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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 43. Go back in thread:
Posted by Klavot on January 2, 2007, at 15:49:53
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
It's a war. You have to fight it every step of the way, work at it. NEVER GIVE UP. Never become a victim.
Posted by Phillipa on January 2, 2007, at 16:45:26
In reply to Re: Has anyone here had a remssion for long?, posted by Klavot on January 2, 2007, at 15:49:53
Till recently benzos worked for me very well for about 30 years. The ad's never did this for me as initial symtom was panic attacks. Now my thyroid is messing things up and is hyper. Love Phillipa
Posted by Quintal on January 2, 2007, at 17:12:12
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
I'm in remission and asymptomatic from depression and have been for about six months. The key to this recovery seems to have been stopping medication - particularly benzos. Anxiety has increased but that is something I'm working on.
Q
Posted by mindevolution on January 2, 2007, at 17:20:04
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
> Has anyone here been asmptomatic for a good deal of time. What meds (or other) do you think was key?
>
> Linkadge
>
the only cure for MENTAL illness is mental therapy. mental illness in in the mind not the brain, otherwise it would be called a disease like alzeihmer's or parkinsons.you can't cure it with drugs only get some relief from symptoms while you get therapy.
problem is some drugs cause physical brain damage particularly the toxic ones like antipsychotics, and you can't cure permanent damage to your CNS.
so if you want a permanent cure to mental illness, try no meds and therapy.
can someone tell me why psychiatrists are the front line for treatment for mental illness rather than psychologists?????? surely mental illness can be cured with good therapy, but zap someone with ect or give them toxic doses of antipsychotics and it doesn't matter how much therapy they have after that, the patient will never be able to recover fully!
or am i missing something?
ME
Posted by Emme on January 2, 2007, at 17:23:05
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
A good friend of mine has been doing well for the last couple of years on seroquel monotherapy for BPI. She had been to Hades and back with her mood disorder trying different things and this med seems to be working out nicely.
Posted by blueberry1 on January 2, 2007, at 18:19:06
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
Remission? What's that? I've been non-depressed on Paxil or Prozac, but still had significant residual symptoms such as apathy, anhedonia, nervousnes/anxiety, obsessiveness.
ECT had me in remission for 2 whole days.
Posted by laima on January 2, 2007, at 18:23:32
In reply to Re: Has anyone here had a remssion for long? » linkadge, posted by Emme on January 2, 2007, at 17:23:05
Actually, an addendum. Prozac didn't induce a long remission on its own, I also started with a fantastic therapist at the time (who sadly has long since retired.) The therapist was great because I genuinely admired and looked up to her, and she acted more as a mentor than therapists traditionally do. She inspired me, and she also very skillfully deflated all of my excuses over why I'd never feel better, couldn't do anything, and so on.Since then, there is something my doctor said which I think a lot about: "Medication is a tool, it's not going to solve everything by itself. It's not necessarily going to work forever, and it's not perfect. It's not going to make you feel better if you keep a ridiculous schedule and your afairs in shambles. Make sure you sleep and excercise normally. When it works, use the window to make some changes in your life, and see a therapist!"
Posted by linkadge on January 2, 2007, at 18:26:40
In reply to Re: Has anyone here had a remssion for long?, posted by mindevolution on January 2, 2007, at 17:20:04
>you can't cure it with drugs only get some >relief from symptoms while you get therapy.
I think that depends on the nature of the underlying problem. Thyroid problems for instance, are a biochemical cause of depression in some. For some of these people, thyroid can cure the problem.
>problem is some drugs cause physical brain >damage particularly the toxic ones like >antipsychotics, and you can't cure permanent >damage to your CNS.
I agree with that.
>so if you want a permanent cure to mental >illness, try no meds and therapy.
I've gone both ways. With or without meds. I wouldn't say that no meds and therapy have cured anything, but thats not to say it doesn't work for some.
