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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 46. Go back in thread:
Posted by Lamdage22 on July 21, 2013, at 14:35:25
In reply to Re: Anyone!? » Lamdage22, posted by SLS on July 21, 2013, at 4:56:10
Scott, any lack of drive, weight gain or sexual side effects?
Any worrysome long time repercussions?
Posted by SLS on July 21, 2013, at 18:27:40
In reply to Scott Prazosin, posted by Lamdage22 on July 21, 2013, at 14:35:25
> Scott, any lack of drive, weight gain or sexual side effects?
> Any worrysome long time repercussions?I experienced a small amount of dizziness, fatigue, muscle weakness, and malaise for the first week.
* No weight gain.
* Reduced sex drive.
* Slight reduction of motivation at dosages that are too high.
- Scott
Posted by Lamdage22 on July 22, 2013, at 12:24:29
In reply to Re: Scott Prazosin » Lamdage22, posted by SLS on July 21, 2013, at 18:27:40
Doing pretty ok.. although a fellow patient pisses me off. That bitch seriously told a doctor i ate her chocolate. It was in the fridge, there was no name on it so WTF!?
Why doesnt she waste the Professors time with this sh*t. I didnt know it was hers, i told her it was me. She makes this a public thing. What a bitch. She can go f*ck off. Sry.. i tend to indulge in stuff like that alot.
Anyway.. i think the NAC is good. I think the Seroquel is good. Im halfway where i want to be.
Adding Parnate soon. I told the doctors i am willing to raise Seroquel, but that i want a high dose of Parnate.
Posted by Lamdage22 on July 23, 2013, at 4:55:00
In reply to Feelin better yet again. I blame NAC, posted by Lamdage22 on July 22, 2013, at 12:24:29
The doctors pissed me off today. I had a reasonably good mood yesterday maybe even a bit euphoria if you want to call it euphoria.
They talk about it like its a huge problem.I offered to take more Seroquel along Jatrosom, but what i meant was more like "id rather take more seroquel than to get a b*llsh*t low dose of Jatrosom".
Now they raised the Seroquel to 400 and give me 10!!! mg of Jatrosom tomorrow. A nurse told me you had to start the oh so important MAOI diet a couple of days in advance before 10 mg of Parnate?? B*LLSH*T!
I do not feel very supported.. it feels almost like they dont want to change anything about my mental state. Im a schizo-depressive with depression far more strong than psychosis. What the f*ck are they thinking? If i dont get a decent dose of my Parnate im going somewhere else.
Then they bitch around with a financial decision i want to make. How is this their business? I will sell a condo with 50k earned in one year. If i need financial advice i talk to my freakin realtor not these fool doctors.
Im really pissed off and i wonder if this is any good here.
Also i want to move back to my home and they bitch around like its a bad thing that i now have some hope (because i get a medication that is superior to placebo: Parnate) and that i have good plans. They want my father to call here and tell them that its a good idea to sell the home. Who do they think they are the police? Im fuckin 24.
Im pissed off and i wonder how to defend myself against this stupidity.
Help Please
Posted by Lamdage22 on July 23, 2013, at 14:51:18
In reply to Doctors pissed me off. HELP, posted by Lamdage22 on July 23, 2013, at 4:55:00
Posted by Tomatheus on July 23, 2013, at 15:26:14
In reply to Cooled down again. I can be pretty on edge i guess (nm), posted by Lamdage22 on July 23, 2013, at 14:51:18
Lamdage,
I'm sorry to hear that you were feeling upset with the doctors who've been treating you at the hospital. I know that it can be upsetting when those who are responsible for your care at a hospital make decisions that you're at odds with. Patients generally have fewer options when hospitalized than they do when they're being seen on an outpatient basis, and that can be frustrating. Sometimes I think it helps to vent our frustrations about our treatments on forums like this when we're upset. I think it can allow us to sort out what we're going through, and it gives us the opportunity to get others' perspectives.
