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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by orbital on August 14, 2013, at 20:20:04
Hello everyone, it's been a while. I hope this post doesn't turn into yet another battle of insults. So, disclaimer: I need insight re:MEDICATION only, thanks.
I'm wondering if AAPs truly do help with MDD, or if they make matters worse. For the past 18 months my doctor has supplemented my AD du jour with just about every AAP available (currently on Prozac 20, Effexor 150 and Saphris 10). These last few months have been my worst ever.
I'm not BP btw.
Basically, I'm wondering if antagonizing dopamine receptors even makes sense for someone who is already feeling flat, apathetic, and anhedonic or if it's just big pharma (TM) marketing hype. I know the AAPs hit a bunch of other receptors etc but their main function is still to block the D receptors, right?
Any experience? Insights? Thanks!
Posted by Zyprexa on August 14, 2013, at 21:31:51
In reply to Atypical APs and depression, posted by orbital on August 14, 2013, at 20:20:04
I take zyprexa, and never found it to do anything for depression. Thats why I'm on zoloft. The one AP that I found good on depression was abilify, but it didn't work for me on AP effect.
Posted by creepy on August 14, 2013, at 23:29:48
In reply to Atypical APs and depression, posted by orbital on August 14, 2013, at 20:20:04
The AAPs are serotonin receptor antagonists too. Some of these receptors are implicated in mood, sleep, motivation.
I used to think prescribing an AAP for depression was like hitting a nail with a sledgehammer, but now im not so sure.
If you want to try a serotonin receptor antagonist but are afraid of the antipsychotics, you could try trazodone (at antidepressant doses), nefazodone or a few of the TCAs like nortriptyline and amitriptyline.
I think 5ht-2c receptor antagonism may help with the apathy from SSRIs. Something about dopamine regulation via this receptor?
Posted by baseball55 on August 15, 2013, at 19:34:47
In reply to Re: Atypical APs and depression, posted by creepy on August 14, 2013, at 23:29:48
I found that all the AAPs except seroquel and geodon helped my depression within days. They also all made me gain 2-3 pounds per week within days, so I had to stop them ( i went from 150 to 205 pounds in several months). If they don't cause you weight gain, and many people don't experience this, especially with ability, it's worth giving them a try.
Posted by Lou PIlder on August 16, 2013, at 4:56:32
In reply to Atypical APs and depression, posted by orbital on August 14, 2013, at 20:20:04
> Hello everyone, it's been a while. I hope this post doesn't turn into yet another battle of insults. So, disclaimer: I need insight re:MEDICATION only, thanks.
>
> I'm wondering if AAPs truly do help with MDD, or if they make matters worse. For the past 18 months my doctor has supplemented my AD du jour with just about every AAP available (currently on Prozac 20, Effexor 150 and Saphris 10). These last few months have been my worst ever.
>
> I'm not BP btw.
>
> Basically, I'm wondering if antagonizing dopamine receptors even makes sense for someone who is already feeling flat, apathetic, and anhedonic or if it's just big pharma (TM) marketing hype. I know the AAPs hit a bunch of other receptors etc but their main function is still to block the D receptors, right?
>
> Any experience? Insights? Thanks!
>
> orb,
You wrote,[....I need insight re: MEDICATION only...I'm wondering if AAPs truely do help with MDD, or if they make matters worse...currently on Effexor, Prozac, Saphris...I'm wondering..if..even makes sense...Big pharma.. marketing hype...Any..Insights?...].orbital and friends,
Be advised that my insight here sees that the combination of drugs being taken by the poster here could cause death. Death by serotonin syndrome. Death by CNS depression. The question here is if this combination of chemicals truley do help with MDD and that the poster requests insight on medication. Seeing into this situation and the insight that I have here IMHHHO could save lives, prevent life-ruining conditions and addictions. I see so much here, but I am prevented from posting a lot of informational facts due to the prohibitions posted to me here by Mr Hsiung.
Lou
Posted by 10derheart on August 16, 2013, at 12:15:40
In reply to Lou's response and warning- » orbital, posted by Lou PIlder on August 16, 2013, at 4:56:32
Posted by herpills on August 16, 2013, at 15:43:28
In reply to Lou's response and warning- » orbital, posted by Lou PIlder on August 16, 2013, at 4:56:32
(redacted)
Posted by Phillipa on August 18, 2013, at 17:36:16
In reply to Atypical APs and depression » Lou PIlder, posted by herpills on August 16, 2013, at 15:43:28
Ha Ha just saw this. Phillipa
Posted by Christ_empowered on August 20, 2013, at 7:48:00
In reply to Lou's response and warning- » orbital, posted by Lou PIlder on August 16, 2013, at 4:56:32
"Depression" actually covers a lot of ground. You could be: anxious, tired, apathetic, too agitated, psychotic, unable to concentrate, gaining weight, losing weight....so on and so forth.
