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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 44 to 68 of 69. Go back in thread:
Posted by IsoM on March 25, 2002, at 22:43:40
In reply to Re: Anyone had success with ECT? » Elizabeth, posted by Mags on March 25, 2002, at 18:06:03
Excuse me for jumping in but I read in your post that "I actually tried Speed as a teenager and slept for three days!" That sort of reaction sounds very much like you've got ADD traits, no matter what else you may have. Have you been checked by a "QUALIFIED" psychologist who specialises in ADD for it? Most doctors & pdocs will brush it off & refuse to believe that adults really have it. Please post your answer back about this, Mags.
Posted by Mags on March 25, 2002, at 23:25:58
In reply to About Possible ADD » Mags, posted by IsoM on March 25, 2002, at 22:43:40
> Excuse me for jumping in but I read in your post that "I actually tried Speed as a teenager and slept for three days!" That sort of reaction sounds very much like you've got ADD traits, no matter what else you may have. Have you been checked by a "QUALIFIED" psychologist who specialises in ADD for it? Most doctors & pdocs will brush it off & refuse to believe that adults really have it. Please post your answer back about this, Mags.
Thanks for jumping in IsoM!
I have never been diagnosed for ADD...I just kinda wondered because of things I read here plus I took one of those self diagnostic tests on the web, and it said I could possibly be ADD.
Why would my weird reaction to speed be a clue?
Would this make a difference in how I would be treated?
Thanks,
Mags
Posted by IsoM on March 25, 2002, at 23:51:19
In reply to Re: About Possible ADD » IsoM, posted by Mags on March 25, 2002, at 23:25:58
Depending on how I'm feeling Dexedrine will either wake me up & help me focus, or if I'm worn out, it'll calm me down & let me sleep. To a certain extent, it depends on the time of day for the reaction I get.
People with ADD will often have so many things going on in their mind at one time that don't necessarily lead anywhere except to another thought. I compare my thoughts to popcorn being popped & richocheting around in my head. Dexedrine will stop thoughts from bouncing about & calm my focus allowing me to slow my thoughts down to fall asleep. It seems to be fairly common in ADD people but it's not a reaction found in ordinary persons.
I know you're home for now from the hospital but I don't recall reading what your diagnoses is supposed to be. Could you explain first before I suggest anything? Have you taken various ADs before & what was your responses to them? A bit of background info would be helpful.
I have ADHD & narcolepsy. I think depression developed not as a separate issue but related to the ADHD, narcolepsy, & absolutely crappy, stress-filled marriage I had. The depression was secondary.
Posted by BarbaraCat on March 26, 2002, at 0:28:51
In reply to Re: Anyone had success with ECT? » BarbaraCat, posted by Mags on March 25, 2002, at 21:00:20
Mags,
You have no idea how relieved I am to know that I'm not the only one who has these 'irresponsible' habits. I can get so down on myself and frustrated because I know better. I'm beginning to see the light that these behaviors are a product of some weird syndrome we suffer from and not due to some horrible shortcoming. The thing is that I am very talented and could probably put these artsy crafty things to very good use - another Georgia O'Keefe - if only I could concentrate long enough. Or slog through the piles of boxes and stuff to find the darn items I need when I'm wildly inspired. I also wonder about ADD, but what's in a name? It's all just degrees of the same malfunction. Well good. Connect those circuits in our brains and watch out World!The reason I'm so interested in ECT is that I'm coming to believe that medication has the unfortunate effect of lag time. By the time the receptors are duly affected, our chemistry has moved on to new things. I think that resetting our brain's circuits via electric or magnetic means is the key and I hope they figure out how to do it right in our lifetimes. We're rooting for you - what an adventure. Also, if you could let us know when you'll be going in, there's a few of us here who wouldn't mind putting in a good word for you in our daily good thoughts. - Barbara
Posted by BarbaraCat on March 26, 2002, at 0:51:19
In reply to About Possible ADD » Mags, posted by IsoM on March 25, 2002, at 22:43:40
Anyone who has a clue,
My drug of choice when I was in my late teens and early twenties (back in the early '70's) was methadrine. It was the only substance I recall where I would feel sooooo mellow, focused and centered. It was a Zen-like no-thoughts space that I sought forever after. I know now that I was self-medicating via the street scene. Even so, speed in abusive amounts is a killer, no doubt about it. I also stayed up for days, crashed and burned, and fried my delicate system.
