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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by blueberry1 on February 4, 2007, at 6:47:57
Best combo of all:
1. 20mg prozac + 5mg zyprexa + 600mg st johns wort. The morning butterflies and dread nearly gone. Motivated. Interested. But got distressing antipsychotic things such as twitches, head jerking, stuff like that. Actually 10mg prozac + 5mg zyprexa + 1.5mg xanax was pretty good too, but was only on it a week.
2. 20mg prozac + 5mg zyprexa + 300mg adrafinil. Pretty good years on this combo. The problem is that it was before the days of the morning butterflies and dread, so no idea how it would work today.
No matter what I tried in the last 3 years, if 5mg zyprexa was not in the mix, it was bad news. All current probs seemed to slowly begin when zyprexa was reduced from 5mg to 2.5mg. I loathe zyprexa. Hate it. But I can't argue with results. It really did make other meds work.
The thing that scares me about returning to a previous combo is that we all know how previous meds can fail a second time around, be completely different, or have tons of side effects that were never there before. Seems like a 50/50 gamble.
Even worse though is considering trying other things. Venturing into new drugs has been severe punishment for me. I do not feel I have the endurance or the courage to keep trying and failing things, when I look back and see what did work fairly well.
Just wish I had a better handle on the diagnosis.
Posted by ronaldo on February 4, 2007, at 8:00:32
In reply to Forgot to mention....for above post., posted by blueberry1 on February 4, 2007, at 6:47:57
Hi blueberry,
Nice to see you back. Sorry ill health has kept you away.
You talk about moving back to tried and trusted combos. The trouble is they were combos - 3 or 4 different medicines taken at the same time. Which was the one that was pulling the most weight and which ones were shirkers or are we to go with the bland assumption that all components were working equally well. Not likely... My suggestion to you is not to muddy the waters too much by taking too many different medications in combination.
You have identified Zyprexa as the best common denominator. OK try Zyprexa monotherapy and see what happens. Do you want to go back on the full five milligrams or do you want to try a more modest 2.5 mg? I know you have just recently been through a long and arduous and at times painful withdrawal from Zyprexa. Never mind, if that is what works for you that is what you should take.
Now you ask what else should you take with it? Is it possible to say nothing? Once you start juggling with 3 or 4 or more different medications it is very easy to lose sight of which medication is doing what. With your symptoms is it possible to stick with monotherapy? Can you at least give monotherapy a trial run? Perhaps you know your meds so well and also your reaction to them that you can mix and match quite skilfully. I reckon your brain must be quite hungry now for a slice of Zyprexa so imho maybe that is the one to start with.
Zyprexa should give you a really good buzz after being off it for so long. Maybe you should not confuse the issue by adding other meds. You may be surprised how much Zyprexa can do for you. At least give it a chance to show you what you've been missing. After say a few days to a week on the Zyprexa maybe you can try mixing other stuff in. But I would give the Zyprexa a clear run first just to set the base line.
ronaldo
> Best combo of all:
>
> 1. 20mg prozac + 5mg zyprexa + 600mg st johns wort. The morning butterflies and dread nearly gone. Motivated. Interested. But got distressing antipsychotic things such as twitches, head jerking, stuff like that. Actually 10mg prozac + 5mg zyprexa + 1.5mg xanax was pretty good too, but was only on it a week.
>
> 2. 20mg prozac + 5mg zyprexa + 300mg adrafinil. Pretty good years on this combo. The problem is that it was before the days of the morning butterflies and dread, so no idea how it would work today.
>
> No matter what I tried in the last 3 years, if 5mg zyprexa was not in the mix, it was bad news. All current probs seemed to slowly begin when zyprexa was reduced from 5mg to 2.5mg. I loathe zyprexa. Hate it. But I can't argue with results. It really did make other meds work.
>
> The thing that scares me about returning to a previous combo is that we all know how previous meds can fail a second time around, be completely different, or have tons of side effects that were never there before. Seems like a 50/50 gamble.
>
> Even worse though is considering trying other things. Venturing into new drugs has been severe punishment for me. I do not feel I have the endurance or the courage to keep trying and failing things, when I look back and see what did work fairly well.
>
> Just wish I had a better handle on the diagnosis.
Posted by Quintal on February 4, 2007, at 8:41:44
In reply to Forgot to mention....for above post., posted by blueberry1 on February 4, 2007, at 6:47:57
Blueberry, have you thought of visiting a herbaist or trying a combo of different herbal meds? I know this isn't the alternative board, but maybe you've become too sensitive to the effects of synthetic meds since the ECT? Might you cope better with milder treatments?
