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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Ame Sans Vie on July 24, 2003, at 9:35:35
Well, I took my first Xanax XR 3mg last night, and my second this morning. Wow, what a difference from Klonopin!! It lasts at least twice as long (for me, YMMV) and has that wonderful "Xanax effect" that I love so much (i.e. the motivating, antidepressant effect). In combination with Ultram it's a dream come true.
Anyway, I dropped the Desoxyn from my regime, and in case you haven't seen my posts from yesterday, my meds are now 100mg Ultram t.i.d. and 3mg Xanax XR qAM. The Xanax is going to be raised to 6mg in two weeks (if, when the time comes, I deem a dosage increase necessary... also possible I'll just try going up to 4mg or so).
So now that I've dropped the Desoxyn, the only thing I'm lacking is something to help keep my ADHD under wraps and give me that little added energy boost. I'm considering such things as Wellbutrin, Eldepryl, Strattera, Edronax, Meridia, Sanorex, and moderately-high-dose Provigil. Provigil has worked *unbelievably* well for me in the past (I'd honestly say it made me hypomanic, but I just felt so wonderful and outgoing, assertive, etc.), but at a dose of 1,000mg a day, which after a few days led to some horrible headaches. But then, I wasn't on anything for the depression and was being undertreated for anxiety, only on 4mg/day Klonopin and nothing else except the occasionall propranolol 20mg. So I'm thinking maybe 600-800mg would be a good idea, but before I decide, I'd kind of like your opinions of those other possibilities I've listed. Not to mention anything else you think may help.
I already take fish oil, l-tyrosine, l-phenylaline, P-5-P, niacinamide, lecithin, selenium, vitamin C, vitamin E, "Green Source" brand multisupplements, the Chinese remedy Xiao Yao Wan, occasional homemade herbal remedies (kava, chamomile, catnip, rosemary, scullcap, damiana, California poppy, blue lotus, betel nut, sceletium tortuosum, etc.), and I just began taking the homeopathic remedy Gelsemia sempervirens... so I think I have it covered in the supplement department, for the most part. I may consider adding a low dose of l-tryptophan and/or NADH, though. But of course, any other suggestions are more than welcome. (of course, my pdoc knows about all of these supplements and encourages their use--he's very knowledgeable in the areas of Chinese, Ayurvedic, homeopathic, and other supplementation in the treatment of mental disorders--in fact, if anyone would like any information regarding any of this, just let me know, and I'll ask him about it at my next appointment)
I also recently began working out again, after quite a long hiatus (a result of laziness). The Ultram just makes me feel so good, I feel like I *have* to exercise, lol. My pdoc has also recommended Yoga and Tai Chi, both of which I'm studying at the moment.
Finally, I see an acupuncturist for electro-acupuncture treatments biweekly, which are quite helpful. My acupuncturist is also a Chinese herbalist, and he's the one who has me taking the Xiao Yao Wan (see this post, http://www.dr-bob.org/babble/20030718/msgs/243732.html, for its ingredients).
Anyway, to get back to the topic at hand, I originally was also considering Prozac or Effexor as augmentation for this purpose, but 1.) they probably wouldn't work as well as something that works on the noradrenergic system, and 2.) there's a greater risk of serotonin syndrome combining an SRI/SNRI with Ultram.
My interest has also been peaked lately regarding Stablon (tianeptine), the serotonin reuptake enhancer. Though I'll surely add one of the medications I listed above, I'm seriously considering giving Stablon a trial in addition. Once again, my pdoc (whom I absolutely *love*, I don't think I say that enough, lol... he's so compassionate and understanding) is okay with all of this. He knows how thoroughly I research my medications, so he just told me to try to make a decision as to what I'd like to try before our next appointment (in two weeks).
Oh, and for anyone not familiar with my diagnoses, it may help to know that I have moderate ADHD, severe social anxiety, severe agoraphobia, moderate panic disorder, some obsessive-compulsive traits (O-C personality D/O?) and dysthymia, which fairly recently evolved into depression. The Ultram completely takes care of the obsessions, compulsions, depression, and, to a lesser extent, the social anxiety and agoraphobia. The Xanax XR, likewise, completely rids me of my symptoms of social anxiety, agoraphobia, panic disorder, and seems to synergize quite well with the Ultram, giving me more motivation and improving the Ultram's antidepressant effect.
I greatly appreciate any input you guys can give me on this. Peace out! :-)
~~Michael
Posted by jps88 on July 24, 2003, at 13:03:19
In reply to My review of Xanax XR; Advice on med-tweaking?, posted by Ame Sans Vie on July 24, 2003, at 9:35:35
> Well, I took my first Xanax XR 3mg last night, and my second this morning. Wow, what a difference from Klonopin!! It lasts at least twice as long (for me, YMMV) and has that wonderful "Xanax effect" that I love so much (i.e. the motivating, antidepressant effect). In combination with Ultram it's a dream come true.
