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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 45. This is the beginning of the thread.
Posted by TylerJ on April 2, 2006, at 15:05:10
As we all know, Depression is an awful illness! In short, to be depressed is often to experience a living hell.
Depression must be taken seriously as a potential killer by patients, their families and their doctors.
The ominous complication of depression is, of course, suicide. In the U.S., suicide remains a leading cause of death; third among all causes of death for people 25-34 years of age and tenth for adults overall. The highest risk is elderly men, especially those with other medical problems. Teenage suicide is an increasing problem; even children commit suicide.
Hopefully, better medications/treatments, and correct diagnosis, as well as early diagnosis, will reduce these statistics in the future.Tyler
Posted by Glydin on April 2, 2006, at 17:40:51
In reply to Depression Can Be Fatal!, posted by TylerJ on April 2, 2006, at 15:05:10
And I think it's a whole body disease, too.
The negative effects on the body systems like: cardiac, immunity, and a host of others can be quite detrimental also. So, there's acute effects and long term ones as well.
Posted by willyee on April 2, 2006, at 18:24:22
In reply to Re: Depression Can Be Fatal! » TylerJ, posted by Glydin on April 2, 2006, at 17:40:51
I think its a paradoxial effect,a vicious cycle.Your mind,which in turn is ur mood,is like the motor in a car.
If the motor doesent run,the car doesent,and sh*ts in some garage,only to collect dust and months later after just sitting look and operate like crap.
When ur in a depression,a clinical one,it can be to a large degree disabilitating,if ur lucky u can do a few things u HAVE to do.
Example whenver i come out,like i have this past few days,all of a sudden it becomes clear i havent been eating,so my diet and nutrients are poor,i havent excersied which makes my pyshical being weak,bills are piled and everything is just out of tune.
So depression can very destroy ones life if they are not lucky enough to have people around them to help when they are barly functional.
So its much more than just a mind illness,my 2 cents.
Posted by Phillipa on April 2, 2006, at 21:50:44
In reply to Re: Depression Can Be Fatal!, posted by willyee on April 2, 2006, at 18:24:22
As well as anxiety. I just spent two days in two weeks in the ER. Shortness of breathe the first time. Cardiac work-up negative Doc said anxiety attack. Prescription xanax never filled it. Yesterday have been having chest pain on rest for two weeks couldn't sleep roll over etc. ER again this time an angiogram and now back to the GP and then the neurologist the CP on the left side and this ER doc said it could be the slight scoliosis. Meanwhile three MRI's brain, neck, spine no results yet. And this ER doc wants nerve conduction tests. Stress can kill. Love Phillipa ps now I have percocet for the chest pain guess what wierd but my husband said I was laughing today from one meansley percocet last night. Maybe there is something to this opiate thing.
Posted by yxibow on April 3, 2006, at 5:31:49
In reply to Re: Depression Can Be Fatal!, posted by Phillipa on April 2, 2006, at 21:50:44
> As well as anxiety. I just spent two days in two weeks in the ER. Shortness of breathe the first time. Cardiac work-up negative Doc said anxiety attack. Prescription xanax never filled it. Yesterday have been having chest pain on rest for two weeks couldn't sleep roll over etc. ER again this time an angiogram and now back to the GP and then the neurologist the CP on the left side and this ER doc said it could be the slight scoliosis. Meanwhile three MRI's brain, neck, spine no results yet. And this ER doc wants nerve conduction tests. Stress can kill. Love Phillipa ps now I have percocet for the chest pain guess what wierd but my husband said I was laughing today from one meansley percocet last night. Maybe there is something to this opiate thing.
Yes -- percocet is wonderful stuff ... :) For a week or two. Then tolerance sets in and you can't go to the bathroom -- which is why Imodium is such a good drug because it is an opiate that cant cross the blood brain barrier.
Stress can kill, over the long term, but one also has to look at the feedback loop of stress and anxiety, and overmonitoring and overvigilance, which leads to more panic episodes and the like, none of course which are anyone's fault.-- J
Posted by yxibow on April 3, 2006, at 5:36:00
In reply to Depression Can Be Fatal!, posted by TylerJ on April 2, 2006, at 15:05:10
> As we all know, Depression is an awful illness! In short, to be depressed is often to experience a living hell.
>
> Depression must be taken seriously as a potential killer by patients, their families and their doctors.
>
> The ominous complication of depression is, of course, suicide. In the U.S., suicide remains a leading cause of death; third among all causes of death fhill eventuor people 25-34 years of age and tenth for adults overall. The highest risk is elderly men, especially those with other medical problems. Teenage suicide is an increasing problem; even children commit suicide.
