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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Paulbwell on January 18, 2006, at 22:31:49
I have been apathetic lately and tired, all i wanna do is sleep, and leave the world alone.
I have had blood work done, repetedly, and it's ok.
I'm taking:
-Diazepam 5-20mgs daily
-Methylphenidate 20-80mgs
-propranolol 10-40mgsI feel like sleeping away my life and waking up in my 70's 80's only to die.
What gives?
Cheers
Posted by rjlockhart on January 18, 2006, at 23:44:57
In reply to Tired-all the time? advice?, posted by Paulbwell on January 18, 2006, at 22:31:49
mmm paul
man, sorry im just tired i had a rough day.
Sleeping too much causes depression, usally you dont want to deal with reality. I did once and i got more depressed.
You just have to get back up, and it feels bad and your not going to like it, but your mind will get used to it and be more active.
Im thinking your really feeling bad, i though you went to dexedrine 40mg?
alright, i've been on dexedrine for a while makes you feel more alive, its an amphetamine.
But i just crashed after taking repeated doses, it is not worth it, you want take more after it wears off, but everytime you do it feels less.
I have had it. Amphetamine really can make you feel your going crazy if over taken and frequent doses.
Adderall was worse....
and thinking desoxyn... all those guys who took that dont post here, it makes you shut off from others,rerember utopizen?
he would posts like long enthusastic posts, which i knew he was on desoxyn, i could just tell. Then he would not respond back, guessing it wore off.I just wanted to put what amphetamine does to you after a long time.
Anyways, the betablocker definely may make you lethargic my dad takes one, and he's always tired, and doesnt take them.
Dexedrine may help, in your situation i think it would, but i have been on prescription amphetamines 9 years. It can effect you diffrent at diffrent times.
Have some coffee, just to see to wake you up a little.
I feel for you man.
You take Care.
babblemail
Matt
Posted by shasling on January 19, 2006, at 0:41:24
In reply to Tired-all the time? advice?, posted by Paulbwell on January 18, 2006, at 22:31:49
> I have been apathetic lately and tired, all i wanna do is sleep, and leave the world alone.
>
> I have had blood work done, repetedly, and it's ok.
> I feel like sleeping away my life and waking up in my 70's 80's only to die.Agghghhg! I have spent most of my life doing those three things. That waking up at 80 to die thing constantly eats at me. It frightens me and makes me angry.
After hiding my condition for so many years and feeling like such a freak for sleeping my life away like a zombie, having zero interest in life, and losing friends and marriages over it, it simply blows me away that you all can keep speaking my mind and articulating my experience in ways I never could. Its incredible, and makes me feel at home. Thank you for that. I thought I was the only one who thought I 'd wake up only in time to die. I even felt like a freak as a depressive because nothing ever worked, and all those "just ask your doctor" commercials just mocked me, saying all they have to do is give me a pill and then I'd be all better. Nothing ever worked and I felt like even more of a failure and a freak.
I was recently diagnosed with atypical depression and the more I learn about it the more it appropriate the dx. I am SO relieved to actually have a valid diagnosis of a real condition that explains me, and it isn't my fault, and that I'm not just super lazy. Anyway, they are starting to think Atypical Depression may be a discrete depressive condition, not simply a spot on the depressive continuum (sp?) because our cortisol response and perhaps sleep architecture is different from both non-depressives and 'typical" depressives. (I know cortisol always made me feel GREAT.) But I digress...
Sorry to derail your post, but it still freaks me out when you all describe my life so well. I have spent so much energy trying to cover up the condition so as not to lose people that accepting it feels so free and I get excited sometimes.
Okay, I say all that to say this: you might want to Google atypical depression or vegetative or retarded depression, see if it rings a bell with you. Knowing the enemy is the first step in defeating it. Now that I know what mine is, they gave me the right meds and I had my very first positive medication response. Only took them three decades to figure it out - cause a lot of docs aren't aware of it - and I don't want anyone else to have to wait that long in the off chance that they have the same condition. Particularly since its fairly easily treated once you know what it is.
I really hope for relief for you, whatever your condition. Living like that is awful.
