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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by jono_in_adelaide on October 20, 2012, at 23:11:25
In reply to Re: up and down, posted by Dr. Bob on October 20, 2012, at 22:14:49
Did the nortriptyline make you feel worse, or merely not help you sleep, so you changed to amitriptyline?
If it was just the sleep thing I would restart nortriptyline at 75mg at night, and also take amitriptyline (oe even better doxepin 25mg) for sleep, you will be hitting your depression with the 1-2 knockout punch, and still remain within normal doseage limits for a tricyclic.
I agree with scott, a list of what drugs have helped and which ones havent would be very usefull.
If things are realy bad, would your insurance cover a short period of treatment in a specialised institution, for example, the Menninger Clinic?
Posted by phidippus on October 20, 2012, at 23:36:52
In reply to Feeling REALLY down, posted by ChicagoKat on October 20, 2012, at 15:58:55
Kat,
Do you have a therapist that you work with? I'm wondering if some of your depression might be better handled psychologically.
How many antidepressants have you been on? Have you ever been on two at the same time? List them all for me :)
Eric
Posted by ChicagoKat on October 21, 2012, at 0:40:53
In reply to Re: up and down, posted by Dr. Bob on October 20, 2012, at 22:14:49
> > it's really up and down with Nardil, but lately it's been mostly down :( And I know logically that it can take weeks to months for the benefits of Nardil to fully kick in, but I am not known for my patience!
>
> It occurs to me that up and down moods are associated with optimistic and pessimistic views of the future. And that both of those views are expressed on this board.
>
> BobHow true, Dr. Bob! Sometimes I feel like I'm attending Psycho Babble High School. It seems people have been more negative of late; perhaps that's contributing to a worsening of my symptoms. I like it when the board is just full of people who understand what others are going through, and give them advice and support. Hopefully things will start to get that way more and more in the near future.
My best,
Kat
Posted by ChicagoKat on October 21, 2012, at 0:49:40
In reply to Re: up and down, posted by jono_in_adelaide on October 20, 2012, at 23:11:25
Thanks for the advice Jon. There have been updates to my therapy, but maybe you missed them.
1. I'm taking 50mg/day bid (25mg) of Nortriptyline. Then I am taking 50mg qhs of amitryptiline...it helps me sleep, but as I'm sure you know amitryptiline is metabolized to Nortriptyline. So that pretty much covers the TCA side of my therapy.
2. I went up to 60mg/day of Nardil
3. If I ever feel really awful I take some Ritalin.
4. pdoc prescribed Klonopin + Neurontin for the anxiety, which has been much improved since.Kat
> Did the nortriptyline make you feel worse, or merely not help you sleep, so you changed to amitriptyline?
>
> If it was just the sleep thing I would restart nortriptyline at 75mg at night, and also take amitriptyline (oe even better doxepin 25mg) for sleep, you will be hitting your depression with the 1-2 knockout punch, and still remain within normal doseage limits for a tricyclic.
>
> I agree with scott, a list of what drugs have helped and which ones havent would be very usefull.
>
> If things are realy bad, would your insurance cover a short period of treatment in a specialised institution, for example, the Menninger Clinic?
Posted by ChicagoKat on October 21, 2012, at 0:51:52
In reply to Re: Feeling REALLY down, posted by phillipa on October 20, 2012, at 20:09:22
> Kat shoot I thought things a bit better? I'm sorry? I can't advise no experience with Nardil. Phillipa
Things *were* a bit better, but now they're worse. It's like being on a see saw..can't wait til effects truly kick in...that is, if they do
Kat
Posted by ChicagoKat on October 21, 2012, at 0:56:17
In reply to Re: Feeling REALLY down » ChicagoKat, posted by phidippus on October 20, 2012, at 23:36:52
I have a very excellent therapist who is really helping me.
It's late and I'm too sleepy to list all the meds I've been on, but suffice it to say, I've pretty much been on them all. And yes, I've taken two at a time. I'll work on a list tomorrow when I'm not fighting to keep my eyes open. :)
Kat
> Kat,
>
> Do you have a therapist that you work with? I'm wondering if some of your depression might be better handled psychologically.
