![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by bigcat on November 28, 2005, at 16:16:17
It's arrived. Full remission- Effexor 75mgs, Lamictal 400mgs. But that's not important. What's important is my story.
Depressed since age 10, now 24. Have been trying antidepressants for 6 torturous years. Brief Nardil remission which I couldn't recover having tried virtually every single antidepressant on the market in the U.S. or abroad. 16 ECT treatments. Suicidal ideations. Alien to love and life. This is my 3rd Effexor trial, first response to the med.
The point of my story is to fight. Never stop fighting. Never ever stop fighting for the peace that you'll find. I fleed from encouragement like this for so long. It simply didn't apply to me, and I was convinced of this. Even positive messages seemed negative. Why can't I achieve remission? Why can other's find a way out and not me? It's not fair, I thought. I was suffocated. Bound and gagged, suffering torture that knew no end or limit. I thought I was written off. Born into life never to be alive. It's been too long, I thought, it would have happened by now. I'll never be free.
Peace. You have it inside you, it's waiting. YOU'RE WAITING FOR THE REAL YOU WILL BE REALIZED. You'll get there, trust me. Please have patience when patience is impossible. Please reach out to others who have had a taste of the suffering you know entirely too well.
Now I gotta give a couple shouts out to my bro Ed, a life saver as I'm sure you all know. Ace the Nardil fanatic (good stuff, eh?. Love you're energy, eccentricity, lust for life). My girl Phillipa, whose presence is warmly felt and appreciated by all who are a part of this close community. Chairman MAO, SLS, Declan, Tom Twighlight, Blueberry, MedEmpowered (long overdue superstar) and countless other compassionate veterans and newbies who are iron- willed, even in times of the most profound pain.
Listen to Sublime. Entrance yourself in Vincent's painting's. Love your dog above all else. These were my personal precursors. Find and hold what pierces through you're pain and feeds your soul with love. Believe in what compells you to keep pushing. Push for you're mother, push for your partner, push for all those hoping and hoping for you. Push for the you that you're missing. You are all so wonderful.
My God my self loathing was horrendous. My anxiety was crippling. My depression regularly confined me to my bed. I was essentially mute for months, not a single clairvoiant thought. Utterly isolated, estranged, entangled, reclusive; total aversion towards eveyrone and everything. Not even capable of crying, I was down so deep. I hurt other people and even as I realized this, I couldn't change it.
Please believe that emancipation is possible. You can't afford not to. Hope- ugotta have it.
I admire and love you all.
-matt-
Posted by Bill LL on November 28, 2005, at 17:08:55
In reply to SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by bigcat on November 28, 2005, at 16:16:17
I am really happy for you. Effexor is one of the most prescribed drugs. And now you know why.
I think that Lamictal is an excellent choice for some one who is on an antidepressant such as Effexor, Cymbalta, pregabalin, or one of the SSRI's. Lamictal is a good balance for these drugs.
I know all too well about cripplying (I can't spell) anxiety and horrible depression. Like you, I also love my dog. (Gives me less aggrevation than my kids.)
It's really a coincidence that you posted your success today because today is the first time in my life that I have felt an almost total remission. I feel better than I have ever felt.
I take Provigil 400 mg, Lamictal 200 mg, and Lyrica (pregabalin) 600 mg.
The change I made a few days ago was to increase the Lryica from 300 to 600. That made a great difference by decreasing my residual anxiety. I know that in studies for ADD, Lyrica 600 mg did very well. Pregabalin soon could get FDA approval for GAD (generalized anxiety disorder).
Like you, I encourage people to be very aggressive in their treatment.
Posted by Bill LL on November 28, 2005, at 17:12:42
In reply to SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by bigcat on November 28, 2005, at 16:16:17
I forgot to mention in my last post. When I started Lyrica a couple of weeks ago, I was able to stop taking Lunesta. Lunesta is a great drug with no side effects. But the Lyrica helped me fall asleep, so I didn't need Lunesta anymore.
Lyrica does not make me tired, but relaxes me enough to go to sleep.
Posted by Tomatheus on November 28, 2005, at 18:18:18
In reply to SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by bigcat on November 28, 2005, at 16:16:17
bigcat,
I really enjoy reading success stories such as yours.
I hope the remission continues.
Congratulations (again)!
Tomatheus
Posted by bigcat on November 28, 2005, at 19:16:29
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by Bill LL on November 28, 2005, at 17:08:55
> I am really happy for you. Effexor is one of the most prescribed drugs. And now you know why.
