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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 34 to 58 of 76. Go back in thread:
Posted by ed_uk on April 23, 2006, at 9:43:45
In reply to Re: Another drug failure » linkadge, posted by SLS on April 23, 2006, at 8:50:27
Hi Scott
I hope Valdoxan is approved in Europe soon. Do you think it will be easy for you to obtain?
Regards
Ed
Posted by platinumbride on April 23, 2006, at 9:54:55
In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50
Scott,
I'm so sorry you are going through this again. I wish you the best.
Diane
Posted by bassman on April 23, 2006, at 10:10:50
In reply to Re: Another drug failure » SLS, posted by ed_uk on April 23, 2006, at 9:43:45
Is Valdoxan approved in the US? The only thing I could find on the net were Phase III trials..
Posted by SLS on April 23, 2006, at 10:53:47
In reply to Re: Another drug failure » SLS, posted by ed_uk on April 23, 2006, at 9:43:45
> Hi Scott
>
> I hope Valdoxan is approved in Europe soon. Do you think it will be easy for you to obtain?If the guy is still in business, I have used a pharmacy in the UK to procure sulpiride.
- Scott
Posted by ed_uk on April 23, 2006, at 11:22:46
In reply to Re: Another drug failure » ed_uk, posted by SLS on April 23, 2006, at 10:53:47
Hi Scott
What sort of pharmacy was it?
Ed
Posted by SLS on April 23, 2006, at 11:56:25
In reply to Re: Another drug failure » SLS, posted by ed_uk on April 23, 2006, at 11:22:46
> Hi Scott
>
> What sort of pharmacy was it?Probably a Mom and Pop store. I don't think it was a chain store.
You're not going to tell on me, are you?
:-)
- Scott
Posted by ed_uk on April 23, 2006, at 12:20:20
In reply to Re: Another drug failure » ed_uk, posted by SLS on April 23, 2006, at 11:56:25
Hi Scott
>You're not going to tell on me, are you?
LOL. No!
Ed
Posted by linkadge on April 23, 2006, at 12:28:56
In reply to Re: Another drug failure » linkadge, posted by SLS on April 23, 2006, at 8:50:27
I've heard the theory thrown around somewhere on biopsychiatry.com, that in a state of catecholamine excess one can feel profoundly unsatisfied. Thats where serotonergics come in (or so the theory goes).
Linkadge
Posted by linkadge on April 23, 2006, at 12:48:44
In reply to Re: Another drug failure » SLS, posted by linkadge on April 23, 2006, at 12:28:56
How do you feel about the abilify. The reason I ask is that it does have a strong antagonistic affinity for d3 receptors. These receptors are loaded in pleasure centres of the brain. So I don't know the kind of effect that blocking those would have on anhedonia.
The theraputic effect you're getting from this drug is probably a combination of 5-ht2a antagonism and 5-ht1a agonism, and perhaps d2 agonism.
The combination of dopamine + serotonin agonism is an unexplored terrain. For instance one study showed that (in parkonsons disease) adding gepirone to a dopamine agonist resulted in significant improvements in both movement and depressive symtpoms.
Ie buspar + mirapex.
What about replaceing the abilify with trazodone ?
Lamictal + trazodone + nortryptaline.
It might be cleaner.
Linkadge
Posted by ravenstorm on April 23, 2006, at 13:01:22
In reply to Re: Another drug failure, posted by linkadge on April 23, 2006, at 12:48:44
Scott-
Forgive me if you already tried this. I took a break from the boards for about six months so I'm not up on anything that happened during that time frame.
I remember you being interested in a trial of RU486, did that ever come to fruition? If not, is it a possibility in the near future?
Also, would you consider being in a trial for DBS if it was available. Those reports out of Toronto looked pretty promising.
You are in my thoughts.
