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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by BorgMan on September 16, 2004, at 10:06:40
Hi, I'm new.
I've been pouring over these posts for at least an hour and it is so neat to see such a caring group of people that post here. I’ve done Internet Newsgroups on and off for years. They usually become very vile and uncaring. But not so here, keep up the good work!!!
At any rate, my diagnosis is Depression and Anxiety. There are many different types of Depression and Anxiety disorders. I don’t fall neatly into any one of them. Ah yes... There is the 'Treatment Resistant Depression' classification… I’ll go with that!
I have tried many different drugs over the last 12 years:
MAOIs (My PDoc combined Nardil with Luvox and I spent a couple of weeks in the hospital with Serotonin Syndrome!)
TCAs
SSRIs
ECT!!!
Antipsychotics
Mood Stabilizers
AugmentersI’ve been on Cymbalta for a couple of days. “Please, God… Please, let it be different from all the rest. I’m not looking for a cure just some relief!”.
Any support you guys would give me would be greatly appreciated. I feel so isolated. It would be great to converse with others that understand.
Oh... just to complicate things, I also take:
80mgs Prozac
800mgs Seroquel
1200mgs Neurontin
8mgs Lorazepam
LIKE MANY OF YOU, I'M A WALKING PHARMACY!(Poly)psychopharmacology (<-- is that the right word?) that is, [mixing meds] was taboo ten years ago. Now, anything goes with psychotropics!
Hoping to make some friends,
BorgMan
Posted by cache-monkey on September 16, 2004, at 13:58:28
In reply to Cymbalta Newbie and Psycho-Babble Newbie, posted by BorgMan on September 16, 2004, at 10:06:40
>
> At any rate, my diagnosis is Depression and Anxiety. There are many different types of Depression and Anxiety disorders. I don’t fall neatly into any one of them. Ah yes... There is the 'Treatment Resistant Depression' classification… I’ll go with that!
>
> I have tried many different drugs over the last 12 years:
> MAOIs (My PDoc combined Nardil with Luvox and I spent a couple of weeks in the hospital with Serotonin Syndrome!)
> TCAs
> SSRIs
> ECT!!!
> Antipsychotics
> Mood Stabilizers
> Augmenters
>
> I’ve been on Cymbalta for a couple of days. “Please, God… Please, let it be different from all the rest. I’m not looking for a cure just some relief!”.
>
> Any support you guys would give me would be greatly appreciated. I feel so isolated. It would be great to converse with others that understand.
>
> Oh... just to complicate things, I also take:
> 80mgs Prozac
> 800mgs Seroquel
> 1200mgs Neurontin
> 8mgs Lorazepam
> LIKE MANY OF YOU, I'M A WALKING PHARMACY!
>
> (Poly)psychopharmacology (<-- is that the right word?) that is, [mixing meds] was taboo ten years ago. Now, anything goes with psychotropics!My heart goes out to you BorgMan. Trying to even find the path to wellness can be so frustrating (let alone climbing up it). Good luck with the Cymbalta, I hope it works for you!
One thing, though, I think that Cymbalta should be used with caution when mixed with Prozac. Both work on 5-HT reuptake, and so serotonin syndrome is possible here. Is this the same psychiatrist who mixed the Nardil and Luvox? If so, I'd consider getting a second opinion. Of course, it may very well be that there's a solid rationale behind this, but I just thought I'd put that out there.
Also, just so you know, there's an additional board (Psycho-Social-Babble) which is a good place to chat about what you've been going through and get more social-type support.
Best,
cache-monkey
Posted by mattw84 on September 16, 2004, at 14:44:45
In reply to Cymbalta Newbie and Psycho-Babble Newbie, posted by BorgMan on September 16, 2004, at 10:06:40
Welcome! I too am green to this board, but I also have noticed that the group is very much so supportive; unlike many of the others....
I am shocked that any doctor would prescribe two MAOI's simultaneously! :^O Regardless, my understanding is that MAOI's are typically the last resort, but most often the most effective of the arsenal! If you have had serotonin syndrome I suspect, that your serotonin levels are (Or have been) more than 'adequate' as far as is concerned for depressive symptoms. Cymbalta is likely a great change of pace, in addition it will hit another neurotransmitter, norepinephrine, which is quickly changing the way causes of depression are viewed. Have you tried Effexor yet? Cymbalta is very similar to Efxr as far as pharmacology is concerned, except it acts on norepinephrine at it's standard dose. As the last poster mentioned you may be putting yourself at a slight risk of Serotonin Syndrome again. Since you are already taking prozac, you might consider asking for a strictly SNRI such as Edronax or Strattera. Or Wellbutrin might also proove beneficial. Best of luck and welcome!
