Psycho-Babble Medication Thread 2037

Shown: posts 1 to 25 of 32. This is the beginning of the thread.

 

Sleep, Toby advise?

Posted by DL on January 4, 1999, at 7:30:31

It's probably silly, but I'm scared...I upped the dose from 30 to 45mg of Remeron for the last 2 nights to see if it would decrease the terrible cravings and weight gain and perhaps raise my level of enjoyment of life. The first night I didn't really connect, but I awoke after 4 hours sleep at about 4 in the morning. Then I did sleep off and on but kept waking up and didn't feel as relaxed as I have been while sleeping. I just thought it was a normal variation or perhaps something stimulating I ate or drank. But, last night I had that same awful turned into high gear, somewhat agitated feeling, like those chemicals were just too active to let me sleep. I did not sleep. I saw the clock over and over and could not find a comfortable position. It was uncomfortable to stay still in one place. Now I'm scared because I don't think I could live without sleep again. I don't know how I got through those years.

I remember that the Remeron did not seem to give me good sleep for a few weeks after taking it. Remember I took the klonopin for a while?

Is this just coincidence? Or is the increased dose doing this? Does Remeron in higher amounts act more like the other AD's? Is it possible that this effect will wear off soon? I'm afraid to go to bed again and have no sleep. I'm also afraid to start the klonopin again. Can you give me some help here? Should I continue or stop? Should I take the klonopin? Should I take the extra Remeron in the morning?

I do know that benadryl ( antihistamine--same group as Remeron?) does help me sleep because I used it when I was desperate before. But it seems to hang with me in the morning. Would this be better to take with the Remeron for a few days?

This is similar to the way I felt anyway and that was increased by the SSRI's, Welbutrin, and Effexor.

Help! Suggestions?

 

Re: Sleep, Toby advise?

Posted by Toby on January 4, 1999, at 15:20:43

In reply to Sleep, Toby advise?, posted by DL on January 4, 1999, at 7:30:31

Did you try this on your own or did you check in with your doctor first? if you did it on your own, I's suggest going back to the 30 mg and see if the restful sleep returns. If it does and you you just can't kick the appetite thing any other way, you might have to talk with your doc about adding another antidepressant during the day. I'd be a little curious about maybe a tiny dose of Cylert or even a small dose of an appetite suppressant to get over the hurdle of depression, help the appetite, but not so much as to give you the jitters. Cylert gives almost nobody the jitters and an appetite suppressant can be much milder than a true stimulant. If you did talk with your doctor first and told him of your experiment and he's OK with you trying a bit of Klonopin for a day or two to see if the sleep/jitters will even out like they did before, then by all means try it. A few days will not make your body dependent on Klonopin, nor should a few days on the higher dose make you nonresponsive to 30 mg if you end up needing to return to it after all.

 

Re: Sleep, Toby advise?

Posted by DL on January 4, 1999, at 19:45:09

In reply to Re: Sleep, Toby advise?, posted by Toby on January 4, 1999, at 15:20:43

> Did you try this on your own or did you check in with your doctor first?

I did it on my own. I figured he doesn't know much more about the dose than I do. I actually took your ideas in printied out as e-mail back when I started Remeron and let him read it! He agreed and wrote the prescription--but for only a very tiny dose--told me to stay on it and come back in 3 months! Then he went on vacation with no notation of the script in my chart, which ended up in the crazy prescription mess you might remember. I don't get the impression his specialty is psychopharmacology. I thought if it seemed to work I could ask for a new script (needed for new insurance coverage since no more refils)-in the higher dose. And if it didn't work out it would help anyway since I may have to pay $25/month for it now and it would last longer!

> if you did it on your own, I's suggest going back to the 30 mg and see if the restful sleep returns.

Then I'll never know if things could be better? But I may do it anyway....

If it does and you just can't kick the appetite thing any other way, you might have to talk with your doc about adding another antidepressant during the day.

What kind of AD? Is there one that wouldn't zing me up like the others?

> I'd be a little curious about maybe a tiny dose of Cylert. Cylert gives almost nobody the jitters.

Isn't that a stimulant used in ADD? It's not an AD? Wouldn't it act like caffeine in my system?

>or even a small dose of an appetite suppressant to get over the hurdle of depression, help the appetite, but not so much as to give you the jitters. An appetite suppressant can be much milder than a true stimulant.

