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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on May 4, 2011, at 14:38:41
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 4, 2011, at 14:28:03
> "if you dont like it you can always discontinue" yes that's true. thats what was in my head when i first started taking any meds that affect your mood..unfortunately, every single med ive taken, and the effect it had on my emotions, has stayed with me to this day. for the past 5 years all ive been living with the awful hell the 1st set of meds i took caused me, and trying to find a way to undo it. i mean, ive read about many people that had anhedonia caused by mirapex, but their brain got over it in like a month.. and im sure this sounds unreal, but i took buspirone last week, ne time, it made me feel horrible, and i still feel exactly like i did an hour after i took it...
Have you ever tried a stimulant?
- Scott
Posted by floatingbridge on May 4, 2011, at 15:04:09
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 4, 2011, at 14:28:03
poser, I imagine you've shared some of this with your doctor. Is she (you said she?) aware how much you struggle with med sensitivities and post-discontinuation issues?
I can only speak for myself, but I don't take med trials lightly, either. You aren't alone in your concerns at all. I hope you can get through to your doctor and air
out your concerns to your satisfaction. I am curious what she says about prescribing risperdal and how that fits into your treatment strategy if you are interested in posting about it. Hang in there.fb
Posted by poser938 on May 4, 2011, at 15:05:02
In reply to Re: What Do You Think Of This Idea? » poser938, posted by SLS on May 4, 2011, at 14:38:41
yes, the first meds i was prescribed were cymbalta and adderall. the adderall was amazing for a month til it caused anhedonia. long story short, i stumbled upon cyproheptadine, and it helped to give me like 70 percent of my feelings back. i waited 2 years to see if id improve, but i didnt improve much. thats when i tried mirapex... and once again i have anhedonia.. tried cyproheptadine again and it helped but this time, only a small amount and my tolerance got too high to it....
Posted by SLS on May 4, 2011, at 15:26:43
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 4, 2011, at 15:05:02
Anhedonia is a symptom of depressive illness. It is possible that the course of your illness has changed trajectory, leaving you more depressed than you had been previously. In any event, I don't think it is productive to look to treat anhedonia as a separate condition. Try treating the anhedonia as if it were a symptom of a depressive disorder. Treat the depression, and the anhedonia might diminish.
You might want to combine Wellbutrin with Abilify if you can't tolerate SSRIs / SNRIs.
- Scott
Posted by poser938 on May 4, 2011, at 16:33:29
In reply to Re: What Do You Think Of This Idea? » poser938, posted by SLS on May 4, 2011, at 15:26:43
the way i look it, at it, i never had depression or anything before i started meds. i only thought i did. it was just normal teen problems. the state of mind im in occured because of the meds.. it cant be a coincidence that the anhedonia that started while i was taking meds was not caused by the meds. my doctor told me yesterday that we're running out of options for me to try...
and with the cyproheptadine, it was as if it made my brain more tolerant of dopamine, such as the dopamine that my brain naturally produces. and in the past when it helped me with the anhedonia caused by adderall.. right before taking the cyproheptadine my brain was completely numnb to all effects of the adderall. right after my course on cyproheptadine, which lasted about a month, i figured id try adderall one time.. and i could feel the effects of it fully.
Posted by poser938 on May 4, 2011, at 16:38:44
In reply to Re: What Do You Think Of This Idea? » poser938, posted by SLS on May 4, 2011, at 15:26:43
now you're right, i do need to treat the depression i have right now. the doctor and i, from experimentint with meds, have figured out that my depression is dopamine related. i dont do well on ssri's or snri's. but because of the mirapex making my receptors unresponsive to dopamine, taking any med now causes the receptors to become less and less sensitive... while making me worse.. blahh i just dont know..
Posted by Zyprexa on May 5, 2011, at 4:20:11
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 4, 2011, at 16:38:44
I've had many med trials with APs. Yes they have a long lasting effect on me even after I discontinue them. The best thing to do is take the first dose on a day you don't have to do anything, like a weekend. Maybe start with a reduced dose the first time to see what it does. And the shorter the trial the shorter the side effects last after discontinuation. They do go away it just takes some time, could be years but usualy goes away. I took abilify for 2 weeks and the withdraw effects lasted 1.5 months. Later I took abilify for 6 months and its taking years to get over it. I'm stable again now but still not back where I started. I got TD from an AP I took in the hospital and It took about 4 years for it to totaly go away. I took geodon and it gave me blured vision, took about 4 months to go away after discontinuation.
