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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by platinumbride on February 2, 2007, at 19:52:01
Hi ...
I had a distressing visit with my p-doc yesterday. The worst of it was that he wanted to stick me in the hospital immediately for ECT (I am not through thinking about wheter or not I want that, and if I DO, I am NOT going to live in a psych ward for 3 weeks to get it! I will wait till the weather gets better to make the hour long drive at 5:00 am and do it as an outpatient).
After I refused, he started picking things out of a hat. Geodon was what he decided, until I reminded him that I was worried about akathesia. (I experienced this badly on 5 mgs abilify). I just needed a little hand - holding on this one!
Then he seemed annoyed. He mentioned parnate, since I DID get releif from nardil, but with a lot of side-effects, that, as I got ready to start grad school, I was afraid of - like the need for the 4 hour nap. I needed a little reassurance that the crippling anxiety that I have would not be exacerbated by parnate, and he went blank. This guy who has such a great reputation in an area where there are a lot of depressed and suicidal people (I live in an Ivy League College town in NY state) gets stumped at parnate! And I ask him, point blank, how many people he has prescribed it to. One, he says. I was kind of scared when he admitted that. It reminded me that he was totally against using provigil with nardil and made me see more ignorance in his arrogance.
So I mentioned (after doing so before) that maybe I should try abilify again, but at a 2.5 mg dose. He says you could do that, and then seems really annoyed and starts telling me that he is just frustrated because he cannot seem to help me. I let him know that I am angry at him for this.
He then proposes vicodin. I see this as only a temporary solution, but since I KNOW how it feels (great) I think about it (plus, he is starting to run over and has about had it with me).
I quickly mention tricyclics and he acts as if a light bulb has been turned on. There will be a lot of weight gain with this, he says. I shudder, since I gained at least 25 lbs on nardil within 3 months, and I am already very heavy, in large part due to med trials (no pun intended).
Well, you choose, he says.
I feel pressured. I choose the vicodin, because IF I have ECT, he tells me that I will have to go off of neurontin and klonopin because they are anti-convulsants. Just what a nervous, chain smoking woman needs to hear! And yet I know that if I am ever going to be able to comprehend my reading in school, (which I took medical leave from after week 3) I am going to have to 86 the neurontin. It turns me into a moron. That is one of the reasons I took medical leave. No comprendo nada, get it???
Now I am second-guessing my decision to just go with the vicodin because I will become addicted eventually to it and then I will be in more trouble!
Does geodon produce less akathesia than abilify? Is it worth it to give parnate a try with a dr, who doesn't know much about it?
I know the obvious answer is change doctors! But I am really kind of afraid to drive long distances at this time, in the snow...
Besides, if I DO go for ECT, he is the one who makes a referral to someone he respects.Sorry this is so long and convoluted, but I would really appreciate help on any or all of these med issues.
Thank you,
Diane
Posted by Honore on February 2, 2007, at 20:29:02
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
Hi, Platinumbride.
Serious, you need a new pdoc. I know it's obvious-- but it *is* what you need. ASAP.
Is it really that snowy all the time where you are? How about a consult in NYC-- if you're in NY State. Even if you're fairly far away, how about a pdoc's used MAOIs for quite a while-- they do exist--
a pdoc who isn't against provigil-- eg, with Nardil-- (what's wrong with that???)-- I don't know your specific reactions, but per se, there' s no problem.
Maybe your pdoc doesn't know enough about MAOIS to give you a reasonable trial-- with appropriate adjunctives.
By the way, Geodon is less likely to cause akathesia-- abilify is the most prone to creating that effect of the atypical APs.
Plus how does he know you'll gain weight on the tricyclics?
My question is: if you haven't tried parnate, Emsam, tricyclics, Geodon; he wouldn't let you use nardil with provigil (or other stimulants, I assume)-- why would you rely on him for a referral for ECT.
You really should exhaust all possiblities before ECT, imo. This is, of course, just my opinion, but ECT should be a treatment of last resort because of the frequency of memory problems, and uncertainty about other effects.
