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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by SLS on August 6, 2008, at 18:40:16
Make three lists and see what you come up with.
1. Drugs that have helped with depression, regardless of time or magnitude.
2. Drugs that made your depression worse.
3. Drugs that were neutral but tolerable.
- Scott
Posted by Sigismund on August 6, 2008, at 20:57:23
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
This is just off the top of my head, but how about.......
1. Ones that were euphoric (not many of them?).
2. Ones that were quite dysphoric (plenty in this category?).
3. Ones that made you feel more normal or well.
Posted by Phillipa on August 7, 2008, at 0:56:48
In reply to Re: Make three lists., posted by Sigismund on August 6, 2008, at 20:57:23
Benzos worked for 37 years. paxil l0mg with lopressor and xanax and luvox my body refuses to let go of why? I don't get it? Love Phillipa
Posted by SLS on August 7, 2008, at 2:19:08
In reply to Re: Make three lists., posted by Sigismund on August 6, 2008, at 20:57:23
Hi.
I hadn't thought about manic reactions to medication as a criterion.
Anyway, I would like to see you make the three lists of drugs according to my criteria here. It might be very informative.
********************************************
1. Drugs that have helped with depression, regardless of time or magnitude.2. Drugs that made your depression worse.
3. Drugs that were neutral but tolerable.
********************************************
Doing this helped me choose drugs to combine.
- Scott
Posted by B2chica on August 7, 2008, at 8:59:36
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
1. zyprexa, wellbutrin, ritalin, trazadone
2. prozac (symbyax), effexor, lexapro (small mood swings), Geodon, budeprion
3. ripersal, zoloft, remeron, topomax
actually this did help "clean up" what i've been on, and what i could try again in a different mix.
thanks SLS, nice thinkin.b2c.
Posted by SLS on August 7, 2008, at 9:08:45
In reply to Re: Make three lists. » SLS, posted by B2chica on August 7, 2008, at 8:59:36
> 1. zyprexa, wellbutrin, ritalin, trazadone
> 2. prozac (symbyax), effexor, lexapro (small mood swings), Geodon, budeprion
> 3. ripersal, zoloft, remeron, topomax
>
>
> actually this did help "clean up" what i've been on, and what i could try again in a different mix.
> thanks SLS, nice thinkin.
>
> b2c.
From your list, I would say that combining Zoloft with Wellbutrin has a fair chance of working. You might even want to add either Abilify or Geodon instead of Zyprexa if you want to avoid metabolic syndrome and diabetes.
- Scott
Posted by SLS on August 7, 2008, at 14:56:31
In reply to Re: Make three lists. » SLS, posted by B2chica on August 7, 2008, at 8:59:36
> From your list, I would say that combining Zoloft with Wellbutrin has a fair chance of working. You might even want to add either Abilify or Geodon instead of Zyprexa if you want to avoid metabolic syndrome and diabetes.
Oops. I forgot that you had a bad reaction to Geodon. Scratch that.
Regarding Geodon, did you start low at 20mg? What untoward effects did you experience?
- Scott
Posted by B2chica on August 7, 2008, at 15:33:05
In reply to Re: Make three lists. » B2chica, posted by SLS on August 7, 2008, at 14:56:31
wellbutrin used to work but no longer does.
and the last time i used it it was in combination with zoloft, and zoloft alone did nothing. so those are no longer options.started Geodon at 80 and stayed there for a while fine (thought it was working, but either the zyprexa just kept working for extended time or i was actually somewhat stable on my own) then i started going downhill and pdoc doubled dose to 160, i got psychotically depressed, with suicidal visions and thoughts bombarding throughout each day, and crying.
i still can't believe that i made it through that alive.
(was also on topomax and buproprion (neither of which i think did anything) and ritalin)maybe going back down to 80 would have been enough for me but when i went down i didn't get any better so i was taken off completely so that i could get back on zyprexa (the only thing that has ever seemed to work for my psychotic depression).
i'm actually thinking that its more of a dopamine issue with me than a seratonin issue.
i definately know to stay clear of norepinephrine ones like effexor-those make me rapid cycle and DEFINATELY get manic.i may try some TCA's next. but for now, i'm taking a rest of the med game, this last battle almost cost me my life and i'm still recouping. i need to gain some mental and physical strength back.
thanks for the input Scott. its always nice to talk with you.
b2c.