>
> Hopefully, better medications/treatments, and correct diagnosis, as well as early diagnosis, will reduce these statistics in the future.
>
> Tyler
I do hope so -- I could have had a second aunt, had she not succumbed (I needn't go into the obvious details) from Bipolar II. Of course this was early days when I guess lithium was around, maybe Elavil, I don't know.
But I share your hope too, and research of all kinds will eventually have to get to the genetic level, and all the politics and personal positions on stem cells, etc, etc. Our country will be seen as seriously lagging behind in science if we don't do something about it, now more in the private sector since governments around the country have hampered things. But thats just my 2c.
Cheers-- Jay
Posted by SLS on April 3, 2006, at 7:15:09
In reply to Re: Depression Can Be Fatal! » Phillipa, posted by yxibow on April 3, 2006, at 5:31:49
Hi.
> Yes -- percocet is wonderful stuff ... :) For a week or two. Then tolerance sets in and you can't go to the bathroom -- which is why Imodium is such a good drug because it is an opiate that cant cross the blood brain barrier.
What would work to alleviate the nausea associated with opioids?
- Scott
Posted by TylerJ on April 3, 2006, at 9:02:58
In reply to Re: Depression Can Be Fatal!, posted by Phillipa on April 2, 2006, at 21:50:44
> As well as anxiety. I just spent two days in two weeks in the ER. Shortness of breathe the first time. Cardiac work-up negative Doc said anxiety attack. Prescription xanax never filled it. Yesterday have been having chest pain on rest for two weeks couldn't sleep roll over etc. ER again this time an angiogram and now back to the GP and then the neurologist the CP on the left side and this ER doc said it could be the slight scoliosis. Meanwhile three MRI's brain, neck, spine no results yet. And this ER doc wants nerve conduction tests. Stress can kill. Love Phillipa ps now I have percocet for the chest pain guess what wierd but my husband said I was laughing today from one meansley percocet last night. Maybe there is something to this opiate thing.
Your right, stress can kill. I'm so sorry that you had to go through all that. You cracked me up about the opiates...they definitely make a person feel better! :} I'll keep you in my prayers dear. Get well.
Love, Tyler
Posted by naughtypuppy on April 3, 2006, at 10:15:54
In reply to Re: Depression Can Be Fatal!, posted by Phillipa on April 2, 2006, at 21:50:44
Wouldn't that be a hoot if they discovered that the basis of all mood disorders was in the opiate system instead of the usual suspect neurotransmitters.
Posted by TylerJ on April 3, 2006, at 11:35:13
In reply to Re: Depression Can Be Fatal! » Phillipa, posted by naughtypuppy on April 3, 2006, at 10:15:54
> Wouldn't that be a hoot if they discovered that the basis of all mood disorders was in the opiate system instead of the usual suspect neurotransmitters.
I know when I take Opiates they put me in a better mood...The problem is I build tolerance to them very quickly, like 3-4 days. But even that's better than some AD's. :}Tyler
Posted by ed_uk on April 3, 2006, at 14:18:29
In reply to Re: Depression Can Be Fatal! » yxibow, posted by SLS on April 3, 2006, at 7:15:09
Hi Scott
>What would work to alleviate the nausea associated with opioids?
The nausea usually disappears after the first few days. During that time, lying down can do a lot to relieve the nausea.
Useful antiemetics for opioid-induced nausea include......
Metoclopramide 10mg tid
Prochlorperazine 5mg tid
Cyclizine 50mg tidIf you initiate the opioid at a low dose you probably won't need an antiemetic - which is good because antiemetics have their own side effects.
Regards
Ed
Posted by SLS on April 3, 2006, at 15:01:17
In reply to Re: Depression Can Be Fatal! » SLS, posted by ed_uk on April 3, 2006, at 14:18:29
:-)
Posted by yxibow on April 3, 2006, at 15:13:39
In reply to Re: Depression Can Be Fatal! » yxibow, posted by SLS on April 3, 2006, at 7:15:09
> Hi.
>
> > Yes -- percocet is wonderful stuff ... :) For a week or two. Then tolerance sets in and you can't go to the bathroom -- which is why Imodium is such a good drug because it is an opiate that cant cross the blood brain barrier.
>
> What would work to alleviate the nausea associated with opioids?
>
>
> - Scott
>Meclizine is similar to Cyclizine and is OTC as Dramamine II (and generic), and you can use it "off label" -- with the side effects like Cogentin if you get to a full dose.
If you can stand it, and I dont particularly mind, a lot of macerated raw ginger does partially block 5HT3 (I had to do that the other week for a virus in my inner ear -- so we think)
And then there's Tigan, which has some but not all the pitfalls of Compazine, and does carry some but not all the risks of TD. But as ed says, its worse than a stiff upper lip, so the people across the pond say.
