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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Kneeko on September 16, 2007, at 23:17:57
Hi everyone, Ive tried 28 Depression and except for Nardil and Tramadol, none of them have worked Anxiety, the anti-depressants were mainly Paxil, Lexapro, Wellbutrin, Remeron, Imipramine, Desipramine, Nardil, and Parnate. As well as most of the anti-Anxiety drugs Klonopin, Xanax, Ativan and some anti-psychotic stabilizers Lamictal, Lithium and Zyprexa and combinations of these. The only thing that has really kept my going is exercise and thai boxing(alone most of the time). The Nardil made me go hypomanic once, worked the second time and plain didn't work with and without augmentation the 3rd and 4th times. (Tramadol the tolerance rose too fast The anxiety medications just make me sleep at this point.
At this point having looked at most of med ratings sites and having seen very few things of interest I was thinking of only a few more things, At this point life is so depressing I dont worry about ECT so if you have any hard info on its efficacy or usefulness on anxiety it is much appreciated, Buprenorphine and maybe Effexor. Was wondering any of you have figured out strategies to make it out of these situations. Most of you seem to know more then my doctor(well the long term crew) so thankyou!
Posted by stargazer2 on September 17, 2007, at 7:31:23
In reply to Treatment resistant here!, posted by Kneeko on September 16, 2007, at 23:17:57
I too have TRD, just having gotten out of along bout with the beast (1+ year). I was just started on Nardil, Nortriptyline and synthroid. Nardil alone wasn't helping enough and I went to a endocrinologist to have my blood tests checked for any potential thyroid deficiencies. My TSH (Thyroid Stimulating hormone) was within the normal range but a small dose of Synthroid has been added to make the TSH lower which can help someone with resistent depression.
Have you ever had your thyroid tested? That may shed some light on whether or not you may need to have a thyroid medication added to make your levels a bit lower. The normal range is 0.5 to 5.0 and mine was around 3 but the endocriologist felt a lower level may help me since I have such severe depression.
Also have you taken combinations of meds since for someone with TRD, one med or even two may not be enough to target the different chemicals for depression.
I believe the number of medications you have taken only shows you have tried alot (me too) but until you have a combination of different meds you may not get an optimal response.
I told my doctor no ECT because I really believe medication is the answer for most TRD but getting the right combination is the hardest part and can take a long time. I was reaching my limit until the current combination seemed to break through to the depression. I've only been on this combination a few weeks myself.
Stargazer
Posted by Kneeko on September 17, 2007, at 8:38:36
In reply to Re: Treatment resistant here!/Kneeko, posted by stargazer2 on September 17, 2007, at 7:31:23
We'll I was told over and over again that my thyroid was perfectly fine and forgot to mention that I took Adderall and had a bad reaction so psychostimulants may be out. My doctor refuses to prescribe Nortriptyline because of potential seretonin syndrome. Also had a very bad reaction to adderall which I didn't mention, so I dont think I respond well to noradrenalenrgic based medications. Im really hoping he does Subutex because this is getting ridiculous
Posted by polarbear206 on September 17, 2007, at 8:40:33
In reply to Treatment resistant here!, posted by Kneeko on September 16, 2007, at 23:17:57
> Hi everyone, Ive tried 28 Depression and except for Nardil and Tramadol, none of them have worked Anxiety, the anti-depressants were mainly Paxil, Lexapro, Wellbutrin, Remeron, Imipramine, Desipramine, Nardil, and Parnate. As well as most of the anti-Anxiety drugs Klonopin, Xanax, Ativan and some anti-psychotic stabilizers Lamictal, Lithium and Zyprexa and combinations of these. The only thing that has really kept my going is exercise and thai boxing(alone most of the time). The Nardil made me go hypomanic once, worked the second time and plain didn't work with and without augmentation the 3rd and 4th times. (Tramadol the tolerance rose too fast The anxiety medications just make me sleep at this point.
>
>
> At this point having looked at most of med ratings sites and having seen very few things of interest I was thinking of only a few more things, At this point life is so depressing I dont worry about ECT so if you have any hard info on its efficacy or usefulness on anxiety it is much appreciated, Buprenorphine and maybe Effexor. Was wondering any of you have figured out strategies to make it out of these situations. Most of you seem to know more then my doctor(well the long term crew) so thankyou!
Hi,I'm on a combo of Effexor, Wellbutrin and Lamictal. Until I added Lamictal, nothing helped my anxiety/depression. This is the best combo I've been on.
