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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 77. Go back in thread:
Posted by J Kelly on March 8, 2016, at 19:11:09
In reply to Re: Magic Pill, posted by Tabitha on March 8, 2016, at 12:31:44
> None of these pills are magic, but these are the ones that made a dramatic difference
>
> 1) Prozac. The first SSRI that worked for me. It lifted a very heavy and long-standing depression. Ultimately it was too activating and I discontinued it.
>
> 2) Cytomel. A thyroid hormone that I started as an augment to anti-depressant (off-label). My thinking was a lot clearer on it and it didn't have the usual AD side-effects. It was working so well I fell prey to an "alternative" doctor who diagnosed me with a bogus thyroid disorder and I became convinced that was my problem all along (rather than bipolar). Wishful thinking on my part. I went off it because it's probably not safe for long-term, my pdoc quit using it, and my GP was very opposed to it since it made my blood levels of thyroid hormone very abnormal.
>
> 3) Seroquel. Very helpful for obsessive thoughts, although too sedating to use regularly.
>
> 4) Lamotrigine. Helped depression with no noticeable side effects. Depression returned in a couple years.
>
> 5) Cymbalta. Worked well as an anti-depressant and really helped chronic joint pain. Depression returned in a year though. Also had bad sexual side effects that did not go away.
>
> 6) Fetzima. Replaced the cymbalta, worked well as an anti-depressant without sexual side effects. Depression returned though.
>
> 7) Lithium. Probably the last med I ever wanted to try, but it lifted my mood dramatically in about four days. I'm hoping this one will stick. Side effects are noticeable but manageable (tremor and water retention).Hi Tabitha,
Thanks so much for this list. Certainly gives me (and I'm sure others) some meds to consider. Glad the Lithium is working for you, I may give it a try.
Jade
Posted by Horse on March 8, 2016, at 22:42:24
In reply to Re: Magic Pill » Tabitha, posted by J Kelly on March 8, 2016, at 19:11:09
Hi Jade,
I'm a little late here. I'm wondering what symptoms you want to treat. I apologize if you've gone over this already.
First med that comes to mind is lamotigine (lamictal). Helps soooo much with rapid cycling. I'm almost normal :P
Posted by J Kelly on March 9, 2016, at 7:34:02
In reply to Re: Magic Pill » J Kelly, posted by Horse on March 8, 2016, at 22:42:24
> Hi Jade,
>
> I'm a little late here. I'm wondering what symptoms you want to treat. I apologize if you've gone over this already.I took these off the net (yes I'm that lazy) but they accurately describe my symptoms:
Feelings of helplessness and hopelessness. A bleak outlooknothing will ever get better and theres nothing I can do to improve my situation (most of the time, not always).Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. Ive lost my ability to feel joy and pleasure.
Loss of energy. Feeling fatigued, sluggish, and physically drained. My whole body feels heavy, and even small tasks are exhausting or take longer to complete.
Self-loathing. Strong feelings of worthlessness or guilt. I harshly criticize myself for perceived faults and mistakes.
Concentration problems. Trouble focusing, making decisions, or remembering things.
I also suffer from anxiety that gets bad at times. Almost panic. I'm developing a fear of leaving my house, don't like to be around others, and sometimes I feel sketchy when driving.>
> First med that comes to mind is lamotigine (lamictal). Helps soooo much with rapid cycling.
This med keeps popping up for me. I'm going to mention it to my pdoc later today.
>I'm almost normal :PWhat a wonderful state. Normal. I'd even settle for almost :)
Jade
Posted by Lamdage22 on March 11, 2016, at 7:20:45
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 8, 2016, at 17:27:21
> > Nardil.
> >
> > But it didnt go very well in the end and i have damned psychemeds.
>
> How long on Nardil? At what dose did it cause problems for you?
>
> Jade
>I was on Nardil for a total of 3 times. Those 3 times maybe 14 months total?
All doses made problems.
Posted by J Kelly on March 13, 2016, at 14:41:49
In reply to Re: Magic Pill, posted by Lamdage22 on March 11, 2016, at 7:20:45
> > > Nardil.
> > >
> > > But it didnt go very well in the end and i have damned psychemeds.
> >
> > How long on Nardil? At what dose did it cause problems for you?
> >
> > Jade
> >
>
> I was on Nardil for a total of 3 times. Those 3 times maybe 14 months total?
>
> All doses made problems.
>
>Even on AP's and Lithium?
