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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 42. Go back in thread:
Posted by morgan miller on July 27, 2011, at 11:08:03
In reply to Re: calling ZYPREXA, posted by Zyprexa on July 27, 2011, at 9:28:12
If you take folate, take Solgar's l-methylfolate. Some of your meds may be depleting nutrients like folate, something your doctors don't talk about, so you should probably be taking it anyway.
Posted by morgan miller on July 27, 2011, at 11:13:22
In reply to calling ZYPREXA, posted by B2chica on July 26, 2011, at 14:02:25
The problem I have with this polypharmacy is that you are taking a powerful stimulant like adderall, which might be making it necessary for you to take some of the other medications. Or, your condition is less stable and some of the meds are not as effective because of the adderall. I bet with time, you could find a way to function well and feel better, more stable, without something like adderally in your regimen. Adderall cannot be good for anyone with a disorder that involves mood swings or psychosis.
I'm sure you have tried lithium and depakote. How did you do on these? Did you take time to try to find a dose that was still somewhat effective without unbearable side effects? Did you know you have to take L-carnitine and folate when you are on Depakote? And folate and maybe inositol when you are on a reasonable dose of Lithium? You see, doctors neglect to talk about these things. Another reason why I'm totally disappointed in the field of psychiatry.
Morgan
Posted by Christ_empowered on July 27, 2011, at 11:20:21
In reply to Re: calling ZYPREXA, posted by morgan miller on July 27, 2011, at 11:13:22
Hey. I take a B-100 capsule 2x daily. I take lots of other stuff, too (niacinamide, taurine, green tea extract, vitamin c, vitamin e+selenium, zinc, etc.), but the B-100 really does help a lot. Take it with food.
Posted by B2chica on July 27, 2011, at 12:37:19
In reply to Re: calling ZYPREXA » B2chica, posted by morgan miller on July 27, 2011, at 11:05:56
thanks mm.
i have pretty much cut out most processed foods. at home we cook almost all dinners from scratch. including my bread with flax seed (which sounds very good right now) though i make it less in the summer due to it heating up the house.
and i know i really need to stop or limit my doughnut in the morning. i think i work great from toast with (real)butter and tahini. its a great start for morning.
just been lazy lately and in a rush.
we don't fry very much but we only use olive oil. one of my daughters has a very severe pn/tn allergy so we need to watch what is in our house. her specialist did say to avoid coconut till she gets a bit older and retested. otherwise id give it a try.as for grains. i don't think i eat a whole lot of those except oatmeal and i use granola (hard to find with no pn/tn) with my plain yogurt.
if you have any favorites, im always looking for fresh ideas.
btw i LOVE tabour salad, put that in a tortilla with spinach-from garden;) and UM!
(ok, there's my other grain)
Posted by B2chica on July 27, 2011, at 12:49:39
In reply to Re: calling ZYPREXA, posted by morgan miller on July 27, 2011, at 11:13:22
actually there was one point where i was ONLY on adderall. i am taking it mostly for mood, some for focus and energy due to lethargy.
you would have to fight me tooth and nail to convince me to have that taken away :)
i know its strong, but i also don't have the same SE some have due to its strength, so i think my body does need it.
the perphenazine i'm on for anxiety but i have that whether i'm on adderall or not and to a similar severe degree, so i have chosen to stay on it.i have not tried lithium or depakote. vie been on three other mood stabilizers and do very poorly on them, they actually create mood swings in me. I haven't tried lithium only because i've said no in the past.
my 'previous' best friend was on that when she past away. i know we are all different, but i equate lithium with her suicide. i just cant go there. MOAI's and Lithium are on my 'last ditch effort' list.and yes. i know you are disappointed with psychiatry as a field.
i agree to an extent. i believe that psychiatrists in general are not allowed the same research funds as other fields. the research is all on the meds not on practice.and i would be fully disappointed if not for my current pdoc. He is so different from any others i've had.
1. he spends at least a half hour with me each visit.
2. he is Very holistic
3. he differentiates psychological issues from biological ones
4. is well versed in psychopharmacology
5. he's cute
ooops i didn't need to put that in there :)
5b. he is very intelligent and has been at several big hospitals
6. and is up on latest research.but that is my personal opinion and BELIEVE ME! i have had some DOOOSIES
in the past. people who probably Barely graduated medical school.
and if that was what i'd base it on, id tell EVERYONE to be their own doc!but alas. it is not. i account this one very caring and intelligent doctor.
i feel blessed to such a competent doctor.