A question I'd like to put out there is: this suggests to me that I have ADD in addition to depression. However I also have a tendency towards severe anxiety and panic disorder. I'd hesitate at this stage to take a stim because I do not want to elicit a strung-out spin into hypomania or compromise my fledgling health and immune system. I have an appt with my pdoc this week. He's very wary of prescribing a stim because he knows I had a bit of a Jones in the past. The bottom line of my question is, how do speed-type drugs affect those with serious affective/anxiety disorders? - BCat
Posted by Zo on March 26, 2002, at 3:56:56
In reply to Re: About Possible ADD - Speed anyone?, posted by BarbaraCat on March 26, 2002, at 0:51:19
Hi BCat, I have a friend in same situation, and she survives on Adderall. . .got to THIRTY mgs a grain at a time. I've been on Dex for four years, and some Adderall, am BPII. .. and neither ever rocketed me to any kind of interesting high. Anyway, the Adderall has not triggered any old addiction in her, nor have I gotten manic. On other meds, yes, but not stims! You control the anxiety by ramping up sloooowly, and by using benzos PRN.
Zo
Posted by Mags on March 26, 2002, at 7:47:04
In reply to Re: About Possible ADD » Mags, posted by IsoM on March 25, 2002, at 23:51:19
Pls see this and let ne know what else I can add...
Mags
http://www.dr-bob.org/babble/20020322/msgs/100101.html
Posted by Mags on March 26, 2002, at 7:52:37
In reply to Re: About Possible ADD » IsoM, posted by Mags on March 26, 2002, at 7:47:04
Hi folks,
Heard from pdoc this morning. My first ECT is set for April 16. I will be admitted the day before. Depending on how I do they will start with 2 a week and then bump it to three.....I am actually getting excited about it...it has given me back hope which I haven;t had for a looong time.
Wish me luck and I will keep you all posted.IsoM, I will discuss Adderral if needed after ECT's. We had at one time discussed stims, but for some reason tried Wellbutrin and Remeron instead.....
Mags
Posted by BarbaraCat on March 26, 2002, at 11:10:02
In reply to ECT date is set » Mags, posted by Mags on March 26, 2002, at 7:52:37
Mags,
You're on my special 'prayer calendar'. I'm not particularly religious but I find it a powerful practice. - Barbara> Hi folks,
> Heard from pdoc this morning. My first ECT is set for April 16. I will be admitted the day before. Depending on how I do they will start with 2 a week and then bump it to three.....I am actually getting excited about it...it has given me back hope which I haven;t had for a looong time.
> Wish me luck and I will keep you all posted.
>
> IsoM, I will discuss Adderral if needed after ECT's. We had at one time discussed stims, but for some reason tried Wellbutrin and Remeron instead.....
>
> Mags
Posted by Zo on March 26, 2002, at 16:35:11
In reply to Re: About Possible ADD » IsoM, posted by Mags on March 25, 2002, at 23:25:58
Posted by Zo on March 26, 2002, at 16:39:38
In reply to Re: Anyone had success with ECT? » Mags, posted by BarbaraCat on March 26, 2002, at 0:28:51
Barbara, Where you at w/ meds? Any ADD demanding tasks get done solely related to how my meds are.
Have been on Dex since '97. .. Just added Provigil a few weeks ago, and lo and behold, suddenly-----I can sort and file papers and handle business matters. And when the day's Provigil wore off, the papers abruptly became "unreadable" again. It was striking. Provigil opens a whole new part of my brain.
Zo
Posted by BarbaraCat on March 26, 2002, at 16:58:02
In reply to Re: Anyone had success with ECT? » BarbaraCat, posted by Zo on March 26, 2002, at 16:39:38
Hi Zo,
I'm on Remeron, lithium, klonopin primarily (plus natural estrogen/progesterone and natural thyroid). The only 'pstim' I've tried recently was adrafinal which made me feel uneasy and restless. I have no idea what my real dx is. Non response to AD's hence the lithium, but maybe BPII because of some possible hypomania which could be stress related. I'm not always symptomatic, and have long clear stretches. But when I'm feeling overloaded, I'll start things and not finish, overspend, get totally flustered like a brain lock. You talk about filing. I could start with a pile of papers and end up with a bigger messier pile and end up crying from sheer frustration.Isn't ADD an all the time thing (without meds)? Also, coffee really affects me. If I have more than one cup I'm up all night. I sometimes get wired by benzos. My major experience with stims is when I abused meth in my wild days of youth, and I often wonder if I burnt out my dopamine system. But maybe a therapeutic pinch of a stim might really do something for me. Geez, I just hate to keep adding stuff to my poor body. Barbara
, > Barbara, Where you at w/ meds? Any ADD demanding tasks get done solely related to how my meds are.
