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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 SteelyDan on January 6, 2008, at 19:07:29
I have chronic treatment resistant atypical depression. I have tried everything...even ECT, am currently on 90 mgs. Remeron, and 300 mgs. of Effexor. I'm still severely depressed...my Pdoc mentioned maybe trying a stimulant like ritalin or concerta. I would appreciate your ideas and opinions please.
Dan
Posted by Maxime on January 6, 2008, at 21:17:03
In reply to Are stimulants a good option for TR Depression?, posted by SteelyDan on January 6, 2008, at 19:07:29
> I have chronic treatment resistant atypical depression. I have tried everything...even ECT, am currently on 90 mgs. Remeron, and 300 mgs. of Effexor. I'm still severely depressed...my Pdoc mentioned maybe trying a stimulant like ritalin or concerta. I would appreciate your ideas and opinions please.
>
> DanHave you tried MAOIs yet? If not you should.
What are your symptoms? I was given a stimulant as a last ditch effort to help me. It gave me a false sense of well being (so I felt good). Over time though it made me more depressed. If you have tried everything then I think you should try a stimulant and see what happens. But first you try an MAOI.
Maxime
Posted by SteelyDan on January 6, 2008, at 22:31:11
In reply to Re: Are stimulants a good option for TR Depression? » SteelyDan, posted by Maxime on January 6, 2008, at 21:17:03
I have tried all the MAOI's, Parnate worked well for a while but the insomnia was unbearable. Thanks for your imput, i think will give stimulants a try...my worry is that they won't be a long term solution.
-Dan
Posted by maxime on January 6, 2008, at 22:42:47
In reply to Re: Are stimulants a good option for TR Depression? » Maxime, posted by SteelyDan on January 6, 2008, at 22:31:11
> I have tried all the MAOI's, Parnate worked well for a while but the insomnia was unbearable. Thanks for your imput, i think will give stimulants a try...my worry is that they won't be a long term solution.
>
> -DanThat's too bad about the Parnate. You are right, stimulants are not a long time solution but it will give you a reprieve. Some find that Provigil has an anti-depressant effect.
Speaking of effects, not all stimulants are the same. Ritalin and dexedrine made my depression worse, especially once it wore off. My saviour was Adderall XR. So if one doesn't work for you, there are more to try. :)
Let us know how it goes.
Maxime
Posted by SteelyDan on January 6, 2008, at 23:07:14
In reply to Re: Are stimulants a good option for TR Depression? » SteelyDan, posted by maxime on January 6, 2008, at 22:42:47
> > I have tried all the MAOI's, Parnate worked well for a while but the insomnia was unbearable. Thanks for your imput, i think will give stimulants a try...my worry is that they won't be a long term solution.
> >
> > -Dan
>
> That's too bad about the Parnate. You are right, stimulants are not a long time solution but it will give you a reprieve. Some find that Provigil has an anti-depressant effect.
>
> Speaking of effects, not all stimulants are the same. Ritalin and dexedrine made my depression worse, especially once it wore off. My saviour was Adderall XR. So if one doesn't work for you, there are more to try. :)
>
> Let us know how it goes.
>
> Maxime
>Will do...Thank You :)
-Dan
Posted by Phillipa on January 6, 2008, at 23:54:27
In reply to Re: Are stimulants a good option for TR Depression?, posted by SteelyDan on January 6, 2008, at 23:07:14
I know I have no experience with them but two people I e-mail with former posters are doing well on vyvanase it's longer acting they say. Hope you don't mind me butting in with what is not personal experience but it's made a huge difference in their lives they say. Phillipa
Posted by SteelyDan on January 7, 2008, at 16:41:13
In reply to Re: Are stimulants a good option for TR Depression?, posted by Phillipa on January 6, 2008, at 23:54:27
> I know I have no experience with them but two people I e-mail with former posters are doing well on vyvanase it's longer acting they say. Hope you don't mind me butting in with what is not personal experience but it's made a huge difference in their lives they say. Phillipa
No not at all, thank you for your imput. :)
Posted by Fivefires on January 7, 2008, at 20:07:06
In reply to Are stimulants a good option for TR Depression?, posted by SteelyDan on January 6, 2008, at 19:07:29
Taken carefully and, in my case, on a more as-needed basis, Provigil has been helpful. I've actually not been taking too much of it recently. I have samples. I sort of keep it for times when I might have something to do in my life and don't have the umpf to get out and do it. Also, for me, they help my thought patterns a little ... seems I don't 'worry' quite as much. I believe Provigil is $10 a tab, so I cannot afford it, and it's not approved for TRD, even w/ sleep deprivation. I actually wrote my own prior auth. I wrote TRD w/ sleep deprivation and was turned down. My pdoc said the company wasn't going to be bringing any more samples for a while, so like said, I'm stashing for when needed. I have high anxiety as well, but Provigil doesn't seem to make it worse. I know, it seems as it might, but it doesn't. I think it is helpful for 1) energy and 2) better thoughts.
best wishes, 5f
Posted by Maxime on January 7, 2008, at 20:59:28
In reply to Re: Are stimulants a good option for TR Depression?, posted by Fivefires on January 7, 2008, at 20:07:06
Provigil isn't really $10 a tab? I was able to get a month's supply for $40. Where do you live?