Matt
Posted by iris2 on September 16, 2004, at 16:37:13
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie, posted by mattw84 on September 16, 2004, at 14:44:45
I guess even though I started posting here about a year ago I think. Most of my posts have been recent. I think I will always feel like a Newbie.
Anyway I wanted to inquire what "Serotonin Syndrome" was? Having taken Parnate augmented with a whole lot of other stuff for many years I have seen this before and wondered. I wonder if it has anything to do as to why the MAOI's do not work for me anymore?
Irene
Posted by BorgMan on September 16, 2004, at 17:24:20
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie, posted by cache-monkey on September 16, 2004, at 13:58:28
cache-monkey,
I appreciate your friendly welcome to this board.
Mixing Prozac, a SSRI, with Cymbalta, a SNRI can make both more potent. This is beneficial for folks, like me, who need a lot of Serotonin and Norepinephrine to not be extremely depressed. Does that make sense? I can feel when Serotonin Syndrom is coming on and I don't feel that with this combination, yet.
BorgMan
> > At any rate, my diagnosis is Depression and Anxiety. There are many different types of Depression and Anxiety disorders. I don’t fall neatly into any one of them. Ah yes... There is the 'Treatment Resistant Depression' classification… I’ll go with that!
> >
> > I have tried many different drugs over the last 12 years:
> > MAOIs (My PDoc combined Nardil with Luvox and I spent a couple of weeks in the hospital with Serotonin Syndrome!)
> > TCAs
> > SSRIs
> > ECT!!!
> > Antipsychotics
> > Mood Stabilizers
> > Augmenters
> >
> > I’ve been on Cymbalta for a couple of days. “Please, God… Please, let it be different from all the rest. I’m not looking for a cure just some relief!”.
> >
> > Any support you guys would give me would be greatly appreciated. I feel so isolated. It would be great to converse with others that understand.
> >
> > Oh... just to complicate things, I also take:
> > 80mgs Prozac
> > 800mgs Seroquel
> > 1200mgs Neurontin
> > 8mgs Lorazepam
> > LIKE MANY OF YOU, I'M A WALKING PHARMACY!
> >
> > (Poly)psychopharmacology (<-- is that the right word?) that is, [mixing meds] was taboo ten years ago. Now, anything goes with psychotropics!
>
> My heart goes out to you BorgMan. Trying to even find the path to wellness can be so frustrating (let alone climbing up it). Good luck with the Cymbalta, I hope it works for you!
>
> One thing, though, I think that Cymbalta should be used with caution when mixed with Prozac. Both work on 5-HT reuptake, and so serotonin syndrome is possible here. Is this the same psychiatrist who mixed the Nardil and Luvox? If so, I'd consider getting a second opinion. Of course, it may very well be that there's a solid rationale behind this, but I just thought I'd put that out there.
>
> Also, just so you know, there's an additional board (Psycho-Social-Babble) which is a good place to chat about what you've been going through and get more social-type support.
>
> Best,
> cache-monkey
>
Posted by RWF on September 16, 2004, at 17:52:41
In reply to Cymbalta Newbie and Psycho-Babble Newbie, posted by BorgMan on September 16, 2004, at 10:06:40
> Hi, I'm new.
>
> I've been pouring over these posts for at least an hour and it is so neat to see such a caring group of people that post here. I’ve done Internet Newsgroups on and off for years. They usually become very vile and uncaring. But not so here, keep up the good work!!!
>
> At any rate, my diagnosis is Depression and Anxiety. There are many different types of Depression and Anxiety disorders. I don’t fall neatly into any one of them. Ah yes... There is the 'Treatment Resistant Depression' classification… I’ll go with that!
>
> I have tried many different drugs over the last 12 years:
> MAOIs (My PDoc combined Nardil with Luvox and I spent a couple of weeks in the hospital with Serotonin Syndrome!)
> TCAs
> SSRIs
> ECT!!!
> Antipsychotics
> Mood Stabilizers
> Augmenters
>
> I’ve been on Cymbalta for a couple of days. “Please, God… Please, let it be different from all the rest. I’m not looking for a cure just some relief!”.
>
> Any support you guys would give me would be greatly appreciated. I feel so isolated. It would be great to converse with others that understand.
>
> Oh... just to complicate things, I also take:
> 80mgs Prozac
> 800mgs Seroquel
> 1200mgs Neurontin
> 8mgs Lorazepam
> LIKE MANY OF YOU, I'M A WALKING PHARMACY!
