidence. It just might require an open mind to start with.
Right in our first encounter, I mentioned the Luvox-clomipramine combination, and he immediately remarked that such a combo is a rational one because of Luvox' lowering of blood levels of desmethylclomipramine, the noradrenergic metabolite that probably doesn't contribute to the drug's anti-OCD potential. Just the fact that he knew about this interaction by head was enough for him to gain my trust in his being grounded in pharmacotherapy.
>
> My doctor is interested in using magnetic treatments for me. Have you been presented with rTMS as an alternative?No, I haven't.
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 100mg
> Abilify 10mg
> lithium 300mgWow, you've got quite a cocktail. How is the Abilify working out?
Posted by SLS on July 12, 2010, at 15:38:44
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!', posted by Brainbeard on July 12, 2010, at 14:24:50
> > Nardil 90mg
> > nortriptyline 150mg
> > Lamictal 100mg
> > Abilify 10mg
> > lithium 300mg
> Wow, you've got quite a cocktail. How is the Abilify working out?All I know is that when I try to discontinue Abilify, my depression gets worse. All of these drugs make a dent, but do not produce a true antidepressant effect. I receive a little more mental energy and avoid suicidal states - that's about it though. I do worse off drugs than on drugs. Right now, the Nardil is not doing nearly enough for me. I am very disappointed. It has only been a few weeks, though. Still, I am not encouraged by what I am currently feeling.
Abilify has produced significant weight-gain and possibly elevated my trigylcerides as has been measured in blood tests.
- Scott
Posted by Bob on July 12, 2010, at 16:50:07
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!' » Brainbeard, posted by SLS on July 12, 2010, at 15:38:44
> > > Nardil 90mg
> > > nortriptyline 150mg
> > > Lamictal 100mg
> > > Abilify 10mg
> > > lithium 300mg
>
>
> Abilify has produced significant weight-gain and possibly elevated my trigylcerides as has been measured in blood tests.
>
>
> - Scott
Scott- I didn't realize that Abilify was associated with weight gain. I thought it was supposed to be relatively neutral, but looking back, I gained weight while on very small amounts of it. I think maybe all the AAPs may have health ramifications in the long run. My triglycerides and cholesterol are also elevated and have been for awhile now. I wouldn't hesitate to blame my exposure to psychiatric drugs, but of course no one will ever know for sure.
Posted by Bob on July 12, 2010, at 16:54:17
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!' » Brainbeard, posted by SLS on July 12, 2010, at 15:38:44
> > > Nardil 90mg
> > > nortriptyline 150mg
> > > Lamictal 100mg
> > > Abilify 10mg
> > > lithium 300mg
>
> > Wow, you've got quite a cocktail. How is the Abilify working out?
>
> All I know is that when I try to discontinue Abilify, my depression gets worse.
>
>
> - Scott
I have found AAPs to be some of the diciest drug in terms of dosage changes. I have found them very difficult to taper off of.-Bob
Posted by Bob on July 12, 2010, at 16:59:07
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!' » Brainbeard, posted by SLS on July 12, 2010, at 15:38:44
> > > Nardil 90mg
> > > nortriptyline 150mg
> > > Lamictal 100mg
> > > Abilify 10mg
> > > lithium 300mg
All of these drugs make a dent, but do not produce a true antidepressant effect. I receive a little more mental energy and avoid suicidal states - that's about it though. I do worse off drugs than on drugs. Right now, the Nardil is not doing nearly enough for me. I am very disappointed. It has only been a few weeks, though. Still, I am not encouraged by what I am currently feeling.>
>
> - Scott
Scott-That is a very good description of the kind of experience I've had with a few exceptions. I can say, at least years ago, that many of the drugs I took would make "a dent" in my depression but never really achieved a true antidepressant effect. In these later years though, it has been much, much less with the results. Ironically, I am closer to death off drugs than on. I don't seem to have a choice as I see it.
-Bob
Posted by Bob on July 13, 2010, at 1:21:17
In reply to Why Trivastal Is Not Associated With Sleep Attacks, posted by Brainbeard on July 6, 2010, at 5:55:25
> > Why is Trivastal the only one not asociated with sleep attacks?
> >
> >
>
> I don't know!
Well are you assuming that Trivastal doesn't lead to sleep attacks, or just saying the association didn't show up in pubmed?
Posted by Brainbeard on July 13, 2010, at 4:31:12
In reply to Re: Why Trivastal Is Not Associated With Sleep Attacks » Brainbeard, posted by Bob on July 13, 2010, at 1:21:17
> Well are you assuming that Trivastal doesn't lead to sleep attacks, or just saying the association didn't show up in pubmed?
>Both, actually.