Posted by SLS on May 5, 2011, at 5:23:29
In reply to Re: What Do You Think Of This Idea?, posted by Zyprexa on May 5, 2011, at 4:20:11
> I've had many med trials with APs. Yes they have a long lasting effect on me even after I discontinue them. The best thing to do is take the first dose on a day you don't have to do anything, like a weekend. Maybe start with a reduced dose the first time to see what it does. And the shorter the trial the shorter the side effects last after discontinuation. They do go away it just takes some time, could be years but usualy goes away. I took abilify for 2 weeks and the withdraw effects lasted 1.5 months. Later I took abilify for 6 months and its taking years to get over it. I'm stable again now but still not back where I started. I got TD from an AP I took in the hospital and It took about 4 years for it to totaly go away. I took geodon and it gave me blured vision, took about 4 months to go away after discontinuation.
I can't imagine how frustrating and demoralizing your experience with APs has been. I would say that yours have been atypical reactions to these drugs. That doesn't make them any less real, of course.
What were the lingering effects of Abilify?
- Scott
Posted by poser938 on May 5, 2011, at 15:17:36
In reply to Re: What Do You Think Of This Idea?, posted by Zyprexa on May 5, 2011, at 4:20:11
yahh i cant imagine being made worse than i am right now.. im just pissed at what these meds have done to me.. every single thing ive taken has stuck with me years after stopping it. im completely numb already :(
Posted by floatingbridge on May 5, 2011, at 15:57:01
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 5, 2011, at 15:17:36
Poser, I was thinking about your posts and this thread in particular along with all sorts of random thoughts of my own.
Thinking about a treatment strategy that includes medication if that is your choice, (it should always be a personal choice imo), and other elements as well.
You still have neuroplasticity. I happen to believe studies that suggest this. So what can you do? I know you are in an awful fix right now, the intensity of which I don't feel I underestimate.
What can we do to promote brain and nerve health?
What can you do for yourself in your unique situation?
I like that you can see a trajectory of your condition. Teen within normal spectrum of distress medicated with unfortunate results. You presented symptoms of ADD or ADHD plus stuff I didn't pick up on. But you can see your beginning in context. Do you think therapy alone would have helped? (I ask
because of the regret read into your posts. And the anger.) Whether therapy helped then, wasn't tried, whatever, it could help now. If it isn't helping a bit right now, could you have a more helpful therapist. Could you work your therapy more effectively?Treating the depression you experience now sounds like some solid advice. Through meds, therapy, and/or ? Even if therapy helps move through regret of mistakes made by you, doctors, well or not so well-intentioned or lucid others (quaintly known as family, school, parental units).
There is a real value, to me at least, in being able to form a coherent narrative of events that one can live with. (I'm still
working on mine.) Positive decisions, including positive risk-taking are more easily made. Like thinking about trying Risperdal, for instance. Get as much facts and info. Information includes you
and your observations, satisfactory discussions with your providers (that can include their narrative of your treatment), and insight and connection to friends or family, even if that has dwindled for the time being.Facts are, well, facts--but facts are debatable, right? And part of the debate is the contents of that beautiful and scary black box called the human brain.
I hope this reads alright to you, and I certainly hope you know that somehow you are alright or going to be alright, and judging by the responses to your threads, people care about you, and you are worth caring for.
My 2¢ today from a gal that remembers when candy was sold two for a penny.
take very good care, and forgive the lecture; it's partly a genetic feature methinks.
fb
Posted by poser938 on May 5, 2011, at 21:56:28
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 5, 2011, at 15:17:36
floatingbridge.. there was a problem with your last post. everytime i try to open it.. it says error. maybe if you post it again it will work.
Posted by floatingbridge on May 5, 2011, at 22:42:03
In reply to Re: What Do You Think Of This Idea? » poser938, posted by floatingbridge on May 5, 2011, at 15:57:01
The only way I have to repost. For what it's worth. I really can sympathize with your dilemma.
Sometime I get a server error. I click my phone screen (a long press or something like that), and that will pull babble up on another browser window. Hope your day has been alright. Take care. fb
> Poser, I was thinking about your posts and this thread in particular along with all sorts of random thoughts of my own.