Jade
Posted by J Kelly on March 13, 2016, at 14:43:16
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 13, 2016, at 14:41:49
> > > > Nardil.
> > > >
> > > > But it didnt go very well in the end and i have damned psychemeds.
> > >
> > > How long on Nardil? At what dose did it cause problems for you?
> > >
> > > Jade
> > >
> >
> > I was on Nardil for a total of 3 times. Those 3 times maybe 14 months total?
> >
> > All doses made problems.
> >
> >
>
> Even on AP's and Lithium?
>
> Jade
>I'm feeling a little desperate :(
Posted by Lamdage22 on March 14, 2016, at 16:18:55
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 13, 2016, at 14:41:49
Yes even on APs. I needed much more APs when Parnate kicked in. Lithium made me gain weight SO fast that i decided not to pursue it.
There is such a thing as post psychotic depression and post manic depression!
The feeling you have now (post manic/post psychotic) may go away. And MAOI may be contraindicated for you now.
Posted by Lamdage22 on March 14, 2016, at 16:24:30
In reply to Re: Magic Pill, posted by Lamdage22 on March 14, 2016, at 16:18:55
Jeez i really dont know what to tell you... I wish i had psychic abilities to tell yo what is best for you, but i dont.
Hmmm.
You tried other options? Maybe you can try to remember what you tried and more importantly what you didnt try.
You are not boring anyone.
Posted by J Kelly on March 14, 2016, at 19:07:49
In reply to Re: Magic Pill, posted by Lamdage22 on March 14, 2016, at 16:24:30
> Jeez i really dont know what to tell you... I wish i had psychic abilities to tell yo what is best for you, but i dont.
>
> Hmmm.
>
> You tried other options? Maybe you can try to remember what you tried and more importantly what you didnt try.
>
> You are not boring anyone.Not true. I'm boring myself.
Jade
>
Posted by Lamdage22 on March 15, 2016, at 5:49:02
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 14, 2016, at 19:07:49
If you just want someone to listen, thats fine with me. If you want help though we would need more info.
Posted by Lamdage22 on March 15, 2016, at 5:49:43
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 5:49:02
i wonder why Scott hasnt said anything yet
Posted by SLS on March 15, 2016, at 6:21:44
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 5:49:43
> i wonder why Scott hasnt said anything yet
Hi Lamdage.
Hi Jade.
I agree with Lamdage in his saying that you are not boring. If you bore yourself, maybe you are just sick and tired of being sick and tired. Perhaps you feel that your complaints are repetitious. They are - too much so. However, until you have good reason to feel healthy and joyful, people will afford you a listening ear and a smile if they can. Remaining ill over an extended period of time will garner empathy and compassion - not boredom.
- Scott
Posted by SLS on March 15, 2016, at 6:36:30
In reply to Re: Magic Pill » J Kelly, posted by J Kelly on March 13, 2016, at 14:43:16
> I'm feeling a little desperate :(
Any particular reason?
I understand that you are very ill, but from where comes your despair? Despair is not good. Maybe we can figure out precisely what is causing it. Is it being caused by the frustration of past failures, or by the fear and confusion in thinking that there is nothing left to try?
- Scott
Posted by J Kelly on March 15, 2016, at 7:27:15
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 5:49:02
> If you just want someone to listen, thats fine with me. If you want help though we would need more info.
>Nope I think my work here is done :)
I just was curious about what others found helpful as I may be making some med changes. Thanks all for the ideas.
Jade
Posted by J Kelly on March 15, 2016, at 7:29:57
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 5:49:43
> i wonder why Scott hasnt said anything yet
Not sure what you mean here. He's been consistently posting to my many threads and posts. His input, and yours, has been greatly appreciated :)
Jade
Posted by J Kelly on March 15, 2016, at 8:02:48
In reply to Re: Magic Pill » J Kelly » Lamdage22, posted by SLS on March 15, 2016, at 6:21:44
>
> Hi Lamdage.
>
> Hi Jade.
>
> I agree with Lamdage in his saying that you are not boring. If you bore yourself, maybe you are just sick and tired of being sick and tired."Enough about me. I am boring myself and I'm sure others :)"
I actually posted the above in the "Nardil safe?" thread because I thought Lamdage and I had hit the subject from all sides and I felt it was time to put it to rest. That's all.
> Perhaps you feel that your complaints are repetitious. They are - too much so.