Personally, AAPs don't help my sad states. I either have to deal or add in a short term SRI for bouts of psychotic depression (I'm on Abilify @ 20 for bipolar, with trileptal @ 1200). But I'm not you.
Even though AAPs are the latest thing for depression, and shrinks are a trendy bunch, I'm starting to suspect they're not gonna work for you. Antipsychotics can actually cause or worsen depression in some people. If you're already apathetic from antidepressants, a tranquilizer probably isn't going to be the best thing for you. Then again, I'm not an MD.
Have you tried BuSpar? Does some of the same things for AD-boosting as an AAP, but its cheaper, probably safer (TD, NMS, all that), and the immediate side effects usually aren't nearly as terrible.
There's also: low dose lithium, lamictal, a benzo (xanax or xanax xr comes to mind), stimulants. You've got options.
Like I said, "depression" is now a fairly meaningless diagnosis. Shrinks (and GPs, too) just throw antidepressants at people and hope it goes OK. Re-diagnosis isn't really all that helpful, unless something crazy is going on (psychosis, manic episodes).
All I could think of, looking over your meds, would be to drop the Effexor, keep the Prozac, and maybe add in Ritalin, Provigil, or one of the amphetamines (Vyvanse is the new "it" Rx speed). Or not.
Posted by orbital on August 20, 2013, at 15:36:32
In reply to Re: Lou's response and warning-, posted by Christ_empowered on August 20, 2013, at 7:48:00
Well, thanks for the insights. I checked my notes, with the exception of Saphris, all the AAPs did worsen my depression. They flatten my mood and kill what little motivation I may have. Saphris is good stuff, it calms me down without flattening my mood .. but it's not like it perks me up. I'd compare it to a benzo, actually.
I suspect stimulants could help, but my old doctor refused to prescribe them, claiming they were addictive.
I'm seeing a new doc next week, should I just show up and ask for Vyvanese? LOL. At this point, I might just do that.
Provigil worsens my depression very badly. I take it anyway whenever I'm feeling too foggy and sleepy, maybe once a week.
Thanks everyone, I'm too tired to answer each post individually, but I appreciate your time very very much.
> "Depression" actually covers a lot of ground. You could be: anxious, tired, apathetic, too agitated, psychotic, unable to concentrate, gaining weight, losing weight....so on and so forth.
>
> Personally, AAPs don't help my sad states. I either have to deal or add in a short term SRI for bouts of psychotic depression (I'm on Abilify @ 20 for bipolar, with trileptal @ 1200). But I'm not you.
>
> Even though AAPs are the latest thing for depression, and shrinks are a trendy bunch, I'm starting to suspect they're not gonna work for you. Antipsychotics can actually cause or worsen depression in some people. If you're already apathetic from antidepressants, a tranquilizer probably isn't going to be the best thing for you. Then again, I'm not an MD.
>
> Have you tried BuSpar? Does some of the same things for AD-boosting as an AAP, but its cheaper, probably safer (TD, NMS, all that), and the immediate side effects usually aren't nearly as terrible.
>
> There's also: low dose lithium, lamictal, a benzo (xanax or xanax xr comes to mind), stimulants. You've got options.
>
> Like I said, "depression" is now a fairly meaningless diagnosis. Shrinks (and GPs, too) just throw antidepressants at people and hope it goes OK. Re-diagnosis isn't really all that helpful, unless something crazy is going on (psychosis, manic episodes).
>
> All I could think of, looking over your meds, would be to drop the Effexor, keep the Prozac, and maybe add in Ritalin, Provigil, or one of the amphetamines (Vyvanse is the new "it" Rx speed). Or not.
Posted by orbital on August 20, 2013, at 15:39:00
In reply to Lou's response and warning- » orbital, posted by Lou PIlder on August 16, 2013, at 4:56:32
Hi Lou, so we meet again. I hope you are doing well.
O.
> orbital and friends,
> Be advised that my insight here sees that the combination of drugs being taken by the poster here could cause death. Death by serotonin syndrome. Death by CNS depression. The question here is if this combination of chemicals truley do help with MDD and that the poster requests insight on medication. Seeing into this situation and the insight that I have here IMHHHO could save lives, prevent life-ruining conditions and addictions. I see so much here, but I am prevented from posting a lot of informational facts due to the prohibitions posted to me here by Mr Hsiung.