>can someone tell me why psychiatrists are the >front line for treatment for mental illness >rather than psychologists?????? surely mental >illness can be cured with good therapy,
Thats not always true. I know people who have attended years of the best therapy money can buy, and can gain tremendous insight to the nature of their suffering, but are yet still completely unable to change the way they feel on a daily basis. Brain chemistry can profoundly affect mood just like it can affect movement, hence I would say that depression is no less a biochemical problem (for some) than parkinsons.
>but zap someone with ect or give them toxic >doses of antipsychotics and it doesn't matter >how much therapy they have after that, the >patient will never be able to recover fully!
I'd have to say I agree. Thought, just because our treatments are fairly crappy, doesn't detract from the fact that some people's mood disorders may be a result of some form of brain abnormality.
>or am i missing something?
I think that some people are prone to these types of illnesses. Just because they havn't found a cure doesn't mean there isn't one (for certain forms of depression)
Its just like depression in epilepsy. Some think that the epileptic dysfunction is the same dysfunction that mediates the mood disorder. As such, the depression is no less a brain abnormality than the seizures.
Linkadge
Posted by Farkus on January 2, 2007, at 18:32:00
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
> Has anyone here been asmptomatic for a good deal of time.
<< For almost two years - a record for me. It's been great. I credit a med but I tend to not bring it up here any longer as the reactions and feedback (based on the past) isn't, uh, in my best interest to be exposed to.
Posted by laima on January 2, 2007, at 18:34:11
In reply to Re: Has anyone here had a remssion for long?, posted by Farkus on January 2, 2007, at 18:32:00
Farkus, is it an unpopular med or perhaps one with an image problem? Glad to hear it works, though, whatever it is.
> > Has anyone here been asmptomatic for a good deal of time.
>
> << For almost two years - a record for me. It's been great. I credit a med but I tend to not bring it up here any longer as the reactions and feedback (based on the past) isn't, uh, in my best interest to be exposed to.
Posted by notfred on January 2, 2007, at 18:36:33
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
Yes, for decades, since 1984. I have posted quite a bit about what I take and my general feelings on things so I will not repeat that here.
Posted by NYCguy on January 2, 2007, at 19:05:39
In reply to Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 14:02:39
> Has anyone here been asmptomatic for a good deal of time. What meds (or other) do you think was key?
>
> Linkadge
>Tons of people. Millions of them all over the world, actually. Babble is not ever going to be remotely representative of the general population because it is a community made up of people who have found little relief from many med trials.
There's my girlfriend, who takes 30mg Cymbalta and that's all she needs. Also my Mum, who's on Prozac only in the winter to chase off the seasonal blues. My GF's father... who after 40 years of depression found Paxil 7 years ago and it's been wonderful for him. Some others in my fam with BP: they use Lithium and while it gives them a little weight gain and the shakes, they can work and study and lead much better lives...
P-Babble is a great place... but it's not some sample of the world at large... or even of the depressed people of the world at large. It is made up of a bunch of fine and caring people who have not yet found an adequate long-term solution to their mental pain. I'm one of them.
All I'm getting at is there are lots of people that have been helped my meds and have been asympomatic or "normal" for years or decades out there. They just don't usually come to post here.
Posted by Farkus on January 2, 2007, at 19:43:41
In reply to Re: Has anyone here had a remssion for long?, posted by laima on January 2, 2007, at 18:34:11
> Farkus, is it an unpopular med or perhaps one with an image problem?<< In terms of it's class, it's gets a little better rep around this board than some of the others. I've had some unsettling and confusing feedback, so my decision was to avoid the "kitchen" as I did not want to take the "heat". I understand the frustration people have trying to find a workable treatment plan. I think it can be easy to wonder about (and question) other's success when one is struggling. It was not very fun to have it done to me.
> Glad to hear it works, though, whatever it is.
<< Very nice of you to say, I appreciate that ---
Posted by mindevolution on January 2, 2007, at 21:01:48
In reply to Re: Has anyone here had a remssion for long?, posted by linkadge on January 2, 2007, at 18:26:40
hiya linkadge you bring up some good and interesting points, which made me think!