Posted by jade k on July 13, 2010, at 12:50:36
In reply to Potentiating Dopaminergic Drugs, posted by Brainbeard on July 12, 2010, at 5:10:28
> One way to potentiate dopaminergic drugs is to combine them with selegiline, the MAO-B inhibitor (at doses of 10mg or below), BUT this is very dangerous when you take too much of the dopaminergic add-on. Potentiation is estimated to be five-fold at least at the Bluelight forum. I've combined 10mg of selegiline with only 5mg of Ritalin and the boost lasted all day, but it was too jittery for my taste.
Wow, I didn't know that. How is it that many people can take high doses of other MAOI's and augment with stims without problems? Is it that Selegiline only involves the MAO-B inhibitor?
What are the potential dangers you mentioned?
Thanx,~Jade
Posted by Brainbeard on July 13, 2010, at 13:27:20
In reply to Re: Potentiating Dopaminergic Drugs » Brainbeard, posted by jade k on July 13, 2010, at 12:50:36
> > One way to potentiate dopaminergic drugs is to combine them with selegiline, the MAO-B inhibitor (at doses of 10mg or below), BUT this is very dangerous when you take too much of the dopaminergic add-on. Potentiation is estimated to be five-fold at least at the Bluelight forum. I've combined 10mg of selegiline with only 5mg of Ritalin and the boost lasted all day, but it was too jittery for my taste.
>
> Wow, I didn't know that. How is it that many people can take high doses of other MAOI's and augment with stims without problems? Is it that Selegiline only involves the MAO-B inhibitor?
> What are the potential dangers you mentioned?
> Thanx,
>
> ~Jade
>
>Perhaps those people are actually zombies? Just kidding, I don't know, full MAOI's are MAO-A and -B-inhibitors, aren't they?
Potential dangers are overheating, high blood pressure, cardiac trouble..
Posted by jade k on July 13, 2010, at 14:15:05
In reply to Re: Potentiating Dopaminergic Drugs, posted by Brainbeard on July 13, 2010, at 13:27:20
I got up to 80mg parnate and 40mg dexedrine, nixed the dexedrine, and subsequently had to stop the Parnate. It was a bummer cause I was in full remission for a while.
I'm currently trying to recreate this a/d effect. I know I'm low on dopamine. I responded to Parnate (don't know how much of that was due to the stim factor), stims: ritalin, dexedrine (not provigil), (not Wellbutrin, don't know why).
Stims only do so much, and I don't abuse.
SSRI's or anything serotonin makes me ill.
Aap's make me anxious. Lamictal, lithium, no good.I also take small amount of clonazapam for nerve pain, and have reduced as far as I can without headaches. I want to discontinue. Could I cross taper clon with xanax? (xanax has some a/d effect I read). I do really well on dexedrine, but I think I need to find a "true" a/d to go with it, not sure.
~Jade (Dx-MDD)
Posted by emmanuel98 on July 13, 2010, at 21:33:57
In reply to Re: Dopaminergic A/D's? Anyone? » Brainbeard, posted by jade k on July 13, 2010, at 14:15:05
Why did you have to stop the parnate?
Posted by jade k on July 13, 2010, at 22:05:16
In reply to Re: Dopaminergic A/D's? Anyone?, posted by emmanuel98 on July 13, 2010, at 21:33:57
> Why did you have to stop the parnate?
I was having some delusional episodes that told me (my family) I was sensitive enough that it was time to quit.
I've seen posts of people taking much higher doses and not having a problem. I'm definately in the minority. I took dexedrine as an augment, but stopped that early on, and the episodes continued. It was the parnate I couln't tolerate.
What dose are you on? Do you augment?
~Jade
Posted by emmanuel98 on July 13, 2010, at 23:22:16
In reply to Re: Dopaminergic A/D's? Anyone? » emmanuel98, posted by jade k on July 13, 2010, at 22:05:16
I augment with 12mg perphenizine and 200mg lamicatal. Neither gives me any s/e's.
Posted by jade k on July 13, 2010, at 23:31:06
In reply to Re: Dopaminergic A/D's? Anyone?, posted by emmanuel98 on July 13, 2010, at 23:22:16
Sounds like a safe combo, hope its working for you!
~Jade
Posted by SLS on July 14, 2010, at 5:19:45
In reply to Re: Dopaminergic A/D's? Anyone? » Brainbeard, posted by jade k on July 13, 2010, at 14:15:05
Neurontin (gabapentin) is good for nerve pain. You could do a quick trial and see if it produces an antidepressant effect as well. If your headaches are migraine, a low dosage of Topamax (topiramate) might make sense. It, too, can produce an antidepressant and mood-stabilizing effect. The other option, to which I would give careful consideration, is to return to the Parnate and use an anti-manic agent in combination. These would include Zyprexa, Seroquel, Risperdal, and possibly Geodon. Also, there are the anticonvulsants, which I would recommend looking at Depakote and Trileptal.
