![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 37 to 61 of 61. Go back in thread:
Posted by SLS on August 24, 2004, at 13:29:03
In reply to Re: To Scott, posted by Denise1904 on August 24, 2004, at 10:54:48
Hi there Humpty Dumpty.
> That sounds great, taking a drug and it putting you back to normal again and then just being able to come off it and still be normal. That's what I want as I feel like Humpty Dumpty who just wants to be put back together again. I just hope there are no withdrawal effects from it. Will you be able to get hold of any from your Psychiatrist?
I have made some preliminary contacts that should help me find mifepristone on a compassionate use basis. Believe it or not, the FDA has placed mifepristone on its "fast track" program for investigation into its use in depression. I guess the data from the initial studies were pursuasive enough.
Your experience with Dothiepin represents a scenario that is far too common. I hope doctors will soon be able to determine who needs to stay on an antidepressant long-term so as not to foster a circumstance of treatment-resistance by multiple exposures to medication.
> How do you know that your HPA axis is off kilter, have you had one of those dexamone (not sure how to spell it) suppression testsYup. My DST (dexamethasone suppression test) came back abnormal. Other tests have shown my cortisol levels to be too high.
> and how long have you been taking the Cymbalta?
I am day 5 of Cymbalta. I have been taking only 30mg, which is considered to be lower than what the manufacturer recommends as a starting dose. My doctor is being cautious. I'll defer to his judgment on this. I actually experienced a mood/function lift for a few hours after my first dose. Right now, the only side effect that is emerging is sleepiness. It is significant, though, and would be a real obstacle were it to continue. I think it will pass, though. I'm trying to keep up with a log of my experience with Cymbalta as a thread below listed as "Cymbalta (duloxetine) - report". I'll try to keep the subject line the same, as it gets edited from time to time.
What has been you history with the MAOIs (monoamine oxidase inhibitors)?
Zyprexa really can be a life-saver. I'm glad it did the job for you. I take a small amount of Abilify. I recieved a robust antidepressant effect during the first week. I think it still helps prevent me from reaching the desperate suicidal states that I sometimes experience. The one caveat when using Abilify is that it often produces anxiety and restlessness in the beginning. It usually passes, but it is important to understand that it is a likely startup side effect.
- Scott
Posted by SLS on August 24, 2004, at 13:39:57
In reply to Re: Shouldn't there be a limit to this, tried rTMS » SLS, posted by iris2 on August 24, 2004, at 11:10:39
Dear Irene,
> Thanks for telling me about your exerience with Cymbalta. I am interested and would appreciate it if you could update me about it at some later time?
I'm trying to maintain a log of my experience with Cymbalta along a thread titled "Cymbalta (duloxetine) - report". The one thing that is important to report is the emergence of somnolence (profound sleepiness). I'm guessing that it is just a startup side effect that will eventually pass.
> I will be posting my experience with Milnacipran as I have read several posts inquiring about it.
I look forward with excitement to see how you do with it. Good luck!
> By the way I sent a post to Andrewb for the information on Amisulpride. Is he still around? The post seemed to go through. Sometimes they do not get returned right away though.
How did you post to him - email? I use to have a copy of the synopsis he composed regarding amisulpride, but it got lost when I transfered data to my new computer.
> I am doing well on it. I will not bore you with the details, as there is a lot of information on psycho-babble about it.
I don't get bored. Did you feel an improvement within the first few days? How is it treating you otherwise?
> I do have one question of course!!
>
> I am ordering the Milnacipran at 50mg I believe gel caps (so they cannot be cut) I did not order 25mg ones to begin with because of the expense. I can still do this. I plan on taking 50mg a day to start then 50mg b.i.d. What is your opinion?The dosage range for milnacipran (Ixel) is 50-200mg per day. It has a half-life of 8 hours. I think your plan makes sense.
> By the way I really appreciate all the help you have given to me.
I apologize that my posts are so short. I wish I had the mental energy to elaborate on things more. I hope you don't mind if I say a little prayer for you. I don't think it could hurt. :-)
Take care,
- Scott
Posted by iris2 on August 24, 2004, at 17:41:11
In reply to Re: Shouldn't there be a limit to this, tried rTMS » iris2, posted by SLS on August 24, 2004, at 13:39:57
> I apologize that my posts are so short.Your posts are great. I always come away with a smile, and that takes some doing!
