![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by utopizen on April 22, 2004, at 22:21:22
I've been seeing this new psycopharmacologist weekly for the 7th time now.
I'll mention to him how I want an antidepressant, or Straterra, or possibly an antipsychotic, and he never takes my suggestions seriously.
I make it very clear to him that this is advice I'm getting from past doctors I've had consults with him, that my docs have been leading their fields like in social anxiety, sleep medicine, etc. And later he'll say, "but are the experts?" And I'm like, "um, well, generally if they lead their fields, they might be called that."
He has me on Klonopin 1mg 3x/day for social anxiety and 20mg of Desoxyn/day for ADD. I also have narcolepsy. And lately, depression, and my therapist also recently diagnosed me with obsessional thoughts.
What kind of a doctor refuses to give Straterra or an antidepressant over methamphetamine+klonopin? And he thinks he's being conservative. He claimed last week that he'd have to ask his colleagues about Strattera because "it was a new drug."
I think it's lying to me. I can't imagine a college not giving him a funny look if he asked what Straterra was all about. He didn't feel shy telling me he's never thought of Straterra for his ADD patients. That's ridiculious! Especially for someone who's failing it.
He last time asked if upping my Desoxyn would help. I said no, that's not realistic, I've been up to 50mg/day by another doc.
This week I mention, "um, so, you just want to up the Desoxyn?" He goes, "no!" as if I was the one who originally said it.
So now he's just not doing anything. If I mention something at an appointment, he'll claim to look into, but forget we even had the conversation the following week.
I'd just switch psychiatrists, but this is the 7th one. Sadly, he's the worst one, he's the only doc I've actually had to sell an antidepressant on. Now that I've actually matured over thinking Klonopin and Desoxyn is the ultimate combo, realized it's not working out, I have to deal with this clown.
Oh yeah, I'm also depressed these days, but forgot to even mention it this appointment because I have to focus on the pathetic little stupid things that you'd think any other pdoc wouldn't have to be explained over, like how Klonopin isn't going to help me in the long-term and Desoxyn doesn't work when you're depressed like I am now... god.
Posted by King Vultan on April 23, 2004, at 7:42:08
In reply to My doctor is weird., posted by utopizen on April 22, 2004, at 22:21:22
Even if you have gone through seven doctors, I would switch again. This guy doesn't really sound like he knows what he's doing, and you are just hurting yourself staying with him. Perhaps one of the better ones of the previous six might be worth considering if you do not have any other immediate alternatives.
Todd
Posted by River1924 on April 23, 2004, at 13:34:02
In reply to Re: My doctor is weird., posted by King Vultan on April 23, 2004, at 7:42:08
I had pretty good luck several years ago when I found a DO who specialized in neurology through Dr. Amens "Change Your Brain, Change Your Life." He was listed in the appendix. He gives me credit for the research I do and realizes with his busy schedule I MAY know more than he does about new research or meds. By the way he never remembers one conversation from the next (I think he has ADD) but I put up with this because I like him overall. Good Luck in finding a good doc, most of them ARE weird and/or arrogant.
Posted by Sad Panda on April 23, 2004, at 14:11:59
In reply to My doctor is weird., posted by utopizen on April 22, 2004, at 22:21:22
> I've been seeing this new psycopharmacologist weekly for the 7th time now.
>
> I'll mention to him how I want an antidepressant, or Straterra, or possibly an antipsychotic, and he never takes my suggestions seriously.
>
> I make it very clear to him that this is advice I'm getting from past doctors I've had consults with him, that my docs have been leading their fields like in social anxiety, sleep medicine, etc. And later he'll say, "but are the experts?" And I'm like, "um, well, generally if they lead their fields, they might be called that."
>
> He has me on Klonopin 1mg 3x/day for social anxiety and 20mg of Desoxyn/day for ADD. I also have narcolepsy. And lately, depression, and my therapist also recently diagnosed me with obsessional thoughts.
>
> What kind of a doctor refuses to give Straterra or an antidepressant over methamphetamine+klonopin? And he thinks he's being conservative. He claimed last week that he'd have to ask his colleagues about Strattera because "it was a new drug."