Do you think that there's any chance that your doctors might be planning on eventually increasing your Jatrosom dose? A lot of times doctors like to start off by prescribing low doses of medications to make sure that patients can tolerate the drugs before increasing to the target dose. Could your doctors be planning something like this?
T.
Posted by Lamdage22 on July 24, 2013, at 1:19:45
In reply to Re: Cooled down again. I can be pretty on edge i guess » Lamdage22, posted by Tomatheus on July 23, 2013, at 15:26:14
Yes, they sure are. But given my extensive positive experience with MAOI i think they could have gone with 25 mgs without a problem.
I will ask for such a rase tomorrow. 10mg is really a joke.Im a little worried Parnate will send me on the edge to much. Idk if Seroquel counteracts this much.
Anyway, i think ill be fine. Just have to figure out some stuff now. Lots of decision making these days. But in a way its fun not being that passive anymore.
Posted by Tomatheus on July 24, 2013, at 2:07:58
In reply to Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 1:19:45
Lamdage,
You might be right that starting out at 25 mg of Jatrosom/Parnate wouldn't cause any problems for you. I think that your doctors are probably just trying to be safe by having you slowly work your way up to a therapeutic dose. Sometimes we don't always respond to medications in the same way that we used to respond to them, and I think (from experience) that this is especially true when psychosis is involved. And given the fact that you said that you were worried about Jatrosom/Parnate sending you "on edge too much," I can see why your doctors would want you to start low on Jatrosom/Parnate and to work your way up. Having said this, I don't think that you'd be out of line by asking your doctors if they could increase your Jatrosom dose to 25 mg. I of course would like for your doctors to agree to the dose increase and for you to do well on 25 mg or higher of Jatrosom/Parnate, but if your doctors don't agree to the increase, that doesn't necessarily mean that you won't eventually get to take the dose of the medication that you'd like to take. It could just mean that you might have to wait longer than you'd like to get to where you want to be medication wise.
I think that you're probably right in saying that you'll be fine. I think that you've already made some progress in the treatment of your conditions, and I think that the odds are favorable that you'll make more progress. Sometimes the process of getting to where you want to be can be one of taking two steps forward and one step backward, as the saying goes, but I think it's most likely that if you remain patient and keep trying different treatment options that you'll at least get closer to where you want to be. So, good luck with everything, and if you'd like, please feel free to keep letting us know how things are going.
T.
Posted by Lamdage22 on July 24, 2013, at 3:45:49
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 2:07:58
Thanks Thomatheus.
Im angry like sh*t! Look at the list of my diagnoses.. look at all the things i need to decide and take care of.
I dont even have an psychologist to help me. Now i eventually am treated by an GP !?? Mind you i pay a bit short of 300$ a day.
They keep telling me how i need to be patient. Because they are too f*ck*ng lazy and partially incompetent to help me!
F*CK
Posted by SLS on July 24, 2013, at 6:05:33
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 3:45:49
I like what Tomatheus wrote to you.
It is incredibly difficult to be patient when one is in pain. This is especially true when the mental illness itself creates a state of mind that compromises one's ability to remain patient.
For me, I have made a habit of starting tranylcypromine at 20 mg/day for a few days before moving up to 30 mg/day. As Tomatheus noted, one can react differently to the same drug at different times. This is especially true if the system has been exposed to a different set of drugs. Hopefully, you will begin to feel better soon after reaching 40 mg/day.
- Scott
Posted by Lamdage22 on July 24, 2013, at 13:48:38
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 2:07:58
Thanks folks, for your backup.. i need all the backup i can get right now. I will try to articulate that to the doctors.. But they are soo sensitive. Why do i have to worry all the time about hurting my doctors feelings?
Today they told me to not "indulge in too much activism".. Are their brains wired the wrong way or something? Im freakin 24 years old and i havent really moved for almost a year.
So its not good news to them that i am finally able to kick my own *ss a little bit? Maybe they dont wanna have their *ss*s kicked by me to WORK.
I have so many problems, i cant even tell them all of it because it would overwhelm them. If i approach this in a "not too much activism" manner, a lifetime will not be enough to get to the point of enjoying life to the fullest.