What is an appetite supressant? Give me an example. You don't mean those over the counter things do you? Those have an ingredient, often found in cold meds that acts on my system like caffeine. So what is an appetite supressant and what do you mean by a true stimulant (Cylert?).

> If you did talk with your doctor first and told him of your experiment and he's OK with you trying a bit of Klonopin for a day or two to see if the sleep/jitters will even out like they did before, then by all means try it.

No, I didn't ask him. It is nearly impossible to talk to him between appts. He always asks when I come in if I want another prescription for Klonopin. I have plenty left since I never took as much as was prescribed. It never gave me real sleep--just enough for survival. I'm sure if I ask him he'd just write another prescription and say to come back in 3 months....

> , nor should a few days on the higher dose make you nonresponsive to 30 mg if you end up needing to return to it after all.

Would more than a few days make me non responsive? I never thought of that since I was always too responsive to everything.

Sorry for being such a pain. All I want is to really feel excited, silly, absorbed or awed etc.-- Connecting with the new ins. co. tomorrow. perhaps it will all work out. Thanks for hangin on. When the sleep deprivation moves in I truely feel that I am "teetering on the edge". It always surprises me when someone finds out that my life was not "Brady Bunch" and they just can't believe it. Somehow with all the teetering I have done I haven't fallen so far that I can't painfully scratch my way up the cliff--All the time looking as if I'm just a glamorous rock climber.

 

Re: Sleep

Posted by Toby on January 5, 1999, at 16:28:19

In reply to Re: Sleep, Toby advise?, posted by DL on January 4, 1999, at 19:45:09

Cylert is a stimulant, but it is a long acting, slow release kind of stimulant (it isn't related to amphetamines, though; it works through some other mechanism I can't recall off the top of my head) and I use it for augmenting antidepressants when other things don't work and also to reverse the side effect of some antidepressants, which is the flat, no energy side effect.

The appetite stimulant I was thinking of is Fastin. It is a weak, long acting stimulant that many of the depression gurus are fond of adding to other antidepressants. I have never seen it make anyone jittery, although of course I wouldn't want to make any guarantees, blah blah blah. At any rate, both the Fastin and the Cylert are once a day meds (morning dose) and don't disrupt sleep (because they are given in the morning).

I would definitey NOT take an over the counter appetite suppressant as a substitute for what we are talking about above. They don't have cross tolerance, and the OTC meds are usually based on ephedrine, pseudoephedrine or caffeine and just tend to rev people up so much, who could think about eating? They don't do a thing for depression.

By the way, just curious... What's the name of the therapist you had talked to about EMDR that we talked about? I thought I might recognize the name and see if I had any other knowledge about whether he'd be good to go ahead and see so you wouldn't have to worry with checking the others first.

 

Re: Sleep

Posted by DL on January 5, 1999, at 23:45:51

In reply to Re: Sleep, posted by Toby on January 5, 1999, at 16:28:19

> Cylert is a stimulant, but it is a long acting, slow release kind of stimulant-- I use it for augmenting antidepressants when other things don't work and also to reverse the side effect of some antidepressants, which is the flat, no energy side effect.

I guess I just have that fear of taking anything like those other AD's because they so intensified the hyper state I was already in. THere I was looking for something to make me feel better, and they gave me something to make me feel much worse! ...

THe therapist I saw (before the insurance change) had a theory that people like me who were using so much energy to fuel their hyper state and anxiety, gain weight when they finally find something to help them sleep and calm down--just because they are burning less calories!

> The appetite stimulant I was thinking of is Fastin. It is a weak, long acting stimulant that many of the depression gurus are fond of adding to other antidepressants. I have never seen it make anyone jittery. At any rate, both the Fastin and the Cylert are once a day meds (morning dose) and don't disrupt sleep (because they are given in the morning).

Would this also be true of someone who took Paxil in the morning and felt plugged into an electric outlet all the time?--- I will bring this info to appt on Thurs afternoon and present it to MD. I think he sees so many pts that if he sees I have improved some on Remeron he won't see a reason to do anything else.

UPDATE: I decided not to continue the increased Remeron experiment last night--I just took the 30mg. I went back to the wake up a lot type of sleep, but the terrible aggitated/reved up feeling was gone. We'll see what happens tonight.

> By the way, just curious... What's the name of the therapist you had talked to about EMDR that we talked about? I thought I might recognize the name and see if I had any other knowledge about whether he'd be good to go ahead and see so you wouldn't have to worry with checking the others first.