I'm taking:
Agnus castus - has some D2 antagonism and seems to help a bit with paranoia and intrusive thoughts. Also seems to boost libido and orgasm despite what the name might suggest. http://en.wikipedia.org/wiki/Vitex_agnus-castus
Rhodiola Rosea: General antidepressant and stimulant - very effective. I sometimes get little tingles of excitement like with amphetamine (much milder of course) a few hours after taking a dose. http://en.wikipedia.org/wiki/Rhodiola_rosea
Tribulus: Raises levels of Luteinizing Hormone which stimulates the testes into producing more testosterone in men.http://en.wikipedia.org/wiki/Tribulus
Ashwagandha: Sedative and anxiolytic - has a general calming and soothing effect. Also alledgedly helps reduce tolerance to opiates. http://en.wikipedia.org/wiki/Ashwaganda
Poppy seed tea: I take it twice a week for the opiate effect which lifts my mood and has a general soothing effect. The afterglow lasts for a few days so by taking it twice a week I keep my mood elevated and feel quite good most of the time. http://en.wikipedia.org/wiki/Poppy_seed_tea
Valerian, hops and opium lettuce: A sedative/hypnotic blend that helps me sleep.
OTC codeine containing prodcts: I take ~40mg codeine to lift me up if I get down or very anxious.
Fish Oil: I take 2g daily and it seems to hep as a general antidepressant and mood stabilizer.
L-carnitine: Gives me energy and motivation. I take it as needed, not every day as I end up crashing afer a few days of continuous use.
Spice: A legal marijuana substitute. I take at weekends to help me chill out. That in itself has a powerful antidepressant effect. http://en.wikipedia.org/wiki/Spice_%28drug%29
I remember you saying benzos helped you feel more comfortable and sociable - have you tried them long-term?
Q
Posted by laima on February 4, 2007, at 10:37:08
In reply to Re: Forgot to mention....for above post. » blueberry1, posted by Quintal on February 4, 2007, at 8:41:44
Blueberry, have you tried, would it make sense to try something very similar to zyprexa which might be kinder in terms of side effects? Something like geodon, abilify, seroquel? And while not in the same class, a researcher I had a consultation with tossed out the idea of depakote as a zyprexa substitute when I myself complained about zyprexa. He talked about recent research (not sure if published yet) about low-dose depakote being effective for some tough cases of anxiety/depression. I never did try that route, but I thought I'd toss the idea out for your possible examination.
Posted by Phillipa on February 4, 2007, at 12:03:44
In reply to Re: Forgot to mention....for above post., posted by laima on February 4, 2007, at 10:37:08
Blueberry for you I think I'd go with the zyprexa first. Love Phillipa
Posted by blueberry1 on February 4, 2007, at 13:52:39
In reply to Re: Forgot to mention....for above post., posted by laima on February 4, 2007, at 10:37:08
Geodon...no. Too much noradrenergic action, bad for me. Too many bad reports about this drug.
Abilify...thought about it. I seem extremely sensitive to anxiety/akathesia/restlessness, so this one scares me.
Seroquel...tried it for a week. Extremely depressing. Had me on my knees in tears.
Depakote...tried it a month at 500mg. The first 2 days I could definitely tell this was a good one. After that it seemed invisible. Didn't seem to do anything good or bad. Studies show that when combined with atypical antipsychotics, depakote increases dopamine release. I think that is what I felt. I also experienced what felt like a dopamine crash when I stopped it. Recently tried it again. First couple hours felt decent improvement. Then invisible the rest of the day. Second day, same. Third day, depression getting a lot worse. Fourth day, depression definitely a lot worse. Something about depakote plus zyprexa is a lot different than just depakote by itself.
>
> Blueberry, have you tried, would it make sense to try something very similar to zyprexa which might be kinder in terms of side effects? Something like geodon, abilify, seroquel? And while not in the same class, a researcher I had a consultation with tossed out the idea of depakote as a zyprexa substitute when I myself complained about zyprexa. He talked about recent research (not sure if published yet) about low-dose depakote being effective for some tough cases of anxiety/depression. I never did try that route, but I thought I'd toss the idea out for your possible examination.
Posted by laima on February 4, 2007, at 20:45:15
In reply to Re: Forgot to mention....for above post. » laima, posted by blueberry1 on February 4, 2007, at 13:52:39
Oh, I'm sorry to hear. Forgive me if I'm making you repeat yourself, but is it the severe weight gain/diabetes risk that most bothers you about zyprexa, or something else? I sure was no fan of it myself, and my trials were so brief.Can you give abilify a one night trial or so? No weight gain, supposedly. I tried it before- and it was way too wacky for me- I felt severe myoclonus that night, like electric shocks as if I was being electrocuted- but klonopin remedied this almost immediately when I broke down took lots extra of it. (Needless to say, that wan't a good med for me.) But maybe it could be worth a trial, just in case it would work for you? Just an idea.
Another idea- supposing it is the weight gain/appetite issues that are part of your issue with zyprexa, would it be plausable to request some sort of appetite suppressent to use along with it?
I just hope this can get figured out- no sense in a cure worse than what its remedying- I can relate to some of that.
This is the end of the thread.
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