How can i reason with these folks?
Lamdage needs backup in Germany;)
Thx guys.
Posted by Tomatheus on July 24, 2013, at 13:50:12
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 3:45:49
Hello again Lamdage,
You sound frustrated, to say the least. I think that your frustration is understandable. Receiving care that's not up to your expectations can be frustrating. Although psychiatric care has made what I think is significant progress over the past century, I think that there is still more guesswork and trial and error in psychiatry than most patients like us can stand, and I think that that can be one source of the resentment that a lot of patients feel toward the mental health and medical systems. I can't say from my position the degree to which you might be right about your doctors being lazy and incompetent, but I think that even the best doctors might seem incompetent when the treatment options that they have to work with leave a lot to be desired. In much the same way that a master chef is only as good as the ingredients that he or she uses, psychiatrists in a lot of ways are only as good as the treatment options that they have available to them. In their quests to first do no harm, your doctors probably want to be as careful as they can be to avoid prescribing any treatment that might lead to added distress and/or dysfunction. Unfortunately, this can sometimes interfere with getting you the treatment that might serve you best in the shortest time frame possible.
So, how are things going for you at present? If you already asked your doctors about increasing your Jatrosom/Parnate dose, what did they say?
Here's to hoping that you're finding some peace of mind.
T.
Posted by Lamdage22 on July 24, 2013, at 14:19:24
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 13:50:12
Thomateus,
i didnt ask them. Once again i was afraid to overwhelm them or hurt their feelings.. Though i think this is more of a pride and having to be right issue.
I will defenitely ask tomorrow if they wanna raise it at all and if not, then WHY THE F*CK not. Then i will ask for 25 mgs.
Then i will tell them to stop the damn "dont be too active" and that i need them to go through the things i want to do with me... so i can go ahead and pick up that piece of sh*t of life and turn it into something worth living.
I have been such a zombie, i guess i was an easier patient in a way when i was staying in bed all day and nodding and agreeing to every word they say. They love that.
Then i want to tell them that i have so many urgent problems, that i dont even want to tell them to not overwhelm them. I will tell them about the other diagnoses i have (signature) and i tell them how much my weight distresses me. (overwheight due to Seroquel)
I have been working out like a maniac in my teenage years and early twenties. And i didnt do that too walk around with embarassing belly fat.
I will leave them alone with the nightmaires, because i think at that point they would just leave the room and declare me crazy.
What do you think?
> Hello again Lamdage,
>
> You sound frustrated, to say the least. I think that your frustration is understandable. Receiving care that's not up to your expectations can be frustrating. Although psychiatric care has made what I think is significant progress over the past century, I think that there is still more guesswork and trial and error in psychiatry than most patients like us can stand, and I think that that can be one source of the resentment that a lot of patients feel toward the mental health and medical systems. I can't say from my position the degree to which you might be right about your doctors being lazy and incompetent, but I think that even the best doctors might seem incompetent when the treatment options that they have to work with leave a lot to be desired. In much the same way that a master chef is only as good as the ingredients that he or she uses, psychiatrists in a lot of ways are only as good as the treatment options that they have available to them. In their quests to first do no harm, your doctors probably want to be as careful as they can be to avoid prescribing any treatment that might lead to added distress and/or dysfunction. Unfortunately, this can sometimes interfere with getting you the treatment that might serve you best in the shortest time frame possible.
>
> So, how are things going for you at present? If you already asked your doctors about increasing your Jatrosom/Parnate dose, what did they say?
>
> Here's to hoping that you're finding some peace of mind.
>
> T.
Posted by Tomatheus on July 24, 2013, at 14:32:51
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 13:48:38
Lamdage,
It looks like we were writing our last two posts right around the same time. I was actually responding to your message from 3:45 a.m. central U.S. time in my last post, and I'll respond to your message that just came in now.