1. First one to respond to me was Roger Poire. He was listed in the first EMDR list I got about a year ago--as an instructor. All the others on the more recent list were Level II. He is at Atlantic Behavioral Medicine in Dover, NH. He is the one who apparently has taught many of the EMDR people in NH and said he directed some of the trauma care at the Oklahoma bombing. He sounded very nice but said he does not do insurance any more. So I could call him and pay for sessions on my own... He also works with Ronald Longpre who does take insurance and was trained by Poire. I did not speak to Mr. Longpre but could call.

2. Bruce Altman, Psy.D. also called (Associates for Cognitive Thereapy) Portsmouth NH. He does take insurance. He was the one who stressed that he was not sure that EMDR would be right for me--that he would have to interview me to see if he felt it was appropriate. He did not say how experienced he was with EMDR or if he uses it much.

3. Judy Wilber Alberson (Master Social Work)--Portsmouth-- responded via voice mail that she does do EMDR but wasn't sure exactly what I was looking for. She was going on vacation till mid-Jan and said she was quite busy but that I was welcome to call when she was back.

4. Mark Moses PhD also left message that he was currently using EMDR and worked a lot with family issues and relationships. But he did not take health insurance either. He is in Portsmouth NH

The other 3 did not respond at all.

Called insurance co. They do not have me in their computers yet, but I am told at work that I was submitted and am on their list as covered from 1/1 on. Their behavioral med (mental health) company gave me a number to take in to the Thurs appt so it would be covered (good for 5 medication checks). They also said that when I choose a therapist on the list, they will automatically grant 8 visits. After that anymore would be up to the co. and the therapist. I asked about the REmeron being a "non preferred" med and they said it's status hadn't changed. Therefore I would have to pay $25 per 30 day supply.....unless I wanted to switch to Prozac, Paxil, Zoloft ($10) or a TCA ($3). Who makes these decisions? I'm pretty sure Remeron costs less than Prozac.

Any input greatly appreciated.!--
Any screening of above people would be so helpful
Or what to say to MD on Thrus?

WHat did you tell me once before about how to go about fighting managed care policies-about the Remeron?

Good night--I bow to your persistent giving...

 

Therapist

Posted by DL on January 5, 1999, at 23:58:14

In reply to Re: Sleep, posted by DL on January 5, 1999, at 23:45:51

Forgot to say. I am certainly willing to go anywhere within an hour or so driving distance. I live near Durham NH--for a good therapist!

 

Re: Meds and such

Posted by Toby on January 6, 1999, at 16:22:42

In reply to Re: Sleep, posted by DL on January 5, 1999, at 23:45:51

Indeed, I have used Cylert and Fastin for depressed people who couldn't tolerate the SSRI's due to jitteriness and who did not get jittery with these two.

You might want to call Dr. Longpre and get a feel for him and whether you feel comfortable talking to him before deciding between him and Dr. Altman. Since Ms. Alberson is busy, you might not be able to see her often enough to keep the momentum going (although to tell the truth, even monthly sessions still work, but you are wanting, I think, to kind of go ahead and get it over with).

You have to request an appeal from your doctor to the insurance company stating that other medications do not work for you and that they cause intolerable side effects. It has to state that Remeron is effective for you with few to no side effects and that it is your doctor's medical opinion that Remeron is medically necessary to treat your depression and he requests that the insurance company cover the cost of the medication, less the usual and customary copay for other medications. (And you are correct about the cost. Remeron is $77 per month for #30 30 mg tablets and Prozac is $84 per month for #30 20 mg capsules.)

 

Re: Meds and such

Posted by Shirley on January 6, 1999, at 23:12:42

In reply to Re: Meds and such, posted by Toby on January 6, 1999, at 16:22:42

> You have to request an appeal from your doctor to the insurance company stating that other medications do not work for you and that they cause intolerable side effects. It has to state that Remeron is effective for you with few to no side effects and that it is your doctor's medical opinion that Remeron is medically necessary to treat your depression and he requests that the insurance company cover the cost of the medication, less the usual and customary copay for other medications. (And you are correct about the cost. Remeron is $77 per month for #30 30 mg tablets and Prozac is $84 per month for #30 20 mg capsules.)