>
> I think it's lying to me. I can't imagine a college not giving him a funny look if he asked what Straterra was all about. He didn't feel shy telling me he's never thought of Straterra for his ADD patients. That's ridiculious! Especially for someone who's failing it.
>
> He last time asked if upping my Desoxyn would help. I said no, that's not realistic, I've been up to 50mg/day by another doc.
>
> This week I mention, "um, so, you just want to up the Desoxyn?" He goes, "no!" as if I was the one who originally said it.
>
> So now he's just not doing anything. If I mention something at an appointment, he'll claim to look into, but forget we even had the conversation the following week.
>
> I'd just switch psychiatrists, but this is the 7th one. Sadly, he's the worst one, he's the only doc I've actually had to sell an antidepressant on. Now that I've actually matured over thinking Klonopin and Desoxyn is the ultimate combo, realized it's not working out, I have to deal with this clown.
>
> Oh yeah, I'm also depressed these days, but forgot to even mention it this appointment because I have to focus on the pathetic little stupid things that you'd think any other pdoc wouldn't have to be explained over, like how Klonopin isn't going to help me in the long-term and Desoxyn doesn't work when you're depressed like I am now... god.
>
>
>Hi utopizen,
I don't know how to say this without insulting you, but you may be being overassertive with your docs. :) I try my hardest not to sound like an expert patient when I see my docs, but it is hard sometimes. You have to try & organise him into making him think that the drug you want to trial is his idea. In a way, methamphetamines & benzos are conservative because they have a long record of use, OTOH, SSRI's & SNRI's are fairly new drugs & so far have not proven to be any better than the older AD's & may have unforseen long term side effects that haven't emerged yet such as all of the Atypical AP's causing an increased risk of hyperglycmia & Diabetes. Atleast he hasn't been brainwashed by a team of Eli Lily salesmen into believing that Straterra is a miracle drug. Remember their last blockbuster Prozac isn't really any better than the TCA's that preceeded it.
Cheers,
Panda.
Posted by 1980Monroe on April 23, 2004, at 16:20:08
In reply to Re: My doctor is weird. » utopizen, posted by Sad Panda on April 23, 2004, at 14:11:59
Hey utopizen,
That is an unsolved Mystery. He actually asked to raise your dose OF desoxyn to 50mg over strattera? This guy sounds like he dosent know the diffrence between diladin and aspirin. You can get high on desoxyn, because ive taken it. Usally drug seeking behavior would actually be for desoxyn, not stattera. Lucky he would give you that much. Oh well, stattera for me was just a placebo.
Posted by utopizen on April 23, 2004, at 19:02:04
In reply to Re: My doctor is weird., posted by 1980Monroe on April 23, 2004, at 16:20:08
> Hey utopizen,
>
> That is an unsolved Mystery. He actually asked to raise your dose OF desoxyn to 50mg over strattera? This guy sounds like he dosent know the diffrence between diladin and aspirin. You can get high on desoxyn, because ive taken it. Usally drug seeking behavior would actually be for desoxyn, not stattera. Lucky he would give you that much. Oh well, stattera for me was just a placebo.
>Okay, I'll say this once, I did experiment, literally, once, and never again, with 25mg of Desoxyn when I first got the script. I never did it again, and came down an hour later with Klonopin ( a neuroprotective, to quell potential neurotoxicity issues).
But I've had previous docs who have given me 50mg/day of Desoxyn, given I have sleep attacks and several sleep lab studies that you can't fake if you wanted to.
This doc doesn't really seem to care that I get sleep attacks under control. He seems more concerned about my "ADD" (um, it's hard to focus when you're asleep!) and my social anxiety (um, I don't care anymore!)
I've tried 50mg of Desoxyn. You don't want to do it. Yes, you'd likely get "high" for the first couple of days, maybe, if you were new to it, but then that wouldn't last, obviously, as any meth addict will even tell you. You'd have to continiously up the dose to achieve euphoria.