> >you can't cure it with drugs only get some >relief from symptoms while you get therapy.
> I think that depends on the nature of the underlying problem. Thyroid problems for instance, are a biochemical cause of depression in some. For some of these people, thyroid can cure the problem.
sure, but I said you can't cure or prevent mental illness with drugs. thyroid problems, cancers, viruses, etc can all cause mental illness symptoms, but they have a physical cause and therefore and not considered mental illnesses, well at least that's how I understand it. :)
> >problem is some drugs cause physical brain >damage particularly the toxic ones like >antipsychotics, and you can't cure permanent >damage to your CNS.
>
> I agree with that.
>it makes me shudder to think how many people have been permanently damaged by the mental health system that forces toxic brain damaging chemical such as antipsychotic down mental illness patients throats against their will. I think i read somewhere that sales of antipsychotics are now greater than sales of antidepressants. why don't they force mental illness patients to have therapy as a front line treatment and then if that fails hit the meds????
> >so if you want a permanent cure to mental >illness, try no meds and therapy.
>
> I've gone both ways. With or without meds. I wouldn't say that no meds and therapy have cured anything, but thats not to say it doesn't work for some.
>
as long as your meds don't have toxic side effects I say go for it and enjoy the relief! when we have a cold, no one says you have to tough it out without sleeping aids and pseudoephidrine. but even anti depressants cause an antipsychotic side effect of akathisia which increases suicide potential, they even put warnings on ssris and snris. akathisia is generally linked to damage to the cholinergic system in particular (bad damage = Alzeimers), nerve toxins such as vx or sarin gas or pesticides kill via damaging the cholinergic system. with less damage it shows up as akathisia, insomnia, and anxiety.so starting on an antidepressant may lead to suicide or physical damage to the cholinergic system creating a physicl disease in the patient in the form of physically based chronic anxiety, and once physical damage is incurred, the patient is no longer able to make as high a level recovery. also they may trigger mania requiring antipsychotics and before you know it the patient is on a one way path to severe disease and illness.
i still think that many can benefit from the drugs, and i am in no way anti-drugs in any way shape or form, I just think due to the risks they should be seen as second line treatments, if you know what i mean?
> >can someone tell me why psychiatrists are the >front line for treatment for mental illness >rather than psychologists?????? surely mental >illness can be cured with good therapy,
>
> Thats not always true. I know people who have attended years of the best therapy money can buy, and can gain tremendous insight to the nature of their suffering, but are yet still completely unable to change the way they feel on a daily basis. Brain chemistry can profoundly affect mood just like it can affect movement, hence I would say that depression is no less a biochemical problem (for some) than parkinsons.
>thumbs up, therapy can cure, but doesn't work for everyone. but those that get cured with therapy make a complete recoveries of the highest level. so that's why i think it should be front line rather than forcing drugs on people.
> >but zap someone with ect or give them toxic >doses of antipsychotics and it doesn't matter >how much therapy they have after that, the >patient will never be able to recover fully!
>
> I'd have to say I agree. Thought, just because our treatments are fairly crappy, doesn't detract from the fact that some people's mood disorders may be a result of some form of brain abnormality.sure, but it is impossible to separate those with things like pathological depression from depression from choosing the wrong wife or the wrong job, or childhood issues, etc. can't we try everyone on therapy first then send those that still have problems to get some meds? by sending them all to meds introduces unnecessary disease in many patients that could have otherwise made a full recovery.
>
> >or am i missing something?
>
> I think that some people are prone to these types of illnesses. Just because they havn't found a cure doesn't mean there isn't one (for certain forms of depression)
>
> Its just like depression in epilepsy. Some think that the epileptic dysfunction is the same dysfunction that mediates the mood disorder. As such, the depression is no less a brain abnormality than the seizures.
>
I don't know enough about epilepsy to be able to comment, is it a mental illness or a physical disease?