Posted by TJO on April 23, 2006, at 15:40:54
In reply to Re: Another drug failure » SLS, posted by linkadge on April 23, 2006, at 12:28:56
Hi Scott,
Hang in there!! :-)Tam
Posted by Jay on April 23, 2006, at 16:46:07
In reply to Re: Another drug failure » ed_uk, posted by SLS on April 23, 2006, at 11:56:25
Posted by SLS on April 23, 2006, at 19:03:35
In reply to Re: Another drug failure..PLEASE READ » SLS, posted by Jay on April 22, 2006, at 15:05:27
Hi Jay.
Thanks for the good ideas.
> So here goes my reccomendations:
>
> -Add another mood stabalizer..possibly a good one, like depakote.I think I'll try adding back the Keppra as a mood stabilizer.
> -You've got stimulating antidepressants, so add some Prozac, at a GOOD dose. (i.e. 80mg's)
Yeah. I never tried more than 20mg a day.
> -Add another atypical antipsychotic. Risperdal seems safest as far as diabetes goes, and don't be afraid to bump around the dose.
I've tried Zyprexa, Risperdal, Seroquel, and Geodon. Low dosages of Risperdal did help, but only for a few weeks.
> -I'd suggest maybe dumping the Wellbutrin, in place of some new Dexedrine.
Maybe I could just add it to the Wellbutrin. I would hate to give up on the Wellbutrin too quickly.
> -Add a PRN benzo if anxiety is still a problem.
I have some social anxiety, but nothing that I would consider paralyzing.
Your suggestions are valid, and I'll keep them in mind for the future. With so many ideas being presented, it is hard to know which ones to choose.
> Good luck...you still have a long road to travel my friend.
You might be right. I hope it is not too much longer. I've waited too long already.
Thanks again.
- Scott
Posted by Phillipa on April 23, 2006, at 20:05:29
In reply to Re: New Idea Scott » Phillipa, posted by SLS on April 23, 2006, at 8:10:05
Scott sorry I did mean VNS. Love Phillipa
Posted by Crazy Horse on April 23, 2006, at 20:56:57
In reply to Re: Another drug failure » SLS, posted by linkadge on April 23, 2006, at 12:28:56
Posted by maxime on April 24, 2006, at 0:27:18
In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50
i'm sorry scott. but there will be more drugs to try. i know that doesn't help you now. I wish I could make you feel better.
love, maxie
> Another drug failure.
>
> The addition of Wellbutrin to my treatment produced a profound improvement in my depression during weeks 3 and 4. No more. I have relapsed. There is no vestige of an antidepressant response. I do not expect one to reappear regardless of how much time I remain on this drug.
>
> I don't know how much more I can take. I don't know what there is left to try. The logical part of me concluded quite some time ago that my brain will never respond to treatment. The emotional part of me masks the logical part and continues to have hope. I probably would not continue to live without it. I must therefore suppress and ignore my logic in order to survive.
>
>
> - Scott
Posted by jedi on April 24, 2006, at 1:20:33
In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50
Hi Scott,
There is probably nothing I can say about your medications that you haven't thought of already. I have been reading your posts since the early days of Babble and I really appreciate the wealth of information you have provided to myself and others. I sure wish there was the magic pill that could take the pain away. All I can say is hang in there like you have in the past; things will get better. Some of us are in this for the long haul.
Take care,
Jedi> Another drug failure.
>
> The addition of Wellbutrin to my treatment produced a profound improvement in my depression during weeks 3 and 4. No more. I have relapsed. There is no vestige of an antidepressant response. I do not expect one to reappear regardless of how much time I remain on this drug.
>
> I don't know how much more I can take. I don't know what there is left to try. The logical part of me concluded quite some time ago that my brain will never respond to treatment. The emotional part of me masks the logical part and continues to have hope. I probably would not continue to live without it. I must therefore suppress and ignore my logic in order to survive.
>
>
> - Scott
Posted by scatterbrained on April 24, 2006, at 2:20:03
In reply to Another drug failure, posted by SLS on April 22, 2006, at 9:11:50
I can relate to trying to supress reality for hope. I wish I could offer some medication suggestions but I'm in the same boat.
Have you tried one of those cbt workbooks? I've found them to be more beneficial than one on one therapy. You strike me as lucid enough to respond to it because you are able to work.
