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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Chairman_MAO on November 1, 2005, at 9:00:15
After about 7 months on 90mg/day phenelzine, and having come off of buprenorphine (except for PRN use), I had an orgasm yesterday without exerting any undue effort. Who knows when or if it will ever work that way again, but it does give me a lot more hope than I had!
I cannot believe how effective this medication is. My drive and focus are superior to 40mg-80mg/day d-amphetamine + 80mg/day citalopram (though that was back in 2001-2002). Fine-grained cognitive abilities that I displayed in high school and even moreso during the time as an undergrad when I managed to get nominated for philosophy undergrad of the year, faculties that I thought I a) had to take psychostimulants to access b) were gone forever are starting to come back.
CAVEAT: I feel this way when I CAN GET SLEEP.
Unfortunately, I a feel as if I'm locked in a chinese finger trap trying to get someone to Rx me a real (read: GABAnergic) sleep aid. I Almost ran my car off the road the other day due to some kind of "microsleep" happening; I managed to come upon 8mg of lunesta to split up over 3 days or so, but that is not a long-term solution. I am supposed to be workjing toward getting back into school in January, but I spend whole days camped out in the clinic nodding off.
I have exhausted every non-GABAnergic sleep option and OTC option I can find. Until I got this lunesta, I shot dope for about 4 nights in a row PLUS take a billion other things (clonidine, diphenhydramine, bacopa, ramelteon, etc). When I built tolerance to that, I had to drop it. Plus, I didn't even WANT to do it; I just want to sleep!
Antipsychotics/trazodone/etc are not an option because at sufficient doses they negate all of the antidepressant effect of the drug.
I have started becoming so sleep deprived that if I managed to hit REM sleep, I would have violent night terrors and/or heavily emotional dreams where I would ACTUALLY od things like scream, cry out for help. One dream I had to throw myself from a speeding car. I was staying at my g/f's,a nd actually thew myself off the bed onto a picture frame on the floor, my head landing two inches from a dumbell on the floor.
Whatever happened to the hippocratic oath?!? If I can't get something soon going for me you will see me here soliciting sedative/hypnotic donations!
Posted by Bill LL on November 1, 2005, at 9:34:03
In reply to Nardil update, posted by Chairman_MAO on November 1, 2005, at 9:00:15
Hi- Lunesta was tested and found to be effective for long term usage. It comes in 1, 2, and 3 mg tablets. Also it has no significant side effects and does not cause next day drowsiness.
> After about 7 months on 90mg/day phenelzine, and having come off of buprenorphine (except for PRN use), I had an orgasm yesterday without exerting any undue effort. Who knows when or if it will ever work that way again, but it does give me a lot more hope than I had!
>
> I cannot believe how effective this medication is. My drive and focus are superior to 40mg-80mg/day d-amphetamine + 80mg/day citalopram (though that was back in 2001-2002). Fine-grained cognitive abilities that I displayed in high school and even moreso during the time as an undergrad when I managed to get nominated for philosophy undergrad of the year, faculties that I thought I a) had to take psychostimulants to access b) were gone forever are starting to come back.
>
> CAVEAT: I feel this way when I CAN GET SLEEP.
>
> Unfortunately, I a feel as if I'm locked in a chinese finger trap trying to get someone to Rx me a real (read: GABAnergic) sleep aid. I Almost ran my car off the road the other day due to some kind of "microsleep" happening; I managed to come upon 8mg of lunesta to split up over 3 days or so, but that is not a long-term solution. I am supposed to be workjing toward getting back into school in January, but I spend whole days camped out in the clinic nodding off.
>
> I have exhausted every non-GABAnergic sleep option and OTC option I can find. Until I got this lunesta, I shot dope for about 4 nights in a row PLUS take a billion other things (clonidine, diphenhydramine, bacopa, ramelteon, etc). When I built tolerance to that, I had to drop it. Plus, I didn't even WANT to do it; I just want to sleep!
>
> Antipsychotics/trazodone/etc are not an option because at sufficient doses they negate all of the antidepressant effect of the drug.
>
> I have started becoming so sleep deprived that if I managed to hit REM sleep, I would have violent night terrors and/or heavily emotional dreams where I would ACTUALLY od things like scream, cry out for help. One dream I had to throw myself from a speeding car. I was staying at my g/f's,a nd actually thew myself off the bed onto a picture frame on the floor, my head landing two inches from a dumbell on the floor.