>
> Have been on Dex since '97. .. Just added Provigil a few weeks ago, and lo and behold, suddenly-----I can sort and file papers and handle business matters. And when the day's Provigil wore off, the papers abruptly became "unreadable" again. It was striking. Provigil opens a whole new part of my brain.
>
> Zo
Posted by Zo on March 26, 2002, at 17:34:16
In reply to Re: Hurting all the time? » BarbaraCat, posted by shelliR on March 24, 2002, at 20:51:33
Posted by Zo on March 26, 2002, at 17:43:54
In reply to Re: Anyone had success with ECT? » Zo, posted by BarbaraCat on March 26, 2002, at 16:58:02
All I can say is, Remeron stupified me, lithium was difficult and crude compared to Lamictal. . .ADD varies a lot from hour to hour, day to day. True pstims--Dex, Ritalin, Adderall, and subjectively, Provigil, tho it is not chemically a pstim--even things out. I could handle papers and piles--but before Dex was as you described, and cried every day at the too-muchness. Provigil just opened up a whole new area of paper-clarity. You should see my file--you could eat off the floof!
I am BPII, ADD, TLE, CFS. Respond to coffee same as you.
Prescribed stims *are* a pinch of speed, in comparison to the amount one uses "recreationally"---and truly, have been nothing but helpful to my body. Better posture, muscle tone.Klonopin, while a great med, aggravated my ADD so much all the next day, it also got filed under Stupid-making drugs.
ADD and BP II are almost impossible to separate, and are both Kindling disorders of the brain. Your long clear stretches *strongly* suggest that BPII is your primary dx. Which the stims do not aggravate, they are very organizing, which always helps. My life didn't come together, however (15 years of trying meds) til I added Lamictal just last fall. I encourage you to consider it.
Zo
Posted by BarbaraCat on March 26, 2002, at 18:08:30
In reply to Re: Anyone had success with ECT?, posted by Zo on March 26, 2002, at 17:43:54
Thanks for the clarification. Lamactil, as I understand, is another mood stabilizer and would most likely replace the lithium. Concerning another thread we had going about fibro, would neurontin be added to it, or combined, or. . . duh! there is so much to keep together in this poor befuddled brain. Good thing I have an appointment with my shrink tommorrow. I'm going to definitely ask for the lamactil and a wee dram of a stim.
Zo, just what is TLE and what is your current med brew? Do you not take anything for anxiety? - BCat
Posted by Elizabeth on March 26, 2002, at 20:11:59
In reply to Re: Anyone had success with ECT?, posted by OldSchool on March 25, 2002, at 22:12:17
> I dont know what type of depression I have at this stage anyway. I dont think any of my doctors do either.
It might very well be like you said, that they just don't think in any terms that are more exact than "major depression." Anyway, "major depression" isn't at all exact; I think that, as you suggest, it's probably not "a" disease, but many different diseases.
> Its changed probably ten times thru the years.
That's possible; I've read that it isn't always consistent over the course of a person's illness. And of course, there really haven't been many different types that have been identified; the only ones I know of that predict treatment outcomes at all are psychotic, melancholic, and atypical features. I think the majority probably don't fit into any of these categories; this is called "simple mood-reactive depression," although it really doesn't tell us anything to say something this vague (that it doesn't fit into any known subtype, that is).
I think that you're right that it would help if we worked on the biological research, although I also think that we're limited by technology.
> I personally think I have melancholic depression with some psychotic depression mixed in with it.
Psychotic? What sort of delusions or hallucinations have you had? I can see the melancholic part (not sure if it's "technically" right, but it's probably at least close), but you never struck me as psychotic. I'd be careful about going on that assumption.
BTW, are you taking any medication now, and if so: 1) what? 2) how much is it helping? 3) what is it not helping with (or only partially helping with)?
> So Im just gonna do the bilateral ECT thing. Ive also been told I have a retarded depression but with "mood reactivity" and a "rigid" personality. whatever that means.
"Mood reactivity" means it's nonmelancholic: your mood changes, somewhat, in response to things that happen around you (i.e., environmental stuff). "Retarded" means you're slowed down rather than agitated. Anything a psychiatrist says about your personality probably tells you more about the psychiatrist than about you, but FWIW, "rigid" would mean "not amenable to change."
> And Ive had atypical depression dx a few times.
Huh. That is sometimes associated with irritability and moodiness, as well as psychomotor retardation and reactive mood, but that stuff alone isn't sufficient. I wonder why they thought that.
