Psycho-Babble Medication Thread 946

Shown: posts 1 to 5 of 5. This is the beginning of the thread.

 

Hey Toby! Are you a doc?

Posted by carter on October 23, 1998, at 20:50:22

Toby I've been reading your posts and would like to know if you're an M.D.; your advice sounds more categorical than that of poor patient/guinea pigs like me.

I'm particularly interested in meds to regain motivation and "hedonia" -- have been severe, melancholic, anhedonic 10 years. Last 2 years have been helped somewhat by nortriptyline, on physical energy at least. Only marginally helped by Cylert (DA stimulant). If norepi and dopamine rule drive and pleasure, how come I have neither? Only vigorous exercise leaves me feeling relaxed and clear headed; but only until next morning.

Thanks,

carter

 

Follow-up for Toby

Posted by carter on October 23, 1998, at 21:35:03

In reply to Hey Toby! Are you a doc?, posted by carter on October 23, 1998, at 20:50:22

My other project, like everyone else, is to find more pro-sexual AD's or supplements.

I take nortriptyline 75-100 for physical energy; mood, reward and mental drive still very low. backbone. Looking to supplement or replace it.
I've read your posts on serzone, remeron, wellbutrin. First 2 probably 2 sedating for me; I've tried wellbu and SR version and couldn't get past jumping out of my skin 1st time and spastic hands and feet 2nd time. (I'm already a little shaky on the nortrip.) Taking the SR, I rushed the net once and when I landed after my split-step, my feet were headed in 2 diff. directions, neither toward the net. Not great for your confidence, espec. for impressing the chicks in mixed doubles. But I digress...

Questions:

Can I get past the wellbutrin craziness over time?
Does amantadine work for the tremors?
Is amantadine pro-sexual by itself?
What's this about Borna virus in brain of depressives and possible anti-viral angle of amantadine?
Can you run this by the all-knowing, all-caring Dr. Bob?

Thanks, Toby dude!

 

Re: Follow-up

Posted by Toby on October 26, 1998, at 16:11:28

In reply to Follow-up for Toby, posted by carter on October 23, 1998, at 21:35:03

I am indeed a doctor, board certified in psychiatry and neurology.

You've had this depression pretty consistently over the last 10 years? Have you been treated all along, or only recently? Has nothing really given much benefit or too many side effects to really tell?

Have you been tried on an MAOI, specifically tranylcypromine? MAOI's are superior to TCA's in treating atypical depression (overeating, increased appetite and weight gain, sweet craving, hypersomnia--too much time in bed, "rejection-sensitivity," profound loss of energy or "leaden paralysis," feeling better in the morning and worse as the day proceeds, phobic-anxiety, panic attacks, worries about physical health without reason). Any of those apply to you? You did list a few in your post. MAOI's successfully treat 55-70% of depressions that fail to respond to other antidepressants. I recommended tranylcypromine because it has much less risk of sexual side effects and better track record for improving energy.

Side effects: mild hypotension, dizziness, palpitations, dry mouth, sedation when first starting out and typically resolve pretty quickly.

Regarding the jitteriness from the Wellbutrin -- that usually goes away within 4-6 weeks of starting it, so if you took it that long without any change in symptoms, taking it longer probably won't show any benefit.

Amantadine for tremors from Wellbutrin I have not tried or heard of. I'm not sure that it would do much because amantadine increases dopamine, as does Wellbutrin so it may even increase the tremors as a side effect. Amantadine shouldn't have adverse sexual side effects. It works as an antiviral for Influenza A, and I guess might work for the Borna virus (I haven't read that, so don't know specifically). Amantadine has caused depression in some clinical trials. I wonder if Dr. Bob knows about antidepressant properties.

 

Reply to Toby

Posted by carter on October 27, 1998, at 11:40:10

In reply to Re: Follow-up , posted by Toby on October 26, 1998, at 16:11:28

Thanks for your informative note. I thought maybe you were Dr. Bob's assistant, not having a "Dr." by your name.

I'm not an atypical dep. case -- of those symptoms I really only have 1, fatigue. I feel worst in the AM, best in PM; and I'm not rejection-sensitive -- I'm less so than many "normal" people I know. I do crave starches but that started w/ the nortriptyline. For the first time in my life bagels taste like manna from heaven, and Wheaties are infinitely enjoyable.

I did take Parnate for awhile, but only 10mg. It may have helped marginally, and maybe I didn't take enough. Nortriptyline is the only thing (out of 12 diff. drugs from all classes)where I thought, I can really tell the diff. But it makes me both tense and groggy at same time, and I don't have the mental energy to do software work anymore.

Are you at U. of Chicago Hospital? I used to live in Hyde Park near the Museum of S and I; two of my housemates were med students there(late 1980's). I'm now in Boston. I miss the cheap Thai food, Harold's Chicken (get the hot sauce!), and the awesome modern arch. of downtown. But not the weather!


 

assistants and chicken

Posted by Dr. Bob on October 29, 1998, at 0:20:56

In reply to Reply to Toby, posted by carter on October 27, 1998, at 11:40:10

> I thought maybe you were Dr. Bob's assistant,
> not having a "Dr." by your name.

I don't have any official assistants. At least not
yet, anyway. Other people who help out here are
helping out on their own. I tried to address this
before and have to say I was disappointed by the
response. See:

http://www.dr-bob.org/babble/199809/msgs/604.html

> I'm now in Boston. I miss the cheap Thai food,
> Harold's Chicken (get the hot sauce!), and the
> awesome modern arch. of downtown. But not the
> weather!

My own personal preference is Popeye's. :-)

If you enjoy architecture, take the boat ride on
the Chicago River that the Chicago Architecture
Foundation sponsors. You get a nice ride, you get
their talk, and you get to see the architecture
from a different vantage point.

Is Boston weather so much better? :-)

Bob


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