> Did you feel an improvement within the first few days? How is it treating you otherwise?
I have had improvement on the amisulpride within the first couple of days I call it a mood shift. Not much motivation stuff. Definitely taking a lot less benzo's and less oxycontin after the first couple of days on it. So having less anxiety for sure.
> How did you post to him - email?
emailed AndrewB.I think about you often, that is my way of prayer.
Wishing this works for you.
irene
Posted by owensmar on August 24, 2004, at 20:17:23
In reply to Re: To Scott » Denise1904, posted by SLS on August 24, 2004, at 13:29:03
Scott,
What test should I ask my doc to do to determine cortisol levels? I feel intuitively that my levels are too high - way too high.
Also, imipramine was the drug that saved my life when I first began treatment with ADs in 1986. I didn't know I was depressed - just lazy and sorry and maybe crazy, you know. I was on it for a year, then they weaned me off it. I relapsed and they put me on desipramine, which I couldn't take. So they put me back on imipramine but the magic didn't happen so well the second time. Then when Prozac came out, my doc, too, wanted to play with the new toy and put me on that.
Do you think that a trial of imipramine now, after 18 intervening years of Prozac, Selexa, Lexapro and Effexor alternately would be of any use?
I've been trying to decide between this and trying Cymbalta. I really dread the washout period of getting off Effexor before being able to start the imipramine so that's a factor.
Sorry to bug you with so many questions. Pleae feel free, anyone out there, to comment.
ThanksMarsha
Posted by Denise1904 on August 25, 2004, at 11:53:30
In reply to Re: To Scott » Denise1904, posted by SLS on August 24, 2004, at 13:29:03
Scott,
That sounds very promising if they're trying to fast track it for trials for depression, I could only find one or two studies on it but they looked promising, it's nothing to do with the fact that they couldn't get it approved for what it was originally intended though is it?
This CRF axis theory on depression sounds really interesting and if I did have a test I'd absolutely love to get abnormal results back at least then I'd know I haven't been imagining these last three years. Do you have any symptoms ones that you can see, related to high Corisol levels. The studies I've been looking at talk about problems with GR Receptors and MR receptors as well but I'm not sure if they are supposed all lead to high levels of Cortisol. According to one study I read this Mefepristone was the only medication which seemed to affect both.
I've only been on Nardil, that was the last one I tried before I went on Seroxat and although it made me more relaxed I felt soooo strange on it. I was doing things without actually feeling like I was doing them. I know you feel like that with depression sometimes but I drove all the way to the seaside to see a friend and afterwards could hardly remember any of the journey it was almost as if I'd done it but not really been there. I had very little real motivation on it and spent ages in the supermarket zoned out trying to concentrate hard enough to pick something to eat. I didn't like Nardil at all. Whether the dose was high enough I really don't know but I only stayed on it for about a month and then gave up on it.
Denise
Posted by iris2 on August 25, 2004, at 14:10:26
In reply to Re: To Scott, posted by owensmar on August 24, 2004, at 20:17:23
I saw your post and thought I maybe could help. I too am interested in having my cortical levels tested. Here are a few links I found.
http://www.dr-bob.org/babble/20030530/msgs/231255.html
http://www.nlm.nih.gov/medlineplus/ency/article/003694.htm
http://www.dr-bob.org/babble/20030525/msgs/230049.htmlIn a book called "The Antidepressant Survival Program" it says one test is ASI (adrenal stress index) and another is a standard adrenal test.
I am not as knowledgeable as Scott but if the Effexor is not doing the job I would probably try something else that is not an SSRI. So Cymbalta would be one option. I have not heard of imipramine poop out but since it did not work the second time you took it anything is possible. Considering that it worked so well at first and the likelihood of poop out is not great it is also an option. My observation with others is that if Effexor is not working the tricyclic is less likely to work too. That is only an observation of others though.Another great link to learn about different options is: xxx
There is an abstract about Duloxetine being more effective for people that Effexor does not work so well. Also one about SSRI's being more effective than TCA's. I would think the later to be more subjective for an individual patient.
Good Luck.