>
> Linkadge
>
ME
Posted by laima on January 2, 2007, at 21:12:24
In reply to Re: Has anyone here had a remssion for long? » laima, posted by Farkus on January 2, 2007, at 19:43:41
Wow, well I'm dismayed to hear that anyone would question or wonder about your success with your medication. Why make new problems, especially as you start to feel better? Sounds like you've got things worked out though, and that's really good to hear, it's huge. :)
> << In terms of it's class, it's gets a little better rep around this board than some of the others. I've had some unsettling and confusing feedback, so my decision was to avoid the "kitchen" as I did not want to take the "heat". I understand the frustration people have trying to find a workable treatment plan. I think it can be easy to wonder about (and question) other's success when one is struggling. It was not very fun to have it done to me.
Posted by saturn on January 2, 2007, at 23:19:06
In reply to Re: Has anyone here had a remssion for long? » linkadge, posted by tensor on January 2, 2007, at 15:07:49
> Remeron kept me in remission for three years.
>
> /MattiasMay I ask if it pooped-out or you stopped for other reasons (assuming you stopped)?
Posted by tensor on January 3, 2007, at 5:47:02
In reply to Re: Has anyone here had a remssion for long? » tensor, posted by saturn on January 2, 2007, at 23:19:06
May I ask if it pooped-out or you stopped for other reasons (assuming you stopped)?
It has pooped out several time, but I've always kept it in my combo, partly because it helps a bit with sleep. However, I stopped it two weeks ago but I'm seriously thinking of starting it again.
That would be remeron+wellbutrin+zoloft, but will maybe ditch zoloft, not sure yet.
/Mattias
Posted by Farkus on January 3, 2007, at 5:59:05
In reply to Re: Has anyone here had a remssion for long?, posted by laima on January 2, 2007, at 18:23:32
Posted by SLS on January 3, 2007, at 7:07:56
In reply to Re: Has anyone here had a remssion for long? » saturn, posted by tensor on January 3, 2007, at 5:47:02
> May I ask if it pooped-out or you stopped for other reasons (assuming you stopped)?
>
> It has pooped out several time, but I've always kept it in my combo, partly because it helps a bit with sleep. However, I stopped it two weeks ago but I'm seriously thinking of starting it again.
> That would be remeron+wellbutrin+zoloft, but will maybe ditch zoloft, not sure yet.Have you been up to 200mg with the Zoloft?
Have you tried Effexor in place of Zoloft in the combination? On paper, it should be a potent combination. Wellbutrin + Effexor is often more effective than either drug alone, and Remeron + Effexor is the noted "California Rocket Fuel" combination advocated by Stephen Stahl, MD. You might want to try working up to 300mg with the Effexor. Zoloft wasnt' a bad choice, though.
- Scott
Posted by tensor on January 3, 2007, at 7:28:03
In reply to Re: Has anyone here had a remssion for long? » tensor, posted by SLS on January 3, 2007, at 7:07:56
Hi Scott,
>Have you been up to 200mg with the Zoloft?
>Have you tried Effexor in place of Zoloft in the combination? On paper, it should be a potent combination. Wellbutrin + Effexor is often more effective than either drug alone, and Remeron + Effexor is the noted "California Rocket Fuel" combination advocated by Stephen Stahl, MD. You might want to try working up to 300mg with the Effexor. Zoloft wasnt' a bad choice, though.
High doses of Zoloft gives me akathisia, and effexor gave me horrible s/e. However, last night I took 15mg of Remeron to induce sleep + a hypnotic, it worked. More interestingly, I woke up this morning without being nauseous and without abdominal pain and not as shaky as I usually do. I wonder if this is indicating that Remeron + Wellbutrin would be a better choice than Wellbutrin + Zoloft. What do you think?
I really don't like doing any changes this early in a trial(two weeks on Wellbutrin), but if the difference is the big I wonder if it could be clever anyway. I have a speical realtionship with remeron, though it has failed me many times, it still going strong when it does work.
I have a book with Stephen M. Stahl, MD which I like a lot, he's also saying that Zoloft+Wellbutrin is used with success under the name "Well-loft".