No, instead you have sweat armpits that requires $1650 in botox-A injections every 6-12 months and talk so much you're a laughing stock of anyone you come across. And it may have caused my depression to get worse.
It sounds cute, if you're new to these meds, but euphoria exists and then before you know it you're chasing a downward spiral. Somethings are worse than they sound. This would be one of them. Luckily I'm smart, and knew not to repeat my experiment...
If someone's an incredibly empty and hallow person with no purpose in this world at all and never helps others in anyway, I suppose they may seek out the euphoria from meth. It's rather sad how empty people can be, so empty they never truly felt a natural high in their lifetime... the kind I would experience when I was 13 climbing a large mountain, something like that. Trust me, these highs are better, and I speak from experience into both kinds.
If Desoxyn doesn't help your school performance, it's no longer cute, it's hoilding you back. Just because it's novel to you doesn't mean it will help. I take these meds to help me, not to take these meds for the sake of taking these meds. That would be the most futile and empty thing I could ever do to myself.
Posted by 1980Monroe on April 23, 2004, at 22:06:22
In reply to Re: My doctor is weird., posted by utopizen on April 23, 2004, at 19:02:04
Hey
I do agree with you about hollow people, they have no sense of direction or purpose, listen, this may sound ironic but my life was grey, depressing, world was soo dull looking before i started Dexedrine, it made me actually look at work in a motivated way, and basically life in general.I admit too i have abuse once and while, ill go up to 60mg sometimes, anything more than that becomes unpleasant, i get paranoid at those doses. Desoxyn defiently is stronger than Dexedrine, the methyl is amphetamine on steroids. My friend took it once and i popped a moderate amount of those small 5mg's, around 50mg. But anyways, i don't make a habit of highs becuase they lose there worth, and your doctor gets after you.
One of these days, im just going to get off, not addicted, just think i need to let my dopamine levels normalize out. Anyways later
Posted by River1924 on April 23, 2004, at 23:57:03
In reply to Re: My doctor is weird. » utopizen, posted by Sad Panda on April 23, 2004, at 14:11:59
> Hi utopizen,
>
> I don't know how to say this without insulting you, but you may be being overassertive with your docs. :) I try my hardest not to sound like an expert patient when I see my docs, but it is hard sometimes. You have to try & organise him into making him think that the drug you want to trial is his idea. In a way, methamphetamines & benzos are conservative because they have a long record of use, OTOH, SSRI's & SNRI's are fairly new drugs & so far have not proven to be any better than the older AD's & may have unforseen long term side effects that haven't emerged yet such as all of the Atypical AP's causing an increased risk of hyperglycmia & Diabetes. Atleast he hasn't been brainwashed by a team of Eli Lily salesmen into believing that Straterra is a miracle drug. Remember their last blockbuster Prozac isn't really any better than the TCA's that preceeded it.
>
> Cheers,
> Panda.
>
I agree with Panda about using a certain amount of diplomacy with docs. It doesn't have to be total manipulation or acting or buttkissing...just respect, thoughtful questions...ask out of curiousity why he prefers this to that. I send my doc emails (short and sweet) with info I read and ask if "this sounds like me" or "sounds like it would help me." It helps if you can prime the doc with ideas prior to meeting or plant seeds for future appointments. It sounds ridiculous, I guess, but doctors are human. But if the vibe just feels wrong or you just don't know how to talk to a doc, get another. For myself, I've learned that some "arrogant" docs who gave me meds (that I did not want and therefore did not work) or a diagnosis (that I thought wrong)...ended up being correct. Sometimes, years later, I realized I got in my own way. I don't know if that applies to you. Good luck and Good health.