>
> How many antidepressants have you been on? Have you ever been on two at the same time? List them all for me :)
>
> Eric
Posted by Dr. Bob on October 21, 2012, at 2:13:16
In reply to Re: up and down » Dr. Bob, posted by ChicagoKat on October 21, 2012, at 0:40:53
> > It occurs to me that up and down moods are associated with optimistic and pessimistic views of the future. And that both of those views are expressed on this board.
>
> How true, Dr. Bob! Sometimes I feel like I'm attending Psycho Babble High School. It seems people have been more negative of late; perhaps that's contributing to a worsening of my symptoms. I like it when the board is just full of people who understand what others are going through, and give them advice and support. Hopefully things will start to get that way more and more in the near future.Hopefully! In the meantime, how did you get through high school?
Bob
Posted by jono_in_adelaide on October 21, 2012, at 2:14:56
In reply to Re: up and down » jono_in_adelaide, posted by ChicagoKat on October 21, 2012, at 0:49:40
Damn, not sure what to suggest - thats a pretty potent cocktail that you're on, once its had a chance to fully kick it, but it isnt the end of the road by a long shot.
I'm realy hopeing for you that the drus start to kick in soon, I know how deep the abyss can be.
thinking of you
J
Posted by Jeroen on October 21, 2012, at 6:00:52
In reply to Lou's response-, posted by Lou Pilder on October 20, 2012, at 20:34:24
psychiatry's HOLT GRAIL ???
are those the glutamate anti psychotics?
or any known medicine..it propably hasnt been invented yet
what it should do is, minimal side effects, no serious ones like diabetes, TD, neuroleptic maligniant syndrome, dystonia, cardiac side effects
Cures, depression(s), psychosis(es), acute psychosis
When will it come and what will be the name of the medication?I once had this effect on seroquel i summer of 2004, complete remission, it pooped out on me, maybe because seroquel is a salt, and in some people the body adjust to it...
then there's a story about namenda that it can combat poopout, but i cant try this it will worsen psychosis or do other bad things :(
Posted by ChicagoKat on October 21, 2012, at 9:41:56
In reply to Re: up and down, posted by Dr. Bob on October 21, 2012, at 2:13:16
> > > It occurs to me that up and down moods are associated with optimistic and pessimistic views of the future. And that both of those views are expressed on this board.
> >
> > How true, Dr. Bob! Sometimes I feel like I'm attending Psycho Babble High School. It seems people have been more negative of late; perhaps that's contributing to a worsening of my symptoms. I like it when the board is just full of people who understand what others are going through, and give them advice and support. Hopefully things will start to get that way more and more in the near future.
>
> Hopefully! In the meantime, how did you get through high school?
>
> BobMe, I got through high school by being invisible :)
Posted by ChicagoKat on October 21, 2012, at 9:49:19
In reply to Re: up and down, posted by jono_in_adelaide on October 21, 2012, at 2:14:56
> Damn, not sure what to suggest - thats a pretty potent cocktail that you're on, once its had a chance to fully kick it, but it isnt the end of the road by a long shot.
>
> I'm realy hopeing for you that the drus start to kick in soon, I know how deep the abyss can be.
>
> thinking of you
>
> J
>
>
Thanks Jon.And how's the Wellbutrin going for you?
Kat
Posted by sleepygirl2 on October 21, 2012, at 10:19:07
In reply to Re: up and down » Dr. Bob, posted by ChicagoKat on October 21, 2012, at 9:41:56
I hated high school. I was miserable, ANXIOUS.
I alternated between that extreme anxiety to numbness, those were the good days.
I got by on fantasy. I imagined someone in my head that I was always talking to, not voices, but the way you might run through conversations with other people in your head.
It's just the ultimate belief that someone could care, will help you figure things out.
Posted by Dinah on October 21, 2012, at 11:47:06
In reply to Re: up and down, posted by sleepygirl2 on October 21, 2012, at 10:19:07
> It's just the ultimate belief that someone could care, will help you figure things out.