I lucked out with my Internist who now prescribes my Effexor. When my therapist prescribed it, I was in for quite a shock when the pharmacy informed that my Qual Med insurance wouldn't cover it. It would run me well over $125 per month, so I asked my internist to do as you have suggested, and make a case to my ins. co. justifying it. He said that was way too much trouble, and filled up a bag with samples for me. I would come back for more when I got close to running out, and he'd fill another bag. Those "free" samples have kept me going for over two months now!

We just switched to another insurance (Regence), so now I have a real prescription to have filled (I think they cover it--details like this are overwhelming to me!) I don't care about the copay. I just want to be a regular kind of human again!

Insurance companies have too much control over our health care, IMHO.
Shirley

 

Disappointment

Posted by DL on January 7, 1999, at 21:06:00

In reply to Re: Meds and such, posted by Toby on January 6, 1999, at 16:22:42

I stopped the Remeron increase after those 2 nights and sleep is returning to previous Remeron status.....I was just too afraid of the unknown results with no one for support at home.

Disappointment: I had my med check appt. today. The Dr. said:
1. Increase in Remeron won't affect the appetite. He would not increase script.
2. Nixed Cylert or Fastin etc.
3. I explained the Remeron problem and asked if he would call the ins. co. or write an appeal. He just said it wouldn't do any good. He said I could write them a letter and complain. When I pressed him he said he would call if I find out the proper person to talk to and call it in to him. so far I have had little luck even trying to find out my ID #!
4. He asked how my life was going, if I still had the job. He then said to come back in 3 months and gave me a script for 30mg Remeron since the other had no refils.

I felt like the $50 per med check (perhaps 10 min) could have been saved and I could have skipped it and called the secretary for a script......

I alternate between feeling insensed that this doctor just does not consider my less earth shaking problems on par with the dramatic intensive care cases he may see.......and wondering if I am just a complainer who should grit my teeth and bare it, or wait it out or just accept what life is giving me now and be satisfied.--after all, that's what I have done most of my life and perhaps that is the ceiling of living for me.......

I want to stand on a chair in the waiting room and yell.......why won't you listen? I'm important too! Can't you just interview me carefully and sit down and figure out the mystery here?
And I want to stomp on the phone when the ins. co. puts me on hold for 15 min. while I'm at work. And I can't call from home since they close down at 4PM. Then they can't find my info and I'm not sure if I'm covered at all. If they all have samples, how come I never was offered any even when I tried all those meds? Or when the Remeron problem came up? Am I just too acquiescent? Too passive? Low self esteem? I don't know. I think you once said everyone deserves a listener...........

I am just so tired of calling and writing. With the divorce, house sale, new life, new job, new med, and a cold look at no retirement funds and no emergency funds and etc. I am so tired. I am in the middle of trying to get a QDRO written (divides a small retirement fund I had through husband pre-divorce). He refuses to help in any way and is putting up road blocks...So tired.

> You might want to call Dr. Longpre and get a feel for him and whether you feel comfortable talking to him before deciding between him and Dr. Altman. , but you are wanting, I think, to kind of go ahead and get it over with).

Yes, I would. But I am still afraid of ending up with someone who will not be helpful and not know it till too late....I feel like I am dragging under.
I will try to find a private time to call. Dr. Longpre and Poire's office called and left me a message at work today asking if I was still interested. But, of the people I have asked who have therapy, no one has heard of their practice. (not that i asked all that many..). Only comment I have heard about the other one (Altman) is that he is kindly and gentle (not necessarily a testimonial to his expertise)

Boy, what a pain I am, huh? Why am I not content to just hang on, like I always was before during the battering, tossing, drowning storm of my life? It's like a tug o war--I want more but I can't get there.

 

Toby, legality of sharing unused meds

Posted by Susan on January 8, 1999, at 9:18:12

In reply to Disappointment, posted by DL on January 7, 1999, at 21:06:00

Toby, if someone has a 90 day supply of a medication that cannot be used because of adverse reactions should that med (ex. Remeron) be flushed down the toilet or can it be given to someone who has a real financial need? It seems like such a waste to flush it when someone who has the same prescription could use it. Wouldn't it be the same as receiving samples? Do medications lose therapeutic properties after a year? I know it is illegal to share meds but if someone already uses them what is the harm? Thanks for your input.

 

Re: Disappointment

Posted by Elizabeth on January 8, 1999, at 15:49:25

In reply to Disappointment, posted by DL on January 7, 1999, at 21:06:00

Hey DL, sorry I didn't respond earlier - been having computer troubles.