/Mattias
Posted by joslynn on January 3, 2007, at 8:41:50
In reply to Re: Has anyone here had a remssion for long?, posted by mindevolution on January 2, 2007, at 21:01:48
> sure, but it is impossible to separate those with things like pathological depression from depression from choosing the wrong wife or the wrong job, or childhood issues, etc. can't we try everyone on therapy first then send those that still have problems to get some meds?I used to think that way too. But through reading different things, I am starting to think that it could be a chicken and egg thing. That is, someone who has a low level of depression already there could make bad choices about a spouse, job, etc., so it may not be the choices that made them depressed, but the depression that made them make bad choices.
Also, even if one does have depression that is only the result of bad choices, the change in their brain chemistry can still, in some cases, be helped by meds. So I don't think it's as simple as: depression caused by lifestyle, fix with just lifestyle changes; depression caused by biology, fix by biological changes via meds.
There is overlap. Bad lifestyle choices can alter what happens physiologically in your brain. And having a depressed brain can cause you to make bad lifestyle choices.
This is at least how I understand it now. I also did not believe in meds the first time I was severely depressed, and just did therapy. The depression did lift after about 6 long months. But years later, it came back, and I couldn't afford to be out of commission for 6 months again. Plus it was worse the second time. So I went on meds. And did therapy. The therapy helped immensely, as did better lifestyle choices, but the question is...would I have been stable enough to get anything out of therapy had I not taken the meds?
It is so very confusing sometimes. I can go back and forth on this myself. But, I am on meds, and I am in remission. So, I don't want to chuck the meds yet.
Just my .02
Posted by SLS on January 3, 2007, at 8:46:23
In reply to Re: Has anyone here had a remssion for long? » SLS, posted by tensor on January 3, 2007, at 7:28:03
> Hi Scott,
>
> >Have you been up to 200mg with the Zoloft?
>
> >Have you tried Effexor in place of Zoloft in the combination? On paper, it should be a potent combination. Wellbutrin + Effexor is often more effective than either drug alone, and Remeron + Effexor is the noted "California Rocket Fuel" combination advocated by Stephen Stahl, MD. You might want to try working up to 300mg with the Effexor. Zoloft wasnt' a bad choice, though.
>
> High doses of Zoloft gives me akathisia, and effexor gave me horrible s/e. However, last night I took 15mg of Remeron to induce sleep + a hypnotic, it worked. More interestingly, I woke up this morning without being nauseous and without abdominal pain and not as shaky as I usually do. I wonder if this is indicating that Remeron + Wellbutrin would be a better choice than Wellbutrin + Zoloft. What do you think?
>
> I really don't like doing any changes this early in a trial(two weeks on Wellbutrin), but if the difference is the big I wonder if it could be clever anyway. I have a speical realtionship with remeron, though it has failed me many times, it still going strong when it does work.
>
> I have a book with Stephen M. Stahl, MD which I like a lot, he's also saying that Zoloft+Wellbutrin is used with success under the name "Well-loft".
>
> /Mattias
The Wellbutrin + Remeron combination is rather novel, and I would definitely not skip over it given the positive hints it has given you. I've tried the Well-oft combination, and received a short antidepressant effect. However, when we teased out the components in my regimen, it seems likely that it was Lamictal + Wellbutrin that was most contributory. My doctor has had quite a bit of success with the Lamictal + Wellbutrin combination, although I have seen a few people get a little manic and others get agitated on it. It is difficult for me to say whether or not these are self-limiting effects because these people discontinued the medication once they appeared. In my case, if mania were to appear, I wouldn't hesitate to add Zyprexa temporarily to see if it would squash the reaction. I would then attempt to remove it after a period of a month or two. I believe Lamictal is secondarily pro-dopaminergic via glutamate release inhibition, and might act synergistically with Wellbutrin to produce activated and perhaps less anhedonic states.If you have the patience, you might want to consider adding Lamictal before abandoning Wellbutrin.
I would be most interested to see how Remeron + Wellbutrin works out for you. There are quite a few mechanisms involved. It is suspected that the predominant final outcome of Wellbutrin is pro-noradrenergic, probably through mechanisms other than reuptake inhibition. This might be amplified by the NE alpha-2 antagonist properties of Remeron.