Yep.
>
> I think that Lamictal is an excellent choice for some one who is on an antidepressant such as Effexor, Cymbalta, pregabalin, or one of the SSRI's. Lamictal is a good balance for these drugs.
>
> I know all too well about cripplying (I can't spell) anxiety and horrible depression. Like you, I also love my dog. (Gives me less aggrevation than my kids.)Ha! I have a husky named Sam. He's The Buddha Dog. And you?
> It's really a coincidence that you posted your success today because today is the first time in my life that I have felt an almost total remission. I feel better than I have ever felt.
>Yeeehaw Bill, I'm so happy for you!!! We were both long overdue! I love coincidences.
> I take Provigil 400 mg, Lamictal 200 mg, and Lyrica (pregabalin) 600 mg.I know very little about Lyrica and would love to hear a little more if you care to enlighten me. GAD and ADD were entangled in my depression. The cruel bastard really covered all the bases.
>
> The change I made a few days ago was to increase the Lryica from 300 to 600. That made a great difference by decreasing my residual anxiety. I know that in studies for ADD, Lyrica 600 mg did very well. Pregabalin soon could get FDA approval for GAD (generalized anxiety disorder).
>
> Like you, I encourage people to be very aggressive in their treatment.Hell yeah. I'm not convinced about dose cielings or seemingly wild med propositions outside the marketed drug scene. The PDR is a joke. My current pdoc abides by it. Kinda' narrow-minded, but who knows, maybe thats a good thing. I shouldn't diss the heavily marketed meds if you know what I mean). I've also pushed real high on some meds without nasty side effects (no remission, granted), but nothing alarming. (This is how my body responds and is NOT a universal rule. Totally different wiring I suppose). That said, I take my new pdoc's directions more as suggestions. She had me on 225mgs Lamictal (claiming I could only titrate 25mgs per month or something ridiculous, totally spooked by the infamous rash ordeal), and wanted a 3 week washout after the MAOI trial before starting the Effexor. Sorry, not gonna' happen lady. I had samples from long ago, took a week off after Nardil (I've done this before after a very experienced psychopharmacologist deemed it was OK), and hopped on the Effexor at a miniscule dose. I felt the Effexor doing something by day 5, but not quite "IT". I casually took 400mgs Lamictal one morning and BOOM, there it was in a matter of hours. I responded to the Effexor within a week of starting it. My body, mind, and soul were famished and ready to eat that Effexor up! It knew a good thing when it finally saw one (for the third time nonetheless. So strange??). I've had the Lamictal at 400 when it was used in conjunction with other meds, so I knew the rash thing wouldn't be an issue. I may be dumb, but I'm not stupid:). Well, that's up for debate. We'll see what the experts say.
Peace Be With You Champ!
-matt-
Posted by bigcat on November 28, 2005, at 19:18:22
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by Bill LL on November 28, 2005, at 17:12:42
> I forgot to mention in my last post. When I started Lyrica a couple of weeks ago, I was able to stop taking Lunesta. Lunesta is a great drug with no side effects. But the Lyrica helped me fall asleep, so I didn't need Lunesta anymore.
>
> Lyrica does not make me tired, but relaxes me enough to go to sleep.I couldn't handle the Lunesta taste. I take Seroquel for sleep. Works every time.
Posted by willyee on November 28, 2005, at 19:21:35
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by Bill LL on November 28, 2005, at 17:12:42
I dont have access to it yet,but do u think Nuerotion its early cousin can hold the same possability,because that i do have.
MY doc actualy wasnt aware of pregablin and said next visit she should know,so i have to wait.
Posted by mike99 on November 28, 2005, at 19:24:56
In reply to Congratulations!, posted by Tomatheus on November 28, 2005, at 18:18:18
Good for you, Matt.Stories like yours encourage me to not give up on finding a treatment that works, which isn't always easy.
Posted by Declan on November 28, 2005, at 19:37:09
In reply to SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by bigcat on November 28, 2005, at 16:16:17
Good luck sweetie, I hope it stays with you. That Lamictal stuff, maybe I should read up. Because you've had a hell of a time.
Declan
Posted by Phillipa on November 28, 2005, at 20:04:16
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by Declan on November 28, 2005, at 19:37:09
Matt, I am honored to be mentioned in your Thread. From all the stories you hear to have a med work the third time around is great to hear. Have your life circumstances changed. But congratulations to you! Fondly, Phillipa
Posted by bigcat on November 28, 2005, at 21:55:27
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by Phillipa on November 28, 2005, at 20:04:16
Thank you. I have so much love for you all.