> I also have the EPS symptoms now, mild parkinsons type symptoms, mild rigid right arm and stuff.
Oh god, that sucks. How did that happen? Have you tried any antiparkinsonian drugs, like Cogentin, Benadryl, Artane, Symmetrel, etc.?
If you really think that psychosis is involved, and if you think you could deal with the regular tests required, Clozaril might be something to consider; it hardly ever causes EPS (like, very rarely even compared to other atypicals) and can even be used to treat them. Psychotic depression pretty much requires either a dopamine antagonist, or maintenance ECT (the latter being rather a PITA).
> Frankly, I think the only thing anybody knows is Ihave some sortof mood disorder and thats about all.
If it's any comfort, that's all they know about anybody, pretty much!
> Is it really that much different in Boston?
Yes, very. I guess that I should really say it's different if you see a pdoc who's affiliated with Harvard, because those are the only ones I have experience with. I don't know if doctors at BU and Tufts, or non-academic psychiatrists, are similar.
> I realize its an elite academic town and all. But when it comes to psychiatry, which is so primitive about wherever you go, I find it hard to believe the psychiatric services there would be much different than in Winston, or Charlotte...or NYC..or wherever. Are there really experimental drugs there available for the taking?
There's an awful lot of research there. (New York is probably similar, I'd think.) I was thinking more of the willingness of the doctors there to try off-label stuff, though. Like, at some point I was told by a pdoc here that they were starting to use Neurontin for mood disorders. I said, "yeah, I tried that three years ago," and he seemed startled. I think that pdocs here are much less likely to suggest something like selegiline (or indeed, to be comfortable with MAOIs in general), pindolol, ketoconazole, that amoxapine-Parnate cocktail that I've heard such good things about, etc., and most of the ones I've spoken to have been downright hostile when I mentioned that I take buprenorphine. (I'm afraid that all the publicity about its use as a treatment for addiction has given it a bad name.) I've been having a problem getting my pdoc to let me take 20 mg of Ambien (10 mg is useless for me -- not tolerance, just the way my body works), or even to let me try more than 300 mg/day of Effexor XR. (Strangely, the labelling for immediate-release Effexor recommends a higher maximum dose than the labelling for Effexor XR -- 375 mg vs. 225. I guess they just didn't bother studying Effexor XR at > 225 mg.)
> I realize people up there are probably more open minded than down here. But are there really more treatments up there?
Not that so much, no (although there really is very little research down here) -- but practically speaking, it's a lot easier to get newer off-label treatments there than it is here.
> Bilateral is just plain stronger and it doesnt require a titration procedure so the first treatment is not wasted like in unilateral. I figure I should just go for the gusto and go for bilateral and expect memory loss. At least Iknow it will be powerful.
Running out of patience? I can understand it, although on the other hand I'd really think twice about rushing if it might mean that even recovery would be bitter. Wasting one session of ECT doesn't seem so bad from that perspective. On the other hand, I wouldn't mind forgetting what it was like when I was depressed (unfortunately I don't think you get to choose what you forget).
> Bifrontal is supposed to have the effectiveness of bilateral, but without the memory loss side effects. Its the best of both worlds. The electrodes are placed above the eyes, on the forehead instead of the temples. Its making a comeback from what Ive read.
I looked it up after reading your post. It sounds promising. Why do you want to have bilateral ECT when something like this is an option?
Whatever you decide, I hope it helps turn things around for you.
-e
Posted by Elizabeth on March 26, 2002, at 20:39:11
In reply to About Possible ADD » Mags, posted by IsoM on March 25, 2002, at 22:43:40
> Excuse me for jumping in but I read in your post that "I actually tried Speed as a teenager and slept for three days!" That sort of reaction sounds very much like you've got ADD traits, no matter what else you may have.
Some people just don't get activated on amphetamine -- it's just an unusual reaction, it doesn't necessarily mean that you have ADD. (If that were true, it'd be easy to test people for ADD.) It is interesting how some people have these so-called "paradoxical" reactions, though. (I'm the same way: I took several different stimulants at various times and they didn't make me at all tired -- and on the other hand, opioids act like stimulants for me.)
On a different subject: that's interesting what happened to you when you were taking lithium (I know it wasn't interesting to you at the time, of course!). The reaction you had to lithium after you had the crash sounds very much like lithium toxicity, but I don't know why that would happen all of a sudden. Did you have your lithium levels, kidney function, etc. checked when you were on it?