My very good friend gave me permission to repeat something she told me that affected me on a bone deep level. It was said with reference to my therapist, but it easily applies to parents, board administrators, communities, and life in general. I'm paraphrasing from memory, so forgive me if I get it wrong.
*It's not that we quit needing someone to take care of us, to nurture us, to help us. It's not that we outgrow that need. It's just that we eventually figure out that they just aren't very good at it.*
For some reason that hit me like a sledgehammer. It somehow freed me, yet made me feel very very alone.
Posted by sleepygirl2 on October 21, 2012, at 12:17:05
In reply to Re: up and down » sleepygirl2, posted by Dinah on October 21, 2012, at 11:47:06
Yeah, I know what you mean.
It keeps me grounded.
At times, it's been more than I can take.
It hits me at my core, a terrible kind of lonely. I don't even know if lonely covers it. For me, it's like a void.I know that therapy, in a lot of ways, is unreasonable.
And I'll get reminded again, of my insignificance.
But it's not for nothing.
Posted by Dinah on October 21, 2012, at 12:39:19
In reply to Re: up and down » Dinah, posted by sleepygirl2 on October 21, 2012, at 12:17:05
But you see, it's not a reminder of insignificance or anything else about you.
It's about the incompetence, in some cases, and inability, in others (and ill intentions in still others) of our caretakers.
My therapist wants to be there for me. But he's not always very good at it. An acceptance of that makes me feel alone, but not bad about myself.
And only a little about him.
Think about your parents. If I recall correctly, they weren't good at taking care of you. It wasn't your fault, really it had to do with them, not you. But hoping to get that from them will just hurt. Recognizing that they can't or won't is different.
Posted by schleprock on October 21, 2012, at 16:30:47
In reply to Feeling REALLY down, posted by ChicagoKat on October 20, 2012, at 15:58:55
I would suggest trying Lyrica if you begin to suspect that the neurontin is no longer helping (I initially chose Lyrica over neurontin because it was initially developed as a more potent version of it. It looks like it's been the most successful thing for me over the last month+ I've been taking it. (of course it could also be the 1.5 mg dosage of clonazepam, but needless to say I haven't had to raise my clonazepam dose in over a month, which I had to keep increasing for a couple of months before.)Whatever depression i was feeling from it before seems to have passed. I don't feel "great", but it's been quite a while since I felt myslef in an exruciating condition. I'm going to try replacing my clonazepam with buspar soon, so I might get a better idea of what the Lyrica is doing.
Truth be told, I haven't been through a panopoly of medications (somewhat due to being tied to a tricyclic,) but for the time being, but I don't see any immediate reason to stop taking Lyrica.
Posted by phidippus on October 21, 2012, at 18:23:46
In reply to Re: up and down » Dinah, posted by sleepygirl2 on October 21, 2012, at 12:17:05
>a terrible kind of lonely. I don't even know if lonely covers it. For me, it's like a void.
Is this in the absence of people?
Eric
Posted by ChicagoKat on October 21, 2012, at 18:39:31
In reply to Re: Feeling REALLY down, posted by schleprock on October 21, 2012, at 16:30:47
Actually, I tried Lyrica before I tried neurontin. Lyrica made me feel more depressed and didn't work very well for me. Neurontin, on the other hand, does not make me feel more depressed and it works great. Only problem is a rapid development of tolerance.
Kat
> I would suggest trying Lyrica if you begin to suspect that the neurontin is no longer helping (I initially chose Lyrica over neurontin because it was initially developed as a more potent version of it. It looks like it's been the most successful thing for me over the last month+ I've been taking it. (of course it could also be the 1.5 mg dosage of clonazepam, but needless to say I haven't had to raise my clonazepam dose in over a month, which I had to keep increasing for a couple of months before.)Whatever depression i was feeling from it before seems to have passed. I don't feel "great", but it's been quite a while since I felt myslef in an exruciating condition. I'm going to try replacing my clonazepam with buspar soon, so I might get a better idea of what the Lyrica is doing.
>
> Truth be told, I haven't been through a panopoly of medications (somewhat due to being tied to a tricyclic,) but for the time being, but I don't see any immediate reason to stop taking Lyrica.