Posted by B2chica on July 27, 2011, at 12:50:18
In reply to B-100, posted by Christ_empowered on July 27, 2011, at 11:20:21
Posted by morgan miller on July 27, 2011, at 13:23:45
In reply to Re: calling ZYPREXA » morgan miller, posted by B2chica on July 27, 2011, at 12:49:39
Sorry about your friend. I do not believe that lithium had anything to do with her suicide though. Unless maybe, she was mistreated with it, and given too high a dose, which made her feel worse and worsened her physical health.
Lithium and depakote get a bad rap, if used properly with the right supplementation, many people can do well on these medications and live very healthy lives. You just never know until you try something.
What SSRIs have you tried?
Morgan
Posted by B2chica on July 27, 2011, at 13:41:49
In reply to Re: calling ZYPREXA » B2chica, posted by morgan miller on July 27, 2011, at 13:23:45
Logically i know it wasn't the drug that did it. but i still link the fact of it not working for her. i think if my current pdoc strongly suggested it i would take it.
anyway. thank you.
and here is a link from last month that i listed (i think) everything i've tried. i think i forgot ativan and maybe one AD, not for sure...there've been so many.but i'm going to keep my hopes up for now that deplin will work. maybe...just maybe its right for me.
but if not. i will try again. i have nothing to lose.
thanks
b2c.
Posted by floatingbridge on July 27, 2011, at 14:34:16
In reply to Re: calling ZYPREXA » floatingbridge, posted by morgan miller on July 27, 2011, at 6:12:47
Morgan, I do look at my treatment history. Dexidrine was amazing. I suspect it wrecked my health (which was already diving due to chronic PTSD and depression) but it flipped the lights on. However, I will also never take it again.
Since recovery and rerecovery is a process of continual re-evaluation, I have currently decided that no ssri nor snri has served me. Notice the use of I statements here. This is not prescriptive. Those two agents created a deep instability in my mood. So let me update you about my current thoughts
on my initial ssri. That and they drained the joy out of my own personal life. No deep laughter, no orgasm, pointless crying for no reason. At least now, when I cry, I have a reason.Polypharmacy for myself is completely out of the question.
My new (thank god good) shrink suggested an augment if
things don't speed up, and I said no. Flatly no. And you know what he said? He actually agreed. He was just trying to his job, but when I said I am done having my meds stacked like jets over JFK airport, he was very cool about it.
And kinda' sad and sober. To his credit, he's just doing the best he can with his science, and he very clearly sees the limits. No drug reps. No piles of samples. He went straight
to the mildest maoi because I said snri's make me worse. Clearly he reads and is aware that snri's are *theoretically* implicated in complicated mood issues.And just so you know that I hear you and respect your advice, I told my old pdoc to f*ck off with his %100 remission
rate. I even say forget %70 in my case. I'll settle for %50 as
long as I can find a way to live that is worthwhile. I am open to being surprised, though. %70 would be happily accepted
here.How many times do I need to remind you, yes to:
Yoga
Therapy
Exercise
Breathing
Dbt skills
Socialization
Fish oil
Whole foodsI have a child. Do you know that the greatest taboo in the United States is to be a mother with chronic depression? Yeah. I break taboos every f*ck*ng day of my life. What else is taboo in this country? Depression (unless it's called feeling blue). Anxiety is well, *just* anxiety. How many times per day can someone feel the fear and do it anyway? Guess that varies from person to person. Being afraid and being
vulnerable is taboo. Having PTSD. No matter what press PTSD gets, everyone is haunted by the 'why me' thing? And if some people know how frightened a person is, well it makes them angry or
worse. Some people will say *it's only PTSD. You don't need any medication. In fact, I'm gonna take away every medication you have because all addicts have PTSD, and if you have PTSD, then you are an addict at heart, too.*That's my recovery to date. So yes I hear you. Yes, I look at my treatment history. Please stop asking me to do that, okay? I can hear you just fine. In fact, I now take lemon balm with my GABA--because of you.