>
> Whatever happened to the hippocratic oath?!? If I can't get something soon going for me you will see me here soliciting sedative/hypnotic donations!
>
>
Posted by SLS on November 1, 2005, at 9:48:36
In reply to Nardil update, posted by Chairman_MAO on November 1, 2005, at 9:00:15
Hi C_M.
That's GREAT news. I'm glad you no longer have a disincentive to continue with Nardil.
Like you, I much prefer the way I feel on Nardil to Parnate when I can get it to work. Unfortunately, my response to Nardil is brief and incomplete, even when combined with a TCA. I'm thinking of cycling between MAOIs just to experience a higher quality of relief than what I do now. It is the damned washout period that disuades me from doing it right now. I'm going on a trip in a few weeks, and I don't want to do anything that might allow for my condition to deteriorate. When I get back, I will hopefully have mifepristone waiting for me.
Drive safely.
- Scott
Posted by Chairman_MAO on November 1, 2005, at 9:58:54
In reply to Re: Nardil update, posted by Bill LL on November 1, 2005, at 9:34:03
Lunesta is one of the drugs my @*#$(@*#$(*#@$(*#@$ current doctor considers "too abusable" for me.
I have tried it. It works pefectly at 3mg. I do not understand why it is even a controlled substance, personally;I notice NO euphoria or anything whatsoever.
Posted by Chairman_MAO on November 1, 2005, at 10:01:22
In reply to Re: Nardil update » Chairman_MAO, posted by SLS on November 1, 2005, at 9:48:36
If you describe in detail the cycle of effects/uselessness that you get with Nardil (time course, etc) I can send a brief email to one or more professioanls that I know for opinions. Is it a clearly identifiable thing? that is, it ALWAYS works and then fades? Have you ever tried it with precursor loading?
Posted by gardenergirl on November 1, 2005, at 10:04:32
In reply to Re: Nardil update » Bill LL, posted by Chairman_MAO on November 1, 2005, at 9:58:54
> Lunesta is one of the drugs my @*#$(@*#$(*#@$(*#@$ current doctor considers "too abusable" for me.
>
Lunesta is considered "abusable"???? sheesh. I can't imagine abusing ambien. All it would do is put me to sleep, I would guess. Huh.I'm sorry your pdoc won't consider it. It's controlled, so if you only get so many per month, really, what's the abuse worry? If you take it too often, you're SOL for the rest of the month, right?
gg
Posted by WeeWilly on November 1, 2005, at 10:11:38
In reply to Re: Nardil update » SLS, posted by Chairman_MAO on November 1, 2005, at 10:01:22
I am currently at 3 weeks on Nardil. Finally got a possitive response a couple of days ago at 90mg. I hope to taper down gradually while keeping the positive response. The label says a maintanence dose of 15mg every other day may be sufficient. Has this method been successful with others? Best wishes.
Posted by Chairman_MAO on November 1, 2005, at 10:16:38
In reply to Re: Nardil update » Chairman_MAO, posted by gardenergirl on November 1, 2005, at 10:04:32
One would think you are correct. However, I suppose for one to think you are correct, one would have to think at all. Sometimes I want to tell these doctors tah think they know so much about addiction because "I've been doing this for 20/30/etc years", "Well, man, I'm sorry to hear that, because you're awfully clueless for someone who's been doing something for two decades!"
Having taken 3mg of Lunesta last night, I have no reservations saything that I have never, in my entire life, felt so balanced, focused, clear-headed, spiritually connected, motivated and SOBER in my entire life. I feel like I did when I was 20-21 and started seeing the Hegelian dialect in everything--like the trees that lined the streets. A certain ineffable "richness" to the content of thought in my mind is coming back which is something that I thought quite frankly was permanently over for me, a rhelic of a time and place in my life that I could never return to. The difference between then and now is that back then, I would feel elated at such thoughts and then out of nowhere, for seemingly no reason, plunge into depression and self-loathing. Sometimes I'd end up being in tears by the time I finished that walk that started out so well.Quite a few doctors have tried to "rule out bipolar", but a)I have never had a positive response to a mood staiblizer b) I have only experienced a drug-precipitated manic epiosde ONCE (high dose amphetamine, opioids, marijuana, and god knows what else).