> Lou
>
Posted by polarbear206 on August 20, 2013, at 18:21:18
In reply to Re: Lou's response and warning-, posted by Christ_empowered on August 20, 2013, at 7:48:00
Posted by damnthislife on August 30, 2013, at 9:43:52
In reply to Lou's response and warning- » orbital, posted by Lou PIlder on August 16, 2013, at 4:56:32
> > Hello everyone, it's been a while. I hope this post doesn't turn into yet another battle of insults. So, disclaimer: I need insight re:MEDICATION only, thanks.
> >
> > I'm wondering if AAPs truly do help with MDD, or if they make matters worse. For the past 18 months my doctor has supplemented my AD du jour with just about every AAP available (currently on Prozac 20, Effexor 150 and Saphris 10). These last few months have been my worst ever.
> >
> > I'm not BP btw.
> >
> > Basically, I'm wondering if antagonizing dopamine receptors even makes sense for someone who is already feeling flat, apathetic, and anhedonic or if it's just big pharma (TM) marketing hype. I know the AAPs hit a bunch of other receptors etc but their main function is still to block the D receptors, right?
> >
> > Any experience? Insights? Thanks!
> >
> > orb,
> You wrote,[....I need insight re: MEDICATION only...I'm wondering if AAPs truely do help with MDD, or if they make matters worse...currently on Effexor, Prozac, Saphris...I'm wondering..if..even makes sense...Big pharma.. marketing hype...Any..Insights?...].
>
> orbital and friends,
> Be advised that my insight here sees that the combination of drugs being taken by the poster here could cause death. Death by serotonin syndrome. Death by CNS depression. The question here is if this combination of chemicals truley do help with MDD and that the poster requests insight on medication. Seeing into this situation and the insight that I have here IMHHHO could save lives, prevent life-ruining conditions and addictions. I see so much here, but I am prevented from posting a lot of informational facts due to the prohibitions posted to me here by Mr Hsiung.
> Lou
>While I respect your opinion, you have to realize that just about everyone here is suffering and ready to take the quick way out. I have been living in hell for almost 8 years now. So to say, that taking a combination of drugs could cause death, I would welcome it if that is the adverse effect it could cause. But the possibility of it pulling me out of this pit of hell I have been living for so long... I would gladly take the risk.
Posted by Lou Pilder on August 30, 2013, at 10:04:48
In reply to Re: Lou's response and warning- » Lou PIlder, posted by damnthislife on August 30, 2013, at 9:43:52
> > > Hello everyone, it's been a while. I hope this post doesn't turn into yet another battle of insults. So, disclaimer: I need insight re:MEDICATION only, thanks.
> > >
> > > I'm wondering if AAPs truly do help with MDD, or if they make matters worse. For the past 18 months my doctor has supplemented my AD du jour with just about every AAP available (currently on Prozac 20, Effexor 150 and Saphris 10). These last few months have been my worst ever.
> > >
> > > I'm not BP btw.
> > >
> > > Basically, I'm wondering if antagonizing dopamine receptors even makes sense for someone who is already feeling flat, apathetic, and anhedonic or if it's just big pharma (TM) marketing hype. I know the AAPs hit a bunch of other receptors etc but their main function is still to block the D receptors, right?
> > >
> > > Any experience? Insights? Thanks!
> > >
> > > orb,
> > You wrote,[....I need insight re: MEDICATION only...I'm wondering if AAPs truely do help with MDD, or if they make matters worse...currently on Effexor, Prozac, Saphris...I'm wondering..if..even makes sense...Big pharma.. marketing hype...Any..Insights?...].
> >
> > orbital and friends,
> > Be advised that my insight here sees that the combination of drugs being taken by the poster here could cause death. Death by serotonin syndrome. Death by CNS depression. The question here is if this combination of chemicals truley do help with MDD and that the poster requests insight on medication. Seeing into this situation and the insight that I have here IMHHHO could save lives, prevent life-ruining conditions and addictions. I see so much here, but I am prevented from posting a lot of informational facts due to the prohibitions posted to me here by Mr Hsiung.
> > Lou
> >
>
> While I respect your opinion, you have to realize that just about everyone here is suffering and ready to take the quick way out. I have been living in hell for almost 8 years now. So to say, that taking a combination of drugs could cause death, I would welcome it if that is the adverse effect it could cause. But the possibility of it pulling me out of this pit of hell I have been living for so long... I would gladly take the risk.
>
> dtl,
You wrote,[...just about everyone here is suffering and ready to take the quick way out...].
What criteria did you use to make such a conclusion?
Lou
This is the end of the thread.
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