I mean how many times have we heard you say that some combo or drug is "a dream come true"--it's hard to take you seriously. Mirapex. Lexapro. Provigil. Klonopin. etc. etc. etc.
I mean no offense but some of us on this site are really suffering and it is quite frustrating to keep being told that you are finding things that work "wonderfully" for you only to read two weeks later that you have decided to switch off of them. We have no idea why and in the meantime some people have decided to try drugs based on your "dream come true" experiences with them. Then we read that you are off those drugs and on to the next thing. . . .
Also, I have found your posts very confusing. At one point I think you said that you live in the EU but you constantly talk about US FDA guidelines and how you get your drugs from a good pdoc follosing us regs. Then you write some posts in French? I am not accusing you but I really suspect that you are not fully honest on this site.
Also, I think you are bipolar and need to be treated for that. Your constant switching and changing of meds after a wonderful response seems to be classic manic symptoms of looking for bigger and better things. Good luck.
Jon
Posted by linkadge on July 24, 2003, at 15:59:52
In reply to Are you on a mission to try every psychiatric drug » Ame Sans Vie, posted by jps88 on July 24, 2003, at 13:03:19
Posted by Ame Sans Vie on July 24, 2003, at 16:27:24
In reply to Are you on a mission to try every psychiatric drug » Ame Sans Vie, posted by jps88 on July 24, 2003, at 13:03:19
>I mean how many times have we heard you say that some combo or drug is "a dream come true"--it's hard to take you seriously. Mirapex. Lexapro. Provigil. Klonopin. etc. etc. etc.
Perhaps if you'd paid attention more closely, you would have seen that there were good reasons for my discontinuation of each of those drugs, despite my initial good response to them. I.E., Mirapex=narcoleptic-like side effects, Lexapro=sexual side effects, Provigil=only worked at enormous (and expensive doses) and caused headaches after a few days, Klonopin=Xanax works better for me. Period.
>I mean no offense but some of us on this site are really suffering...
I assure you, you don't know what suffering truly is until you've walked a mile in my shoes.
>...and it is quite frustrating to keep being told that you are finding things that work "wonderfully" for you only to read two weeks later that you have decided to switch off of them. We have no idea why and in the meantime some people have decided to try drugs based on your "dream come true" experiences with them. Then we read that you are off those drugs and on to the next thing. . . .
Your point being? Just because I had to stop taking these drugs doesn't mean others who find them helpful will have to. Sure, I tended to get excited when a drug was showing a positive effect, but when the side effects don't show themselves for another two or three weeks, well that's not exactly something I can control.
>Also, I have found your posts very confusing. At one point I think you said that you live in the EU but you constantly talk about US FDA guidelines and how you get your drugs from a good pdoc follosing us regs. Then you write some posts in French? I am not accusing you but I really suspect that you are not fully honest on this site.
I take *very* personal offense to that accusation. I would suggest you take a look at the civility guidelines:
http://www.dr-bob.org/babble/faq.html#civil
"Please don't be sarcastic, joke about death or suicide, suggest that others harm themselves or others, JUMP TO CONCLUSIONS ABOUT OTHERS, POST ANYTHING THAT COULD LEAD OTHERS TO FEEL ACCUSED OR PUT DOWN, harass or pressure others, use language that could offend others, exaggerate or overgeneralize -- et cetera."
1.) I never said I lived in the EU.
2.) So I speak French, so what? A lot of people would do well to learn a second and third language.
3.) What exactly is it that you are accusing me of not being honest about? I happen to respect this board and the people on it a lot more than that--I never have been dishonest on this board, and never will.>Also, I think you are bipolar and need to be treated for that. Your constant switching and changing of meds after a wonderful response seems to be classic manic symptoms of looking for bigger and better things. Good luck.
Well, you're dead wrong on that one. I've never been manic. The closest I've ever gotten was the hypomania caused by Provigil. What you are mistaking for mania is in fact content euthymia.
This board is for support and education purposes. If you aren't going to educate and can't be supportive, then think twice before clicking that "Confirm your post" button, please.
Posted by linkadge on July 24, 2003, at 17:50:47
In reply to That was quite rude. Dr. Bob? » jps88, posted by Ame Sans Vie on July 24, 2003, at 16:27:24
Lets not get into the little - 'I've suffered much more than you ever could' competiton.
It's pointless, not to mention unjustifiable.
Most people on this board have suffered, but the ones who have truely suffered the most, are probably the ones who post the least, or the ones who don't feel up to visiting this board all the time.
What JPS88 said is valid. We all need to refrain from saying things like "this combo is the best ever", or "this drug rocks", or "this is the ultimate combo", or "everbody needs this drug"
The simple fact is that *everybody is different*. What works for one person, may worsen another's condition. We are not all sick for the same reason.