You have peaked my interest in getting the cortical test done for myself again.Thanks,
irene
Posted by owensmar on August 25, 2004, at 15:40:03
In reply to Re: To Scott » owensmar, posted by iris2 on August 25, 2004, at 14:10:26
> I saw your post and thought I maybe could help. I too am interested in having my cortical levels tested. Here are a few links I found.
>
> http://www.dr-bob.org/babble/20030530/msgs/231255.html
>
> http://www.nlm.nih.gov/medlineplus/ency/article/003694.htm
>
>
> http://www.dr-bob.org/babble/20030525/msgs/230049.html
>
> In a book called "The Antidepressant Survival Program" it says one test is ASI (adrenal stress index) and another is a standard adrenal test.
>Thanks for the links. There was great information there. Some of it was way over my head but I'm printing it out to puzzle over.
>
> I am not as knowledgeable as Scott but if the Effexor is not doing the job I would probably try something else that is not an SSRI. So Cymbalta would be one option. I have not heard of imipramine poop out but since it did not work the second time you took it anything is possible. Considering that it worked so well at first and the likelihood of poop out is not great it is also an option. My observation with others is that if Effexor is not working the tricyclic is less likely to work too. That is only an observation of others though.I didn't get the Imipramine poop out until they took me off it and then put me back on it after relapse (with a couple others in b etween).
As far as Effexor not working. ITs hard to say how well it might work if I could take more than 37.5 mg per day. Above that the side effects are intolerable. At least I don't imagine different ways to kill myself while I'm on the Effexor. That's something, I guess. I hate the anhedonia and the total lack of energy, though.
Thanks for the info
Marsha
Posted by owensmar on August 25, 2004, at 17:32:15
In reply to Re: To Scott » owensmar, posted by iris2 on August 25, 2004, at 14:10:26
Irene,
I decided not to wait! I just went to this doc in my small town and asked to have my cortisol and adrenaline levels tested. I go in the morning to have blood drawn and get the instructions for the 24 hour urine sample collection. He also threw in a TSH test (thyroid stimulating hormone). THe cortisol test is just written as "cortisol level" and the adrenaline one is "urinary U.M.A. x 24 hr."
This doc has been great to me. When I went to him in the middle of an anxiety attack (brought on by Paxil), he brought me into his office, gave me a xanax to chew up and sat with me til I calmed down. What makes it so unusual is that this guy is a family practice doc with a storefront office. But he's Canadian and has this wonderful holistic approach to medicine.
Anyway, you inspired me to get off my ass and go see about this. Thanks.
Marsha
Posted by iris2 on August 25, 2004, at 18:00:03
In reply to Re: To Scott » iris2, posted by owensmar on August 25, 2004, at 15:40:03
Marsha,A lot of that stuff is over my head too. Especially the last couple of years as my cognitive skills declined with my continuing depression.
Not sure right now (memory!) if another word is used when a medication does not work again. I had a combination of not working as well and then having "holidays" and it finally not working at all. I also had an experience specifically with amineptine where it worked wonders the first time and I had to go off of it because of another disease. When I tried again (as you did) a few months later nothing, and tried again after a year or so and still nothing.
With certain drugs like the MAO's there is a chemical reason why this happens. Again both over my head and do not remember. I have not seen this about TCA's. I had a similar effect with Effexor as you. This is one of the reasons I considered taking either Milnacipran or Duloxetine. I think you should give those two some thought based on your experience with Effexor. I think your thinking is right on. By the way are you working with a pdoc.? Is he/she giving you good advice?
I do find that even among those that have a great understanding of the chemical changes meds make that there is generally not a great amount of being able to link that knowledge to prescribing decisions. I know a little bit and I hope you are aware of this, not a lot. This is just not an exact science.
I hope you’re in a better place soon. I am not functioning at all. Except I do not want to die all of the time anymore either.
irene
p.s.If I post back to you again I will laeve poor Scott's name out of the subject heading!!
Posted by SLS on August 25, 2004, at 20:47:48
In reply to Re: To Scott, posted by owensmar on August 24, 2004, at 20:17:23
Dear Marsha,
> Do you think that a trial of imipramine now, after 18 intervening years of Prozac, Selexa, Lexapro and Effexor alternately would be of any use?
