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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by sciutti on August 8, 2002, at 13:22:27
I am just learning to use the computer, mainly to find a place where I can ask questions and find ways to help myself. Long involved hx., I am 54! and haven't the time or energy to fully explain. But, here is first question. Have not been able to find an AD to work, dr. is researching MAO's because he has never prescribed them! I am a retired nurse anesthetist which is sometimes helpful, but also gets me in trouble! I have come to the conclusion my serotonin and probably the rest of the neurotransmitters level is not working (either decreased level or decreased receptor sites) Have been on 22 meds (tricy.& ssi) with not results. Like I said too much to write, so my question is: I am at the end of my ropes, was going to ECT until my husband had a fit (can you cuss?), and said no, due to the memory problem, so I am looking for a place that is doing the research &/or does the PET scans after taking fenfluramine or does spinal tap to test for for 5H1AA level. I am probably on the wrong track, but something, someone, somewhere can help me. THANK ANYONE who can help.
Posted by sciutti on August 8, 2002, at 13:26:02
Believe I need to say I am in a pain mgement group,have pain pump etc. One thing that has worked in my life is unfortunaly now illegal!!! Thanks again
Posted by katekite on August 11, 2002, at 21:52:53
In reply to need to add to 1st post, posted by sciutti on August 8, 2002, at 13:26:02
Sorry to hear you have to live with chronic pain. That's never helpful to depression.
Have you had a good endocrine workup, not just thyroid? Have you gone through menopause? (sorry don't know your gender for sure and apologize for the very personal question) If you are or are not on hormonal replacement, on the Pill, or could be perimenopausal (the 3-5 years prior to menopause) your own depression might be being affected by low or fluctuating hormone levels.
If memory is a problem, are you completely sure ADD is not an issue (quiz at www.mindfixers.com)?
Usually if antidepressants just don't work there's some reason.
Kate
Posted by sciutti on August 12, 2002, at 11:53:14
In reply to Re: need to add to 1st post, posted by katekite on August 11, 2002, at 21:52:53
> Sorry to hear you have to live with chronic pain. That's never helpful to depression.
>
> Have you had a good endocrine workup, not just thyroid? Have you gone through menopause? (sorry don't know your gender for sure and apologize for the very personal question) If you are or are not on hormonal replacement, on the Pill, or could be perimenopausal (the 3-5 years prior to menopause) your own depression might be being affected by low or fluctuating hormone levels.
>
> If memory is a problem, are you completely sure ADD is not an issue (quiz at www.mindfixers.com)?
>
> Usually if antidepressants just don't work there's some reason.
>
> KateThank you so much for answering. I am 54 and am perimenopausal, been having hot flashes for such a long time(12 yrs) that I probably should explore other avenues, but no one seems to believe me. I have had lab work done, but it may be time to update. I began to get really drugged out from all the narc (oxycontin 240mg three times a day, norco up to 8 a day as needed, I have an internal pain pump with dilauded (15mg a day, and someone told me about ritalin. I can't believe the difference!!! As for ADD, you may be right. New psychiatrist has not diagnosed this nor do I have a bipolar component. I truly believe that my neurotransmitter system is really screwed up and there are some tests out there, but I cant't find them. I live on a farm out in the boonies and that is why I am trying to learn a computer. I'm sorry this is so long but my history is way longer than it should be!! and I have and I have been tying to find help since 1995. Since I am just learning should I send all my threads? and answers when I submit?
Thanks Kate and anyone who can help. Joanne
Posted by katekite on August 12, 2002, at 14:44:44
In reply to Re: need to add to 1st post » katekite, posted by sciutti on August 12, 2002, at 11:53:14
You can send whatever you feel like. Personally I like it when people just write their own message, as you did, not including previous posts, since they are already there to look at. Not sure if that's what you were asking.
Congratulations on taking the computerization step. I too live in the boonies and its become indespensible to me.
I'm convinced I'm also perimenopausal. I'm only 31 but since starting the birth control pill 24 of the 28 (not sure on the exact number there) symptoms of menopause have gone away for me. My FSH was normal although I do have high urine cortisols... which I'm working on. My current obgyn believes I am perimenopausal but a neurologist and an endocrinologist both simply smiled and said it wasn't possible due to the normal FSH. My mood is much more stable so I just smiled back and went back to the obgyn for more, LOL.
