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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 34 to 58 of 77. Go back in thread:
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.
Posted by Lamdage22 on March 15, 2016, at 14:01:39
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 14:00:24
So i am not "crazy" and this happens to other people, too.
I am careful to recommend MAOI because of what it did to me.
Posted by J Kelly on March 15, 2016, at 14:22:06
In reply to Re: Magic Pill » J Kelly, posted by SLS on March 15, 2016, at 13:27:50
> 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.Yes akathisia from Abilify was intolerable. I tried Saphris years ago and didn't respond well. I didn't take it for its a/p effect. I'm realizing I need to do some research. I was negligent in keeping track of the meds I've tried and the resulting s/e's. My previous pdoc's should have those records I would think. However, I suppose its possible that a med or meds that were ineffective years ago, may show promise today.
>
> 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.I was diagnosed with Schizoaffective disorder at one point. That's been dismissed as it was an isolated incident. However, when considering adding Nardil, I think Saphris and Navane are worth thinking about.
Thanks for the comments :)
Jade
>
>
> - Scott
>
Posted by Lamdage22 on March 15, 2016, at 14:34:54
In reply to Re: Magic Pill » SLS, posted by J Kelly on March 15, 2016, at 14:22:06
> I was diagnosed with Schizoaffective disorder at one point. That's been dismissed as it was an isolated incident.
> >
>
>You are lucky. It sounds like my story could have been. But it wasnt:) I think due to too many of those MAOI trials. It sounds really stupid now but back then i thought i was doing the right thing.
I carry that diagnosis schizo-affective.
We are similar in some ways.
Lucky under the circumstances though i may find a way out of AP consumption through Cannabidiol.
I hold the belief that i could discontinue APs if i only do it slowly enough. But it would take too long. I could still get Diabetes or something equally ugly. So i try CBD.
Posted by J Kelly on March 15, 2016, at 14:42:22
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 14:00:24
> 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.
I've gone long periods of time with no A/P on board since my psychotic reaction to Parnate. The reason I'm currently taking Zyprexa is not to treat psychosis, but hard to treat depression.
>
> Maybe i could have weined off if i didnt try it (MAOI) 4 times and for such long periods of time.
>
> Ouch.I'm so sorry that happened to you Lamdage. Psychosis s*cks. And its tough to discard a group of meds (MAOI's) when they have brought me/you remission. I'm assuming this is why you continued to take them?
You are like the Angel on my shoulder lol. "Don't do it Jade, its not worth it. Bad things could happen".
The Devil is telling me "go for it Jade! remission is in sight!!"
>
>Believe me Lamdage, I am listening and I hear you. I know you don't want to see me end up with permanent psychosis as a result of MAOI use. I thank you for your very real concern.
Jade
Posted by Lamdage22 on March 15, 2016, at 14:49:50
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 14:34:54
I dont want these additional health risks you know?
I want to be worry free.
Posted by Lamdage22 on March 15, 2016, at 14:58:26
In reply to Re: Magic Pill, posted by J Kelly on March 15, 2016, at 14:42:22
> > 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.
>
> I've gone long periods of time with no A/P on board since my psychotic reaction to Parnate. The reason I'm currently taking Zyprexa is not to treat psychosis, but hard to treat depression.Its funny how different we all are. Zyprexa makes me lazy and lethargic. I would never think it could help depression.
> >
> > Maybe i could have weined off if i didnt try it (MAOI) 4 times and for such long periods of time.
> >
> > Ouch.
>
> I'm so sorry that happened to you Lamdage. Psychosis s*cks. And its tough to discard a group of meds (MAOI's) when they have brought me/you remission. I'm assuming this is why you continued to take them?Yes depression and social anxiety was much improved. At a time i was doing so freaking well when i was in Hawaii. but i took more than Just Nardil. Also Wellbutrin and a shitload of supplements. I was like "life? f*ck yeah lets do it". 1 1/2hours of sports every day. I wasnt always psychotic on Nardil.
> You are like the Angel on my shoulder lol. "Don't do it Jade, its not worth it. Bad things could happen".
Well if there is no alternative to Zyprexa then at least you could do regular bloodwork. If your sugar goes up you can stop.
> The Devil is telling me "go for it Jade! remission is in sight!!"
> >
> >
>
> Believe me Lamdage, I am listening and I hear you. I know you don't want to see me end up with permanent psychosis as a result of MAOI use. I thank you for your very real concern.
>
> Jade
Good:)
Posted by J Kelly on March 15, 2016, at 15:07:41
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 14:34:54
> > I was diagnosed with Schizoaffective disorder at one point. That's been dismissed as it was an isolated incident.