I think your pdoc has a good point, a lot of things about your history suggest bipolar II. I don't think that ECT has been researched in bipolar II people, though. It has been known to trigger mania on occasion, so keep your eyes open for that sort of thing. ECT isn't supposed to be very good for atypical unipolar depression, but that might not apply to bipolar II atypical depression.
Speaking of atypical depression, though, I don't recall you mentioning whether you'd tried any MAOIs. Have you? Intolerance of other ADs doesn't necessarily mean that you won't tolerate MAOIs -- they have different sorts of side effects than other ADs, and you might well find them less troublesome.
Anyway -- I hope the ECT helps you. Keep posting if you can.
best,
-elizabeth
Posted by Elizabeth on March 26, 2002, at 20:52:38
In reply to Re: About Possible ADD - Speed anyone?, posted by BarbaraCat on March 26, 2002, at 0:51:19
No thanks. :-)
Seriously...
> The bottom line of my question is, how do speed-type drugs affect those with serious affective/anxiety disorders? - BCat
That's not something that can really be predicted or generalized about -- "serious affective/anxiety disorders" covers a lot of territory. Amphetamine was often used as an antidepressant before TCAs and MAOIs were discovered (about 1960) and even for a while afterwards. Stimulants won't necessarily trigger (hypo)mania, although that's one thing to watch out for. And of course, they can exacerbate panic disorder, although they don't always (especially if you're taking something else, like an AD or a benzo, to treat the panic).
A couple of years ago, I was at the memorial service for a relative (the relationship is too complicated to explain) who had died, and my brother and I were talking about him. It turned out that he'd been depressed (this was before I was born) and had taken amphetamine for years. It seems to have worked for him (although he went on a TCA later on, simply because the standard had changed). Just FWIW.
best,
-elizabeth
Posted by OldSchool on March 26, 2002, at 21:20:03
In reply to Re: Anyone had success with ECT? » OldSchool, posted by Elizabeth on March 26, 2002, at 20:11:59
> > I dont know what type of depression I have at this stage anyway. I dont think any of my doctors do either.
>
> It might very well be like you said, that they just don't think in any terms that are more exact than "major depression." Anyway, "major depression" isn't at all exact; I think that, as you suggest, it's probably not "a" disease, but many different diseases.
>
> > Its changed probably ten times thru the years.
>
> That's possible; I've read that it isn't always consistent over the course of a person's illness. And of course, there really haven't been many different types that have been identified; the only ones I know of that predict treatment outcomes at all are psychotic, melancholic, and atypical features. I think the majority probably don't fit into any of these categories; this is called "simple mood-reactive depression," although it really doesn't tell us anything to say something this vague (that it doesn't fit into any known subtype, that is).there are no tests available in psychiatry Elizabeth. None. If there are no tests available, how can anyone be sure of any diagnosis? Especially when something as complex as the human brain is involved. Psychiatry isnt interested in developing any real tests IMO either.
>
> I think that you're right that it would help if we worked on the biological research, although I also think that we're limited by technology.
>Give it to Neurology to fix. I think the technology is here, it just needs to be focused the right way. With lots of money spent on it. The present setup will never work to achieve to unlock the brain's secrets and thus solve severe mental illness. Im not a science person, but I know anything can be done if the right amount of money is spent on it. They got AIDS under control fast and how come? Cause they spent a huge amount of money on it. We sent man to the moon and have a big space program. Why? Because we spent a bunch of money on it. We beat the Soviets in the cold war and why? Because we outspent them in the cold war.
Mental illness can be beaten only if it goes the high tech route and a lot of money is spent on research.
> > I personally think I have melancholic depression with some psychotic depression mixed in with it.
>
> Psychotic? What sort of delusions or hallucinations have you had? I can see the melancholic part (not sure if it's "technically" right, but it's probably at least close), but you never struck me as psychotic. I'd be careful about going on that assumption.I dont know. I dont have hallucinations or anything like that, nothing that bad. I just think Im insane...warped...psychotic.
>
> BTW, are you taking any medication now, and if so: 1) what? 2) how much is it helping? 3) what is it not helping with (or only partially helping with)?
>Yeah, just Zoloft and a BP med and Klonopin as needed. Take a lot of benadryl these days for EPS and I also have taken Amantadine recently, which has helped me more than any drug Ive taken in years.
> > So Im just gonna do the bilateral ECT thing. Ive also been told I have a retarded depression but with "mood reactivity" and a "rigid" personality. whatever that means.
>
> "Mood reactivity" means it's nonmelancholic: your mood changes, somewhat, in response to things that happen around you (i.e., environmental stuff). "Retarded" means you're slowed down rather than agitated. Anything a psychiatrist says about your personality probably tells you more about the psychiatrist than about you, but FWIW, "rigid" would mean "not amenable to change."Yeah, I know that. It doesnt mean much either.