We are truly united in this. Undiagnosed at age 10 with onset of depression/OCD/anxiety. Eight years of quiet desperation before trying AD's. For six years I walked incessantly to the local phramacy and picked up new meds, each week seeming worse than the last. I never thought twice about ECT. I didn't let two seizures from med toxicity stop me. I couldn't have deteriorated anymore, and yet I did. My mind would find new and horrifyingly brutal avenues to attack myself with. It was so hard. School buses past as I walked on the sidewalk and I would think "two step to the left, that's all it would take to end this." But what I always kept in my head was a new take on the old saying which is: THERE HAS TO BE A CALM AFTER THE STORM. There has to, and there always is. Please believe this.One Love My Friends,
-matt-
Posted by jclint on November 29, 2005, at 6:32:58
In reply to SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by bigcat on November 28, 2005, at 16:16:17
Oh Bigcat, thanks for the inspiring story! That actually means a lot to me, not just because its good hearing of someone getting better, but because my situation is very similar to yours, my symptoms being very similar, and my new med regime also - cymbalta and lamictal. I hope as I increase the lamictal I can feel relief like you inevitably do.
Good luck sir, well done :)
John
Posted by bigcat on November 29, 2005, at 7:05:08
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!, posted by jclint on November 29, 2005, at 6:32:58
Thanks John. Like I said, we're all in this together, pushing not only for ourselves but for eachother. If it is the Lamictal that's jumpstaring the Effexor, it has taken a bit of time to kick in, so stick with it. I had a favorite song throughout much of my depression that goes a little something like this:
Blues Traveler - Just Wait
If ever you are feeling like you're tired
And all your uphill struggles leave you headed downhill
If you realize your wildest dreams can hurt you
And your appetite for pain has drinken its fillI ask of you a very simple question
Did you think for one minute that you are alone
And is your suffering a privilege you share only
Or did you think that everybody else feels completely at homeJust wait
Just wait
Just wait
And it will comeIf you think I've given up on you you're crazy
And if you think I don't love you well then you're just wrong
In time you just might take to feeling better
Time is the beauty of the road being longI know that now you feel no consolation
But maybe if I told you and informed you out loud
I say this without fear of hesitation
I can honestly tell you that you make me proudJust wait
Just wait
Just wait
And it will come
Just wait
Just wait
Just wait
And it will comeIf anything I might have just said has helped you
If anything I might have just said helped you just carry on
Your rise uphill may no longer seem a struggle
And your appetite for pain may all but be goneI hope for you and cannot stop at hoping
Until that smile has once again returned to your face
There's no such thing as a failure who keeps trying
Coasting to the bottom is the only disgraceJust wait
Just wait
Just wait
And it will come
Just wait
Just wait
Just wait
And it will come
Just wait
Just wait
Just wait
And it will comeYou are not alone.
Thanks Old Friend,
-matt-
Posted by Bill LL on November 29, 2005, at 13:32:54
In reply to Re: SUCESS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! » jclint, posted by bigcat on November 29, 2005, at 7:05:08
Matt- what dose of Seroquel do you take for sleep. What about the next day. Is there tiredness. Is there further relief of anxiety?
I would like to answer the questions that you directed to me, as well as give some other observations I've had.
First the most important question you asked; My dog is a Sheltie. Very cuddly and lovable. But hates other dogs for some reason. Might need Prozac. My friend's sheltie likes other dogs.
You wanted more info on Lyrica. It recently hit the US market. The generic name is pregabalin. Here is a blurb that I pasted:
Lyrica (LEER-ih-kah) is the brand name used in the United States and some other countries for the seizure medicine pregabalin (pree-GABA-lin).
Lyrica is similar in structure to one of the major chemical neurotransmitters in the human brain, GABA (gamma aminobutyric acid). GABA is the most important inhibitory neurotransmitter—that is, it prevents nerve cells in the brain from firing too quickly, as they do in seizures. As it turns out, however, Lyrica does not act like GABA in the brain.
Lyrica was approved by the United States Food and Drug Administration (FDA) in 2005.
End of quote; it’s me again
It’s possible that Lyrica might soon be FDA approved for generalized anxiety disorder. If memory serves, it compared very well with Klonopin in a clinical trial. But memory might not serve.For me, it works great for anxiety and sleep without making me tired, just more calm. I feel a lot better on the 600 mg dose, than on the 300 mg.
Now your issue of going over “maximum” doses. I could not agree more. Clinical trials are usually done for a 6 week period. That has little or no predictive value for long term use.