It's too bad your doctor didn't want to let you try Cylert; did he say why? I took 18.75mg (the lowest dose it comes in) for about 6 months and it actually improved my sleep (as long as I took it first thing in the morning). I have big problems maintaining a regular sleep schedule, even though I try to do all the "sleep hygeine" tricks. It didn't make me feel anxious or jittery, and I don't remember any appetite loss.

Also, where in NH are you exactly? I'm in Boston and know a few good doctors here, if it's not too far away. It does sound like your doctor isn't taking your problems seriously enough. :-(

 

Other options

Posted by Dr. Bob on January 9, 1999, at 12:25:49

In reply to Disappointment, posted by DL on January 7, 1999, at 21:06:00

> I want to stand on a chair in the waiting room and yell.......why won't you listen? I'm important too! Can't you just interview me carefully and sit down and figure out the mystery here?

> And I want to stomp on the phone when the ins. co. puts me on hold for 15 min. while I'm at work. And I can't call from home since they close down at 4PM. Then they can't find my info and I'm not sure if I'm covered at all.

Sometimes if you try working with a doctor, or an insurance company, and don't get anywhere, it's time to look for another.

I realize that unfortunately there aren't always other doctor options...

If there aren't other insurance options, it might not hurt to give your employer some feedback on this one and to lobby for either a different choice or more choices in the future.

Good luck,

Bob

 

Re: Other options

Posted by Toby on January 11, 1999, at 10:22:35

In reply to Other options, posted by Dr. Bob on January 9, 1999, at 12:25:49

Is the doc that you see in private practice or at a mental health center? You might get more help at a mental health center with the meds than with a doc in private practice. Sometimes they have programs where they can assist with part of the cost of medications. You probably don't qualify for the patient assistance program that the Remeron company has since you have a prescription program with your insurance, but maybe you could talk to your doc about getting a month's supply of samples every other month or something so that your $25 copay would stretch a little farther.

Regarding the EMDR therapists, do talk with them on the phone and then just pick one you feel reasonably comfortable talking to. If they've had the real training then you shouldn't have anything to fear about how "good" they are; remember, this is technique where you will be doing most of the work; the therapist is there just to make sure your brain is continuing to move along and to keep you safe.

Susan asked about returning meds to give to someone else. I checked with a pharmacy and they can't redistribute meds that have been removed from the original stock bottle. However, certain crisis offices that help indigent folks do collect unused meds and samples from the local neighborhood and use them. My clinic will reuse samples if inspection doesn't reveal tampering, but meds in a bottle can't be reused because you just can't ever be sure that tampering hasn't been done and also once the med is out of the stock bottle you don't know the true expiration date or stock number so that if a recall was made by the company because of a problem you wouldn't be able to properly identify the recalled meds.

 

Re: Other options

Posted by shelley on January 11, 1999, at 16:56:13

In reply to Re: Other options, posted by Toby on January 11, 1999, at 10:22:35

Interesting. Where can I send these unopened samples to? I hate to trash them if they could be of some use to some other financially unfortunate person like myself.

 

Reply to Elizabeth

Posted by DL on January 11, 1999, at 20:16:17

In reply to Re: Disappointment, posted by Elizabeth on January 8, 1999, at 15:49:25

> Hey DL, sorry I didn't respond earlier - been having computer troubles.

Thanks for the response. Things have been tumbling in on me lately. I seem to be able to bumble along ok until too many things pile up..then I'm back there hanging off the cliff.

> It's too bad your doctor didn't want to let you try Cylert; did he say why? I took 18.75mg (the lowest dose it comes in) for about 6 months and it actually improved my sleep

He feels that if I am sleeping most of the time and getting to work that there's no reason to add anything. I think he is a little suspicious of the information I come in with from this site? THis is a doc at a mental health center who sees a lot of more dramatic cases. I have always tenaciously hung on, even at great expense to my physical and spiritual person--in some of the most terrible circumstances--all the while putting on a wonderful front to the world. I'm sure the doc is overly busy.