Well I do now lol. I wasn't aware of that. Its easy to be repetitive here at first, I think its a result of wanting to feel understood, and I do. And everyone is so kind and empathetic. You are all generous with personal experiences and ideas.
Do you know the feeling, where you walk into a pdoc's office, like a deer in the headlights, he looks at his comp while you try to get in a couple of words, and 10 minutes later you walk out with a script you didn't want? Babble helps me be better prepared. Does that make sense?
> However, until you have good reason to feel healthy and joyful, people will afford you a listening ear and a smile if they can. Remaining ill over an extended period of time will garner empathy and compassion - not boredom.
I appreciate this. Again, I was bored with the Nardil thread and I was afraid others were too. I never meant that I thought posters would react with boredom when it came to my illness. I'm sorry if I wasn't clear.
Thanks for your many helpful posts. Even when my "complaints" are repetitive :)
Jade
Btw-I do get sick and tired of being sick and tired. Don't we all?
>
>
> - Scott
Posted by J Kelly on March 15, 2016, at 8:12:43
In reply to Re: Magic Pill » J Kelly, posted by SLS on March 15, 2016, at 6:36:30
> > I'm feeling a little desperate :(
>
> Any particular reason?
>
> I understand that you are very ill, but from where comes your despair? Despair is not good. Maybe we can figure out precisely what is causing it. Is it being caused by the frustration of past failuresYes, it comes from the frustration of past failures. That maybe I will never feel remission again.
> or by the fear and confusion in thinking that there is nothing left to try?
No, I know there are things left to try. That's mainly why I'm here. As you know, I'm looking at Lamictal and Nardil. In that order.
Jade
>
>
> - Scott
Posted by SLS on March 15, 2016, at 8:17:50
In reply to Re: Sick and tired » SLS, posted by J Kelly on March 15, 2016, at 8:02:48
> > Perhaps you feel that your complaints are repetitious. They are - too much so.
> Well I do now lol. I wasn't aware of that.I hope you understood my intent. Your complaints are too repetitious only in that it means that you are not feeling as well as we would all like you to. With each complaint comes another day of frustration and pain that you don't deserve and that we wish we could take away from you. The people here have managed to tolerate my complaints for over 15 years.
Get well.
You have been a very pleasant catalyst to stimulate participation on Psycho-Babble.
- Scott
Posted by SLS on March 15, 2016, at 8:29:51
In reply to Re: Magic Pill » SLS, posted by J Kelly on March 15, 2016, at 8:12:43
> No, I know there are things left to try. That's mainly why I'm here. As you know, I'm looking at Lamictal and Nardil. In that order.
Interestingly, I have not had a manic episode since starting Abilify in 2002, despite quite a few trials of MAOI-TCA combinations. Abilify is a dopamine system stabilizer due to its partial agonist properties on dopamine receptors. I attribute the improvement in depression to this. So... You might want to try adding Abilify to Lamictal before starting Nardil. If it helps, you can then try to discontinue the Zyprexa.
- Scott
Posted by J Kelly on March 15, 2016, at 9:05:15
In reply to Re: Sick and tired » J Kelly, posted by SLS on March 15, 2016, at 8:17:50
> > > Perhaps you feel that your complaints are repetitious. They are - too much so.
>
> > Well I do now lol. I wasn't aware of that.
>
> I hope you understood my intent. Your complaints are too repetitious only in that it means that you are not feeling as well as we would all like you to. With each complaint comes another day of frustration and pain that you don't deserve and that we wish we could take away from you. The people here have managed to tolerate my complaints for over 15 years.I do understand.
>
> Get well.I plan to :)
>
> You have been a very pleasant catalyst to stimulate participation on Psycho-Babble.Thank you. I would love to see Babble thrive once again.
Jade
>
>
> - Scott
Posted by J Kelly on March 15, 2016, at 9:12:08
In reply to Re: Magic Pill » J Kelly, posted by SLS on March 15, 2016, at 8:29:51
> > No, I know there are things left to try. That's mainly why I'm here. As you know, I'm looking at Lamictal and Nardil. In that order.
>
> Interestingly, I have not had a manic episode since starting Abilify in 2002, despite quite a few trials of MAOI-TCA combinations. Abilify is a dopamine system stabilizer due to its partial agonist properties on dopamine receptors. I attribute the improvement in depression to this. So... You might want to try adding Abilify to Lamictal before starting Nardil. If it helps, you can then try to discontinue the Zyprexa.