It is possible, but I wouldn't bet on it. I think I would go with the Cymbalta now. Like imipramine, it works on both norepinephrine and serotonin. My guess is that if you were to begin the Cymbalta as you are coming off the Effexor, your withdrawal effects should be reduced significantly. In other words, you would be weaning off the Effexor and titrating up on the Cymbalta at the same time.
Did you respond positively to Effexor in any way?
- Scott
Posted by SLS on August 25, 2004, at 20:57:21
In reply to Re: To Scott, posted by Denise1904 on August 25, 2004, at 11:53:30
Hi.
Regarding mifepristone:
> That sounds very promising if they're trying to fast track it for trials for depression, I could only find one or two studies on it but they looked promising, it's nothing to do with the fact that they couldn't get it approved for what it was originally intended though is it?
I believe it is already available as an abortifacient in the US under the name Mifeprex.
http://www.fda.gov/bbs/topics/NEWS/NEW00737.html
> I've only been on Nardil, that was the last one I tried before I went on Seroxat and although it made me more relaxed I felt soooo strange on it. I was doing things without actually feeling like I was doing them. I know you feel like that with depression sometimes but I drove all the way to the seaside to see a friend and afterwards could hardly remember any of the journey it was almost as if I'd done it but not really been there. I had very little real motivation on it and spent ages in the supermarket zoned out trying to concentrate hard enough to pick something to eat. I didn't like Nardil at all. Whether the dose was high enough I really don't know but I only stayed on it for about a month and then gave up on it.
If anything, it sounds like you were started at too high a dosage. What you describe sounds reminescent of what I have experienced when increasing the dosage too fast. Of course, Nardil might not be right for you at all. I would not generalize your experience with Nardil to all MAOIs, though. Parnate might treat you very well.
- Scott
Posted by owensmar on August 25, 2004, at 23:03:46
In reply to Re: To Scott » owensmar, posted by iris2 on August 25, 2004, at 18:00:03
Irene,
In reply to your post:
> I also had an experience specifically with >amineptine where it worked wonders the first >time and I had to go off of it because of >another disease. When I tried again (as you did) >a few months later nothing, and tried again >after a >year or so and still nothing.
Amineptine is one of the ADs I've been toying with the idea of trying. Also tianeptine. I believe the brand names are Survector and Stablon, respectively. I've read a little about milnaciprin as well which would be great since I've recently been told I probably have fibromyalgia.
I am working with a P-doc though I am switching to a new one - first appointment is Sept. 2. (I'm switching because while the first guy is very nice he seems to spend most of my appointment time flipping through his PDR to see if my side effects are valid, i.e. listed in his book. He also has ADHD and can never remember from one appointment to the next what my situation is. No offense to him -I actually like him a lot but I need to feel my doc is able to give me his sustained concentrated attention while I'm there.
Anyway, I'm sure he'd be glad to write me a script for either the amineptine or tianeptine or whichever if I asked so I could order online legitimately. Problem is, who do you trust (re online vendors, I mean)? How did you determine a reputable source? Or do you live somewhere it's not an issue?
ANd of course there's alway duloxetine. I'd planned to ask the new P-doc to start me on that. I know, though, that dopamine is a big issue for me in that I'm missing there big time. My brain's reward system has been on strike for years now.
>
> I do find that even among those that have a >great understanding of the chemical changes meds >make that there is generally not a great amount >of being able to link that knowledge to >prescribing decisions. I know a little bit and >I hope you are aware of this, not a lot. This >is just not an exact science.Yeah, I posted somewhere else that I felt like a science experiment that just wouldn't come out right. It gets very discouraging.
>
>I hope you’re in a better place soon. I am not >functioning at all. Except I do not want to die >all of the time anymore either.
>I understand exactly. I function but it takes so much effort every day just to go through the motions of living.
Sending motivation and zest for life through the airwaves to you (at least I would if I had any).
Marsha
Posted by owensmar on August 25, 2004, at 23:16:22
In reply to Re: To Scott, posted by SLS on August 25, 2004, at 20:47:48
Scott,
Thanks for the input. Effexor brings me from severe clinical depression (horror, despair, suicidal ideation, chronic weeping and crippling anxiety) up to being able to function most days. I remain apathetic, lethargic, anhedonic - make that severely anhedonic- and emotionally blunted.