Come to NY-- or go to another city, if you need to, on the train, plane, bus--but unless you really feel that you're ready to take the chance of ECT-- you need to do that much for yourself.
I apologize if I'm being too harsh and insistent-- of course, it's your choice. But I'm concerned about you
Honore
Posted by Declan on February 2, 2007, at 20:49:40
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
Well, I dunno. I'd treasure a doctor who would Rx Vicodin for depression, but of course you will, as you know, be hooked on it.
But that is better than ECT, IMO.
And since you have been there (Vicodin?) before, you know what's involved, but since you have been there before you will get there quicker (straight away).
But you don't have to take more than you need.Other than that, I'd be taking the Parnate, but APs are awful for me. Perhaps they really do help some people with depression.
Posted by Phillipa on February 2, 2007, at 21:59:38
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
Originally from Fairfield County CT. Are you near Greenwich or Stamford? Got to be some great pdocs there. Love Phillipa
Posted by platinumbride on February 2, 2007, at 22:53:50
In reply to Re: geodon,abilify or parnate? weird doc appt. » platinumbride, posted by Phillipa on February 2, 2007, at 21:59:38
Thanks so much for your input so far. Honore, you are very kind...
Phillipa, I am not near the Ivy Leagues people think of first. I am in Ithaca,near Cornell, which is an area that, without the University, would be like the movie Deliverance!!!
I'm from NYC. Living here - I feel like a fish out of water!
Posted by UgottaHaveHope on February 3, 2007, at 1:50:24
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
Diane: What type of relief did you get from Nardil? Was it depression and anxiety? Why did you stop taking?
Posted by platinumbride on February 3, 2007, at 2:23:15
In reply to Re: Q about Nardil » platinumbride, posted by UgottaHaveHope on February 3, 2007, at 1:50:24
> Diane: What type of relief did you get from Nardil? Was it depression and anxiety? Why did you stop taking?
> Diane: What type of relief did you get from Nardil? Was it depression and anxiety? Why did you stop taking?I got moderate to good relief from depression by around 60-75 mgs, but no anxiety relief until I got up to 90.
No matter what the dosage, I needed a nap every afternoon. A loooong nap. That was my main reason for discontinuation, though gaining a lot of weight didn't help matters either. Maybe if my friggin' doctor would have rxed provigil to deal with the sleepiness I would still be on it now....but maybe not.
I had to take a lot of neurontin and klonopin to sleep. At 90 mgs. sleep was reaallly tough to get to sometimes.
I hope this is helpful to you. Are you planning on trying it?
Diane
Posted by Quintal on February 3, 2007, at 4:57:24
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
Parnate with Klonopin is good - I had the most robust improvement in my social anxiety and depression with a cocktail of Lamictal, Parnate and Klonopin. There is the afternoon fatigue to deal with but this can usually be overcome if you take a high dose of Parnate and take it every 2-3 hours throughout the day until late afternoon. Vicodin is also good. I'm keeping most of my anxiety/depression symptoms at bay with a mix of OTC codeine containing analgesics - very effective. Lamictal can reduce and prevent tolerance to opiates BTW.
Q
Posted by platinumbride on February 3, 2007, at 16:42:40
In reply to Re: geodon,abilify or parnate? weird doc appt. » platinumbride, posted by Quintal on February 3, 2007, at 4:57:24
Quintal -
Aren't you supposed to avoid opiates while on an maoi? I have to wait 2 weeks, until the nardil is out of my system IF I decide to use vicodin
Diane
Posted by Quintal on February 3, 2007, at 16:52:44
In reply to Re: geodon,abilify or parnate? weird doc appt. » Quintal, posted by platinumbride on February 3, 2007, at 16:42:40
Yes, you're supposed to avoid opiates while taking an MAOI, though small amounts of codeine salts seem to be safe. It's really the synthetic opiates like tramadol and pethidine that you have to careful with, more because of their serotonergic effects rather than their effect at opiate receptors.