>
> > And Ive had atypical depression dx a few times.
>
> Huh. That is sometimes associated with irritability and moodiness, as well as psychomotor retardation and reactive mood, but that stuff alone isn't sufficient. I wonder why they thought that.One psychiatrist I had gave me that dx because he thought my depression was just plain weird. He didnt think I had psychotic depression, he didnt think I had dysthymia. He didnt think I was bipolar. He didnt think I was anti-social or anything like that. He thought I had super duper severe clinical depression that just didnt respond good to meds. So he gave me the dx of atypical depression as in its "unusual." Or "not typical." He also thought I had a lot of somatic complaints, which goes with atypical depression.
>
> > I also have the EPS symptoms now, mild parkinsons type symptoms, mild rigid right arm and stuff.
>
> Oh god, that sucks. How did that happen? Have you tried any antiparkinsonian drugs, like Cogentin, Benadryl, Artane, Symmetrel, etc.?
>
Seroquel back in the fall. Tried benadryl and Amantadine. Amantadine kicks the shit out of it, as well as gets rid of many other complaints Ive had for years. It has some activating antidepressant properties as well. However it changes my personality some, makes me more mellow. I think it makes me psychotic some. But physically I feel great on it.> If you really think that psychosis is involved, and if you think you could deal with the regular tests required, Clozaril might be something to consider; it hardly ever causes EPS (like, very rarely even compared to other atypicals) and can even be used to treat them. Psychotic depression pretty much requires either a dopamine antagonist, or maintenance ECT (the latter being rather a PITA).
No...forget all anti-psychotics. I am DONE WITH THOSE DRUGS. All I even took of them was piddly low doses and got bad EPS from them. Forget anything like clozapine until the day I hallucinate or think aliens landed in my backyard.
I think bilateral ECT is a superior way to combat psychotic depression. No movement disorders, no EPS, no problems except memory loss which isnt a physical neurological disorder. I can deal with memory loss. I cannot deal with this fucking anti-psychtotic drug induced EPS shit, muscle tightness, tongue numbing, twitches, back of my head gets super cinched down feeling...FUCK THAT.
>
> > Frankly, I think the only thing anybody knows is Ihave some sortof mood disorder and thats about all.
>
> If it's any comfort, that's all they know about anybody, pretty much!
>
> > Is it really that much different in Boston?
>
> Yes, very. I guess that I should really say it's different if you see a pdoc who's affiliated with Harvard, because those are the only ones I have experience with. I don't know if doctors at BU and Tufts, or non-academic psychiatrists, are similar.
>
> > I realize its an elite academic town and all. But when it comes to psychiatry, which is so primitive about wherever you go, I find it hard to believe the psychiatric services there would be much different than in Winston, or Charlotte...or NYC..or wherever. Are there really experimental drugs there available for the taking?
>
> There's an awful lot of research there. (New York is probably similar, I'd think.) I was thinking more of the willingness of the doctors there to try off-label stuff, though. Like, at some point I was told by a pdoc here that they were starting to use Neurontin for mood disorders. I said, "yeah, I tried that three years ago," and he seemed startled. I think that pdocs here are much less likely to suggest something like selegiline (or indeed, to be comfortable with MAOIs in general), pindolol, ketoconazole, that amoxapine-Parnate cocktail that I've heard such good things about, etc., and most of the ones I've spoken to have been downright hostile when I mentioned that I take buprenorphine. (I'm afraid that all the publicity about its use as a treatment for addiction has given it a bad name.) I've been having a problem getting my pdoc to let me take 20 mg of Ambien (10 mg is useless for me -- not tolerance, just the way my body works), or even to let me try more than 300 mg/day of Effexor XR. (Strangely, the labelling for immediate-release Effexor recommends a higher maximum dose than the labelling for Effexor XR -- 375 mg vs. 225. I guess they just didn't bother studying Effexor XR at > 225 mg.)20 mg ambien is a lot of ambien. They might be worried about you getting hooked on that stuff. The effexor thing is bullshit. You can go to 375 mg Effexor XR you just have to watch the BP. I did it several years ago. I know a psychiatrist in Winston who is real aggressive with meds, but a dickhead. He likes to slam them down your throat, more is better with this guy...he'd go super high doses on even SSRIs. He offered to put me on 80 mg Paxil. Once...I SWEAR...he told me there is some research on combining SSRIs with MAOIs for TRD. I swear to God he told me that.