Side effects = no libido, mild anorgasmia, dry mouth, inability to cry (even when I desperately need to)and the one I hate most - tinnitus. What scares me about the tinnitus is that the last time I d/c'd the Effexor, the tinnitus didn't completely go away like it had in the past. I'm afraid I'm doing irreversible damage by continuing to take it but the side effects from the others I've tried have been intolerable instead of just unpleasant.
So I always end up going back to Effexor. Lesser of the evils, you know? I have high hopes for Cymbalta when I see my new p-doc next Thursday.
Here's hoping that by then, your Cymbalta will have kicked in and you'll be out organizing a community softball league or something.
Marsha
Posted by iris2 on August 26, 2004, at 10:49:16
In reply to Re: amineptine vs. effexor » iris2, posted by owensmar on August 25, 2004, at 23:03:46
Marsha,Replying to your post to me:
You likewise have inspired me. I started reading that book yesterday to figure out all the tests I think I should get. The tests you got were two of them. I need to find a doc or pdoc who will do them. My father (who is a personal friend of my doctor) gave him this book and he read it and told me he would only do any test if I provided extensive research for him to back up the need for depression.
Sounds like you found a great doctor. Where do you live?
I would love to find a doctor who was holistic. I see a homeopath and saw a nutritionist before. I actually started interacting with a homeopath on the internet now because of the expense and used a supplement regimen that was the "Townsend" newsletter for naturolpath or holistic healing. My brother is in scool for naturopathic medicine so he has advised me.
I have tried Amineptine and Tianeptine. The Tianeptine if I recall correctly only got me nervous if that. I do not remember any side effects and it did not help my mood. If you have further interest:)in these I can be found at lacys34c yahoo.com with an @ after c. I saw someone else do it this way. I am not going to look up the rules and figure out if it is needed.
I think I have a dopamine problem and I know my pdoc does. By the way a question for you. Since I could not decide between the Duloxetine and Milnacipran what do you think I should try next?
I have not ordered the Milnacipran yet. I am taking Oxycontin, Ritalin, Valium, and Klonipin.
Kind of strange for depression but I have been unable to take much else because of interstitial cystitis. Started the Oxycontin for the I.C. but generally do not need it anymore for pain. My pdoc suggested I stay on it since he could not find anything I could tolerate for depression and it helps a little.I started Amisulpride about a week ago and it is definitely shifting my mood to a better place. It has had a little effect on the I.C. but not enough that I would stop taking it yet. That is why I stopped the Amineptine the first time which is very expensive if available at all anymore. I will check:) if you have an interest.
I mentioned a few I tried. I tried most of the SSRI's and they had no effect at all. Also a couple TCA's but probably not long enough yet the side effects were no so great. The Maoi's helped me a lot for many years but pooped out. And of course the Amineptine, Tianeptine, Provigal and a few I cannot remember right now.
This is to help answer my question. I am not assuming you have some profound interest in all the meds I have tried.You are in a place right now I would be glad to be. Of course once I got there, or let me be optimistic, once I get there I will be looking to get to a better place as you are. I know it is hard but you are functioning. Perhaps you can think of it as a great jumping off place. I have to get through the complete inertia of the last two years to have any movement at all. I think I am at that point. It is difficult to tell but I was so upset yesterday about my house being so cluttered and dirty. Even having the energy to be upset is not the norm and the fact that I actually was motivated to do a little was highly unusual. Always I am immobilized by the seemingly immense and overwhelming task at hand. It does not feel good at all and I have experienced this start up before but if this med sticks for a while perhaps it will be more than a start, slow and torturous but continuing.
Aren't I delightful!
I'll try to capture some zest but it will probably turn into the sour lemon kind when it sees me.
Sending happy thoughts and the energy of the universe.
Thanks for being friendly,
irene
p.s. How do you send a post with parts of mine inserted? Is it just cut and paste?
Posted by iris2 on August 26, 2004, at 10:52:38
In reply to Re: To Scott » Denise1904, posted by SLS on August 25, 2004, at 20:57:21
Read several of these posts about mifepristone.