I've found that when medication gets me to the point of being lucid, the three things that offer me a full remission are preductivity, those cbt workbooks and exercise.
I hope this helps and at least you are not the only one suffering.
Posted by SLS on April 24, 2006, at 8:43:50
In reply to Re: Another drug failure » SLS, posted by scatterbrained on April 24, 2006, at 2:20:03
> You strike me as lucid enough to respond to it because you are able to work.
I wish I were. I haven't worked since April 15, 1990. If I can get 50% better, I probably could.
I've never seen a CBT workbook, but I use CBT tools in my day to day life. I have to recognize and "undo" the automatic thoughts that depression produces. Depression taints perceptions and interpretations. It is an unending task to prevent them from becoming internalized.
- Scott
Posted by SLS on April 24, 2006, at 8:49:27
In reply to Re: Another drug failure, posted by SLS on April 24, 2006, at 8:43:50
I have this nervous feeling in the pit of my stomach. I have reached the point where I feel I am doomed to never be free of this ubiquitous cognitive suppression and painful affective oppression. My thoughts turn towards autoeuthanasia.
- Scott
Posted by Crazy Horse on April 24, 2006, at 9:17:55
In reply to Re: Another drug failure, posted by SLS on April 24, 2006, at 8:49:27
> I have this nervous feeling in the pit of my stomach. I have reached the point where I feel I am doomed to never be free of this ubiquitous cognitive suppression and painful affective oppression. My thoughts turn towards autoeuthanasia.
>
>
> - Scott
>
>
I'm sorry that you have to feel this way. It's horrible, i've felt like that many times myself. Do you have and local physical support Scott? A wife, parents, siblings, friends, someone you can lean on to help you at this time? Have you considered being hospitalized? I Just don't think being alone is good.Monte
Posted by SLS on April 24, 2006, at 9:33:26
In reply to Re: Another drug failure » SLS, posted by Crazy Horse on April 24, 2006, at 9:17:55
> > I have this nervous feeling in the pit of my stomach. I have reached the point where I feel I am doomed to never be free of this ubiquitous cognitive suppression and painful affective oppression. My thoughts turn towards autoeuthanasia.
> I'm sorry that you have to feel this way. It's horrible, i've felt like that many times myself. Do you have and local physical support Scott? A wife, parents, siblings, friends, someone you can lean on to help you at this time? Have you considered being hospitalized? I Just don't think being alone is good.
I go to a clinical 2-3 times a week for psychological and emotional support. I almost don't want to be bothered going today, but I guess it would be good for me.
I still can't believe this stuff just stopped working for me. I thought that after two weeks of improvement, I would be home-free. My outlook was positive and optimistic. I was beginning to plan my future as a healthy adult. It all came crashing down on me last week.
- Scott
Posted by jparsell82 on April 24, 2006, at 9:45:21
In reply to Re: Another drug failure » Crazy Horse, posted by SLS on April 24, 2006, at 9:33:26
Have you tried adding a dopamine agonist? I found Trivastal to feel a lot better than Requip or Dostinex. Perhaps you could give Trivastal a try?
Posted by ed_uk on April 24, 2006, at 13:01:41
In reply to Re: Another drug failure, posted by SLS on April 24, 2006, at 8:49:27
Scott,
Are you going to try 450mg Wellbutrin? Perhaps you could decrease your nortriptyline first then increase the Wellbutrin?
Regards
Ed
Posted by SLS on April 24, 2006, at 14:52:25
In reply to Re: Another drug failure » SLS, posted by ed_uk on April 24, 2006, at 13:01:41
> Scott,
>
> Are you going to try 450mg Wellbutrin? Perhaps you could decrease your nortriptyline first then increase the Wellbutrin?That's not a bad idea. I see my doctor on Wednesday. I might skip tonight's dose of nortriptyline to see how I feel tomorrow. Wellbutrin is supposed to be only mild as an inhibitor of 2D6, but I guess it only takes a little to make a big difference.
Thanks.
- Scott
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Dr. Bob is Robert Hsiung, MD,
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