Posted by picklehead on January 19, 2006, at 9:45:17
In reply to Re: Tired-all the time? advice? » Paulbwell, posted by shasling on January 19, 2006, at 0:41:24
My pdoc just told me yesterday that I have atypical depression, which I don't think she mentioned before (I just started seeing her though). I agree.
What did you just start taking that you're noticing a difference on?? An MAOI? That's what I've heard helps Atyp D.
~Jane
P.S. And to Paul and the others, keep doing what we're all doing here on this board and don't give up until you've reached that quality of life that you know you should be living! I honestly think that's why we're prone to depression, we KNOW life doesn't have to be so.... bad... and shouldn't... yet we're not quite sure how to get there.
Posted by shasling on January 19, 2006, at 9:53:56
In reply to Re: Atypical Depression » shasling, posted by picklehead on January 19, 2006, at 9:45:17
If she dx that, hang on to her! She's more informed than many. Can't tell you how many years we chased chronic fatigue with me. Lit says its commonly mistaken for that. Again, fitting my situation like a glove... : )
Yes, I am on Parnate, and I keep getting these great responses. Then they fade, but we're still titrating so I'm not panicked.
I'd been taking Parlodel (and had just started) Parnate on my own before finding this doc, who added Lamictal. That seemed to really boost it, as well.
All the SSRIs I was ever given, I may as well have been eating ice cubes. NO response. So while this isn't perfect, I'm very encouraged.
I have tons of links to good info on Atyp D, if interested. Lots of ongoing research that is interesting...
Glad you have identified your enemy : )
Suzie
Posted by picklehead on January 19, 2006, at 11:15:50
In reply to Re: Atypical Depression » picklehead, posted by shasling on January 19, 2006, at 9:53:56
Hi Suzie,
Sure, I would love the links, and thanks.
I go to see my pdoc today so it would be good to read up on some stuff. I'm actually going to ask her to write me a letter for work stating my need to work from home for a little while as I started Topamax (for my migraines, backaches, moodiness, addiction, etc.) a week ago and it's just added to the stress, depression, etc. because of how tired and out-of-it it makes me. But since those side effects are supposed to wear off in a couple months after you've reached the targeted dose I came up with the solution to try to see if I could work from home till the side effects wore off, besides it'd be perfect too, while I'm trying to find the right med for my Atyp. D. My boss was totally fine with it, corp just needs a letter from my doc. So wish me luck that she'll be cool with it.
Thanks for your help, Suzie.
~ Jane
Posted by shasling on January 19, 2006, at 12:45:06
In reply to Re: Atypical Depression » shasling, posted by picklehead on January 19, 2006, at 11:15:50
> Hi Suzie,
>
> Sure, I would love the links, and thanks.
>
> I go to see my pdoc today so it would be good to read up on some stuff. I'm actually going to ask her to write me a letter for work stating my need to work from home for a little while as I started Topamax (for my migraines, backaches, moodiness, addiction, etc.) a week ago and it's just added to the stress, depression, etc. because of how tired and out-of-it it makes me. But since those side effects are supposed to wear off in a couple months after you've reached the targeted dose I came up with the solution to try to see if I could work from home till the side effects wore off, besides it'd be perfect too, while I'm trying to find the right med for my Atyp. D. My boss was totally fine with it, corp just needs a letter from my doc. So wish me luck that she'll be cool with it.
>
> Thanks for your help, Suzie.
>
> ~ JaneSee the following:
http://www.mcmanweb.com/atypical_posts.htm
http://www.biopsychiatry.com/atypnor.htmhttp://www.neurotransmitter.net/atypicaldepression.html (this has all the research)
http://www.healthyplace.com/Communities/depression/atypical.asp
http://www.psycom.net/depression.central.atypical.html (LOTS of stuff here)
That's great that your work is so understanding.
Like it isn't anough to be depressed, you gotta have physical pain as well : (
I used to suffer horribly from migraines and backaches also. I hope the Topamax helps you with it. Only thing that helped mine was the dearly departed Vioxx and Zanaflex for the back, and repeated 5-day runs of fluconazole for the migraines, which are now completely gone.Let me know what your pdoc says, if you don't mind. Good luck!!