Maxime
Posted by Fivefires on January 7, 2008, at 21:08:44
In reply to Re: Are stimulants a good option for TR Depression? » Fivefires, posted by Maxime on January 7, 2008, at 20:59:28
I'll ask my pharmacist again M, but thought this is what he said.
Tks, 5f
Posted by Polarbear206 on January 7, 2008, at 22:32:06
In reply to Are stimulants a good option for TR Depression?, posted by SteelyDan on January 6, 2008, at 19:07:29
> I have chronic treatment resistant atypical depression. I have tried everything...even ECT, am currently on 90 mgs. Remeron, and 300 mgs. of Effexor. I'm still severely depressed...my Pdoc mentioned maybe trying a stimulant like ritalin or concerta. I would appreciate your ideas and opinions please.
>
> Dan
Dan,have you ever tried to augment with a mood stabilizer?
PB
Posted by trx resistant on January 8, 2008, at 1:13:33
In reply to Are stimulants a good option for TR Depression?, posted by SteelyDan on January 6, 2008, at 19:07:29
Please read about EMSAM. I was placed on Wellbutrin @ 450mg (titrated up slowly) with 30mg Dexidrine. Felt great for 4 months then out of nowhere I had 11 seizures in 5 hours. So all stimulants are out for me. I tried all SSRI's had another seizure on 90mg of Cymbalta in 2005. 9 years and the pdoc says I'm treatment resistant. Went on EMSAM and in 3 months recovering "ME" like I was 9 years ago before MDD caused by hostile work situation. So don't give up. But before you try anything for this condition, EMSAM I'm told by 2nd leading medical institution in US is the gold standard. It's safer than anything out there because it's transdermal patch. I wear it 12 hours and only half a patch. Good luck and keep us posted about your journey.
Posted by SteelyDan on January 8, 2008, at 15:37:34
In reply to Re: Are stimulants a good option for TR Depression?, posted by Polarbear206 on January 7, 2008, at 22:32:06
> > I have chronic treatment resistant atypical depression. I have tried everything...even ECT, am currently on 90 mgs. Remeron, and 300 mgs. of Effexor. I'm still severely depressed...my Pdoc mentioned maybe trying a stimulant like ritalin or concerta. I would appreciate your ideas and opinions please.
> >
> > Dan
>
>
> Dan,
>
> have you ever tried to augment with a mood stabilizer?
>
> PB
>
>
> Yes, they didn't help. Thanks for responding though.
>
Posted by elanor roosevelt on January 8, 2008, at 19:23:13
In reply to Re: Are stimulants a good option for TR Depression? » Polarbear206, posted by SteelyDan on January 8, 2008, at 15:37:34
adderall keeps me a few steps ahead of the depression
it has helped a great deal in many ways
good luck
Posted by Greenmtn on January 9, 2008, at 4:53:36
In reply to Are stimulants a good option for TR Depression?, posted by SteelyDan on January 6, 2008, at 19:07:29
Emsam transdermal patch. Miracle drug for me after years of hell.
Posted by former trx resistant on January 9, 2008, at 22:34:25
In reply to Re: Are stimulants a good option for TR Depression, posted by Greenmtn on January 9, 2008, at 4:53:36
Yes, another Emsam success. We have got to keep this drug on the market and get those of you unsuccessfully treated by SSRI's mixing this and that on one simple patch, if you can!
Posted by Phillipa on January 9, 2008, at 23:33:00
In reply to Re: Are stimulants a good option for TR Depression, posted by former trx resistant on January 9, 2008, at 22:34:25
Wouldn't it be wonderful? Love Phillipa
Posted by 4WD on January 10, 2008, at 21:23:04
In reply to Re: Are stimulants a good option for TR Depression? » SteelyDan, posted by maxime on January 6, 2008, at 22:42:47
> > I have tried all the MAOI's, Parnate worked well for a while but the insomnia was unbearable. Thanks for your imput, i think will give stimulants a try...my worry is that they won't be a long term solution.
> >
> > -Dan
>
> That's too bad about the Parnate. You are right, stimulants are not a long time solution but it will give you a reprieve. Some find that Provigil has an anti-depressant effect.
>
> Speaking of effects, not all stimulants are the same. Ritalin and dexedrine made my depression worse, especially once it wore off. My saviour was Adderall XR. So if one doesn't work for you, there are more to try. :)
>
> Let us know how it goes.
>
> Maxime
>Hi.
I have to agree with Maxime. Ritalin/Concerta made me feel much much worse. Provigil helps for a couple of days and then I get more depressed and have to stop it for a while. I have never tried Adderall.Marsha
Posted by qbsbrown on January 17, 2008, at 12:12:09
In reply to Re: Are stimulants a good option for TR Depression, posted by 4WD on January 10, 2008, at 21:23:04
Stimulants are the only thing that worked for my TR depression
Posted by SteelyDan on January 17, 2008, at 16:37:16
In reply to Re: Are stimulants a good option for TR Depression, posted by qbsbrown on January 17, 2008, at 12:12:09
> Stimulants are the only thing that worked for my TR depression
Tell me more please! My pdoc just started me on ritalin - only 5 mgs. a day to start. What worked for you, how much, etc. please if you don't mind.
Thanks, Dan
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