*Many people try to convince themselves that a drug works, by trying to convice others that the drug is working.*
*Very rarely, does a drug produce the same effect in a few month that it does during the first few days*
I would earnestly ask *everybody* here to take sufficiant time in order to fully asses how a drug is working, before they assert that it has solved all of their problems.And most importantly, always try to describe how the drug has effected you. It is easy to think that the effect would be the same for everyone, but thats just not true. You will find that prudence is one of the best tools for mental illness.
Linkadge
Posted by Ame Sans Vie on July 24, 2003, at 19:50:13
In reply to Avoid the depression competion, posted by linkadge on July 24, 2003, at 17:50:47
> Lets not get into the little - 'I've suffered much more than you ever could' competiton.
> It's pointless, not to mention unjustifiable.
Agreed.
> Most people on this board have suffered, but the ones who have truely suffered the most, are probably the ones who post the least, or the ones who don't feel up to visiting this board all the time.
>
> What JPS88 said is valid. We all need to refrain from saying things like "this combo is the best ever", or "this drug rocks", or "this is the ultimate combo", or "everbody needs this drug"Don't agree with that at all. This board is entirely subjective anyway, and part of the point of Psycho-Babble is to share our *personal* experiences with medications. If I feel that a lot of people can benefit from a particular medication because it had a positive effect on me, then I'm damn sure going to say it.
> The simple fact is that *everybody is different*. What works for one person, may worsen another's condition. We are not all sick for the same reason.
>
> *Many people try to convince themselves that a drug works, by trying to convice others that the drug is working.*
>
> *Very rarely, does a drug produce the same effect in a few month that it does during the first few days*Just to clarify, most of these drugs that worked well for me that I ended up discontinuing had worked very well for weeks or months, not days, before the negative effects set in. The exception to this was Provigil.
> I would earnestly ask *everybody* here to take sufficiant time in order to fully asses how a drug is working, before they assert that it has solved all of their problems.
>
> And most importantly, always try to describe how the drug has effected you. It is easy to think that the effect would be the same for everyone, but thats just not true. You will find that prudence is one of the best tools for mental illness.
>
> Linkadge
Posted by Dr. Bob on July 24, 2003, at 19:58:59
In reply to Are you on a mission to try every psychiatric drug » Ame Sans Vie, posted by jps88 on July 24, 2003, at 13:03:19
> I really suspect that you are not fully honest on this site.
Yes, please be civil. The last time you were blocked, it was for 1 week, so this time, it would've been for 2, but you're also posting under two names at the same time, so I'm going to make it for 4.
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration, thanks.
Posted by Dr. Bob on July 24, 2003, at 20:01:14
In reply to That was quite rude. Dr. Bob? » jps88, posted by Ame Sans Vie on July 24, 2003, at 16:27:24
> That was quite rude.
> you don't know what suffering truly is until you've walked a mile in my shoes.
Please be sensitive to the feelings of others even if yours are hurt and don't post anything that could lead them to feel accused or put down, thanks.
Bob
Posted by Dr. Bob on July 25, 2003, at 20:18:38
In reply to Re: blocked for 4 weeks » jps88, posted by Dr. Bob on July 24, 2003, at 19:58:59
> PS: Follow-ups regarding posting policies ... should be redirected to Psycho-Babble Administration, thanks.
Here's a link:
http://www.dr-bob.org/babble/admin/20030508/msgs/245307.html
Bob
Posted by qwerty on July 28, 2003, at 17:39:57
In reply to My review of Xanax XR; Advice on med-tweaking?, posted by Ame Sans Vie on July 24, 2003, at 9:35:35
My advice (which is worth what you paid for it) would be to concentrate more on the exercise and diet (food, no supplements) and less on the other stuff (note I avoided a perjorative term like "crap").
In your long post there is an extraordinary amount of information on pharmaceuticals, followed by alternative meds and supplements. Then one single line about working out, and none about any dietary changes (increased fresh fruits and veggies, etc).
Don't get me wrong...I know that meds have their place and that for many they are absolutely essential. But I also think it is easy to get tunnel vision with regards to finding the next miracle molecule.
Posted by Ame Sans Vie on July 28, 2003, at 22:11:16
In reply to Re: My review of Xanax XR; Advice on med-tweaking?, posted by qwerty on July 28, 2003, at 17:39:57
I didn't post about my diet simply because I have found a diet that works well for me, and I didn't feel the need to bring it up. But if you're that interested, I follow a diet based around principals of the Mediterranean diet, the Atkins diet, and the glycemic index diet.
I do think it's a little unnecessary to consider medications and supplements "crap" (even though I realize you "avoided" using that term). Supplements have proven benefits; I've gone with and without them, and I (and others) far prefer the me that takes the supplements. They greatly enhance not only my mood, but my health in general.
This is the end of the thread.
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