From my end, it sounds unfortunate that your doctors are telling you not to "indulge in too much activism." I think that some doctors tend to be intimidated when patients take active roles in their treatments, but I've also encountered doctors who like working with patients who are rather proactive. I don't personally see how bringing more information to the table, so to speak, can be a bad thing, but I can also see why doctors find it unsettling when patients come to them seemingly thinking that they know more about medicine than they actually do (and I'm not saying that you're doing this, just that I think that it can sometimes happen). So, maybe your doctors don't necessarily see being a bit proactive as being such a bad thing, but they might be trying to warn you that it could be possible to have too much of a good thing.
I think that you have a good point in saying that if you take your doctors' advice of not engaging in "too much activism" that you might not ever get to where you want to get with your treatment, and ultimately, your life. And yes, I think that being proactive, both with your treatment and in general, is a good thing that's essential to getting what you want out of life. But for better or for worse, one thing that you probably won't be able to change at least for now is the fact that your doctors are responsible for overseeing your care. And so, it would work to your advantage to build a good working relationship with them. How do you do this? I definitely don't have all the answers to this question, but I think that one thing that you need to do is strike a balance between saying what you want and need to say with respect to your treatment and respecting the decisions that the doctors make. You definitely don't want to be afraid of saying something that might push your treatment in a better direction, but at the same time, being too pushy in telling your doctors what medications you'd like to take might strain the relationship between you and your doctors. So, I think that a little bit of balance between being active in your treatment and respecting your doctors' decisions is something that I'd strive for.
I think that this sums up my thoughts on what you've written, but if I think of anything else that I'd like to add, I'll let you know. As always, good luck with everything.
T.
Posted by Lamdage22 on July 24, 2013, at 14:54:20
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 14:32:51
Thanks Tomatheus..
you make good points. Well maybe i should pick them up where they are.
Tell them i understand that they feel uneasy about me being too proactive but i still want to say what i have to say. In a "i dont want to step on your feet", but i still want to say that (....) manner.
I think whatever i say its important to tell them that it is not my intention in any way to step on their feet or strain the relationship.I am still appalled about the fact that i have to care about their feelings just as much or more even than they have to care about mine, even though i pay for this sh*t..
Cant change it, so i guess i just have to go along with it.
Posted by Lamdage22 on July 24, 2013, at 15:02:12
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 14:54:20
So im the therapist now?
Good morning doctor.. do you feel unsettled because of my being so proactive? Do you feel uneasy about me taking action because you believe im just a fool unable of making good decisions anyway?
Jeez.. maybe im just being a dick now.
Probably better go to sleep.See ya
Posted by Tomatheus on July 24, 2013, at 15:17:00
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 14:19:24
> Thomateus,
>
> i didnt ask them. Once again i was afraid to overwhelm them or hurt their feelings.. Though i think this is more of a pride and having to be right issue.
>
> I will defenitely ask tomorrow if they wanna raise it at all and if not, then WHY THE F*CK not. Then i will ask for 25 mgs.
>
> Then i will tell them to stop the damn "dont be too active" and that i need them to go through the things i want to do with me... so i can go ahead and pick up that piece of sh*t of life and turn it into something worth living.
>
> I have been such a zombie, i guess i was an easier patient in a way when i was staying in bed all day and nodding and agreeing to every word they say. They love that.
>
> Then i want to tell them that i have so many urgent problems, that i dont even want to tell them to not overwhelm them. I will tell them about the other diagnoses i have (signature) and i tell them how much my weight distresses me. (overwheight due to Seroquel)
>
> I have been working out like a maniac in my teenage years and early twenties. And i didnt do that too walk around with embarassing belly fat.
>
> I will leave them alone with the nightmaires, because i think at that point they would just leave the room and declare me crazy.