>
> (Poly)psychopharmacology (<-- is that the right word?) that is, [mixing meds] was taboo ten years ago. Now, anything goes with psychotropics!
>
> Hoping to make some friends,
> BorgMan
>BorgMan,
What was ECT like? I have always wanted to try this as opposed to the new AD's.
Were there alot of side effects involved?
Thanks.
Posted by mattw84 on September 16, 2004, at 21:40:16
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » mattw84, posted by iris2 on September 16, 2004, at 16:37:13
Serotonin syndrome essenstially means there is a serious excess of serotonin in one's brain. SSRI's allow the brain to sort of "soak" in serotonin, rather than allowing them to be 'reuptaken' and hence lost. The sydrome is the counterproductive to the goal, and often leads to depersonalization, euphoria, hypomanic type behavior, and a number of physical symptoms(fevers, twitches...). It can actually be fatal in some cases. If you have it, you would know it! It does not account for refractory depression however... sorry Irene.
However in your case it may just be that your ssri has lost it's efficacy, or your body has begun to make enough enzymes to render it's steady plasma state for you ineffective. It which case you can possibly increase your dose, or switch to a different one. IMHO people are far too reliant on the meds and fail to ever actually address the emotional causes of their depression. Most people who successfully escape depression seem to have found god, had an emotional epiphany, have success in therapy, or just eventually snap out of it. Not to say the antidepressants are not effective, just generally are not a very good permanent solution. I.E. You could live the rest of your life semi-happy with any varying number of side-effects from your medications, or directly address the cause (EMOTIONS!!) and hopefully not need the meds anymore!
I mean no offense to anyone here, I am just as dependent on my daily med cocktail as anyone else, just feels good sometimes to 'preach' what I can't make myself practice... Best of luck.
Matt
Posted by iris2 on September 16, 2004, at 22:26:19
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » iris2, posted by mattw84 on September 16, 2004, at 21:40:16
Matt,
Thanks forthe information. I just had no idea what theterm meant.
As for not relying on medication to feel better I only partly agree. For people who have a slight depression often started by some occurence in thier life I agree and think that meds are simply an easy way not to work on the real issues that got them in the place they are in life. Then there are those of us who have chronic severe depression. Who perhaps have gone through years of therapy, in my case with no meds most of the time to absolutely no avail. In an abundance of these cases especially if the illness has been long term medication is almost never the entire answer in MHO. I think meds are just the initial step. They give you a stepping stone to be able to work on those issues. The ones you see who are curred miraculously by God or AA or something outside themselves and not meds I think are in this first catagory. In the second I think medication when it works only gets most of us to this starting point. The rest is a lot of hard work or as you so rightly put it we can not do the work and be saticfied to just not be so depresseed anymore. I myself want to be able to try. Even this small amount of Amisulpride is doing a little and has motivated me to do everything I can to be more social and exorsize so that I will feel even better and if I do then maybe I can go to a next step.But medication alone will not be the end all. Perhaps I will one day again feel well enough to work.
So do not be so hard on yourself. You are probably in need of the meds you are taking. I think believing that a severe depression will go away with God is just rediculous to put it nicely.irene
Posted by sunshine211 on September 18, 2004, at 6:56:00
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » mattw84, posted by iris2 on September 16, 2004, at 22:26:19
I agree. The meds are a stepping stone and even for those that need to take them for extended periods of time, have to work on the REAL issues. therapy is good, but finding the right person is the hardest. I think being reflective about your progress is important. you definitely have to be active.
Posted by BorgMan on September 18, 2004, at 16:14:55
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie, posted by mattw84 on September 16, 2004, at 14:44:45
Hi Matt!
Sorry, I didn’t get back to you right away. I just didn’t have the chance to type until now.
I'm on day 5 of Cymbalta (40mgs) and I'm starting to get hit with some nasty side effects: severe sedation (< -- which I welcome for my agitation), nausea, muscle ache, diarrhea, and irritability. But they are manageable.
> I am shocked that any doctor would prescribe two MAOI's simultaneously!It was just an MAOI and an SSRI. (Nardil and Luvox)
> If you have had serotonin syndrome I suspect, that your serotonin levels are (Or have been) more than 'adequate' as far as is concerned for depressive symptoms.Yes, you would think I would have enough Serotonin going. Perhaps, I just need some Norepinephrine. (Which perfect for Cymbalta)
> Have you tried Effexor yet?Yes, it violently agitated me.
> As the last poster mentioned you may be putting yourself at a slight risk of Serotonin Syndrome again. Since you are already taking Prozac.I’m not worried. I can feel when it’s coming on. Besides, I need a lot of Serotonin to not be depressed.
