Psycho-Babble Medication Thread 7320

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

my latest sleep problem (Dr. Bob et al., help???)

Posted by Elizabeth on June 12, 1999, at 23:10:25

I'm scared. I'm so f***ing scared.

Shortly after Dr. Bob mentioned that loss of dreaming (via abolishment of REM sleep) was sometimes considered a sign that Parnate is at an effective dose, *I started dreaming again*. Vivid, intense REM rebound-style dreams. I've also been having a relapse of my REM sleep behavior disorder. (I haven't done any damage that can't be repaired, fortunately.) I am really worried about the implications of this. I have been feeling depressed, disinterested, apathetic, sad, etc., my appetite's gone, I've been ruminating a lot and feeling very down on myself, and I can't see the future - it's all dim.

In related anxieties, has anyone heard of the phenomenon where an MAOI loses effectiveness and the person develops a refractory depression? This is mentioned in the appendix to _Listening to Prozac_. It happened to me with Nardil, and I'm terrified that it's happening again now.

 

Re: my latest sleep problem (Dr. Bob et al., help???)

Posted by Judy on June 13, 1999, at 10:13:58

In reply to my latest sleep problem (Dr. Bob et al., help???), posted by Elizabeth on June 12, 1999, at 23:10:25

Elizabeth,

I read that same information in Listening to Prozac and it scared the hell out of me (Nardil is my safety net! No matter what else I try, I always come back to it - fourth time right now). However, the paragraph went on to say that the gentleman who developed the tolerance to MAOI's was put on a different med for a little while and when he re-started Nardil, the benefits were there again for him.

Why don't you give Marplan a try? Maybe enough difference in chemical make-up to give you the goose you need. I personally would exhaust the MAOI drugs before turning to something else.

Also, I left some questions for you in a 6/6/99 post titled "Re: Parnate - Elizabeth." I'd appreciate it if you'd give them a shot. Thanks.

Judy

 

Re: my latest sleep problem (Dr. Bob et al., help???)

Posted by anita on June 14, 1999, at 0:21:29

In reply to my latest sleep problem (Dr. Bob et al., help???), posted by Elizabeth on June 12, 1999, at 23:10:25

Hey Elizabeth,

When I was initially taking Parnate, increasing the dose periodically,
I did experience a few days of REM-rebound (at about 40mg, I think),
but it went away once I increased the dose. I had completely forgotten
about this... So don't despair, perhaps a dosage increase is all you need --
I seem to recall you're on a low dose, no? And there's always the option of
adding something else to it of course.

I don't think that developing a tolerance to one MAOI means it'll
happen with the others. Have you considered Marplan? I'm going to try it if Effexor
doesn't work out for me...

good luck,
anita

 

Re: my latest sleep problem (Dr. Bob et al., help???)

Posted by Elizabeth on June 14, 1999, at 1:53:37

In reply to Re: my latest sleep problem (Dr. Bob et al., help???), posted by Judy on June 13, 1999, at 10:13:58

Hi Judy.

Nardil does start working again after a couple months if I stop taking it. That's not what I'm scared of. I'm scared of the depression it sent me into. That was truly horrible.

I've increased my lithium dose, and I'm taking buprenorphine to keep my head above water. (Buprenorphine is one of the five or six aces I keep hidden up my sleeve. It has pretty bad side effects, so I just take it "as needed.") If the lithium doesn't help, I'm thinking of trying a tricyclic - their side effects are pretty bad, but buprenorphine's are worse. If that fails, I guess Marplan will be the thing. This is all very scary...I feel like I'm in free-fall.

 

Re: my latest sleep problem (Dr. Bob et al., help???)

Posted by Annie on June 14, 1999, at 9:34:12

In reply to Re: my latest sleep problem (Dr. Bob et al., help???), posted by Elizabeth on June 14, 1999, at 1:53:37

Elizabeth, I know you are very savvy about psychopharms, but be very careful if you decide to add a TCA to the Parnate. Usually they are either started simultaneously or the MAOI added to the TCA. It is "do-able", but make sure you are even more diligent about monitoring your BP. Everyone reacts differently, but my experience was the combo exacerbated the worst side effects of the TCA and MAOI. The absolute worst for me was the constipation and urinary retention. Horrible. I think you mentioned that you are also taking a beta blocker which should help control any BP problems. Good luck. I hope you start feeling better soon. I'm off to the Pdoc now to discuss starting Marplan when this selegiline patch study ends.
Annie

> Hi Judy.
>
> Nardil does start working again after a couple months if I stop taking it. That's not what I'm scared of. I'm scared of the depression it sent me into. That was truly horrible.
>
> I've increased my lithium dose, and I'm taking buprenorphine to keep my head above water. (Buprenorphine is one of the five or six aces I keep hidden up my sleeve. It has pretty bad side effects, so I just take it "as needed.") If the lithium doesn't help, I'm thinking of trying a tricyclic - their side effects are pretty bad, but buprenorphine's are worse. If that fails, I guess Marplan will be the thing. This is all very scary...I feel like I'm in free-fall.