Suzie
Posted by Paulbwell on January 19, 2006, at 15:54:19
In reply to Re: Tired-all the time? advice?, posted by rjlockhart on January 18, 2006, at 23:44:57
"I have had it. Amphetamine really can make you feel your going crazy if over taken and frequent doses.
Adderall was worse....
and thinking desoxyn... all those guys who took that dont post here, it makes you shut off from others,rerember utopizen?
he would posts like long enthusastic posts, which i knew he was on desoxyn, i could just tell. Then he would not respond back, guessing it wore off."
Yer the Ovation Desoxyn (Methylphetamine Hcl tabs) 5mg IR (all thats around now) dissolves in 5 mins as opposed to 15 mins to the superior Abbort 5mg IR tabs, and MANY who have taken both can tell!-to say nothing of the excellent Abbott, Desoxyn Gradumet SR-5mg, 10mg, 15mg tabs."I just wanted to put what amphetamine does to you after a long time. "
Makes you crazy? I have read that with excessive non medically monitored use. The efects of Ritalin on me have changed after near 2 years."Im thinking your really feeling bad, i though you went to dexedrine 40mg? "---
(I'm not sure if i have some BP or sever ADD/HD problem. I had a talk with 2 dickhead PsyDocs and they suggested bupropiuon then no meds each. I have read Dex is "a Caffeineless Ritalin" and MANY folk prefer it to Rit, so i would probably have to go back to the original PsyDoc who gave me Rit (and said i could try Rit and Dex, to see which is more satisfactory)to get Dexamphetamine, I'm scripted up to 8 10mg Ritalin tabs daily, but usually take less.You mentioned AME SANS VIE, and i agree it's unusual for someone to be scripted 3, 15mg Dexedrine Spans+40mgs desoxyn (Methamphetamine tabs)daily simitanously, + he is also scripted, i think, 2 Barbiturates seconal+tuinal + 2 benzodiazepines at high doses, Xanax 4mgs T.I.D, and Klopnopin 4mgs T.I.D?-amazing, he must have some VERY accomodating PsyDoc!
Cheers
Posted by Phillipa on January 19, 2006, at 21:04:34
In reply to Re: Tired-all the time? advice? » rjlockhart, posted by Paulbwell on January 19, 2006, at 15:54:19
And incredible tolerance. Fondly, Phillipa
Posted by Declan on January 19, 2006, at 23:43:16
In reply to Re: Tired-all the time? advice? » Paulbwell, posted by Phillipa on January 19, 2006, at 21:04:34
And GHB, I think
Posted by rjlockhart on January 21, 2006, at 12:54:32
In reply to Re: Tired-all the time? advice?, posted by Declan on January 19, 2006, at 23:43:16
Ame Sans Vie i dont know what to say about....
That man takes so many danm drugs, desoxyn, dexedrine at high amounts, and i though i was on high amounts of medication.
why doesnt his doctor just give him the whole darn psychiatric book of medications and write a list of what he wants. ROFL!!!!!
Sorry....
Matt
Posted by Paulbwell on January 21, 2006, at 21:01:38
In reply to Re: ame sans, posted by rjlockhart on January 21, 2006, at 12:54:32
> Ame Sans Vie i dont know what to say about....
>
> That man takes so many danm drugs, desoxyn, dexedrine at high amounts, and i though i was on high amounts of medication.
>
> why doesnt his doctor just give him the whole darn psychiatric book of medications and write a list of what he wants. ROFL!!!!!
>
> Sorry....
>
> MattHiya Matt!
Ame Sans Vie apparently used to be (or still is in a music band) and used a ton of illegal drugs. He now gets his drugs, sorry (medication) legally.
His PsyDoc must be VERY accomadating, thats all i can say to allow him to have tried nearly all psych meds out there.
(currently, apparently)He takes 3, 15mg SR Dexedrine Spansules morn+2 5mg IR Methylamphetamine-Desoxyn tabs Q.I.D, apparently this works great-I'm not surprised, if i was given Dextroamphetamine+Methylamphetamine, i prolly would say the same.
Apparently amoung the 7 or so sleep meds he has tried, not even Seconal (Secobarbital sodium) worked, only Tuinal (seconal+amytal) did it.