> Or Wellbutrin might also prove beneficialWellbutrin also violently agitates me.
> Best of luck and welcome!
> MattThanks Matt. I do feel welcome.
Sincerely,
BorgMan
Posted by BorgMan on September 18, 2004, at 16:24:25
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » mattw84, posted by iris2 on September 16, 2004, at 16:37:13
Hi Irene,
> Anyway I wanted to inquire what "Serotonin Syndrome" was?
Serotonin syndrome is a condition caused by an excess of serotonin in the brain. The symptoms of serotonin syndrome are, in order of progressive severity, headaches and dizziness, vomiting, unconsciousness, coma and death. Serotonin syndrome is generally caused by interactions between serotonergic drugs, for example by concurrent use of MAOIs and SSRIs.
I was in the hospital for two weeks with Serotonin Syndrome. But I don’t remember the first week at all. Apparently, I was walking and talking but delusional.
> Having taken Parnate augmented with a whole lot of other stuff for many years I have seen this before and wondered. I wonder if it has anything to do as to why the MAOI's do not work for me anymore?I don’t know why Parnate doesn’t work for you anymore. That’s a very hard question to answer. My motto for psychotropics is:
“Every Drug Is Different and Every Person Is Different!” In other words, a med that works for one person does not mean that it will for another.
Sincerely,
BorgMan
Posted by BorgMan on September 18, 2004, at 16:29:35
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » BorgMan, posted by RWF on September 16, 2004, at 17:52:41
> What was ECT like? I have always wanted to try this as opposed to the new AD's.
>
> Were there alot of side effects involved?
>ECT did not work for me. I only had it done once and hated it. I lost some short term memory but seemed to rebound in about a week. But, again "Every mediation is different and every person is different!" What my work for another might not work for you.
Thanks for asking....
BorgMan
Posted by BorgMan on September 18, 2004, at 16:34:32
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » iris2, posted by mattw84 on September 16, 2004, at 21:40:16
>> IMHO people are far too reliant on the meds and fail to ever actually address the emotional causes of their depression. Most people who successfully escape depression seem to have found god, had an emotional epiphany, have success in therapy, or just eventually snap out of it. Not to say the antidepressants are not effective, just generally are not a very good permanent solution. I.E. You could live the rest of your life semi-happy with any varying number of side-effects from your medications, or directly address the cause (EMOTIONS!!) and hopefully not need the meds anymore! <<
Matt, for some people it truely is just chemical. Psychotherapy has done very little for me over the last 12 years. I would never had served without my meds.
BorgMan
Posted by BorgMan on September 18, 2004, at 16:39:07
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie, posted by sunshine211 on September 18, 2004, at 6:56:00
> I agree. The meds are a stepping stone and even for those that need to take them for extended periods of time, have to work on the REAL issues. therapy is good, but finding the right person is the hardest. I think being reflective about your progress is important. you definitely have to be active.
For some people it truely is just chemical. Psychotherapy has done very little for me over the last 12 years. I would never had survived without my meds.
Posted by jacot on September 18, 2004, at 19:14:12
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » mattw84, posted by iris2 on September 16, 2004, at 16:37:13
I'm new to posting on this web site, but have read it often about different meds out there as well as side effects.
I am currently being treated for an anxiety disorder (GAD) and recently started on cymbalta, but if like effexor...i'm sure it won't last too long because of the sexual side effects.
Does anyone know if medications like edronax and strattera work for GAD, and what about side effect profiles??? Are they the same??
I have tried almost all of the SSRIs, as well as some of the anticonvulsants, but am extremely sensitive to the side effects....sexual, feeling "out of it" etc...
any suggestions????
Posted by theo on September 19, 2004, at 8:28:38
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie, posted by jacot on September 18, 2004, at 19:14:12
What dose of Cymbalta are you taking?
Posted by jacot on September 19, 2004, at 9:29:46
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie » jacot, posted by theo on September 19, 2004, at 8:28:38
> What dose of Cymbalta are you taking?
Right now only on 20 mg. daily....
Posted by BorgMan on September 20, 2004, at 11:16:13
In reply to Re: Cymbalta Newbie and Psycho-Babble Newbie-theo, posted by jacot on September 19, 2004, at 9:29:46
> > What dose of Cymbalta are you taking?
>
> Right now only on 20 mg. daily....
>
>That is an extremely low dose for Cymbalta. But, perhaps that is good because you are hyper-sensitive with side effects. I am the same way.
BorgMan
This is the end of the thread.
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