Posted by 1980Monroe on April 24, 2004, at 9:17:11
In reply to Re: My doctor is weird. » Sad Panda, posted by River1924 on April 23, 2004, at 23:57:03
These are the Main Signs of Drug Seeking Behavior
* Must be seen right away;
* Wants an appointment toward end of office hours;
* Calls or comes in after regular hours;
* States he/she's traveling through town, visiting friends or relatives (not a permanent resident);
* Feigns physical problems, such as abdominal or back pain, kidney stone, or migraine headache in an effort to obtain narcotic drugs;
* Feigns psychological problems, such as anxiety, insomnia, fatigue or depression in an effort to obtain stimulants or depressants;
* States that specific non-narcotic analgesics do not work or that he/she is allergic to them;
* Contends to be a patient of a practitioner who is currently unavailable or will not give the name of a primary or reference physician;
* States that a prescription has been lost or stolen and needs replacing;
* Deceives the practitioner, such as by requesting refills more often than originally prescribed;
* Pressures the practitioner by eliciting sympathy or guilt or by direct threats;
* Utilizes a child or an elderly person when seeking methylphenidate or pain medication.
Posted by utopizen on April 24, 2004, at 9:42:00
In reply to Re: main signs, posted by 1980Monroe on April 24, 2004, at 9:17:11
thanks for that... although I knew everyone, as I read the Office of Drug Diversion's site, for some reason I'm interested in drug control policy.
Just to clarify, my doc is the one pushing me to up my Desoxyn, and I'm the one asking to switch off of it to go on Straterra... I also have asked him to give me an antidepressant/antipsychotic so I don't have to keep taking the Klonopin he put me on.
So none of the drugs I am requesting are even controlled, while my doc is the one pushing me to stay on controlled substances.
Posted by 1980Monroe on April 24, 2004, at 10:49:41
In reply to Re: My doctor is weird., posted by utopizen on April 23, 2004, at 19:02:04
hey
Yea i heard of Methamphetamine not amphetamine, is neurotoxic to the dopamine terminals in the nerve synaspe. Do you have to take high doses or is it still damaging at low doses?I guess that extra methyl group that adds steroids to amphetamine is what causes the damage.
Regular dexamphetamine i read doesnt, its just methamphetamine.
I was just wondering
Posted by utopizen on April 24, 2004, at 15:45:34
In reply to Re: got a question, posted by 1980Monroe on April 24, 2004, at 10:49:41
Well, that's impossible to prove. Any research is reliant upon animal testing. Do you think you're going to find a study of any methamphetamine, most of which are funded by the National Institute for Drug Abuse, to conclude that "methamphetamine does not pose any risk of neurotoxicity"?
Rule #1 for researchers: You only continue making money if your study is either inconclusive or suggests more validity is needed. Doing otherwise is like firing yourself.
Desoxyn (methamphetamine) has been out since 1944 by Abbott Labs. The FDA isn't going to approve neurotoxic doses to you.
The reason why methamphetamine is neurotoxic is simple:
1) people inject or snort it, which doesn't allow their bodies to have enough time to adjust to the changes that is causes in their brain.
2) You are killing brain cells as you write this. That's why you sleep. Brain cells regenerate themselves. Prolonged sleep deprivation-- several days-- is the norm with meth addicts, or monkeys who are dosed meth in a lab.
3) Meth causes your brain to increase in its cellular activity, which helps you to focus. Too much activity, or too high a dose, that is, and you are burning your nerves like rubber tires on the Indy 500. Sleep slows down brain activity for when you're awake, so this effect is negated by a healthy amount of sleep each day.
4) If you're taking an amphetamine, you're taking all of these potential risks.
Meth happens to have fewer peripherial side effects-- meaning your heart, proportional to an equivolent dose of an amphetamine, will be less affected, as well as all other parts of the peripherial nervous system.
Instead, meth is more potent where you want it targeted at: your Central Nervous System.
So it's more likely to be neurotoxic at the equivolently higher doses than amphetamine because it's more potently acting on the brain than regular amphetamine. So yeah, of course, a lower dose is needed for neurotoxicity to occur, but you're talking about doses I would vomit over if you mentioned them, we're talking triple digit doses here. And there's been a great deal of history, especially in the 60's, with Desoxyn back when it was commonly prescribed with a barbitutate in a combonation pill formulation.