Some people are very sensitive to nausea with opiates -- myself I fortunately haven't had that. Its a problem with pain mediation.-- Jay
Posted by SLS on April 3, 2006, at 15:25:41
In reply to Re: Depression Can Be Fatal!, posted by yxibow on April 3, 2006, at 15:13:39
:-)
Posted by Phillipa on April 3, 2006, at 20:25:39
In reply to Re: Depression Can Be Fatal! » yxibow, posted by SLS on April 3, 2006, at 7:15:09
Scott what nausea I didn't have any nausea? Love phillipa
Posted by SLS on April 3, 2006, at 20:30:43
In reply to Re: Depression Can Be Fatal! » SLS, posted by Phillipa on April 3, 2006, at 20:25:39
> Scott what nausea I didn't have any nausea? Love phillipa
My grandmother developed nausea from taking Vicoden. It seems to have passed over the course of a few days.
- Scott
Posted by CEK on April 4, 2006, at 10:07:22
In reply to Re: Depression Can Be Fatal!, posted by SLS on April 3, 2006, at 20:30:43
I had to take Percocet and Loratab before after having teeth pulled and after my c-sections and it made me feel wonderful. Not talking about how it helped my pain, it was how it helped my head! Nothing bothered me! My depression, things at work, my husband ranting, it was all like it didn't exist anymore. I could really see how people could get addicted to this stuff! Nausia was a promblem at first unless I was laying down and slept, but once I got use to it the nausia was gone. Oh what I would give to feel that way again!
Posted by JaclinHyde on April 5, 2006, at 9:35:06
In reply to Re: Depression Can Be Fatal! » Phillipa, posted by TylerJ on April 3, 2006, at 9:02:58
I'm sorry but I have to bring this up. There are so many people out there suffering so badly...close to suicide or house bound because of anxiety who will not even consider an MAOI. Why? Cause if you are not careful it could kill you. Does anyone else see the twisted logic here?
JH
Posted by TylerJ on April 5, 2006, at 10:56:38
In reply to Re: Depression Can Be Fatal!, posted by JaclinHyde on April 5, 2006, at 9:35:06
> I'm sorry but I have to bring this up. There are so many people out there suffering so badly...close to suicide or house bound because of anxiety who will not even consider an MAOI. Why? Cause if you are not careful it could kill you. Does anyone else see the twisted logic here?
>
> JHI definitley do. I really wish Parnate would have been my pdocs first choice when I was 22 years old and bed bound, I saw absolutely no future in my life. My doc put me on Imipramine, and it took me about a year to finally make some progress. With Parnate, I'm sure I wouldn't have been in bed for 2 mos., maybe 2 wks until it kicked in.
People don't be afraid of MAOI's. The chances of a hypertensive episode is not high, and the diet really isn't difficult to follow at all. Most importantly, if your not doing well with other meds., please don't wait 25 years like I did. An MAOI like Parnate, Nardil and maybe even EMSAM, just might change your life from barely hanging on, to feeling really good and enjoying each day.Tyler
Posted by Caedmon on April 5, 2006, at 12:22:59
In reply to Re: Depression Can Be Fatal! » yxibow, posted by SLS on April 3, 2006, at 7:15:09
> What would work to alleviate the nausea associated with opioids?
Just to add, I find that promethazine works really well, probably due to its antihistamine and phenothiazine characteristics.
- C
Posted by yxibow on April 6, 2006, at 1:27:26
In reply to Re: Depression Can Be Fatal!, posted by JaclinHyde on April 5, 2006, at 9:35:06
> I'm sorry but I have to bring this up. There are so many people out there suffering so badly...close to suicide or house bound because of anxiety who will not even consider an MAOI. Why? Cause if you are not careful it could kill you. Does anyone else see the twisted logic here?
>
> JHBecause most suicidal people really do not want to kill themselves in the end. They just want relief from their problems. Its the ones who don't say anything about it that bring real worry. But that's just my opinion.
I would consider ECT over an MAOI. They're just so rife with an eating plan that defies logic. RIMAs are slightly better on that aspect but not available in the US. EMSAM -- still not the panacea that it is, because beyond the little dose patch, there are still bold warnings about hypertensive crisis, which is pretty serious.
I understand your opinion, but I stand to disagree. Yes, there are a number of people on this board who have managed to survive on an MAOI, but there are just so many things, I mean, surviving spring allergies with OTC medication or taking cough syrup or lots of things can mean death to people who really don't actually want that in the end.