>
>
> What do you think?Lamdage,
I can relate to what you wrote about the doctors and the staff in your hospital presumably perceiving you to be a easier patient when you feel like a zombie of sorts and end up spending a lot of your time in bed and questioning little of what the hospital staff tells you. I know that during one of my hospitalizations, my Abilify dose had been raised to 10 mg for about a week, and the way I was feeling was so unbearable that I couldn't even stand to wait in line for my medication. I decided to only take half of my Abilify dose at that point (I was being given it twice a day, which allowed me to refuse my morning dose and still take my evening dose), and one of the staff members questioned my decision because to him, I seemed to be doing "so much better" on the higher dose of Abilify. I do think that there can be a tendency among some hospital doctors and staff members to see patients who engage in few activities and spend a lot of time in bed as being the patients who are doing the best, but I of course don't see functioning at such a level to be good from a mental health standpoint. Engaging in few activities and spending a lot of time in bed aren't things that lead to success in the real world, and I don't think that such behavioral outcomes should be seen as successful outcomes in the hospital, either. But for better or for worse, the goal of hospitalization usually seems to be "stabilization," which involves controlling behaviors that are disruptive and potentially dangerous. Depression only seems to be a major concern to hospital personnel if the patients are making suicidal gestures, and even though feeling really fatigued and/or sleeping a lot could be very problematic and be a major source of functional impairment outside the hospital, these problems aren't thought to interfere so much with mental stability from the perspective of a lot of hospital personnel.
Having said what I've said here, my recommendation would still be to strive to strike a balance between being an active patient (both in your treatment and in general) and respecting where the doctors and other staff members of your hospital are coming from in what they tell you. While I think it's important, on one hand, to do what's best for your mental health, you don't want to compromise your relationships with your doctors and the other staff members in your hospital so much that these individuals might make your daily life in the hospital a lot more difficult. Doctors and other hospital staff members have a lot of power, sometimes too much, if you ask me. Straining your relationship with these individuals too much is definitely not in your best interests, and it will probably interfere with getting what you want out of your hospitalization. So, again, I think that achieving a balance between being an active patient and not being too disrespectful or difficult is something that I would encourage.
T.
Posted by Lamdage22 on July 25, 2013, at 4:20:04
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 15:17:00
So i didnt have the chance to communicate all the grievances i had.
Shrink wanted to increase Seroquel to 500 and leave Parnate at 10mg.
Mind you i didnt even have psychosis at 300 mgs of Seroquel.I said "No" basically in a "go f*** yourself with that manner". I anticipated that. They also want me on Valium. They can go f*ck themselves with that as well. I aint going nowhere with the seroquel without at least 30 or 40 mgs of Parnate.
Thats diplomacy.. i feel they should be diplomatic to. And this gal doesnt give a sh*t. So i dont give a sh*t about her Seroquel plans. Simple as that.They wanna call all the shots.
I will make it through this.. even if it will be worse than anal bleaching. (Just a joke, i have nothing to do with this)
Posted by Lamdage22 on July 25, 2013, at 7:03:42
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 25, 2013, at 4:20:04
Ok, F*CK THEM!!!
They blackmail me if i dont go to the therapies they wont let me decide what to do with my future.
Who the f*ck do they think they are? Someone should lock these niggas up. I dont have myself blackmailed.
F*CK*NG MORONS! I would like to flip the bird on each and everyone of them and tell them to go f*ck themselves!
Posted by Lamdage22 on July 25, 2013, at 8:12:19
So they just want me to surrender and anounce that im totally crazy, that all complaints i have are part of my crazyness and that they are 100% right with all that they are doing.
Can anyone see how this is b*llsh*t?
Ok im too much on edge for sure. But i dont have a single point?
That is not a basis on which i consent to treatment in this hospital.What the hell is going on
Posted by Phillipa on July 25, 2013, at 9:46:12
In reply to Re, posted by Lamdage22 on July 25, 2013, at 8:12:19
I don't know what do you mean surrender? Phillipa
Posted by Lamdage22 on July 25, 2013, at 11:06:49
In reply to Re, posted by Lamdage22 on July 25, 2013, at 8:12:19
Ooops i meant to post that in the other threat.
I dont know Phillipa.. i have been loosing my mind these past days. They raised the Seroquel now. I have decided to stop the posting until im okay again, i am making such a fool of myself right now.