FSH will be normal until you actually stop having periods: it is not a good indicator if you occasionally or often have periods. It statistically gradually rises until after menopause but in practice varies widely, individual women are all over the place. Levels of estrogen, progesterone and testosterone can be helpful but vary over the day and so testing can be inaccurate.
In early 50s its hard to say what to do: one option if you still have periods might be just to try one of the lower dose birth control pills to see if it makes a difference. If that actually worsens things then next would be to try a progesterone only version.
Once you do go on hormone replacement after true menopause (if you choose to, that is) consider also replacing testosterone... women have 1/10th that of men but it is important for overall sense of well-being, libido, and drive. Virtually no one who takes testosterone replacement at a female dose grows hair or becomes mean (as a recent female endocrinologist told me would occur -- just completely silly misconception). It can be the 'missing ingredient' when things are just a little off. Testosterone is also available for women who take birth control pills but you would need to know first whether you benefited from a birth control pill in general, it is a fine tweaking thing.
If you have symptoms of perimenopause like hot flashes I would keep looking for an obgyn that takes you seriously. Hot flashes interfere with sleep, whether you sleep through them or not. No sleep predisposes to more pain. Not to mention the memory issues, emotional swings, etc that can also occur.
Symptoms of menopause like hot flashes will last 1-25 years untreated (that's the range). I would not expect it to go away just by toughing it out. I saw the 25 number and rushed out and got on the Pill and am remarkably stable these days, all the hot flashes etc went away within a few days of starting, and I just felt younger, like myself again. Also have upped my calcium intake considerably.
Not to push the birth control pill or hormone replacement too much, but even female doctors don't seem to give perimenopause much thought.
kate
PS -- I wasn't clear on whether you currently take Ritalin, had just tried it, or? Did it help with pain control? I hadn't heard of it doing that.
Posted by sciutti on August 15, 2002, at 12:30:37
In reply to Re: need to add to 1st post, posted by katekite on August 12, 2002, at 14:44:44
To kate: Have I replied to your last response? I am on ritalin 20mg SR four times a day and an additional 10mg {not sustaind released) with the above dose. I was taking hormones until this June when I ran out and haven't been back to the dr. Then they came out with all that new information about HRT not helping heart disease, cancer or osteoprosis!! but probably causing heart and cancer problems, so what to do? My psychiatrist is going to put me on a MAO inhibitor next week. Don't know which one butI am hoping that class of drugs will work. The big black hole that I'm in is getting deeper my husband can't or won't take anymore and I have no place to go what the hell do I do???? joanne
Posted by katekite on August 18, 2002, at 21:59:21
In reply to Re: need to add to 1st post, posted by sciutti on August 15, 2002, at 12:30:37
There has been a lot of hysteria over that HRT news. I'm not saying it's not important and that some high dose hormone replacements shouldn't be dropped from the market. It's true that they stopped the study with the high dose one that had both progesterone and estrogen. They did not stop several other studies just as far along of replacement hormones in other combinations, as those showed no unexpected problems.
Obviously the truth is now out that hormone replacement is drug therapy like any other drug and can no longer be seen as "natural". However, some people benefit so much in so many ways from a little estrogen that I think the benefits may still outweigh the risks.
Talk to a doctor about hormone replacement and find out the new facts. Weigh the risks and benefits and make an informed decision. Factor in to your decision the possible benefit it could have to your mental health. Don't let having run out take the place of an actual decision.
Talk to your pdoc about hormones too: they may have written down 6 months ago you were on replacement and then never asked since.
I have heard MAO inhibitors are very effective. I have taken moclobemide which is hard to get in the US, it is reversible so one doesn't have to follow a particular diet: I liked it a lot. Actually increased my sex drive: not something most psych meds do.
I just read that over and I'm sounding like I'm lecturing on and on about hormone therapy. I guess I have found it so personally beneficial I can't believe it could be bad. I'm sure there are some people for whom HRT makes moods worse.
On another note, I know how it is to have a hubby really want to 'fix' things. They get frustrated and resent their own inability to fix it (and by extension, resent the depressed person that is still depressed and living evidence of their failure to fix everything) and they work themselves into a tense half-depressed tizzy and then have almost no idea what they are angry about. Hard to be around. Mine ends up just staring at me a lot when I'm depressed. Don't make any big decisions if you're depressed: it's all a product of both of you dealing with the depression and has nothing to do with how you actually relate during better times.
Take care and hang in there,
Kate
This is the end of the thread.
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