>I would love to replace Zyprexa with Abilify. My only objection is the akathisia. I had it pretty bad when taking Abilify. Can you recommend anything to counter this? Would the Lamictal help?
Jade
>
> - Scott
Posted by SLS on March 15, 2016, at 11:16:27
In reply to Re: Magic Pill » SLS, posted by J Kelly on March 15, 2016, at 9:12:08
> > > No, I know there are things left to try. That's mainly why I'm here. As you know, I'm looking at Lamictal and Nardil. In that order.
> >
> > Interestingly, I have not had a manic episode since starting Abilify in 2002, despite quite a few trials of MAOI-TCA combinations. Abilify is a dopamine system stabilizer due to its partial agonist properties on dopamine receptors. I attribute the improvement in depression to this. So... You might want to try adding Abilify to Lamictal before starting Nardil. If it helps, you can then try to discontinue the Zyprexa.
> >
>
> I would love to replace Zyprexa with Abilify. My only objection is the akathisia. I had it pretty bad when taking Abilify. Can you recommend anything to counter this? Would the Lamictal help?Can you describe the symptoms of akathisia that you experienced? What was the dosage that you tried?
I might stay away from Abilify if I were you. You may, instead, opt for trying Rexulti (brexpiprazole). It is a relative of Abilify that has a reduced risk of producing akathisia.
- Scott
Posted by J Kelly on March 15, 2016, at 11:50:54
In reply to Re: Magic Pill » J Kelly, posted by SLS on March 15, 2016, at 11:16:27
> > > > No, I know there are things left to try. That's mainly why I'm here. As you know, I'm looking at Lamictal and Nardil. In that order.
> > >
> > > Interestingly, I have not had a manic episode since starting Abilify in 2002, despite quite a few trials of MAOI-TCA combinations. Abilify is a dopamine system stabilizer due to its partial agonist properties on dopamine receptors. I attribute the improvement in depression to this. So... You might want to try adding Abilify to Lamictal before starting Nardil. If it helps, you can then try to discontinue the Zyprexa.
> > >
> >
> > I would love to replace Zyprexa with Abilify. My only objection is the akathisia. I had it pretty bad when taking Abilify. Can you recommend anything to counter this? Would the Lamictal help?
>
> Can you describe the symptoms of akathisia that you experienced? What was the dosage that you tried?Yes. It was the feeling that I couldn't sit still even if I wanted to. Like I HAD to get out of the chair and walk around. My legs couldn't remain still. I'd compare it to RLS. I don't remember the dose but I believe it was fairly low. I had akathisia at the first dose I tried.
>
> I might stay away from Abilify if I were you. You may, instead, opt for trying Rexulti (brexpiprazole). It is a relative of Abilify that has a reduced risk of producing akathisia.Thanks. I'll add Rexulti to the list I want to run by my pdoc. At some point I'm afraid I will need to replace Zyprexa. The weight issue is a deal breaker for me. Zyprexa (the poster) has had luck with splitting the dose in regards to weight gain. I'm giving this a try. Fingers crossed :)
Jade
>
>
> - Scott
Posted by SLS on March 15, 2016, at 13:27:50
In reply to Re: Magic Pill » SLS, posted by J Kelly on March 15, 2016, at 11:50:54
One more comment:
An antipsychotic named Saphris (asenapine) also has antidepressant effects, but is unlikely to cause akathisia. I have not seen it cause weight gain, and it can be energizing and improve cognition. If your akathisia was severe and intolerable when you tried Abilify, I would choose Saphris before Rexulti.
Okay... One more comment:
If you find yourself choosing Nardil treatment, and Saphris is less than effective at preventing mania, you might consider using Navane (thiothixene). Navane is an older antipsychotic that should be effective without causing weight gain. I know someone with severe schizoaffective disorder who is doing quite well on a combination of Saphris and Navane. She experiences no EPS. She also takes Wellbutrin, but Saphris was the key to unlock her potential.
- Scott
Posted by Lamdage22 on March 15, 2016, at 14:00:24
In reply to Re: Magic Pill » J Kelly, posted by SLS on March 15, 2016, at 13:27:50
Considering that your psychosis was med induced, you may be able to wein off of the APs if you avoid the offending med(s). I wasnt but that doesnt mean that you arent able to. I too never was psychotic before MAOI.
Maybe i could have weined off if i didnt try it (MAOI) 4 times and for such long periods of time.
Ouch.
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