What has been your experience with tricyclics and MAOIs?
It is likely that the 5-HT3 antagonist property of Remeron acts as an antiemetic to reduce nausea. It's good that you are so tuned-in to your mind-body to recognize such things.
Hopefully, you can begin to sort all of this out. I am eager to see you benefit from either Wellbutrin + Remeron or perhaps Wellbutrin + Lamictal.
Good luck.
- Scott
Posted by SLS on January 3, 2007, at 8:49:06
In reply to Re: Has anyone here had a remssion for long?, posted by joslynn on January 3, 2007, at 8:41:50
> > sure, but it is impossible to separate those with things like pathological depression from depression from choosing the wrong wife or the wrong job, or childhood issues, etc. can't we try everyone on therapy first then send those that still have problems to get some meds?
>
> I used to think that way too. But through reading different things, I am starting to think that it could be a chicken and egg thing. That is, someone who has a low level of depression already there could make bad choices about a spouse, job, etc., so it may not be the choices that made them depressed, but the depression that made them make bad choices.
>
> Also, even if one does have depression that is only the result of bad choices, the change in their brain chemistry can still, in some cases, be helped by meds. So I don't think it's as simple as: depression caused by lifestyle, fix with just lifestyle changes; depression caused by biology, fix by biological changes via meds.
>
> There is overlap. Bad lifestyle choices can alter what happens physiologically in your brain. And having a depressed brain can cause you to make bad lifestyle choices.
>
> This is at least how I understand it now. I also did not believe in meds the first time I was severely depressed, and just did therapy. The depression did lift after about 6 long months. But years later, it came back, and I couldn't afford to be out of commission for 6 months again. Plus it was worse the second time. So I went on meds. And did therapy. The therapy helped immensely, as did better lifestyle choices, but the question is...would I have been stable enough to get anything out of therapy had I not taken the meds?
>
> It is so very confusing sometimes. I can go back and forth on this myself. But, I am on meds, and I am in remission. So, I don't want to chuck the meds yet.
>
> Just my .02
Good stuff.
- Scott
Posted by tensor on January 3, 2007, at 9:13:34
In reply to Re: Has anyone here had a remssion for long? » tensor, posted by SLS on January 3, 2007, at 8:46:23
I discontinued Lamictal a few weeks ago because it was making me so tired and I had no response from it. First I took it with nortriptyline+Remeron and later with Zoloft+Remeron. I tried this for several months, but nothing. Nortrip+Rem was the combo I last crashed on, about five-six months ago. So I abandoned Lamictal before Wellbutrin, so to speak.
>I would be most interested to see how Remeron + Wellbutrin works out for you.
Yes, I agree. But maybe I could keep Zoloft in my regime for a while. That would be 15mg Remeron + 300mg Wellbutrin and 50mg of Zoloft.
>What has been your experience with tricyclics and MAOIs?
No MAOIs, I have tried nortrip and clomipramine, I have responded to both. I tried clomipramine years ago but quit in quest for a med with better aim, it has a pretty disturbing s/e profile.
For me the dopaminergic effect of Lamictal was transitory, lasted a few days after each dose increase. Speaking of Stahl, MD. He recommends adding Remeron to Wellbutrin for residual depressive symptoms. Anyway, I could just add 15mg of Remeron to my existing combo and see what happens, I can always ditch Zoloft later, what do you think?
/Mattias
Posted by ClearSkies on January 3, 2007, at 9:28:41
In reply to Re: Has anyone here had a remssion for long?, posted by mindevolution on January 2, 2007, at 17:20:04
> the only cure for MENTAL illness is mental therapy. mental illness in in the mind not the brain, otherwise it would be called a disease like alzeihmer's or parkinsons.Please respect the views of others even if you think they're wrong. Please don’t post anything that could lead others to feel accused or put down.
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http://www.dr-bob.org/babble/faq.html#civil
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