I am always interested in something new and promising. I wonder what you think of the negative side effect profiles I found when I looked googled it?
irene
Posted by SLS on August 26, 2004, at 11:15:38
In reply to Re: To Scott » SLS, posted by iris2 on August 26, 2004, at 10:52:38
> Read several of these posts about mifepristone.
>
> I am always interested in something new and promising. I wonder what you think of the negative side effect profiles I found when I looked googled it?
>
> irene
What sorts of side effects did you find? Maybe you can post the links?Thanks.
- Scott
Posted by Dr. Bob on August 27, 2004, at 8:34:37
In reply to Re: To Scott » owensmar, posted by iris2 on August 25, 2004, at 14:10:26
> Another great link to learn about different options is: xxx
Please don't use this site to exchange information that could be used to import into the US prescription medication without a prescription:
http://www.dr-bob.org/babble/faq.html#illegal
This has come up before, so now I'm going to block you from posting for a week.
Bob
Posted by Dr. Bob on August 27, 2004, at 8:35:24
In reply to Re: To Scott » iris2, posted by owensmar on August 25, 2004, at 17:32:15
> Anyway, you inspired me to get off my [*]ss and go see about this. Thanks.
I'm glad you're looking into that, and sorry to be such a prude, but please don't use language that could offend others.
If you or anyone else has questions about this or about posting policies in general, or is interested in alternative ways of expressing themselves, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration.
Thanks,
Bob
Posted by owensmar on August 27, 2004, at 16:26:37
In reply to Re: amineptine vs. effexor » owensmar, posted by iris2 on August 26, 2004, at 10:49:16
Hi.
I don't remember what book you were reading. Ihaven't been able to summon the energy for the past couple of days to get back to the doctor to have the bloodwork done.
> I have tried Amineptine and Tianeptine. The Tianeptine if I recall correctly only got me nervous if that. I do not remember any side effects and it did not help my mood. If you have further interest:)in these I can be found at lacys34c yahoo.com with an @ after c. I saw someone else do it this way. I am not going to look up the rules and figure out if it is needed.
I'm definitely trying Cymbalta. My appointment with my p-doc is Thursday. This is a new doctor, though, so I'm not sure what to expect.
>
> I think I have a dopamine problem and I know my pdoc does. By the way a question for you. Since I could not decide between the Duloxetine and Milnacipran what do you think I should try next?
> I have not ordered the Milnacipran yet. I am taking Oxycontin, Ritalin, Valium, and Klonipin.I don't know what milnacipran is. Okay, well, I just looked it up on the internet. I didn't know there was another serotonin/norepinephrine drug out there (besides Effexor and before Cymbalta). I thought that's what all the fuss was about Cymbalta.
> I started Amisulpride about a week ago and it is definitely shifting my mood to a better place. It has had a little effect on the I.C. but not enough that I would stop taking it yet.I wonder why my regular doctor prescribed Zyprexa for me, knowing I was a recovering bulimic, when there are other similar drugs out there that don't cause increased hunger.
> I mentioned a few I tried. I tried most of the SSRI's and they had no effect at all. Also a couple TCA's but probably not long enough yet the side effects were no so great. The Maoi's helped me a lot for many years but pooped out. And of course the Amineptine, Tianeptine, Provigal and a few I cannot remember right now.
I just cannot tolerate the side effects from the SSRIs. And Provigil made me wired and jittery in a very unpleasant way.
>
> You are in a place right now I would be glad to be. Of course once I got there, or let me be optimistic, once I get there I will be looking to get to a better place as you are. I know it is hard but you are functioning.Yeah, I read some of the posts here and I guess I'm really pretty lucky. I mean, I'm only on one med and am managing to more or less hold it together most days.
> p.s. How do you send a post with parts of mine inserted? Is it just cut and paste?
There's an option when you go to post "include this post" If you check that box, the post you are replying to comes up in the answer box and you can insert your answers in between parts of the old message.Marsha
Posted by owensmar on August 28, 2004, at 16:11:52
In reply to Re: blocked for week » iris2, posted by Dr. Bob on August 27, 2004, at 8:34:37
> > Another great link to learn about different options is: xxx
>
> Please don't use this site to exchange information that could be used to import into the US prescription medication without a prescription:
>
> http://www.dr-bob.org/babble/faq.html#illegal
>
> This has come up before, so now I'm going to block you from posting for a week.