Q
Posted by platinumbride on February 3, 2007, at 16:53:43
In reply to Re: geodon,abilify or parnate? weird doc appt. » platinumbride, posted by Quintal on February 3, 2007, at 4:57:24
I am a non-responder to flurazepam, ambien and lunesta.
Is rozerem really that different that it would be worth a shot?
I have to lower my nerontin and klonopin doses, which I used for sleep while on nardil. Now I am back to really high doses - over 4800 mgs of neurontin and at least 5 or 6 mgs. of klonopin. At this rate, I won't make it to the end of the month with these drugs!
Thanks,
Diane
Posted by Phillipa on February 3, 2007, at 18:09:54
In reply to Re: geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 22:53:50
Wow you're far away from home. No wonder you feel like a fish out of water. Love Phillipa
Posted by djmmm on February 3, 2007, at 18:12:49
In reply to Any ideas for sleep aids if I get parnate insomnia, posted by platinumbride on February 3, 2007, at 16:53:43
> I am a non-responder to flurazepam, ambien and lunesta.
>
> Is rozerem really that different that it would be worth a shot?
>
> I have to lower my nerontin and klonopin doses, which I used for sleep while on nardil. Now I am back to really high doses - over 4800 mgs of neurontin and at least 5 or 6 mgs. of klonopin. At this rate, I won't make it to the end of the month with these drugs!
>
> Thanks,
>
> Diane
Take a higher dose of Parnate in the morning, and your second Parnate dose BEFORE noon (like 20mgs/ 10mg or 30mg/20mg..etc)...this helped a lot
The only thing that worked (works) for me is melatonin... I've tried xanax, ambien, sonata, etc... I found that the rebound from the "non addictive" sleep aids was HORRIBLE. My doc would give me 8 or 10 for the month (to take as needed), If I took one on monday night, I would have to take one on tuesday, wed, etc just to get asleep :(Now I just take 6-9mg of melatonin, I works so well that I find myself not even remembering falling asleep that night.
currenty take:
Selegiline (liquid deprenyl citrate)
Phenylethylamine
.5 mgs Klonopin
melatonin
(and a few suplements/nootropics)
Posted by Sebastian on February 3, 2007, at 20:08:12
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
What I've found that seems to work good is Zyprexa and abilify. 10mg zyprexa + 5-7.5mg abilify. No weight gain, infact massive weight loss. Plus they seem to cancel bad side-effects with each other. I take the abilify 2-3 times a day and zyprexa at night.
Posted by rina on February 4, 2007, at 15:33:54
In reply to geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 2, 2007, at 19:52:01
> Hi ...
>
> I had a distressing visit with my p-doc yesterday. The worst of it was that he wanted to stick me in the hospital immediately for ECT (I am not through thinking about wheter or not I want that, and if I DO, I am NOT going to live in a psych ward for 3 weeks to get it! I will wait till the weather gets better to make the hour long drive at 5:00 am and do it as an outpatient).
>
> After I refused, he started picking things out of a hat. Geodon was what he decided, until I reminded him that I was worried about akathesia. (I experienced this badly on 5 mgs abilify). I just needed a little hand - holding on this one!
>
> Then he seemed annoyed. He mentioned parnate, since I DID get releif from nardil, but with a lot of side-effects, that, as I got ready to start grad school, I was afraid of - like the need for the 4 hour nap. I needed a little reassurance that the crippling anxiety that I have would not be exacerbated by parnate, and he went blank. This guy who has such a great reputation in an area where there are a lot of depressed and suicidal people (I live in an Ivy League College town in NY state) gets stumped at parnate! And I ask him, point blank, how many people he has prescribed it to. One, he says. I was kind of scared when he admitted that. It reminded me that he was totally against using provigil with nardil and made me see more ignorance in his arrogance.
>
> So I mentioned (after doing so before) that maybe I should try abilify again, but at a 2.5 mg dose. He says you could do that, and then seems really annoyed and starts telling me that he is just frustrated because he cannot seem to help me. I let him know that I am angry at him for this.
>
> He then proposes vicodin. I see this as only a temporary solution, but since I KNOW how it feels (great) I think about it (plus, he is starting to run over and has about had it with me).