You have and continue to be an important voice for me on babble. Thank you for being Morgan.
fb
> FB, look at your medication history, where has it gotten you? Didn't you say one time that you wish you had just stuck with the SSRI that worked o.k. for you. I realize this may have been your doing and not the doctor, but I'm just trying to make the point that the medication merri-go-round and this out of control polypharmacy, in the absence of a more integrative approach, seems to be making recovery harder for many people. Maybe it works for some, like Scott, but I don't know of many people doing very well that take some crazy cocktail of meds. I hear more about side effects than benefits. I'm not saying polypharmacy never works, I just believe it is used all too often, and again, in the absence of a more integrative approach-proper exercise, therapy(group is best!), diet(paleo!), supplements(amino acids/fish oil/magnesium/vitamin D3), the right amount of support(actually, most have zero control over this, which is sad), yoga, meditation, and working hard to socialize and find some kind of easy job that is somewhat enjoyable(if the person has not been working for a while and can work). Oh, and time!!! We are often too much in a rush to stack up the drugs in an attempt to feel better. We also often think we need to solve everything with drugs, we start thinking that drugs are the only way to manage symptoms. I always hear about wanting to reach full remission using medication. What ever happened to getting 70 percent relief, then working hard at other things to get the other 30 percent? Or, just dealing with the other 30 percent, because in my opinion, 70 percent is pretty damn good.
>
> Morgan
Posted by emmanuel98 on July 27, 2011, at 18:46:36
In reply to Re: calling ZYPREXA » morgan miller, posted by B2chica on July 27, 2011, at 12:49:39
Not all p-docs are terrible. Mine has done therapy with me for 6-1/2 years. He insisted I try to find a DBT therapist and group, since these would be more effective for me than medical interventions. He has actually gone to meet with my DBT therapist and speaks with her on the phone nearly every week. A couple of times, he has had me on multiple meds, but immediately begins to try to cut them back -- cutting out one at a time, seeing what effect it has. Maybe it helps that he is older, trained in therapy, ran a clinic where he worked with SWs and PsyDs and has his BA in psychology.
Posted by Phillipa on July 27, 2011, at 19:41:33
In reply to Re: calling ZYPREXA » B2chica, posted by Zyprexa on July 27, 2011, at 7:57:48
Zyprexa thanks for coming. Love Phillipa
Posted by morgan miller on July 27, 2011, at 22:43:08
In reply to Re: calling ZYPREXA » morgan miller, posted by B2chica on July 27, 2011, at 13:41:49
Have you been on several medications at a time for a while now? Did you ever get a chance to try an SSRI for a few months with just one or 2 other medications?
IMHO, it does not appear you have tried the 2 best mood stabilizers, lithium and depakote. It may be worth mentioning these to your pdoc at some point.
Hope you find relief soon! Good luck!
Morgan
Posted by morgan miller on July 27, 2011, at 22:50:39
In reply to Re: calling Morgan » morgan miller, posted by floatingbridge on July 27, 2011, at 14:34:16
I enjoyed that post FB, and hear you loud and clear. I'm sorry for making the point about your medication history. I get fired up sometimes and miss the mark on being gentle. My bad. You're writing is interesting, creative, and stimulating-I thoroughly enjoy reading many of your posts. You truly do have a way with words FB.
I'm glad you're being such a strong advocate for yourself, great for you!
Hope you find more relief soon!
Morgan
Posted by morgan miller on July 27, 2011, at 22:53:04
In reply to Re: calling ZYPREXA, posted by emmanuel98 on July 27, 2011, at 18:46:36
Sounds like a good guy emmanuel, you're lucky. He is right about group, we should all be in it. Actually, everyone, I mean everyone in the world, would benefit from psychodynamic group therapy.
Posted by floatingbridge on July 27, 2011, at 23:43:22
In reply to Re: calling Morgan » floatingbridge, posted by morgan miller on July 27, 2011, at 22:50:39
I get very fired up, too :-/ It's a problem. Thanks for the kind words.
fb
> I enjoyed that post FB, and hear you loud and clear. I'm sorry for making the point about your medication history. I get fired up sometimes and miss the mark on being gentle. My bad. You're writing is interesting, creative, and stimulating-I thoroughly enjoy reading many of your posts. You truly do have a way with words FB.
>
> I'm glad you're being such a strong advocate for yourself, great for you!
>
> Hope you find more relief soon!
>
> Morgan
Posted by Zyprexa on July 28, 2011, at 0:23:50
In reply to Re: calling ZYPREXA » Zyprexa, posted by B2chica on July 27, 2011, at 10:56:57
I take B-100, its 100 mcg/mg of all the B vitamins. I also take a very high dose of folic acid(B9) because I have a defficiency of it. When I first started the B-100 I noticed an imediate difference, not sure how to explain it, but I didn't feel so disconected and felt more here also colors were brighter. At the time it seemed ADing.. Now its been a while taking it and I don't realy notice anymore. But still feel better. Also I take the b-vits becauese drinking alcohol depleated your b-vits, so I counteract this, probably why i have b-9 deficiency.