I bet you could talk him into anything except bupe. But he is a dick. He has to be in control. You could talk the guy into anything I bet except opiates. I know I could. But it got out of hand and I had to split.
>
> > I realize people up there are probably more open minded than down here. But are there really more treatments up there?
>
> Not that so much, no (although there really is very little research down here) -- but practically speaking, it's a lot easier to get newer off-label treatments there than it is here.
>
> > Bilateral is just plain stronger and it doesnt require a titration procedure so the first treatment is not wasted like in unilateral. I figure I should just go for the gusto and go for bilateral and expect memory loss. At least Iknow it will be powerful.
>
> Running out of patience? I can understand it, although on the other hand I'd really think twice about rushing if it might mean that even recovery would be bitter. Wasting one session of ECT doesn't seem so bad from that perspective. On the other hand, I wouldn't mind forgetting what it was like when I was depressed (unfortunately I don't think you get to choose what you forget).
>
> > Bifrontal is supposed to have the effectiveness of bilateral, but without the memory loss side effects. Its the best of both worlds. The electrodes are placed above the eyes, on the forehead instead of the temples. Its making a comeback from what Ive read.
>
> I looked it up after reading your post. It sounds promising. Why do you want to have bilateral ECT when something like this is an option?Because bifrontal isnt done many places right now. In Charlotte, there is only one shock doc who does bifrontal. In Winston, they might do it at Wake Forest. They probably do it at Duke but I cant go there cause of my insurance wont allow me to use Duke psychiatry. But I can use Duke for non psychiatry stuff...stupid huh?
>Im not sure I may end up doing bifrontal ECT, just depends where I get it done at.
Eric
> Whatever you decide, I hope it helps turn things around for you.
>
> -e
Posted by IsoM on March 27, 2002, at 0:01:19
In reply to Re: ADD, ECT, etc. » IsoM, posted by Elizabeth on March 26, 2002, at 20:39:11
Posted by 3 Beer Effect on March 27, 2002, at 4:50:35
In reply to Re: About Possible ADD - Speed anyone?, posted by BarbaraCat on March 26, 2002, at 0:51:19
Methadrine (methamphetamine hcl) is available as "Desoxyn" made by Abbott Laboratories in 5 mg IR tablets & 5 mg Controlled Release tablets (the gradumets were discontinued). But because of the infamous generic name of this medicine, most doctors are afraid of prescribing this medicine.
I found that it is possible to become a "speed freak" on amphetamines like Dexedrine, Adderall, or Ritalin but only if you use them intranasally (snort) them or inject them into your arms (eesh!).
If you take too many orally, they will probably make you feel nauseous & you will throw them up. Plus there is no euphoric 'flash'/rush when you swallow the pill like there is when you snort meth/amphetamines/ritalin/cocaine. So it is quite difficult to get 'high' by swallowing ADD psychostimulants.
The once a day long acting ADD stims like Adderall XR, Dexedrine Spansules, Concerta (extended release Ritalin) are less likely to be abused & much more difficult to crush up & abuse them, so they would be a good choice for former drug abusers or alcoholics if they can handle it.
Posted by Elizabeth on March 28, 2002, at 23:13:17
In reply to Methedrine now called Desoxyn , posted by 3 Beer Effect on March 27, 2002, at 4:50:35
> Methadrine (methamphetamine hcl) is available as "Desoxyn" made by Abbott Laboratories in 5 mg IR tablets & 5 mg Controlled Release tablets (the gradumets were discontinued).
It's actually d-methamphetamine. Methamphetamine isn't marketed as a racemic mixture. But anyway, the name "Methedrine" hasn't been used for years -- that's hardly news.
It's unfortunate that doctors are so afraid of methamphetamine (though understandable, given the harrassment that they are subjected to by the government if it doesn't like their prescribing practices). My understanding, at least, is that it has a favorable ratio of central to peripheral effects, so it could be particularly beneficial for people who are at risk from, for example, cardiovascular side effects.
Do you happen to know what the difference is between the no-longer-made "Desoxyn Gradumets" and "Desoxyn controlled-release tablets?"
I don't recommend trying to get off by ODing on psychostimulants. Amphetamine psychosis really is quite unpleasant (and waking up in restraints with a Haldol hangover can't be very nice, either).