> > >
>
> You are lucky. It sounds like my story could have been. But it wasnt:) I think due to too many of those MAOI trials. It sounds really stupid now but back then i thought i was doing the right thing.It doesn't sound stupid at all Lamdage. You were trying to get well with the choices you felt were available to you. Don't beat yourself up. I would imagine that its possible you might have had a problem with psychosis with or without the MAOI's. We just cant know.
>
> I carry that diagnosis schizo-affective.I did too for a time. Its not easy to accept.
>
> We are similar in some ways.Yes we are. Can I assume that you are fairly young? I'm a mother and my heart goes out to you :) Babble mail me if you ever need to talk to someone.
>
> Lucky under the circumstances though i may find a way out of AP consumption through Cannabidiol.I REALLY hope this works out for you. But if it doesn't you just keep on. That's all we can do. And honestly if I found out I had to be on Zyprexa for the rest of my life I would accept it and move on. I might try and get my jaw wired shut though lol.
>
> I hold the belief that i could discontinue APs if i only do it slowly enough. But it would take too long. I could still get Diabetes or something equally ugly. So i try CBD.Keep trying. I've been pleasantly surprised by some meds. Granted they don't all work long term but there is always hope with new meds/combos.
Jade
Posted by SLS on March 15, 2016, at 15:32:57
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 14:58:26
Metformin?
Posted by Lamdage22 on March 16, 2016, at 3:58:09
In reply to Re: Magic Pill, posted by Lamdage22 on March 15, 2016, at 14:49:50
yes i take Metformin
Posted by SLS on March 16, 2016, at 7:25:27
In reply to Re: Magic Pill, posted by Lamdage22 on March 16, 2016, at 3:58:09
> yes i take Metformin
Would you suggest it for Jade?
- Scott
Posted by Lamdage22 on March 16, 2016, at 7:54:21
In reply to Re: Magic Pill » Lamdage22, posted by SLS on March 16, 2016, at 7:25:27
> > yes i take Metformin
>
> Would you suggest it for Jade?
>
>
> - Scott
>If she has weight gain, high cholesterol, high triglycerides, or a combination thereof, sure. Its worth a shot.
Also, since Jade doesnt take the 10mg Zyprexa for Psychosis (which i thought), she may be able to take Nardil with 10mg Zyprexa. She takes Zyprexa anyway and not because she is psychotic otherwise, so i dont know why she shouldnt try Nardil if she is careful.
With Metformin and Zyprexa i would recommend regular blood tests though. Sugar and kidney function tests.
Its your choice, Jade.
Posted by Zyprexa on March 19, 2016, at 9:46:28
In reply to Re: Magic Pill, posted by Lamdage22 on March 16, 2016, at 7:54:21
When do you start the CBD? Have you seen your doc yet about it?
Posted by Lamdage22 on March 20, 2016, at 6:38:16
In reply to Re: Magic Pill » Lamdage22, posted by Zyprexa on March 19, 2016, at 9:46:28
> When do you start the CBD? Have you seen your doc yet about it?
I see a doctor that is specialized for cannabinoid medicines on April the 3rd. My psychiatrist is fine with me trying CBD.
They are two persons.
Posted by J Kelly on March 20, 2016, at 10:45:25
In reply to Re: Magic Pill » Lamdage22, posted by SLS on March 16, 2016, at 7:25:27
> > yes i take Metformin
>
> Would you suggest it for Jade?
>
>
> - Scott
>I'm gonna ask my pdoc about this if I end up staying on Zyprexa. I'm wondering why more people don't use it. How effective is it? Drawbacks?
Jade
Posted by Lamdage22 on March 20, 2016, at 12:34:11
In reply to Re: Magic Pill » SLS, posted by J Kelly on March 20, 2016, at 10:45:25
> > > yes i take Metformin
> >
> > Would you suggest it for Jade?
> >
> >
> > - Scott
> >
>
> I'm gonna ask my pdoc about this if I end up staying on Zyprexa. I'm wondering why more people don't use it. How effective is it? Drawbacks?
>
> Jade
>
>Once every three months i need to hit the bathroom really quickly (Nr. 2).
There can be some diarrhea but doesnt need to be. For me it passed. It depends on the dosage.When you are taking meds you should do regular blood tests (every 3 months). Kidney function should be monitored.
Gernerally speaking Metformin is very well tolerated. It can even extend life.
Posted by Lamdage22 on March 20, 2016, at 12:37:35
In reply to Re: Magic Pill, posted by Lamdage22 on March 20, 2016, at 12:34:11
It is pretty effective but then again not for all people.
You wont know unless you try.
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Dr. Bob is Robert Hsiung, MD,
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