Posted by Zyprexa on July 28, 2011, at 0:31:56
In reply to Re: calling ZYPREXA, posted by morgan miller on July 27, 2011, at 11:13:22
It was actualy my pdoc who got me on B-100 and my Gdoc on deplin, which didn't work, so I got the idea to take folic acid and it worked, just needed to take 8 times the daily dose.
Posted by B2chica on July 28, 2011, at 11:11:31
In reply to Re: calling ZYPREXA » B2chica, posted by morgan miller on July 27, 2011, at 22:43:08
thanks MM very good comments you pose.
most of the ssri's i tried alone or with only one other med first.
wellbutrin (was the only one that worked alone and worked very well but within -i think-6 months pooped out then added zoloft,etc
i LOVED wellbutrin, and wish i could go back on it. i was on it first in 2004 i think and tried it again in 2008, tried two generics of it and the real deal. nothing worked, then tried polypharmacy with itnothing.Thank you but i will not try depakote. i know my body and its reactions. old pdoc tried me on several MS as mono and polypharmacy i don't have mood swings (perse) until i get on one. Then they are REALLY obvious.
Someday if needed i may try lithium but not now, i think i'd go back on zyprexa before lithium.through all the years the only thing that has worked consistently is zyprexa.
however as of late i was still carrying all my baby weight and was having physical pain due to it so i couldn't gain any more weight (gained 25lbs in little over 2 months on zyprexa this time tipping scale at 180.)i'm now back down to 140. i had to get to atleast 10mg for it to work and that's when i gain weight.
but i think for now i'm too worn out to worry about things right now.
i'm augmenting with zyprexa for two weeks and hopefully my pdoc was right and just temp drop in AD and just augment for few weeks and then i'll be better again.
or maybe deplin.
i just cant think past that right now. no sense in me getting so freaked out until i have too. Lord knows i do enough of that.Thanks for you helpful comments MM.
b2c.
Posted by floatingbridge on July 28, 2011, at 11:54:37
In reply to Re: calling ZYPREXA, posted by B2chica on July 28, 2011, at 11:11:31
Just to second Morgan's idea about lithium, I did well on a dose of 300mg. No sx's. I maybe could have gone to 450mg. It seems more wholesome to me than depakote. Depakote did squat for me personally. I read your post about your friend and lithium. I am very sorry and hope this post isn't going to aggravate any understandable dread may have.
So many are pulling for you here.
(You may have read it, I don't know, but I didn't do too well on the ssri/snri class. Not for want of trying for 12 years :(. )
> thanks MM very good comments you pose.
> most of the ssri's i tried alone or with only one other med first.
> wellbutrin (was the only one that worked alone and worked very well but within -i think-6 months pooped out then added zoloft,etc
> i LOVED wellbutrin, and wish i could go back on it. i was on it first in 2004 i think and tried it again in 2008, tried two generics of it and the real deal. nothing worked, then tried polypharmacy with itnothing.
>
> Thank you but i will not try depakote. i know my body and its reactions. old pdoc tried me on several MS as mono and polypharmacy i don't have mood swings (perse) until i get on one. Then they are REALLY obvious.
> Someday if needed i may try lithium but not now, i think i'd go back on zyprexa before lithium.
>
> through all the years the only thing that has worked consistently is zyprexa.
> however as of late i was still carrying all my baby weight and was having physical pain due to it so i couldn't gain any more weight (gained 25lbs in little over 2 months on zyprexa this time tipping scale at 180.)i'm now back down to 140. i had to get to atleast 10mg for it to work and that's when i gain weight.
>
>
> but i think for now i'm too worn out to worry about things right now.
> i'm augmenting with zyprexa for two weeks and hopefully my pdoc was right and just temp drop in AD and just augment for few weeks and then i'll be better again.
> or maybe deplin.
> i just cant think past that right now. no sense in me getting so freaked out until i have too. Lord knows i do enough of that.
>
> Thanks for you helpful comments MM.
> b2c.