 

to Annie

Posted by Elizabeth on June 14, 1999, at 20:08:07

In reply to Re: my latest sleep problem (Dr. Bob et al., help???), posted by Annie on June 14, 1999, at 9:34:12

Hi Annie, and thanks for your concern.

I've added a TCA (amoxapine) to an MAOI before. I started getting cravings for sweets which was so uncomfortable that I ditched the amoxapine. (I'm not actually sure what was causing the "munchies," in retrospect.) I think I'd use desipramine if I were going to try it again.

I hope I don't have to, though. I really don't like tricyclics (I've never been able to stay on one long enough to find out if they'd work for me).

Marplan is seeming like a really nice idea right now, although my pdoc warns me that going off the Parnate would be a major step (and I do dread the waiting period).

You're in the selegiline patch study? Which center? How is it going? Do you know what the dosage is that they're using? etc.

I hope your pdoc appointment goes well...thanks again.

 

Re: my latest sleep problem (Dr. Bob et al., help???)

Posted by Judy on June 14, 1999, at 20:26:33

In reply to Re: my latest sleep problem (Dr. Bob et al., help???), posted by Elizabeth on June 14, 1999, at 1:53:37

Hang Tough, Elizabeth -

I know your fear - I've been there too many times myself. The wash-out periods and then the trial of a new med that doesn't work, forcing another wash-out, etc., etc. are some of the most frightening, helpless times of my life. I can understand how hysterical you must be when you feel that a med that's been working for you is pooping out. Why don't you try the dosage increase first before going through the hassle of adding/switching to something else.

I don't know whether you meant you might switch to a TCA or combine one with Parnate. If you're combining, Annie is right - please be very careful! MAOI's are usually *added to* TCA's - not the other way around. It can be real dicey!

I think it stinks that you have to take so many different meds for so many different symptoms/side effects. Ahh that we could all find ONE magic pill that would work for us.

To Annie -

I took the tricyclic Imiprimine many years ago and the worst side-effects I remember were gaining tons of weight (although I also remember eating like a pig when my depression lightened) and sweating like a pig as well. I think your urinary retention and constipation were caused by the MAOI. I'm taking Nardill right now and I don't know where all this 'waste' is going, but it isn't coming out!

My bladder feels like a basketball all the time and I have the urge to pee, but nothing happens. I find myself sitting there, chanting a mantra and doing deep breathing exercises to try to relax - still no way! (I don't even attempt to go at work or in a restaurant because they'd send a search party for me after a while!)

As for the constipation, I can't even call mine that - that implies (to me anyway) that you have to go but can't. My intentines seem to have forgotten the peristalsis function completely. I have no sensation that I have to go - ever; and if I didn't take extreme measures, I don't think I'd ever go again. My doctor isn't happy with this at all and has threatened to take me off Nardil. He suggested drinking gallons of water, taking Metamucil and eating all the fiber I can. The next time I'm at the Feed & Grain, I just might pick up a bale of alfafa for myself!

To Elizabeth & Annie et al -

Sorry about the distasteful subject matter - I'm just venting. Hope you understand.

We all seem to be heading toward Marplan. Maybe this will be our "magic pill."

Good luck to us all.

Judy

 

Re: my latest sleep problem (Dr. Bob et al., help???)