Posted by Tomatheus on July 25, 2013, at 13:54:07
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 25, 2013, at 7:03:42
Lamdage,
I know that I've already said this in reference to one of your other posts, but you really sound frustrated, to say the least. I'm really sorry to hear about what you're going through, and I hope that this situation between you and your doctors will not continue to cause you more and more distress as time goes on.
I'm wondering if perhaps your doctors decided to increase your Seroquel dose because they think that you might be exhibiting signs of mania, even though you've said that you weren't experiencing any psychosis at 300 mg of the medication. I think that if I were in your position I would probably try taking what your doctors have prescribed and *then* ask about changing medications to something that you'd be more comfortable with *if* what your doctor prescribes leads you to feel worse. Basically, I think that the more of a chance you give what your doctors prescribe or want to prescribe, the more willing to work with you they will be. Maybe your doctors' plans for you aren't going to produce a favorable outcome, but I don't think that you know that for sure, yet. So, I'd probably give the higher dose of Seroquel a chance if I were in your position. If that treatment plan doesn't produce favorable results, then you'll know that the higher dose of Seroquel isn't for you, and maybe your doctors might be more willing to listen to your pleas for something that's more anti-depressive in nature. But I also think that there's a chance that you might be pleasantly surprised with the results you might get from higher-dose Seroquel. Again, what your doctors want to do with you medication wise might not necessarily lead to the best outcome for you, but certainly there's got to be a logic behind what your doctors want to do.
Of course, what you decide to do is ultimately up to you, and I was just sharing what I would do if I were in your position, but if possible, I would try to give your doctors as little reason as possible to restrict your autonomy and the role that you play in your own treatment. As I said in one of my previous posts, doctors in psychiatric hospitals have a lot of power, and I think that it would be in your best interests to do what you can to prevent your doctors from using their power in a way that might be harmful to you. I know that this is probably easier said than done, though.
I'm not sure if any of what I've said here has been helpful or if what I'm writing might just be leading to more frustration on your part. I do think that you have some valid points in what you say, and even though some of what I've written has been in an attempt to get you to see where your doctors are coming from, I'm certainly not saying that your doctors are completely right. I know that it can be very frustrating to be in a psychiatric hospital where your options and choices are restricted, and I think it's very unfortunate that you're in the predicament that you're in. I can only hope that it will only be a matter of time before your situation changes for the better.
T.
Posted by SLS on July 25, 2013, at 16:08:49
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 25, 2013, at 7:03:42
From what little I have seen, quetiapine (Seroquel) has more therapeutic activity at 400 mg/day than it does at 300 mg/day. Take that with a grain or two of salt, though. For depression, it might be that the norquetiapine metabolite is important, as it is a NE reuptake inhibitor. If the doctors are aware of this, they would be even more cautious to give you tranylcypromine.
I say, let the doctors do their thing. Tell them that you would like to work *with* them to establish a treatment plan. Nothing you say to them is going to change their minds about the tranylcypromine if they are scared to use it in the first place. At least you will find out how high they are willing to go as a maximum dosage and how rapidly you can get there with a titration schedule. I don't think that you have much of a choice. Just ask them to please explain to you how they arrived at their clinical decisions.
It is frustrating.
I participated in a series of double-blind drug trials at the US NIH as an inpatient. It was necessary for me to give my doctors consent to treat me for 9 months without disclosing to me what they were giving to me.
A year from now, it won't matter whether they started you at 10 mg/day or 30 mg/day. There are some doctors who would never treat you with tranylcypromine at all, even if you begged them. As Tomatheus so insightfully pointed out, your doctors might be looking at your frustration and displays of anger as signs that the tranylcypromine is triggering a manic or psychotic episode. Be strategic in your use of words. Exercise as much patience as you can.
I really want to see you get well. I might be wrong, and I might not tell you the things that you want to hear, but I do care.
- Scott
Posted by Lamdage22 on July 26, 2013, at 3:43:55
In reply to Re: Doing a fair bit better » Lamdage22, posted by SLS on July 25, 2013, at 16:08:49
Scott, i had this "episode" before i took the Parnate.
Only explanation there is is it might be from Acetylcystein paradoxically.
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