>
>
>
>
Posted by floatingbridge on July 28, 2011, at 11:59:38
In reply to Re: calling ZYPREXA, posted by B2chica on July 28, 2011, at 11:11:31
Hey B2c, if zyprexa works for you, that's great you know that and you have that to-go-to medication. Whatever anyone says, including your own mind because you are smart and read all this stuff, I support you using zyprexa judiciously. Crashing negative thoughts are damaging to one's brain in a real world way. They are more than inconvenient. I support you taking care of yourself in this crisis.
fb
>
> Thank you but i will not try depakote. i know my body and its reactions. old pdoc tried me on several MS as mono and polypharmacy i don't have mood swings (perse) until i get on one. Then they are REALLY obvious.
> Someday if needed i may try lithium but not now, i think i'd go back on zyprexa before lithium.
>
> through all the years the only thing that has worked consistently is zyprexa.
> however as of late i was still carrying all my baby weight and was having physical pain due to it so i couldn't gain any more weight (gained 25lbs in little over 2 months on zyprexa this time tipping scale at 180.)i'm now back down to 140. i had to get to atleast 10mg for it to work and that's when i gain weight.
>
>
> but i think for now i'm too worn out to worry about things right now.
> i'm augmenting with zyprexa for two weeks and hopefully my pdoc was right and just temp drop in AD and just augment for few weeks and then i'll be better again.
> or maybe deplin.
> i just cant think past that right now. no sense in me getting so freaked out until i have too. Lord knows i do enough of that.
>
> Thanks for you helpful comments MM.
> b2c.
>
>
>
>
Posted by B2chica on July 28, 2011, at 12:28:26
In reply to Re: calling ZYPREXA » B2chica, posted by floatingbridge on July 28, 2011, at 11:59:38
ya zyprexa has always seemed to be my go to med. normally the only side effect is weight gain. but this time i am getting minor headaches and man the dry mouth is crazy bad. i REALLY need to drink more water!
thanks fb.
Posted by emmanuel98 on July 28, 2011, at 21:06:43
In reply to Re: calling ZYPREXA » floatingbridge, posted by B2chica on July 28, 2011, at 12:28:26
Dry mouth is tolerable. I have terrible dry mouth from parnate. My tongue literally sticks to the roof of my mouth and I can't talk without a sip of water. I teach and keep a water bottle handy at all times. I asked my dentist if this was a problem and he said no, as long as I keep hydrated.
Posted by floatingbridge on July 28, 2011, at 22:34:15
In reply to Re: calling ZYPREXA, posted by emmanuel98 on July 28, 2011, at 21:06:43
> Dry mouth is tolerable. I have terrible dry mouth from parnate. My tongue literally sticks to the roof of my mouth and I can't talk without a sip of water. I teach and keep a water bottle handy at all times. I asked my dentist if this was a problem and he said no, as long as I keep hydrated.
Xylitol really helps as well. Also to prevent gum damage due to dry mouth. Look for it in toothpaste, chewing gum, and mouth rinses.
Posted by desolationrower on July 30, 2011, at 21:55:34
In reply to Xylitol for dry mouth, posted by floatingbridge on July 28, 2011, at 22:34:15
> > Dry mouth is tolerable. I have terrible dry mouth from parnate. My tongue literally sticks to the roof of my mouth and I can't talk without a sip of water. I teach and keep a water bottle handy at all times. I asked my dentist if this was a problem and he said no, as long as I keep hydrated.
>
> Xylitol really helps as well. Also to prevent gum damage due to dry mouth. Look for it in toothpaste, chewing gum, and mouth rinses.
>+1
i don't know why anyone buys gum other than xylitol stuff. well, i guess you do need to good for it, not just pick up from the bodega
-d/r
Posted by utopizen on August 8, 2011, at 12:10:08
In reply to Re: Xylitol for dry mouth, posted by desolationrower on July 30, 2011, at 21:55:34
> > Xylitol really helps as well. Also to prevent gum damage due to dry mouth. Look for it in toothpaste, chewing gum, and mouth rinses.
> >yup. Biotene is great stuff. =)
also make sure to use a nightguard if you have any bitemarks/gum recession going on... that's caused by clenching of the teeth, and makes things worse.
If you have it like so bad that you are literally incapable of distinguishing it from cotton balls being squeezed in your mouth, there's always Evoxac...
Keep in mind you don't want to resort to a dry mouth pill unless you have to, as they do have the potential to cause sudden death (a heart condition).
But they do get the job done. You'll drool on your pillow. =)
This is the end of the thread.
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