Posted by Annie on June 15, 1999, at 14:26:28

In reply to Re: my latest sleep problem (Dr. Bob et al., help???), posted by Judy on June 14, 1999, at 20:26:33


Judy
ROFL!!!! My "problem" was just as you described it. How can you stand it? I was sick as a dog and dragging a**. Yes it's distasteful subject but a reality and talking about it may help someone who's been told the med wasn't the problem. I was on Nardil at one time and luckily did not experience this side effect. Desipramine was the culprit for me. I put up with it for 2 month and finally said "enough!!!"
Good luck with the Nardil. Don't wait until you do irreparable damage to your "innards" before you throw in the towel. Some trade-offs aren't worth it!
Annie

> Hang Tough, Elizabeth -
>
> I know your fear - I've been there too many times myself. The wash-out periods and then the trial of a new med that doesn't work, forcing another wash-out, etc., etc. are some of the most frightening, helpless times of my life. I can understand how hysterical you must be when you feel that a med that's been working for you is pooping out. Why don't you try the dosage increase first before going through the hassle of adding/switching to something else.
>
> I don't know whether you meant you might switch to a TCA or combine one with Parnate. If you're combining, Annie is right - please be very careful! MAOI's are usually *added to* TCA's - not the other way around. It can be real dicey!
>
> I think it stinks that you have to take so many different meds for so many different symptoms/side effects. Ahh that we could all find ONE magic pill that would work for us.
>
> To Annie -
>
> I took the tricyclic Imiprimine many years ago and the worst side-effects I remember were gaining tons of weight (although I also remember eating like a pig when my depression lightened) and sweating like a pig as well. I think your urinary retention and constipation were caused by the MAOI. I'm taking Nardill right now and I don't know where all this 'waste' is going, but it isn't coming out!
>
> My bladder feels like a basketball all the time and I have the urge to pee, but nothing happens. I find myself sitting there, chanting a mantra and doing deep breathing exercises to try to relax - still no way! (I don't even attempt to go at work or in a restaurant because they'd send a search party for me after a while!)
>
> As for the constipation, I can't even call mine that - that implies (to me anyway) that you have to go but can't. My intentines seem to have forgotten the peristalsis function completely. I have no sensation that I have to go - ever; and if I didn't take extreme measures, I don't think I'd ever go again. My doctor isn't happy with this at all and has threatened to take me off Nardil. He suggested drinking gallons of water, taking Metamucil and eating all the fiber I can. The next time I'm at the Feed & Grain, I just might pick up a bale of alfafa for myself!
>
> To Elizabeth & Annie et al -
>
> Sorry about the distasteful subject matter - I'm just venting. Hope you understand.
>
> We all seem to be heading toward Marplan. Maybe this will be our "magic pill."
>
> Good luck to us all.
>
> Judy

 

Re: to Annie

Posted by Annie on June 15, 1999, at 17:58:31

In reply to to Annie, posted by Elizabeth on June 14, 1999, at 20:08:07

Hi Elizabeth
Ok, I feel better knowing you've already tried something similar. The chance of any bad reaction seems unlikely. Desipramine is not my favorite TCA because of the side effects I experienced. Everyone's reactions are different and I was on 400mg which hopefully will not be necessary for you. :o)
I participate in the transdermal selegiline study at Univ of Penn. The dosage is 30mg daily for all. I've been using it for about 8 weeks and have noticed some positive signs in the last 2 weeks. My energy and motivation have improved somewhat. The constant "ideations" are on vacation for the most part. Obsessive thoughts and behaviors are almost gone, but they were minor anyway in the grand scheme of things. I am starting to be able to deal with major issues in therapy whereas for the last few years my T just concentrated on keeping me among the living. On the downside, I seem to be more easily triggered into deep depression and ideations by other peoples' comments, so I isolate even more than before. The good news is, I seem to bounce back faster to a more bearable level of depression. My "tolerance level" for people used to be about 3 hours, now it is about 1 hour and I'm outta there!
I'm going to continue in the study to see if there is more improvement in the next month or so. I talked to the doctor about Marplan or possibly some other combo including Naltrexone for post-study treatment. He would prefer the Marplan if it is available in the pharmacies around here, but said he'd check out the work being done with naltrexone and we'd talk about it next month. Sounds like a plan!
Persevere, Annie

> Hi Annie, and thanks for your concern.
>
> I've added a TCA (amoxapine) to an MAOI before. I started getting cravings for sweets which was so uncomfortable that I ditched the amoxapine. (I'm not actually sure what was causing the "munchies," in retrospect.) I think I'd use desipramine if I were going to try it again.
>
> I hope I don't have to, though. I really don't like tricyclics (I've never been able to stay on one long enough to find out if they'd work for me).
>
> Marplan is seeming like a really nice idea right now, although my pdoc warns me that going off the Parnate would be a major step (and I do dread the waiting period).
>
> You're in the selegiline patch study? Which center? How is it going? Do you know what the dosage is that they're using? etc.
>
> I hope your pdoc appointment goes well...thanks again.


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