>
> Thinking about a treatment strategy that includes medication if that is your choice, (it should always be a personal choice imo), and other elements as well.
>
> You still have neuroplasticity. I happen to believe studies that suggest this. So what can you do? I know you are in an awful fix right now, the intensity of which I don't feel I underestimate.
>
> What can we do to promote brain and nerve health?
>
> What can you do for yourself in your unique situation?
>
> I like that you can see a trajectory of your condition. Teen within normal spectrum of distress medicated with unfortunate results. You presented symptoms of ADD or ADHD plus stuff I didn't pick up on. But you can see your beginning in context. Do you think therapy alone would have helped? (I ask
> because of the regret read into your posts. And the anger.) Whether therapy helped then, wasn't tried, whatever, it could help now. If it isn't helping a bit right now, could you have a more helpful therapist. Could you work your therapy more effectively?
>
> Treating the depression you experience now sounds like some solid advice. Through meds, therapy, and/or ? Even if therapy helps move through regret of mistakes made by you, doctors, well or not so well-intentioned or lucid others (quaintly known as family, school, parental units).
>
> There is a real value, to me at least, in being able to form a coherent narrative of events that one can live with. (I'm still
> working on mine.) Positive decisions, including positive risk-taking are more easily made. Like thinking about trying Risperdal, for instance. Get as much facts and info. Information includes you
> and your observations, satisfactory discussions with your providers (that can include their narrative of your treatment), and insight and connection to friends or family, even if that has dwindled for the time being.
>
> Facts are, well, facts--but facts are debatable, right? And part of the debate is the contents of that beautiful and scary black box called the human brain.
>
> I hope this reads alright to you, and I certainly hope you know that somehow you are alright or going to be alright, and judging by the responses to your threads, people care about you, and you are worth caring for.
>
> My 2¢ today from a gal that remembers when candy was sold two for a penny.
>
> take very good care, and forgive the lecture; it's partly a genetic feature methinks.
>
> fb
Posted by creepy on May 8, 2011, at 0:36:03
In reply to What Do You Think Of This Idea?, posted by poser938 on May 3, 2011, at 20:10:48
AAPs also antogonize some serotonin receptors and provide some antidepressant effects that way. Maybe your doc thinks the anhedonia / flatness is a depressive symptom?
Meds like trazodone and nefazodone also work on these same receptors but they dont get prescribed a whole lot.
Posted by poser938 on May 8, 2011, at 1:53:05
In reply to Re: for poser, posted by floatingbridge on May 5, 2011, at 22:42:03
yes, i had therapy when i 1st started getting treatment. i do think it helped with my normal life problems then... it might help some now, but i dont think anything can replace what emotions i cant feel. ive been reading peoples experiences with antipsychotics.. they're scary. it seems only about 10 percent actually like them. but ive been looking at how you can become tolerant to the effects of them. i think the tolerance might benefit me, because thats when it upregulates/sensitizes the receptors so much it cant keep up with it. but then i see how people have suffered because of such an increase in prolactin the meds cause, and that you dont get tolerant to that effect of the med. i'd bet if drug companies down to business on side effects or long term side effects.. theyd make tons of money.
but my theory right now is that it took a little over a month for mirapex to cause anhedonia, which is like a side effect of becoming tolerant to it i guess.. so maybeeee it might take a little over a month to to become tolerant to an antipsychotic and the side effect would be very sensitive dopamine receptors. i think thats my doctors plan too.
i asked her if i start taking that and start to feel even less pleasure in my life if i should stop, she said no, i wish i'd asked more questions tho. im calling her monday. i havent even started the med yet tho.... altho i did start taking an old med, hydroxyzine, which is a very light d2 antagonist, i dont think ive felt any effect of it tho.
Posted by poser938 on May 8, 2011, at 2:08:56
In reply to Re: for poser, posted by floatingbridge on May 5, 2011, at 22:42:03
i think the only people that have liked antipsychotics are people that have schizzophrenia. if its prescribed for anxiety tho, it seems to turn many into a vegetable. im exaggerating a little tho. but im just hoping i'll become tolerant if it does cause that. maybe i wont feel much from it tho because i think it would be mostly blocking off receptors that already arent responsive to dopamine. im now considering amisulpride instead of risperdal. and just to let you know, talking to you helps.