- Scott
Posted by jade k on July 14, 2010, at 13:32:07
In reply to Re: Dopaminergic A/D's? Anyone? » jade k, posted by SLS on July 14, 2010, at 5:19:45
Hi Scott,
> Neurontin (gabapentin) is good for nerve pain. You could do a quick trial and see if it produces an antidepressant effect as well.
I keep looking at this med, but then get scared off. Its seems a quick trial couldn't hurt.
My headaches are severe when they hit but are not real migraines. They're caused by damaged nerves in my neck. Interestingly, I didn't have any headaches, or pain of any kind, while on Parnate.
>The other option, to which I would give careful consideration, is to return to the Parnate and use an anti-manic agent in combination. These would include Zyprexa, Seroquel, Risperdal, and possibly Geodon. Also, there are the anticonvulsants, which I would recommend looking at Depakote and Trileptal.
I've considered this. Not sure it would even be an option at this point. I'll run it by my pdoc. I was on Geodon post parnate.
I wonder if I'm a good candidate for Nardil. My only hesitation is I already suffer from debilitating fatigue.
Thanks,
~Jade
ps-hope your Nardil kicks in soon.
Posted by Brainbeard on July 14, 2010, at 13:49:00
In reply to Re: Dopaminergic A/D's? Anyone? » SLS, posted by jade k on July 14, 2010, at 13:32:07
Hey, for migraines, lisuride may be an option. It's a dopamine agonist, and a 5HT1A-agonist, so you could say it's a dopaminergic antidepressant too.
Posted by jade k on July 14, 2010, at 14:06:11
In reply to How about lisuride?, posted by Brainbeard on July 14, 2010, at 13:49:00
> Hey, for migraines, lisuride may be an option. It's a dopamine agonist, and a 5HT1A-agonist, so you could say it's a dopaminergic antidepressant too.
Hey Brainbeard,
My headaches are severe when they hit but are not real migraines. They're caused by damaged nerves in my neck. The dopaminergic antidipressant part sounds good, is Lisuride available in the US? I was planning to ask my pdoc about meds used for Parkinson's. I have no idea what the effect (if any) would be.
~Jade
Posted by Brainbeard on July 14, 2010, at 14:20:39
In reply to Re: How about lisuride? » Brainbeard, posted by jade k on July 14, 2010, at 14:06:11
> > Hey, for migraines, lisuride may be an option. It's a dopamine agonist, and a 5HT1A-agonist, so you could say it's a dopaminergic antidepressant too.
>
> Hey Brainbeard,
>
> My headaches are severe when they hit but are not real migraines. They're caused by damaged nerves in my neck. The dopaminergic antidipressant part sounds good, is Lisuride available in the US? I was planning to ask my pdoc about meds used for Parkinson's. I have no idea what the effect (if any) would be.
>
> ~Jade
>
>
I dunno if it's available in the US, I'm in Holland. Any antidepressant effect could take a couple of weeks to manifest.
Posted by sigismund on July 14, 2010, at 16:06:49
In reply to Re: How about lisuride?, posted by Brainbeard on July 14, 2010, at 14:20:39
You are liking lisuride?
Posted by jade k on July 14, 2010, at 17:00:37
In reply to Re: Dopaminergic A/D's? Anyone? » SLS, posted by jade k on July 14, 2010, at 13:32:07
"Phenylalanine is converted into tyrosine, then dopamine, L-Dopa, norepinephrine, and lastly epinephrine."
Where in this scenario does an a/d, stim, or other treatment intervene?
What does this mean in terms of treating dopamine depletion, low level dopamine neurotransmitter, etc. (different treatments intervene in different places?)
~Jade
ps-I see pdoc tonight. I'm outta my league here. After tonight I'm gonna stick to the things I have experience with. Too complex for my depressed mind to comprehend.
Posted by jade k on July 14, 2010, at 17:11:11
In reply to Re: Dopamine Trail, posted by jade k on July 14, 2010, at 17:00:37
Dopamine release. MAOI's. Stims. The end.
~Jade
Posted by Brainbeard on July 15, 2010, at 6:53:21
In reply to Re: How about lisuride? » Brainbeard, posted by sigismund on July 14, 2010, at 16:06:49
> You are liking lisuride?
I haven't tried it long enough to know wether I like it. Not immediately, in any case.
Posted by sigismund on July 15, 2010, at 22:13:36
In reply to Re: How about lisuride?, posted by Brainbeard on July 15, 2010, at 6:53:21
After I asked that I read what you wrote on the Neurotransmitters Board.
Doesn't sound better than Trivastal.
This is the end of the 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.