-elizabeth
Posted by Elizabeth on March 28, 2002, at 23:23:04
In reply to Re: ADD, ECT, etc.- Eliza. -Post for Mags??? (nm) » Elizabeth, posted by IsoM on March 27, 2002, at 0:01:19
IsoM --
You're right, that other post was mainly directed at Mags. Sorry about that! (I was writing a response to your post where you said that if someone has a paradoxical response to amphetamine, that person probably has ADD, and then when I finished writing it I clicked the "add name of previous poster" box, having forgotten that the post I'd originally been "reply"ing to was yours, not Mags's.)
-elizabeth
Posted by kazoo on March 31, 2002, at 2:44:45
In reply to Methedrine now called Desoxyn , posted by 3 Beer Effect on March 27, 2002, at 4:50:35
You are obviously not a sixties person, my dear Sir or Madam, which ever the case may be.
"Methedrine" was the proprietary name for a drug manufactured by a company that is now defunct (if I think hard enough, I'll remember what it was). It's main ingredient was methamphetamine, and one other thing, possibly ephedrine and was available via injectable form only. There were NO Methedrine pills, per se.
In the late 1960s, doctors in the San Francisco Bay Area started shooting up their heroin addicted patients with Methedrine in hopes of getting them off the dreaded "hard stuff." Well, guess what: they learned the hard way that the best of the worst still isn't very good, so they developed a new group of Meth Freaks who displayed symptoms of psychosis and were violent, and just as addicted to the original "hard stuff". How were they supposed to know? They're doctors!
In my feeble opinion, methamphetamine is the WORST possible addiction one can have (Shut up! I've been *TOLD* that to be true!). One never quite gets over a "speed Jones," at any age, at any time, the mark of true, die-hard habituation until DEATH.
Today, the government is in a kind of a bind: the drug DESOXYN is manufactured legally and prescribed in a perfuntory manner to those with ADD because it helps this group of people, or so they say ... but then you have the DEA busting those who make it themselves from ingredients OTC. The FDA, since the mid-1970s, has been trying to reclassify this genre of drug into the CONTROL SUBSTANCE I category, or that group of drugs with no medical use or purpose. But they're trying to do that to marijuana as well so whom do you listen to? Whom do you trust? What color is the sky on your planet? And what will "they" do next to make our lives miserable?
If you really want to find out why amphetamine got such a bad rap in this country, then please (by all means) go to my website which deals directly with this subject, Washington D.C. style: http://www.geocities.com/zoots90210/index.htm
The treatise, dated 1972, came from an old law book and some of the things the author says (I admit) are outdated and downright corny, but the basic tenet to get this drug under control is the interesting part. Also note the other drugs the government mickey-moused with, and the MAJOR ROLE these drug companies had in marionetting the strings of those involved. What crap. We are all pawns and victims to the whims of shitheads.
I rest my case, you honor ...
(a mean) kazoo
Posted by BarbaraCat on March 31, 2002, at 13:00:31
In reply to Re: Methedrine now called Desoxyn (no, it's not) » 3 Beer Effect, posted by kazoo on March 31, 2002, at 2:44:45
Interesting article. I agree with you about the life long meth Jones. I also don't know about 'therapeutic doses', I only know about how I abused the stuff. I started innocently enough (doesn't everyone?) in high school - a friend had a part time job at a drug store and used to swipe handfuls of uppers. After my first rush, I thought 'whoa, so THIS is life!' A perfect antidote to a miserable homelife and an annoying shyness. One thing led to another (I was a product of the 60's and did 'em all) but it was Meth that was my fave and eventually I had a full blown meth Jones that lasted for 3 years and then sporadically for another 2. I was even snorting meth while I had a very serious case of mono. Not good when you're staying up 3, 4 days straight without sleep.
The only thing that finally led me away from it was getting into a serious spiritual practice, new friends, and becoming disgustingly squeaky clean (you might say a Pure Jones). I've said it before here - I have found nothing so Zen-like, so focused and clear as a good clean meth buzz. On the other hand, there is also nothing so jagged, frayed, bugs crawling under the skin loony, paranoid, sweating, jigged out weird than a meth bender either. Perhaps it can be likened to the euphoric early state of a productive hypomania vs. the scattered frazzled later state of psychotic mania.
I've got to wonder just how all that dopamine depletion is affecting me now or will in the future (Parkinson's?). I guess that I've been able to get a brain after all and would run from a line like from the beasts of hell. I hear about the Ritalins, dexadrines, etc. for ADD and hope like hell it's doing some good and not only palliative. I get tempted to try a pstim for my own possible ADD, but then think 'Naaah! Don't wanna go down that road no more.'. I'm sure it is a miracle in good hands, but there's just something about those speed like drugs that when abused can open a person to pure evil. - BCat
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