Posted by SLS on May 8, 2011, at 6:52:45
In reply to Re: What Do You Think Of This Idea?, posted by creepy on May 8, 2011, at 0:36:03
> AAPs also antogonize some serotonin receptors and provide some antidepressant effects that way. Maybe your doc thinks the anhedonia / flatness is a depressive symptom?
> Meds like trazodone and nefazodone also work on these same receptors but they dont get prescribed a whole lot.It is too bad that ritanserin will never come to market. It is a selective 5-HT2a/b/c antagonist that would probably do well as an adjunct to standard antidepressants. By itself, it is worthless except as a biological probe to investigate 5-HT receptor function.
Ultimately, pharmacotherapy might advance to the point at which very selective drugs will be designed specifically to use in first-line combination treatment. Of course, gene therapy might emerge first as the treatment of choice.
- Scott
Posted by floatingbridge on May 8, 2011, at 12:39:10
In reply to Re: What Do You Think Of This Idea?, posted by poser938 on May 5, 2011, at 21:56:28
I'm glad to hear you have more questions for your doc. You have alot going for you, unhappy as your situation currently is. I can't really comment about the neuroscience since my knowledge is fairly limited, but I trust your abilities and like that you are willing to wait it out to take a calculated risk. That seems very wise. And of course, I hope it works. Btw, miraprex was
shortlisted for me, and after following your posts and others, I'm less keen to try it. Risperdal sounded very good for my own situation--I had considered trying, but again, bumped up against the
risks, such as discontinuation issues by following various posts. So your posting has been very valuable to me, esp this last explanation of your strategy. I am learning how to better take calculated risks myself.You know many here are wishing you ongoing success.
fb
Posted by poser938 on May 8, 2011, at 19:51:52
In reply to Re: What Do You Think Of This Idea?, posted by SLS on May 8, 2011, at 6:52:45
we do have cyproheptadine tho. it used to help with my tolerance to dopamine agonists and the anhedonia it caused before i got too tolerant to the cyproheptadine. it anatgonizes 5ht2a and 5ht2c receptors, SLS
Posted by Zyprexa on May 11, 2011, at 4:37:14
In reply to Re: What Do You Think Of This Idea? » Zyprexa, posted by SLS on May 5, 2011, at 5:23:29
Abilify made me unbalanced. I was very anxious and panicy for a while. Zyprexa was less effective after the abilify.
Posted by SLS on May 11, 2011, at 5:42:51
In reply to Re: abilify lingering affects. » SLS, posted by Zyprexa on May 11, 2011, at 4:37:14
> Abilify made me unbalanced. I was very anxious and panicy for a while. Zyprexa was less effective after the abilify.
I'm very sorry to hear that.
In what ways does Zyprexa benefit you? Knowing this might help others to brainstorm your condition.
- Scott
Posted by Zyprexa on May 12, 2011, at 2:39:12
In reply to Re: abilify lingering affects. » Zyprexa, posted by SLS on May 11, 2011, at 5:42:51
It keeps me from going psychotic and acting weird.
Posted by SLS on May 12, 2011, at 5:40:36
In reply to Re: abilify lingering affects. » SLS, posted by Zyprexa on May 12, 2011, at 2:39:12
> It keeps me from going psychotic and acting weird.
I would think about adding a low dosage of an older antipsychotic. Navane (thiothixene) or Trilafon (perphenazine) would be good candidates to fill this role.
- Scott
Posted by B2chica on May 13, 2011, at 12:41:26
In reply to Re: abilify lingering affects. » Zyprexa, posted by SLS on May 12, 2011, at 5:40:36
great thought Scott. i think Zyprexa is taking perphenazine to augment zyprexa.
correct me if i'm wrong Zyprexa.
Posted by Phillipa on May 13, 2011, at 21:52:30
In reply to Re: abilify lingering affects., posted by B2chica on May 13, 2011, at 12:41:26
Pretty sure you are right. Phillipa
Posted by Zyprexa on May 15, 2011, at 20:01:11
In reply to Re: abilify lingering affects. » Zyprexa, posted by SLS on May 12, 2011, at 5:40:36
I did! I had to. I take 12mg x3 perphenazine with the higher dose of zyprexa, 15mg instead of 10mg. I feel mostly normal now. Maybe even more than before the abilify. I told my doctor I feel stable. Have not changed my meds now for almost a year!
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