You would be hard pressed to find a PsyDoc to script you 2 different Meth/amphetamines+2 Benzodiazepines+ 2 Barbiturates +GHB+Painkillers.
I would LOVE to have his Doc:)
Cheers
Posted by snapper on January 23, 2006, at 7:33:02
In reply to Re: Atypical Depression » picklehead, posted by shasling on January 19, 2006, at 9:53:56
> If she dx that, hang on to her! She's more informed than many. Can't tell you how many years we chased chronic fatigue with me. Lit says its commonly mistaken for that. Again, fitting my situation like a glove... : )
>
> Yes, I am on Parnate, and I keep getting these great responses. Then they fade, but we're still titrating so I'm not panicked.
>
> I'd been taking Parlodel (and had just started) Parnate on my own before finding this doc, who added Lamictal. That seemed to really boost it, as well.
>
> All the SSRIs I was ever given, I may as well have been eating ice cubes. NO response. So while this isn't perfect, I'm very encouraged.
>
> I have tons of links to good info on Atyp D, if interested. Lots of ongoing research that is interesting...
>
> Glad you have identified your enemy : )
>
> SuzieHi Suzie, I would be interested in those links. BTW I have done the Parnate thing 12 years ago..pooped out on me, after it made me hypo-manic enough to start a very successful business and then see it go out the window to the usual highs and lows of addictive stuff like alcohol and gambling( whole 'nother story!) and could not tolerate Nardil. Let me Know what good and up to date links you may have . I am positive millions more suffer from Atyp Dep and Anxiety than ANY SSRI could evr touch.then add in the bi-polar spectrum.........what a mess!!
Thanks
Snapper
Posted by shasling on January 23, 2006, at 10:08:06
In reply to Re: Atypical Depression, posted by snapper on January 23, 2006, at 7:33:02
Hi Snapper,
Hope this helps. And yes, obtaining the right diagnosis is a mess. Short version of Atyp sympoms are:
1) Oversleeping/overeating
2) Oversensitivity to rejection
3) Heavy, leaden feeling in limbs
4) Mood reactivity, i.e., able to perk up with good news or fun, laugh at jokes, whatever, but when that stimulus is gone we go back into hell (This one is not in the DSM III but is repreatedly mentioned as being typical. Diagnostics and theory I think still being developed).Here are some links, many of them will take you to others. Many personal stories that when I read, I knew I was home. Others are research, etc. I really hope it helps. I wish docs were as interested as us, but then I don't guess they have as much reason to be...
Sorry about your Parnate. I have heard that so many times I am aware that while I finally feel better I'm on borrowed time. Still better than not ever having felt better : )
Best of luck.
Suzie
http://www.mcmanweb.com/dysthymia.htm
http://www.mcmanweb.com/atypical_posts.htm
http://www.biopsychiatry.com/atypnor.htm
http://www.neurotransmitter.net/atypicaldepression.html (this has all the research - my favorite although you have to work at deciphering)
http://www.healthyplace.com/Communities/depression/atypical.asp
http://www.psycom.net/depression.central.atypical.html
http://pn.psychiatryonline.org/cgi/content/full/38/20/20
Posted by jedi on January 25, 2006, at 3:02:49
In reply to Tired-all the time? advice?, posted by Paulbwell on January 18, 2006, at 22:31:49
> I have been apathetic lately and tired, all i wanna do is sleep, and leave the world alone.
>Hi,
The gold standard for treatment resistant atypical depression is the MAOI phenelzine(Nardil). When nothing else works, there is a very good chance that this will. I have been on and off Nardil for ten years. It is the only thing that has brought me out of three major atypical depressions.
Atypical depression is actually quite typical. Probably the most common type of depression.
Take care,
Jedi
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15564336&query_hl=9&itool=pubmed_docsum
Endocrinology. 2005 Mar;146(3):1338-47. Epub 2004 Nov 24. Related
Chronic treatment with the monoamine oxidase inhibitor phenelzine increases hypothalamic-pituitary-adrenocortical activity in male C57BL/6 mice: relevance to atypical depression.Kier A, Han J, Jacobson L.
Center for Neuropharmacology and Neuroscience, MS 501E, Albany Medical College, Mail Code 136, Albany, New York 12208, USA.