>
> I quickly mention tricyclics and he acts as if a light bulb has been turned on. There will be a lot of weight gain with this, he says. I shudder, since I gained at least 25 lbs on nardil within 3 months, and I am already very heavy, in large part due to med trials (no pun intended).
>
> Well, you choose, he says.
>
> I feel pressured. I choose the vicodin, because IF I have ECT, he tells me that I will have to go off of neurontin and klonopin because they are anti-convulsants. Just what a nervous, chain smoking woman needs to hear! And yet I know that if I am ever going to be able to comprehend my reading in school, (which I took medical leave from after week 3) I am going to have to 86 the neurontin. It turns me into a moron. That is one of the reasons I took medical leave. No comprendo nada, get it???
>
> Now I am second-guessing my decision to just go with the vicodin because I will become addicted eventually to it and then I will be in more trouble!
>
> Does geodon produce less akathesia than abilify? Is it worth it to give parnate a try with a dr, who doesn't know much about it?
>
> I know the obvious answer is change doctors! But I am really kind of afraid to drive long distances at this time, in the snow...
> Besides, if I DO go for ECT, he is the one who makes a referral to someone he respects.
>
> Sorry this is so long and convoluted, but I would really appreciate help on any or all of these med issues.
>
> Thank you,
>
> DianeDiane, be very careful with the vicodin...i was hooked on MScontin and had to detox in a clinic...it was awful and totally expensive for me do to the fact i didn't want to use my insurance for fear of my company knowing.
Posted by metalflipflop on February 6, 2007, at 15:11:19
In reply to Re: geodon,abilify or parnate? weird doc appt., posted by rina on February 4, 2007, at 15:33:54
hi diane,
i used to live in ithaca, so i know what you mean about the state of things there. i would call up peter breggin (he has an office on state street), and tell him your story. i saw some less-than-great people in that town.
Posted by platinumbride on February 6, 2007, at 15:19:16
In reply to Re: geodon,abilify or parnate? weird doc appt., posted by metalflipflop on February 6, 2007, at 15:11:19
> hi diane,
> i used to live in ithaca, so i know what you mean about the state of things there. i would call up peter breggin (he has an office on state street), and tell him your story. i saw some less-than-great people in that town.
Thanks for that information. Is there any way I can babble mail you now?
Posted by platinumbride on February 6, 2007, at 15:27:31
In reply to Re: geodon,abilify or parnate? weird doc appt., posted by metalflipflop on February 6, 2007, at 15:11:19
> hi diane,
> i used to live in ithaca, so i know what you mean about the state of things there. i would call up peter breggin (he has an office on state street), and tell him your story. i saw some less-than-great people in that town.
Or maybe we could exchange an email or two...
I am ospinawoman@hotmail.com
Ever see Feinstein?Diane
Posted by metalflipflop on February 6, 2007, at 19:29:10
In reply to Re: geodon,abilify or parnate? weird doc appt., posted by platinumbride on February 6, 2007, at 15:27:31
nope, no feinstein. absolutely babblemail me, or i will email you tomorrow at work!
> Or maybe we could exchange an email or two...
> I am ospinawoman@hotmail.com
> Ever see Feinstein?
>
> Diane
>
Posted by Honore on February 9, 2007, at 8:44:05
In reply to Re: geodon,abilify, or parnate? » platinumbride, posted by metalflipflop on February 6, 2007, at 19:29:10
I'm not so sure that Peter Breggin is the best person to ask about taking ADs or APs, unless his views have evolved in the past four or five years.
He has a very uninflected, and, TMM (to my mind) unthoughtful view of drug therapies for emotional or mental distress. As he articulates it, it's not the most helpful, or the most justified, point of view.
He's more of an advocate for no meds than anyone who's advice on what meds to take I would ever seek. He undoubtedly is opposed to ECT (which I happen to agree should only be undertaken with caution and only after research and reflection).
But there must be pdocs in Ithaca with more fine-edged approaches.
Honore
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