Posted by sleepygirl2 on October 21, 2012, at 19:44:05
In reply to Re: up and down » sleepygirl2, posted by phidippus on October 21, 2012, at 18:23:46
Not necessarily. It's more of a realization, at times when I might wish it were different.
Posted by phidippus on October 21, 2012, at 21:50:57
In reply to Re: Feeling REALLY down » phidippus, posted by ChicagoKat on October 21, 2012, at 0:56:17
I'm really interested to see your list.
Eric
Posted by ChicagoKat on October 22, 2012, at 12:52:36
In reply to Re: Feeling REALLY down » ChicagoKat, posted by phidippus on October 21, 2012, at 21:50:57
> I'm really interested to see your list.
>
> EricI am assuming you mean my list of antidepressants that I've been on. OK. Here goes, hopefully I won't forget too many. ect has really f*ck*d my mind up.
SSRIs: Prozac, Zoloft, Paxil, Lexapro, Viibryd
SNRIs: Effexor, Cymbalta, Pristiq
TCAs: Desipramine, Sinequan, Amitriptyline,
Nortriptyline
Misc: Wellbutrin, Mirtazapine, Trazodone
Mood
Stabilizers: Lamictal, Lithium
Stims: Nuvigil, Straterra, Ritalin, Vyvanse,
Adderall, Concerta
MAOIs: Nardil, MarplanI'm sure I forgot one or two. But the list above includes all the meds I've tried that either worked for a while, then pooped out, or didn't work at all, or had intolerable side effects. Only thing that's working right now is Ritalin, and even that is hit or miss. As you know, I'm waiting for the combo of Nardil/Nortriptyline to kick in, but I've getting extraordinarily frustrated.
If you would also like a list of all the meds I've used for anxiety and/or sleep aids, just let me know.Kat
Posted by ChicagoKat on October 22, 2012, at 12:55:03
In reply to Re: Feeling REALLY down » ChicagoKat, posted by phidippus on October 21, 2012, at 21:50:57
> I'm really interested to see your list.
>
> Eric
Oops! Told you I'd forget some!Atypicals: Abilify, Seroquel, Zyprexa
Posted by phidippus on October 22, 2012, at 13:43:19
In reply to Re: Feeling REALLY down » phidippus, posted by ChicagoKat on October 22, 2012, at 12:52:36
You haven't tried:
SSRIs: Luvox
TCAs: Clomipramine, Imipramine, tons of other TCAs.
MAOIs: Parnate, Ensam, tons of other MAOIs.Have you tried Wellbutrin with an SSRI?
There's also Vagus Nerve Stimulation, Deep Brain Stimulation, etc.
You're not out of options yet!
Eric
Posted by ChicagoKat on October 22, 2012, at 16:25:55
In reply to Re: Feeling REALLY down » ChicagoKat, posted by phidippus on October 22, 2012, at 13:43:19
> You haven't tried:
>
> SSRIs: Luvox
> TCAs: Clomipramine, Imipramine, tons of other TCAs.
> MAOIs: Parnate, Ensam, tons of other MAOIs.
>
> Have you tried Wellbutrin with an SSRI?
>
> There's also Vagus Nerve Stimulation, Deep Brain Stimulation, etc.
>
> You're not out of options yet!
>
> EricThanks Eric. I wanted to try Luvox, but my insurance doesn't cover it and it was gonna cost like 400 bucks out of pocket.
Oh, and I forgot to put Ensam on my list. I've tried it and it made me feel simply horrible.
I can't tolerate Wellbutrin on its own let alone with an SSRI. It makes me so agitaged and kinda crazy. And I've tried it 3x all with those same effects, and during one of the trials I tried to last for several weeks and they did not go away.
I know there are other TCAs and MAOIs I could try. But the thought of either vagus nerve stimulation or deep brain stimulation scares the hell out of me.
Posted by Phillipa on October 22, 2012, at 20:46:11
In reply to Re: Feeling REALLY down » phidippus, posted by ChicagoKat on October 22, 2012, at 16:25:55
Kat I use the fluvoximine maelate the short acting luvox. It costs me $8 a month. The CR probably is expensive. Phillipa
This is the end of the thread.
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