> Also, where in NH are you exactly? I'm in Boston and know a few good doctors here, if it's not too far away. It does sound like your doctor isn't taking your problems seriously enough. :-(

I live near Durham NH--about 45 min drive from MA border down Rte 95 or Rte 125. I am close to Dover and Portsmouth and Exeter also. If you can get recommendations of someone in NH it would be better since there's a better chance of insurance covering it (Healthsource). You can respond to my e-mail if you want. I am still waiting to get a # so I can use the insurance I pay for. Thanks

 

Response to Susan

Posted by DL on January 11, 1999, at 20:26:11

In reply to Toby, legality of sharing unused meds, posted by Susan on January 8, 1999, at 9:18:12

Thanks Susan for the thought! I am finding that living on my own with no real reserves financially is not so easy. There are constantly more bills and glitches. I don't see any reason why the ins co. will cover Prozac but not Remeron at the lower price. Someone on a board somewhere makes these decisions. If the Remeron you have was not a year old it would be great, but I was told to flush the scripts of Paxil, Effexor, Welbutrin and Pamelor I was given. I never was given samples and each script was only for a small supply. Thanks for the thought.

> Toby, if someone has a 90 day supply of a medication that cannot be used because of adverse reactions should that med (ex. Remeron) be flushed down the toilet or can it be given to someone who has a real financial need? It seems like such a waste to flush it when someone who has the same prescription could use it. Wouldn't it be the same as receiving samples? Do medications lose therapeutic properties after a year? I know it is illegal to share meds but if someone already uses them what is the harm? Thanks for your input.

 

Response to Dr. Bob

Posted by DL on January 11, 1999, at 20:33:52

In reply to Other options, posted by Dr. Bob on January 9, 1999, at 12:25:49


> Sometimes if you try working with a doctor, or an insurance company, and don't get anywhere, it's time to look for another.

I have expressed my feelings about the ins co to the rep at my work place. I am told this co is cheaper than the others and that it won't come up for a change till summer...Ins co still does not have me in their computers...It's hard to find a good Doc in the mental health field since most people don't talk about them like they do other docs. Maybe you could add a section to your site. I once visited the site for "Car Talk" a public radio show about cars. They have a place where you can add the name of a really good mecanic by state and town/city and also tell why you like the place. something similar for docs would be good..

 

Response to Toby

Posted by DL on January 11, 1999, at 21:06:30

In reply to Re: Other options, posted by Toby on January 11, 1999, at 10:22:35

> Is the doc that you see in private practice or at a mental health center?

The only place I have been over my stormy last few years is a local mental health center that services seacoast NH. When I was falling apart rapidly a few years ago I called other places and they would not see me for many weeks...only the health center would see me on an emergency basis. I have never been anywhere else. This doc rushes from pt to pt. At my last visit he was rushing in from intensive care. I'm sure my unhuman ability to hang on and look OK on the outside works against me sometimes.

> maybe you could talk to your doc about getting a month's supply of samples every other month or something so that your $25 copay would stretch a little farther.

I can try....he's never available by phone--no matter how many times he tells me to "call if you need anything". I could write a letter or leave a message with the secretary.

I called the ins co as the doc suggested to get a name for him to call. I was told that there is no one for the doc to call. They refused to give me a name. I was told I could write an appeal letter myself but that the rep I talked to had worked there 7 years and had never seen one do any good. She said the preferred and non-preferred drug lists are only updated when new info comes out from the FDA about drugs. At this point I am so tired and depressed with all the things moving in on me I don't think I will even try.

> Regarding the EMDR therapists, do talk with them on the phone and then just pick one you feel reasonably comfortable talking to.

I can't even do that until I have a card or # in the ins co system. Then they will give me an authorization for some visits....

If I hear this week, I will call to talk to the 2 EMDR/cog beh people. Perhaps I can talk on the phone without being charged --to get a feel for if I would feel safe with them. Sounds stupid, but I want to try this out at the same time I am terrified to do so. Sound stupid?

I just don't understand why the wall just tumble in on me sometimes?? Sometimes I am struck almost immobile in some normal daily situation. I watched a Disney movie the other night with a family marooned on an island. I knew the "pirates' were just actors, but when the yelling and guns started I had my hands over my ears and head in my lap and my heart was racing and my body was wired. HOW STUPID! But it just overcomes me..

I rarely see movies since the same thing frequently happens there. Sometimes I jump literally out of my seat. I did just see Patch Adams. I actually laughed a few times. I was so impressed with the real doc and his mission I found the web site on the internet and asked for more info. You, Toby have somethings in common with Patch--sense of humor, respect for people, and a willingness to see other perspectives. you should watch it if you haven't. I wish I were daring enough to follow a star like he did....