>
> Bob
Dear Dr. Bob,I'm not sure this is fair to Irene. I'm the one who asked for info so maybe I'm the one who ought to be punished. But please note: I specifically just asked how to determine which online retailers were reputable and I specifically said I intended to get a prescription from my doctor:
"Anyway, I'm sure he'd be glad to write me a script for either the amineptine or tianeptine or whichever if I asked so I could order online legitimately. Problem is, who do you trust (re online vendors, I mean)? How did you determine a reputable source? Or do you live somewhere it's not an issue?"
Anyway, I'm sorry if I caused a problem for anyone.
Marsha
Posted by iris2 on September 3, 2004, at 23:15:38
> > > Another great link to learn about different options is: xxx
> >
> > Please don't use this site to exchange information that could be used to import into the US prescription medication without a prescription:
> >
> > http://www.dr-bob.org/babble/faq.html#illegal
> >
> > This has come up before, so now I'm going to block you from posting for a week.
> >
> > Bob
>
>
> Dear Dr. Bob,
>
> I'm not sure this is fair to Irene. I'm the one who asked for info so maybe I'm the one who ought to be punished. But please note: I specifically just asked how to determine which online retailers were reputable and I specifically said I intended to get a prescription from my doctor:
> Anyway, I'm sorry if I caused a problem for anyone.
>
> Marsha
>
>Marsha,
You caused no problem for sure. So sorry about this happening. I emailed Dr Bob because I was clueless what site I had used that would be "illegal". I was both aware of the questions you posed being quite acceptable to the site:
” Problem is, who do you trust (re online vendors, I mean)? How did you determine a reputable source? Or do you live somewhere it's not an issue?", and the policy below:“ Please don't use this site to exchange information that could be used to import into the US:
· prescription medication without a prescription or
· medication that hasn't been approved by the US Food and Drug Administration.Both activities appear to be illegal. It's fine to discuss here the pros and cons of the medications, just not how to obtain them in those ways. In fact, this site should not be used to facilitate any illegal activities.”
Dr Bob kindly pointed out that the site I posted was not itself “illegal” but had links on it that were. Just so everyone is aware, neither of us actually posted anything wrong. I feel the need to explain myself as I took it hard because of being so oversensitive.I am now afraid to post any links at all for fear there might be an overlooked “illegal” link on it.
It would be exhaustive for me to read every link on a site to be 100% sure it was okay. Perhaps I should just avoid trying to provide possible helpful information in that way?
If anyone has any suggestions I would appreciate them.
I think what happened is fine. Even if it was a misunderstanding I think it is important to have civil rules for the site.
Sorry again.irene
Posted by 4WD on September 4, 2004, at 21:47:03
In reply to To owensmar others, posted by iris2 on September 3, 2004, at 9:19:50
Hi Irene,
I'm glad you're back.
Marsha
Posted by iris2 on September 5, 2004, at 14:16:48
In reply to Re: To owensmar others » iris2, posted by 4WD on September 4, 2004, at 21:47:03
Marsha,
Thanks.I red several posts from you and to you and found my own questions answered thanks again. I also found we have a lot in commen. I take oxycontin ( a small amount) to be able to gain some pleasure/motivation to do every day tasks.
We seem to be looking at the same medications for similar reasons. I saw Mirapex was one suggested, I have thought of trying that.
"Anhedonia is such a severe problelm for me. I feel that my life is wasting away while I sit on the couch, unable to find pleasure or reward in anything at all"
"If I could experience pleasure normal, everyday life, well then, I'd actually have a life-instead of an existence"
I agree with all the above.
I thought I read you mention being bulimic, I am.
Did you get the answers you were looking for pertaining to Amisulpride?
Amisulpride, a selective antagonist for D2 and D3 dopamine receptors, acts preferentially on presynaptic receptors increasing dopaminergic transmission at low doses.
At low doses (100mg/day), amisulpride enhances
dopamine transmission by selectively binding to
presynaptic autoreceptors, contributing to its efficacy
in primarily negative symptoms.Christine wrote: "...Amisulpride which is also an antagonist of Dopamines D2/D3 receptors. But at the dose I am taking (very low) it has more affinity to presynaptic receptors (called autoreceptors). If these are blocked then the release of Dopamine gets ENHANCED.