You also raised the issue of being aggressive. Right on. My previous doc (internist) got offended when I did things on my own such as suggesting other drugs or changing my dose without first consulting with him. But consulting with him is not always easy. Many times I can’t just call and get a response. I might need to wait 4 weeks for my next appointment. And I would not be able to get a new prescription for a different drug until then. I’m not a patient person when I feel miserable.
I then switched to a different doc that I heard good things about. He is also an internist. What a difference. He respected, and even encouraged me to do my own research, and to play around with the doses (within certain limits) on my own to see what works best. He is very down to earth and doesn’t try to come across as the world’s smartest man.
As for credentials, in an issue of Baltimore Magazine, he was one of only 2 doctors named as the best internist in the Baltimore area. The voting was done by a panel of other doctors in Baltimore. In a different issue of the same magazine, he was named as the best doctor in Baltimore for infectious diseases. His office is in a John’s Hopkins building, so I assume he is in a Hopkins group, although I don’t know for sure.
Wouldn’t one think that this doctor would be uppity? He is in fact is as friendly as can be, and very receptive to my drug suggestions. I can make an appointment and see him within 3 days. Because of his flexibility, I can change doses without telling him. Then when I do see him and tell him that I changed doses or medications, he is totally ok with that.
My first doc had just an ok knowledge of drugs and was therefore hesitant to prescribe a drug that he was not familiar with . My current doc knows a heck of a lot and can on the spot let me know if my suggestions are safe.
What this means is that with the right doctor, either internist or pdoc, an aggressive person can get better in a much shorter time period than otherwise.
You related your feelings that despite possible adverse side effects, you would still try these type of drugs to try to get relief from anxiety and/or depression. That is exactly how I feel. Nothing, and I repeat nothing is worse than crippling anxiety and depression.
As for another coincidence, I too was around 10 years old when I became aware of my miserable mental changes. In 4th grade, I began feeling bad. In 5th and 6th grades and later, I was even more miserable with anxiety and sad feelings and did not get treatment for many years.
Once again, congratulations in your progress.
Posted by bigcat on November 29, 2005, at 22:04:36
In reply to Matt- and all others, posted by Bill LL on November 29, 2005, at 13:32:54
Wow Bill, we are SOOO on the same wavelength. Thank you for taking the time to write such a precise and insightful piece. I connected with everything you said. I'm very glad that you have an internist that you trust and who trusts you. It's very comforting. I have so much to say in response to your post, that I must clear an afternoon to sit down and bang it out. I'm very excited about this and it shouldn't be long before I get my thoughts together, but to answer your questions for now:
Matt- what dose of Seroquel do you take for sleep. What about the next day. Is there tiredness. Is there further relief of anxiety?
I've taken as little as 25mgs while on some meds in the past, and it worked fine for a decent, uninterrupted sleep. I'd say I've taken it regularly for two years and the normal dose range for me has been 600-800mgs. The Effexor has given me some nasty insomnia the last few nights. I took 1000mgs Seroquel last night and it took a while to put me down, and I really only got 5 hours of sleep. At 5am I took another 400mgs and it did nothing to put me back down. Kinda' a pain, but it's early, and we'll figure something out soon enough.
I don't think there's much additional tiredness the next day. Getting out of bed was always a monumental pain in the *ss while depressed, but then again I was lethargic all day, so it's hard to know. I was perky soon after waking this morning, and that's after 1400 mgs Seroquel. Try to beat that! It may be time to look into some other options, but the insomnia and restlessness could settle down as the Effexor settles in.
No further relief of anxiety for me, but my depression and anxiety were inseparable, so it definatley may cut away at the anxiety for some people (xanax, klonapin, valium, and ativan didn't even touch my anxiety at very high doses, which was endlessly frustrating). I do have some residual anxiety, especially around people. Maybe one of the benzos may help now that an AD is working. Right now I don't care if I have to bang back thorazine, haldol, and chloral, AND Seroquel to get a good night's sleep. At this point it's ridiculous to be bothered by things like sleep problems and weight problems after what I've been through. (That said, I'd have no problem if I could get a damn good night's sleep out of this unimaginably good deal that I'm getting now. I could use an orgasm too, but I don't want to get greedy). Will respond in full soon. Till then, may the PDR burn like other certain books that have been misused by humankind.
May Peace Be With You My Friend,
-matt-p.s.- Say hi to your dog and give him a nice rub in his special spot for me.
This is the end of the thread.
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