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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by sar on April 30, 2001, at 14:23:18
Politics. Or maybe it all went as it should have.
I went to the free psychiatric clinic downtown as I'm low on funds and have no insurance. Spent nine hours there of mostly waiting around, so when I finally saw the pdoc in the last hour I was very tired and fighting back tears of frustration.
The interviewer I'd seen earlier, before the pdoc, let me know that the clinic could be utilized only by people with urgent cases...which meant we focused on depression rather than sp, though I did tell them of my sp diagnosis.
The pdoc suggested that my depression is a result of alcohol abuse and that she did not really want to diagnose major depression or prescribe meds until I cut the drinking out, though she said I'm w/o a doubt dysthymic. I responded that alcohol's probably agitated my depression quite a bit, yes, but that I know for certain that substance abuse, in my case, is a symptom of depression not the root cause.
Once I convinced her of that, she said she wanted to try me on an SSRI rather than the lamictal, neurontin, and Sulpiride I suggested. "Those are last resorts," she said & pointed out that I haven't really tried any of the frontline options. (I did Paxil for a week & Effexor for a month, hated both). Wouldn't give me Xanax because of its addictive qualities.
Wanting to just get the hell out of there, I agreed to stop drinking if she prescribed me something (lied, essentially), and in the end I got Prozac. As I drove home I wondered if I'd really been jumping ahead of myself having not tried most of the frontlines...I just know that I bottom out pretty hard every few years and wonder if Prozac's enough for that...so the sp goes largely unaddressed, tho I've read in the archives that it sometimes removes inhibition? & in others it increases anxiety?
Maybe I was just a mixed-up confused person wanting to try the more subversive meds...or did I get a lame pdoc? Both? I don't know yet...this is day 3 of prozac for me.
sar
Posted by SalArmy4me on April 30, 2001, at 14:36:19
In reply to what i got...update, posted by sar on April 30, 2001, at 14:23:18
Prozac is worth a 6-week try for you. It tends to be stimulating, and it is very effective against irritability. Now that it will become generic, you will be able to afford it better. I am hopeful for you...
Posted by Anna P. on April 30, 2001, at 14:41:11
In reply to what i got...update, posted by sar on April 30, 2001, at 14:23:18
> Hi Sal,
I just wanted to find out what other anticonvulsants have you tried besides the conventional ones.
You mention once you were trying Gabitril. Does it help?I tried almost everything, I resist drugs. I want to look at off label anticonvulsants and the calcium channel blokers. Do you have any suggestions?
Anna P.
Posted by JahL on April 30, 2001, at 16:20:22
In reply to what i got...update, posted by sar on April 30, 2001, at 14:23:18
> > The interviewer I'd seen earlier, before the pdoc, let me know that the clinic could be utilized only by people with urgent cases...which meant we focused on depression rather than sp, though I did tell them of my sp diagnosis.I wonder if these people have reviewed the latest literature on s.p., which suggests it is a disorder that can cause acute social dysfunction, & is deserving of much more serious attn than was previously given.
> > She said she wanted to try me on an SSRI rather than the lamictal, neurontin, and Sulpiride I suggested. "Those are last resorts," she said & pointed out that I haven't really tried any of the frontline options. (I did Paxil for a week & Effexor for a month, hated both). Wouldn't give me Xanax because of its addictive qualities.
I just know that I bottom out pretty hard every few years and wonder if Prozac's enough for that...so the sp goes largely unaddressed, tho I've read in the archives that it sometimes removes inhibition? & in others it increases anxiety?FWIW Sar, tho' I was one of those that suggested alternatives, Paxil & Prozac were the *only* drugs to ever cause my s.p. to (completely) remit. Didn't last, tho at least I got 6 wks of anxiety-free euthymia out of it...
All the SSRIs (which *are* first-line treatment) have the potential to effectively treat s.p. (tho' , & it means little, Paxil is the only one with FDA approval for this indication).
If Prozac isn't helping after 5 or 6 weeks then you probably have a case for looking @ alternatives since you've already tried the most 'potent' AD (Effexor).
Hoping the Prozac does it...
J.
Posted by SalArmy4me on May 1, 2001, at 10:04:34
In reply to Re: other anticonvulsants SalArmy4Me, posted by Anna P. on April 30, 2001, at 14:41:11
Every once in a while, a new anticonvulsant comes out, and doctors try to use it for bipolar disorder. But a few of them have been catastrophic failures and taken off the market in some countries (felbamate). Tiagabine is a particularly nasty one, even if it does help bipolar patients. Ultimately, the only anticonvulsants that are any good are divalproex, carbamazepine, gabapentin, lamotrigine, and clonazepam.
Make a list of all the medications you have taken, and I will find some other choices for you.
Posted by sar on May 1, 2001, at 10:17:07
In reply to Re: what i got...update » sar, posted by SalArmy4me on April 30, 2001, at 14:36:19
thanks, Sal & Jah. I'll let you know how it goes.
irie,
sar
Posted by Kingfish on May 1, 2001, at 12:27:38
In reply to Re: other anticonvulsants SalArmy4Me, posted by SalArmy4me on May 1, 2001, at 10:04:34
Sorry, just have to add my two cents. Topamax (another anticon.) has worked for me, BP II.
Peace.
- K.
Posted by Anna P. on May 6, 2001, at 10:45:44
In reply to Re: other anticonvulsants SalArmy4Me » SalArmy4me, posted by Kingfish on May 1, 2001, at 12:27:38
> Sorry, just have to add my two cents. Topamax (another anticon.) has worked for me, BP II.
>
> Peace.
>
> - K.Yes, I've already tried all these standard anticonvulsants for my
anergic/lethargic depression. Now, I'm the third day on Gabitril.
Effect? I got up from bed and can function at the minimum doze of 5 mg a day.Anna P.
Posted by SLS on May 6, 2001, at 18:13:25
In reply to Re: other anticonvulsantts/Gabitril, posted by Anna P. on May 6, 2001, at 10:45:44
> Yes, I've already tried all these standard anticonvulsants for my
> anergic/lethargic depression. Now, I'm the third day on Gabitril.
> Effect? I got up from bed and can function at the minimum doze of 5 mg a day.
>
> Anna P.
Yay!Please continue to post of your progress with Gabitril (tiababine). I am very interested to see how well you do with it as it is a drug I am considering trying.
Are you bipolar? Are you taking any other drugs?
Thanks.
- Scott
Posted by Anna P. on May 6, 2001, at 19:53:48
In reply to Re: other anticonvulsantts/Gabitril » Anna P., posted by SLS on May 6, 2001, at 18:13:25
> > Yes, I've already tried all these standard anticonvulsants for my
> > anergic/lethargic depression. Now, I'm the third day on Gabitril.
> > Effect? I got up from bed and can function at the minimum doze of 5 mg a day.
> >
> > Anna P.
>
>
> Yay!
>
> Please continue to post of your progress with Gabitril (tiababine). I am very interested to see how well you do with it as it is a drug I am considering trying.
>
> Are you bipolar? Are you taking any other drugs?
>
> Thanks.
>
>
> - ScottHi Scott,
I mainly have anergic depression, and I used already all the options available that is Ad's, mood stabilizers, antipsychotic, and stimulants. I respond only to stimulating meds.
I got some energy from Gabitril, but this is still not where I want to be. I still lack some physical energy, but I have the concentration from Gabitril and no more lethargy.
I'm tempted to try buprenorphine that I just got.
I'm just scared of tolerance and addiction.
But maybe tolerance and addiction for the price of normal life?
What do you think, all?Anna P.
This is the end of the thread.
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