Doctors need to understand that for most people with addictions in their past, sobriety was anything but sober. Feeling like this, I don't even want to have a cup of coffee because it would mess up the way I feel.
Posted by Chairman_MAO on November 1, 2005, at 10:20:15
In reply to Re: Nardil update, posted by WeeWilly on November 1, 2005, at 10:11:38
It is my opinion that the 15mg maintenance dosage MAY work for some depressions, but for anxiety disorders and other depressions, you will really regret trying it. At any rate, now that you have a psoitive response, you should stay at that dose for at LEAST six months before you consider changing it again. TRUST ME, ____P-L-E-A-S-E____. Nardil is an extraordinarily powerful medication, and I believe total-body homeostasis happens very slowly over a period of many months after a therapeutic response to Nardil has first been reached. For instance, as I said, seven months later I finally can achieve orgasm in basically the same amount of time I could not on the medication. The anorgasmia now is way milder than that of the SSRIs, in my experience.
Posted by WeeWilly on November 1, 2005, at 11:11:52
In reply to Re: Nardil update » WeeWilly, posted by Chairman_MAO on November 1, 2005, at 10:20:15
> It is my opinion that the 15mg maintenance dosage MAY work for some depressions, but for anxiety disorders and other depressions, you will really regret trying it. At any rate, now that you have a psoitive response, you should stay at that dose for at LEAST six months before you consider changing it again. TRUST ME, ____P-L-E-A-S-E____. Nardil is an extraordinarily powerful medication, and I believe total-body homeostasis happens very slowly over a period of many months after a therapeutic response to Nardil has first been reached. For instance, as I said, seven months later I finally can achieve orgasm in basically the same amount of time I could not on the medication. The anorgasmia now is way milder than that of the SSRIs, in my experience.
>Chairman, could you elaborate on why it is important to stay at the response dose. In my case it was 90mg. The last two days have been at 60mg. Will I risk loseing the response and never regaining it? I am also experiencing extreme insomnia. I would like to avoid adding a sleep med. Another thing I am considering is changing from once in the morning dosing to something like 2 or 5mg's every few hours. Do you see a benefit to something like this? Best wishes
Posted by ed_uk on November 1, 2005, at 16:17:26
In reply to Re: Nardil update, posted by WeeWilly on November 1, 2005, at 10:11:38
Hi Willy
>I hope to taper down gradually while keeping the positive response. The label says a maintanence dose of 15mg every other day may be sufficient. Has this method been successful with others?
In general, no. The 'low maintainance dose' theory is a myth - it's pretty much obsolete these days.
Kind regards
Ed
Posted by Chairman_MAO on November 1, 2005, at 19:44:06
In reply to Re: Nardil update, posted by WeeWilly on November 1, 2005, at 11:11:52
Because the therapeutic effect of MAOIs is due largely to the CNS profoundly re-regulating itself toward a new homeostasis in the face of profoundly increased levels monoamines both at the synapses and intraneuronally. When you get that "hit over the head" sudden therapeutic effect with phenelzine, taht means that you are there. If you muck with the MAO inhibitor concentration after that, you risk compromising what may be your own personal optimal state of being. That is not to say a therapeutic effect is an all-or-nothing thing that requires an exact dose--but full remission very well may be!
Posted by Bill LL on November 2, 2005, at 9:56:53
In reply to Re: Nardil update » Bill LL, posted by Chairman_MAO on November 1, 2005, at 9:58:54
I would consider switching docs. I have never heard of Lunesta being abusable.
> Lunesta is one of the drugs my @*#$(@*#$(*#@$(*#@$ current doctor considers "too abusable" for me.
>
> I have tried it. It works pefectly at 3mg. I do not understand why it is even a controlled substance, personally;I notice NO euphoria or anything whatsoever.
Posted by Chairman_MAO on November 2, 2005, at 10:16:24
In reply to Re: Nardil update - Chairman MAO, posted by Bill LL on November 2, 2005, at 9:56:53
I already have. My internist who is the prescribing physician at a methadone clinic echoed as much to me!
This is the end of the thread.
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