I wish someone would tell me why I am in the clutches of a monster sometimes with no warning. I feel terrified and want to hide--sometimes in the middle of a conversation--sometimes while watching TV etc. Why Why Why???? The energy to cope with life is emence sometimes.

Boy am I in a turmoil now. I want to cry , yell, run, hide all at the same time.
Thanks for letting me spout.

 

Discading Meds

Posted by alan on January 12, 1999, at 9:35:26

In reply to Response to Toby, posted by DL on January 11, 1999, at 21:06:30

I might mention that there are 'third world' countries where many people can' get an aspirin. They could use our discards, if we just maileed them, The problem is that I'm afraid of all the crazies out there and the frequent inability to test drugs in these countries, due to lack of equipmentt etc.. Widespread theft is also a problem: contributed drugs may never reach the poor, only the rich alreeaddy getting theirs from th UK, say. Any suggestions?

 

Don't disappear Toby!

Posted by DL on January 17, 1999, at 22:59:05

In reply to Response to Toby, posted by DL on January 11, 1999, at 21:06:30

Please don't linger on the posts arguing about your gender and intentions. I for one don't mind that you have chosen not to share personal aspects. The best of all worlds would of course to be able to access your skills as a professional in the non-cyber world. But outside of that I will take whatever you graciously offer to me. I don't think you will disagree when I say that I have not met up with the optimum in mental health care--and I didn't even know why I was so frustrated since I had nothing to compare to. Because of you I have been able to sleep for the last 2 months, and the frantic, crazy anxiety has melted. I don't know how much longer I could have lasted the way I was. The years had worn me down to the quick. The MD was charging for visits but not really doing anything--and he had given up long ago on trying to figure out what might help. Just " here, fill this prescription for klonopin and see me in 3 months"----

For all I know I could be in a much better place than I am now. I remember studying Maslow's levels (I think it was him). I have finally accomplished the survival level (which I think was the lowest). But I want to feel what it is like to really live--and your ideas: EMDR, cog-beh therapy, Cylert or similar, even the possibility a while back of sub-clinical thyroid issues, and I haven't forgotten Buspar. I remember all your suggestions. I just have no one to listen and work with me.

I for one want to thank you for being here. You have helped to give me hope and some direction--all the time with a caring and professional mannor. You also are not afraid to include non-drug ideas. I only wish I had a way to implement most of your suggestions.

THANKS FOR GIVING OF YOUR TIME AND KNOWLEDGE!!
And, please warn me if you decide to stop. You have been a guiding path for me--if you suddenly disappear it would be a shock to my system. You will never know how many times I have been in an awful place inside--and found your posting waiting to pull me back up. Once on a Sat. when I started Remeron, I was afraid of its effects and also dealing with some scary things at home. I was very lost. Even though I knew you didn't post on Saturdays, I had no where else to go so I checked, and you were there! That was what I needed to pull by self back.

---Sorry for going on like this.
Questions:
1. Why is it so terribly hard for me to set up this EMDR/cog thing? Writing the letters was not hard, talking when they called wasn't so terribly bad, but for me to call and decide and set up an appt is unbelievable hard for me! I now have an insurance # finally. It was like pulling teeth, but on Friday I forced myself to call one office to set up an appt. And, they were out because of the snow and ice storm! Not in till Tue. Then I have to call from work and that's even harder. Why Why Why??

2. This weight thing is driving me crazy and I hate my self for it. I look in the mirror dispise myself. I have found that some of the eating is a way to keep myself alert. I have more trouble later in the day and look for something cruncy or strong flavored. But I seem to gain the weight out of proportion to the intake also. If you think the Cylert of Fastin (?) would work, what are some persuasive arguements I can use?

3. I also notice that now that I don't have someone yelling and throwing things and I have a safe peaceful place to come home to, a kind of inertia takes over me when I don't have to go to work. I can do nothing for long periods of time--I even can spend hours in a large store just wandering -trying to decide about some small purchase. I don't have the energy or will power to do the things I should be doing. Along with the decrease in anxiety I am finding that I am not rushing around getting things done. I find it hard to get out of bed unless I have to. And, as I think about it now, I have been spending most of my non-work time by myself--at my quiet apartment. All of this is scary to me. What is your take on this?