Summary: all amphetamines are neurotoxic, but it's not neurotoxic at the doses you're taking therapeutically because you aren't going to kill more brain cells than you can regenerate through sleep in a given day's dose. And amphetamines are more likely to be cardiotoxic, so it's not exactly like they're some convervative alternative.
Basically, use whatever stimulant works best for you, and ignore the word "neurotoxic." It's not possible to even measure or determine neurotoxicity if you ever had it and saw a neurologist because brain scans aren't that good yet. And you have to remember, you're a huge step away from a meth addict, who barely ever eats food, doesn't sleep for days, and injects or snorts the stuff.
99.999% of any study you read referring to methamphetamine is assuming it's injected, or at least snorted, and that the animal used received it continiously without sleep for several days at a time. Gosh, if it wasn't neurotoxic under those conditions, it would be some antibiotic or something!
Posted by 1980Monroe on April 24, 2004, at 23:12:49
In reply to Re: got a question, posted by utopizen on April 24, 2004, at 15:45:34
Well, i got more that i asked for, you sound like you know alot, and i thought i knew alot.
Actually i was freaked to start desoxyn, even thought i can get prescribed it, i felt safer with good old dexamphetamine Dexedrine. Desoxyn feels the same as Dexedrine, except with enhanced actions. Even thought it was more effective, i was edgy about the many articles i read about permenant damage to the dopamine terminals in the nerve synapse from methamphetamine, never found any on amphetamine.
But i guess they both have their own pros and cons. But know im so edgy about it, but im still staying on dex, i dont want to go througt a long process with my doc about switcbing medications, you have to indirectly convince them that you need to go on something stonger for them to prescribe with comfort. Thanks for that good info, finally know someone who knows alot about amphetamines.
Posted by 1980Monroe on April 24, 2004, at 23:28:10
In reply to Re: got a question, posted by 1980Monroe on April 24, 2004, at 23:12:49
Posted by Sad Panda on April 25, 2004, at 0:24:38
In reply to Re: got a question, posted by 1980Monroe on April 24, 2004, at 23:12:49
> Well, i got more that i asked for, you sound like you know alot, and i thought i knew alot.
>
> Actually i was freaked to start desoxyn, even thought i can get prescribed it, i felt safer with good old dexamphetamine Dexedrine. Desoxyn feels the same as Dexedrine, except with enhanced actions. Even thought it was more effective, i was edgy about the many articles i read about permenant damage to the dopamine terminals in the nerve synapse from methamphetamine, never found any on amphetamine.
>
> But i guess they both have their own pros and cons. But know im so edgy about it, but im still staying on dex, i dont want to go througt a long process with my doc about switcbing medications, you have to indirectly convince them that you need to go on something stonger for them to prescribe with comfort. Thanks for that good info, finally know someone who knows alot about amphetamines.
>
>
>I wouldn't get too phobic about low dose Methamphetamine, it rates as mothers milk compared to antipsychotics.
Cheers,
Panda.
Posted by Sad Panda on April 25, 2004, at 0:27:46
In reply to Re: main signs, posted by utopizen on April 24, 2004, at 9:42:00
> thanks for that... although I knew everyone, as I read the Office of Drug Diversion's site, for some reason I'm interested in drug control policy.
>
> Just to clarify, my doc is the one pushing me to up my Desoxyn, and I'm the one asking to switch off of it to go on Straterra... I also have asked him to give me an antidepressant/antipsychotic so I don't have to keep taking the Klonopin he put me on.
>
> So none of the drugs I am requesting are even controlled, while my doc is the one pushing me to stay on controlled substances.
>
>Why don't you go to a different pdoc? You could always go back to him if you find out the alternatives don't work.
Cheers,
Panda.
Posted by 1980Monroe on April 25, 2004, at 1:19:29
In reply to Re: got a question, posted by 1980Monroe on April 24, 2004, at 23:12:49
I ment im not edgy about desoxyn anymore, this stupid crap keyboard, my fingers slip on it too much, i put i know am still edgy about desoxyn, my brain doesnt pair words sometimes, i think im dyslexic or something.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.