Atypical depression has been linked to low hypothalamic-pituitary-adrenocortical axis activity and exhibits physical and affective symptoms resembling those of glucocorticoid deficiency. Because atypical depression has also been defined by preferential responsiveness to monoamine oxidase inhibitors (MAO-I), we hypothesized that MAO-I reverse these abnormalities by interfering with glucocorticoid feedback and increasing hypothalamic-pituitary-adrenocortical activity. To test this hypothesis, we measured plasma hormones and ACTH secretagogue gene expression in male C57BL/6 mice treated chronically with saline vehicle or phenelzine, a representative MAO-I. Changes in glucocorticoid feedback were evaluated using adrenalectomized (ADX) mice with and without corticosterone replacement. Antidepressant efficacy was confirmed by decreased immobility during forced swim testing. Phenelzine significantly increased circadian nadir and postrestraint plasma corticosterone levels in sham-operated mice, an effect that correlated with increased adrenocortical sensitivity to ACTH. Phenelzine increased circadian nadir, but not poststress ACTH in ADX mice, suggesting that phenelzine augmented corticosterone secretion in sham-operated mice by increasing stimulation and decreasing feedback inhibition of hypothalamic-pituitary activity. Consistent with the latter possibility, phenelzine significantly increased plasma ACTH and paraventricular hypothalamus CRH mRNA in ADX, corticosterone-replaced mice. Phenelzine did not increase paraventricular hypothalamus CRH or vasopressin mRNA in ADX mice lacking corticosterone replacement. We conclude that chronic phenelzine treatment induces sustained increases in glucocorticoids by impairing glucocorticoid feedback, increasing adrenocortical responsiveness to ACTH, and increasing glucocorticoid-independent stimulation of hypothalamic-pituitary activity. The resulting drive for adrenocortical activity could account for the ability of MAO-I to reverse endocrine and psychiatric symptoms of glucocorticoid deficiency in atypical depression.
PMID: 15564336 [PubMed - indexed for MEDLINE]
Posted by shasling on January 25, 2006, at 7:05:37
In reply to Re: Tired-all the time? advice?, posted by jedi on January 25, 2006, at 3:02:49
Thank you Jedi. Thank you thank you thank you. Where have you been all my life? : ) Wow, what an 'oh yeah' moment this was! Something big just finally clicked into place...
I ALWAYS knew there was a gluccocorticoid deficiency. Since antidepressants never helped, I can't tell you how many years I've been reading books about adrenal fatigue, chronic fatigue, HPA axis, ACTH, dexamethasone, etc and found they were all written about me. But try getting a doc to test your HPA feedback loop; they hate when you know more than they do, so immediately just assume hypochondriasis and discount the suggestion. Then, by mistake, the only time I ever felt GOOD, ever, was when treated for an infection or somethign with 40 mg p/day of cortisol. Years later I finally got a doc to prescribe a smaller daily amount and it felt okay for a while, not as good as the 40 mg, but you know, better. However, the benefit has been lost now. So I now suspected not just a low cortisol level but a feedback thing of some kind.
Just in the past few weeks found the atypical depression diagnosis and knew it was me immediately, and read everything I could on it, but missed the one you posted. I'm on Parnate which kinda works then doesn't then works then doesn't. Feels like I'm kinda chasing the dragon with it. And to be truthful, it feels more like the amphetamine metabolites (to which I'm just super super sensitive) that I feel. I can take one and feel it within an hour and I'm not sure the actual AD effects of Parnate are supposed to work that way.
Do you know if the HPA regulation effects are limited to Nardil? And not Parnate? Kinda what it sounds like, but Nardil may just be the one they chose for the study... Just wondering if you have other knowledge of that.
I'd take it to my pdoc, but you know he'd never take the two minutes to read it. But you have given me hope for something after the Parnate cause I'm starting to worry about it. How very sad that atyp depr is commonly mistaken for chronic fatigue and the like by docs who have just not heard of it. What a colossal waste of lives.
Anyway, Jedi, thanks for knowing about it and posting that. You have made my morning. I feel like I've just now seen land after being at sea for 30 years. I love this place.
Hopeful again,
Suzie
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