I feel like I am becoming a blob sitting on a log. Almost like I am hibernating for the winter--

Sorry for this dragged out mess....Perhaps when you have a chance you can put all your ideas for me in one post and I can print it out and use it as a guide when I talk to the cog guys. Perhaps they can suggest a good MD to switch to....

 

Re: Inertia

Posted by Toby on January 20, 1999, at 8:52:00

In reply to Don't disappear Toby!, posted by DL on January 17, 1999, at 22:59:05

Taking a leap into the unknown future is very scary and change is always disconcerting. Humans like things to be the same and changing our feelings and behaviors involves all sorts of biological changes which the body hates to have. Even when our current state is non-adaptive or even harmful, our biology tells us not to rock the boat. Perhaps that is why it is difficult for you to call for the appointment: the fear of facing the past and making changes, especially with all the changes you have gone through recently, can really put the brakes on assertive actions. Also, that may be part of the inertia you are having at home alone; the relief of stress makes your body loathe to get up and go, to make changes, to make decisions that might be wrong because it remembers what would happen before when any human interaction occurred or when you made a wrong decision. The body doesn't really realize that the danger is gone, so it continues to act the way it feels is protective of you.

Refer your doctor to Essestial Psychopharmacology by Stephen Stahl, MD, p227-229 for the fenfluramine. It acts to release more serotonin which helps with energy, depression and possibly the weight gain from Remeron.

 

Re: Inertia

Posted by Elizabeth on January 20, 1999, at 11:16:49

In reply to Re: Inertia, posted by Toby on January 20, 1999, at 8:52:00

> Refer your doctor to Essestial Psychopharmacology by Stephen Stahl, MD, p227-229 for the fenfluramine. It acts to release more serotonin which helps with energy, depression and possibly the weight gain from Remeron.

Hi Toby. Didn't they take fenfluramine (and d-fenfluramine) off the market (US at least) because of the PPH thing?

 

Book

Posted by DL on January 21, 1999, at 23:40:25

In reply to Re: Inertia, posted by Toby on January 20, 1999, at 8:52:00


> Refer your doctor to Essestial Psychopharmacology by Stephen Stahl, MD, p227-229 for the fenfluramine. It acts to release more serotonin which helps with energy, depression and possibly the weight gain from Remeron.

Will it act like the SSRI's that so hyperaroused me? And is this the same as the Fastin? And is the ins co likely to list it as not covered if it was used for dieting?

I searched amazon.com for the book and then ordered it from my local college library through interlibrary loan (they don't know I am graduated yet!) I will be able to have it for a few weeks. I think it will be interesting to look up some things. Also if you go to amazon .com and search for Stahl, Stephen it brings up the 1996 version and the 1998 version and also lists one coming out next Fall called the "Atlas of Depression". Is the 1998 version the same as the 1996? The title is just slightly different.

I may take a "longcut" between visits tomorrow and find the office of the EMDR/beh guys. (small progress).

Is there a difference between practices that are called cog/beh and the ones that are just beh?

Thanks for hanging in there for me.

 

Re: Book

Posted by Toby on January 22, 1999, at 10:36:05

In reply to Book, posted by DL on January 21, 1999, at 23:40:25

There is a difference between cog/beh and beh therapy. Beh therapy doesn't involve looking at the automatic dysfunctional thoughts that perpetuate unwanted behaviors and an example would be some of the smoking cessation programs that involve snapping a rubberband against the wrist whenever there's an urge to smoke but don't look at why a person believes they need to smoke or why they believe they can't stop.

I'm not sure how different the 1996 and 1998 versions of Dr. Stahl's book are. Probably the 1998 version contains the newer medications that have been released since 1996.

Fenfluramine is still available, just not in the combo with Phentermine for weight loss. You won't be able to tell if the fenfluramine will cause jitteriness until you take it, but again, it hasn't had that effect with any of the other patients who have tried it, even when they had jitteriness from SSRI's. You will have to check I suppose with the insurance company as to whether they will cover it. Some companies cover meds for off label use.

 

Re: Book

Posted by Elizabeth on January 23, 1999, at 0:26:24

In reply to Re: Book, posted by Toby on January 22, 1999, at 10:36:05

> Fenfluramine is still available, just not in the combo with Phentermine for weight loss.

I looked this up...fenfluramine has been taken off teh market; phentermine remains. They were never sold as a combo, BTW: you got scripts for both drugs and took the phen in the morning and the fen at night.

Phentermine (and other stimulants) haven't been linked to any heart valve problems.


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