I take it for depression and it helps some.
What medication have you decided to try?
You were thinking of Cymbalta last I read.
I had inquired if you thought I should first try Milnacipran or Cymbalta? What do you think?
irene
Posted by 4WD on September 5, 2004, at 14:43:32
In reply to Re: To owensmar others, posted by iris2 on September 5, 2004, at 14:16:48
Hi,
I decided to go with the Cymbalta and see what happens. I figure it's a lot easier to try one med and hope that works. If it doesn't, then i guess I'll start monkeying around with augmentation, maybe Mirapex.
I rarely take the pain medicine because I'm so afraid of developing some kind of dependency. It's just that when I do take it, I feel so much better. Not just because the pain is gone, but mentally. I guess that's the "euphoria" you hear about. What I wouldn't give, though, to be able to feel that good all the time. Half that good!
Yes, I'm bulimic, since age 17. I'm 48 now and in remission. I had been working on it real hard for the last few years and was ina akind of partial remission fo the last couple of years (much, much reduced frequency). Now I haven't binged/purged at all in about five weeks. I found that certain SSRI's completely stopped the urge to binge - especially Paxil and to some degree Celexa but they made me anxious, especially Paxil. It was heartening to realize there was a chemical reason for this disease as well as an emotional one. It relieved me of a lot of guilt and I think that contributed to my getting better. Five years of therapy didn't hurt either.
What's your history?
I started a thread on my results with Cymbalta. "Cymbalta Journal"
Marsha
Posted by iris2 on September 5, 2004, at 15:19:27
In reply to Re: To owensmar others » iris2, posted by 4WD on September 5, 2004, at 14:43:32
> Hi,
>
> I decided to go with the Cymbalta and see what happens. I figure it's a lot easier to try one med and hope that works. If it doesn't, then i guess I'll start monkeying around with augmentation, maybe Mirapex.I am augmenting with amisulpride Milnacipran or was going to with Cymbalta.
>
> I rarely take the pain medicine because I'm so afraid of developing some kind of dependency. It's just that when I do take it, I feel so much better. Not just because the pain is gone, but mentally. I guess that's the "euphoria" you hear about. What I wouldn't give, though, to be able to feel that good all the time. Half that good!
>
I guess I could not say I feel eurphoric else I would be worried about taking it too. There is a lot of hype about it that just is not true. It is not very addictive contrary to popular belief. I have read a lot and talked with my pdoc about it since other docs and family gave me so much grief about taking it. It helps me emotionally, if I do not take it I find I am more severely depressed. Of course when I am in great pain I take it regularly and more.
> Yes, I'm bulimic, since age 17. I'm 48 now and in remission. I had been working on it real hard for the last few years and was ina akind of partial remission fo the last couple of years (much, much reduced frequency). Now I haven't binged/purged at all in about five weeks. I found that certain SSRI's completely stopped the urge to binge - especially Paxil and to some degree Celexa but they made me anxious, especially Paxil. It was heartening to realize there was a chemical reason for this disease as well as an emotional one. It relieved me of a lot of guilt and I think that contributed to my getting better. Five years of therapy didn't hurt either.I was diagnosed with anorexia at age 15. I weighed 56 lbs before I started eating. Within a year I was acutely bulimic. A lot of therapy helped some. The Maoi's made my depression almost nonexistent and during those several years I had no bulimia. I always knew when the medication was pooping out as even though I would not be depressed I always started the bulimia first. As I get older it is not a constant no matter how I am feeling. I go months with no bulimia and even at its worst now it is not so frequent. At earlier times it was several times a day. Now when it is bad it might be several times a week and even then it does not last but for a few weeks. I am 45 now.
My last therapist and I agree that the bulimia at this point is a learned response to strees and depression. It is not seperate and apart from thte depression.
I would not concern myself with the pain meds. If they help take them. If you want to I will look up the stuff I read and post it for you?
>
> > I started a thread on my results with Cymbalta. "Cymbalta Journal"I'll check the thread.
irene
This is the end of the thread.
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