Posted by ed_uk on April 6, 2006, at 14:49:39
In reply to Re: Depression Can Be Fatal! » JaclinHyde, posted by yxibow on April 6, 2006, at 1:27:26
Hi Yxi
>I would consider ECT over an MAOI. They're just so rife with an eating plan that defies logic.
MAOIs are relatively safe provided that the appropriate precautions are taken. The eating plan does not defy logic.
>RIMAs are slightly better on that aspect but not available in the US
Dietary restrictions are rarely necessary with RIMAs. Unfortunately, RIMAs do not appear to share the high efficacy of the classical MAOIs.
>I mean, surviving spring allergies with OTC medication or taking cough syrup or lots of things can mean death to people who really don't actually want that in the end.
Oral decongestants are contra-indicated with MAOIs. None of the oral decongestants are particularly effective though. Having to avoid such drugs is hardly a great loss. Steroid nasal sprays and non-sedating antihistamines do not interact with MAOIs.
In general, none of the OTC cough syrups are worth buying. If pneumonia is present, antibiotics with be necessary. Otherwise, the cough will go away on its own.
Regards
Ed
Posted by TylerJ on April 6, 2006, at 18:01:40
In reply to Re: Depression Can Be Fatal! » yxibow, posted by ed_uk on April 6, 2006, at 14:49:39
> Hi Yxi
>
> >I would consider ECT over an MAOI. They're just so rife with an eating plan that defies logic.
>
> MAOIs are relatively safe provided that the appropriate precautions are taken. The eating plan does not defy logic.
>
> >RIMAs are slightly better on that aspect but not available in the US
>
> Dietary restrictions are rarely necessary with RIMAs. Unfortunately, RIMAs do not appear to share the high efficacy of the classical MAOIs.
>
> >I mean, surviving spring allergies with OTC medication or taking cough syrup or lots of things can mean death to people who really don't actually want that in the end.
>
> Oral decongestants are contra-indicated with MAOIs. None of the oral decongestants are particularly effective though. Having to avoid such drugs is hardly a great loss. Steroid nasal sprays and non-sedating antihistamines do not interact with MAOIs.
>
> In general, none of the OTC cough syrups are worth buying. If pneumonia is present, antibiotics with be necessary. Otherwise, the cough will go away on its own.
>
> Regards
>
> EdI totally agree with everything Ed said here. The eating plan does not defy logic. Most good pdocs would consider MAOI's before ECT. Lack of education continues to give maoi's a bad reputation, docs as well as patients are guilt of this.
Tyler
Posted by Caedmon on April 6, 2006, at 18:52:14
In reply to Re: Depression Can Be Fatal! » JaclinHyde, posted by yxibow on April 6, 2006, at 1:27:26
> I would consider ECT over an MAOI.
Interesting. I have strongly considered ECT many times, and if I had the money I would probably give it a go. Although I have no problem trying out MAOIs. The diet is okay, it requires a certain degree of vigilance and mindfulness, but that's something most of us could use anyway.
>EMSAM -- still not the panacea that it is, because beyond the little dose patch, there are still bold warnings about hypertensive crisis, which is pretty serious.
I know. I'm finding EMSAM a disappointing prospect, but I'm trying not to be too cynical. I understand oral selegiline to be somewhat less effective than other nonreversible MAOIs like phenelzine.
- C
Posted by TylerJ on April 6, 2006, at 19:47:31
In reply to Re: Depression Can Be Fatal! » yxibow, posted by Caedmon on April 6, 2006, at 18:52:14
> > I would consider ECT over an MAOI.
>
> Interesting. I have strongly considered ECT many times, and if I had the money I would probably give it a go. Although I have no problem trying out MAOIs. The diet is okay, it requires a certain degree of vigilance and mindfulness, but that's something most of us could use anyway.
>
> >EMSAM -- still not the panacea that it is, because beyond the little dose patch, there are still bold warnings about hypertensive crisis, which is pretty serious.
>
> I know. I'm finding EMSAM a disappointing prospect, but I'm trying not to be too cynical. I understand oral selegiline to be somewhat less effective than other nonreversible MAOIs like phenelzine.
>
> - CThe biggest problem with ECT is that it doesn't last. And believe me, it's not as easy and comfortable as "they" say it is. I had 24 treatments in 1997. The treatment itself is painless, but afterwords you feel like you've been hit by a truck, severe headache and flu like syptoms. And memory loss is worse than most pdocs say it'll be. I've lost for good everything 3 mos. before my treatments. And, oh yea, they want you to keep going back for maintenance treatments. I know I'll never do it again...I seriously think it's way over rated.
Tyler
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