Polarbear
Posted by Phillipa on September 17, 2007, at 11:25:30
In reply to Re: Treatment resistant here! » Kneeko, posted by polarbear206 on September 17, 2007, at 8:40:33
Throid now low.83 but still the fear and not having any energy but then factor in chronic lymes. So I don't know what's what but am old and scared. Phillipa
Posted by deniseuk190466 on September 17, 2007, at 14:52:16
In reply to Re: Treatment resistant here!, posted by Phillipa on September 17, 2007, at 11:25:30
Hi Phillipa,
You are not old, you just feel old and I'm not suprised going through what you are going through and like that other poster say's your like superwoman right now enduring what you are enduring and still managing to get on your bike and go for a bike ride.
I'm 41 and most of the time I feel like I'm about 100 years old :-)
Are you sure about this Lymes Disease thing? How do you know you have this?
Denise
Posted by deniseuk190466 on September 17, 2007, at 14:58:46
In reply to Re: Treatment resistant here!/Kneeko, posted by stargazer2 on September 17, 2007, at 7:31:23
Hi Stargazer,
Just wondering,
How did you feel on the Nardil on it's own?
How did you feel on the Nardil plus Nortryptaline and
How did you feel on the Nardil plus Nortryptaline plus the Synthoid?Just wondering what is doing what?
Also, I had my T3 and T4 checked out and it was in the normal range, although they did comment on something that didn't look quite right but I didn't understand it and My Doctor didn't think it was significant. Afterall I went to some nutrition specialists to have it done.
My psychiatrist did try adding (at my insistance) Liothyronine (which is T3 I think) and I took it for a month but can't say it did much. Synthoid is T4 istn't it? Had you tried T3, what made them decide to add T4 and not T3?
Thanks.....Denise
Posted by Phillipa on September 17, 2007, at 20:07:59
In reply to To Phillipa, posted by deniseuk190466 on September 17, 2007, at 14:52:16
Hi Denise it's a very complicated disease. A lot of blood work from an infection control specialist and two spinal taps and head MRI. Supposed to be in remission now but the spirochettes that cause the disease hide in all body tissues and can come out if something triggers it. Phillipa ps resembles MS and you even test positive for syphylis but don't have it.
Posted by stargazer2 on September 18, 2007, at 8:19:28
In reply to To Stargazer2, posted by deniseuk190466 on September 17, 2007, at 14:58:46
Let's see...
Nardil alone was great after a few days but slowly lost it's effect.
Nardil with Nortriptyline was started on 8/17 and Synthroid was begun on 8/13 so the two were actually together so hard to distinquish which was the actual trigger for improvement.
Looking back at my records, it looks like I also increased Nardil from 30 to 45 on 8/31 so that might have been the trigger.
The Synthroid was started at 25 mcg x 4 days and then increased to 50 mcg, but I now take 25 mcg since I was having symptoms of feeling excessively warm.
So overall, I take 25 mcg Synthroid upon getting up and wait a half hour before eating, then I take 15 mg Nardil. At night I take 50 mg of Nortriptyline and 30 mg Nardil. The Nortriptyline was reduced from 75 to 50 mg since I had dry mouth and dizziness.
All I know is that I woke up one day and said what the hell has been going on for the past year. I felt like I couldn't understand why I had been unable to leave to house or sit around/sleep all day without any interest or motivation to do anything. This has been the longest that I have been housebound with no energy or interst in doing anything.
All I know about Synthroid is it is a long acting med and impacts the TSH directly. Like I said, my level was within the normal range, around 3, and the endo felt with my history of TRD, a level closer to 1 might benefit me and that is regulated by Synthroid, not Cytomel, which is quicker acting and targets T3. I took Cytomel years ago without any significant improvement.
My pdoc would not have been able to make the recommendation for Synthroid since a normal level would not indicate the thyroid needed a boost. I'm glad I went specifically to an endocrinologist, actually the APRN in his office, since the endo MD did not have an appt until March of 2008!
Posted by deniseuk190466 on September 18, 2007, at 14:49:32
In reply to Denise, posted by stargazer2 on September 18, 2007, at 8:19:28
Hi,
Hmmmm, so you don't really know what's triggered off the improvement. I expect you don't really care just glad to feel alive again :-)
Hope you continue to feel well.
Denise
Posted by deniseuk190466 on September 18, 2007, at 14:50:33
In reply to Re: To Phillipa » deniseuk190466, posted by Phillipa on September 17, 2007, at 20:07:59
Hi Phillipa,
Ok, I wasn't aware of that, thanks for the education.
Denise
This is the end of the thread.
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