Posted by Bob on August 7, 2008, at 17:50:09
In reply to Re: Make three lists. » SLS, posted by B2chica on August 7, 2008, at 15:33:05
>
> i may try some TCA's next. but for now, i'm taking a rest of the med game, this last battle almost cost me my life and i'm still recouping. i need to gain some mental and physical strength back.
>
> b2c.
I know what you mean b2c. I've had more than one "battle" that I came might close to losing. It definitely makes it harder to try med combos in the future after getting stung real, real bad. Once you get trapped in a real bad place from meds gone bad it's extremely difficult to get back out.
Posted by Tomatheus on August 7, 2008, at 18:56:46
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
> 1. Drugs that have helped with depression, regardless of time or magnitude.
Nardil, Parnate, Marplan, Paxil, Wellbutrin, fluoxetine (Prozac), selegiline, moclobemide, adrafinil, tianeptine, lithium carbonate
> 2. Drugs that made your depression worse.
Cymbalta, Paxil (made it both better and worse), sertraline (Zoloft), Depakote, Zyprexa, Seroquel, Risperdal, Perphenazine (Trilafon), Abilify
> 3. Drugs that were neutral but tolerable.
Ativan
No section for drugs that were intolerable?
Tomatheus
Posted by SLS on August 7, 2008, at 19:19:26
In reply to Re: Make three lists. » SLS, posted by Tomatheus on August 7, 2008, at 18:56:46
Hi Tomatheus.
The reason I decided to not include "neutral but intolerable" is because those drugs would be excluded from consideration. The three lists are all about trying to choose drug combinations. I'm sure that knowing the pharmacodynamics of the intolerable drugs might provide some relevant data, but it might be difficult to interpret.
I noticed you haven't yet tried a tricylic. Are you bipolar? Have you ever been manic? What about Lamictal? Wellbutrin + Lamictal is a combination my doctor favors, even for unipolar depression.
- Scott
> > 1. Drugs that have helped with depression, regardless of time or magnitude.
>
> Nardil, Parnate, Marplan, Paxil, Wellbutrin, fluoxetine (Prozac), selegiline, moclobemide, adrafinil, tianeptine, lithium carbonate
>
> > 2. Drugs that made your depression worse.
>
> Cymbalta, Paxil (made it both better and worse), sertraline (Zoloft), Depakote, Zyprexa, Seroquel, Risperdal, Perphenazine (Trilafon), Abilify
>
> > 3. Drugs that were neutral but tolerable.
>
> Ativan
>
> No section for drugs that were intolerable?
>
> Tomatheus
Posted by Racer on August 7, 2008, at 19:28:54
In reply to Re: Make three lists. » Tomatheus, posted by SLS on August 7, 2008, at 19:19:26
> Hi Tomatheus.
>
> The reason I decided to not include "neutral but intolerable" is because those drugs would be excluded from consideration. The three lists are all about trying to choose drug combinations. I'm sure that knowing the pharmacodynamics of the intolerable drugs might provide some relevant data, but it might be difficult to interpret.
>How about "helpful but intolerable?" Or "potentially helpful but intolerable?" That's actually been more of a problem for me -- drugs that relieved my distress, but caused problems that interfered with functioning almost as much as the depression itself.
And I'm afraid I've been experiencing a pretty severe worsening of my depression lately, and don't have the energy right now to think about those lists. Besides, it would just make me feel worse, since I've just restarted one of those "somewhat helpful but intolerable" medications, so I'm feeling even worse...
It does seem like a good exercise, and I thank you for posting it.
Posted by Tomatheus on August 7, 2008, at 19:47:37
In reply to Re: Make three lists. » Tomatheus, posted by SLS on August 7, 2008, at 19:19:26
> The reason I decided to not include "neutral but intolerable" is because those drugs would be excluded from consideration. The three lists are all about trying to choose drug combinations. I'm sure that knowing the pharmacodynamics of the intolerable drugs might provide some relevant data, but it might be difficult to interpret.
Ok, makes sense.
> I noticed you haven't yet tried a tricylic.
Actually, I've tried clomipramine (Anafranil), but found it to be intolerable after one day due to strong irritability. I wasn't on it for long enough to determine whether it was reducing my depressive symptoms or making them worse, so I didn't include it on any of my three lists.
> Are you bipolar? Have you ever been manic?
My current diagnosis is schizoaffective disorder. My experience with mania is as follows: I cycled in and out of hypomania when I was taking Paxil several years back only at the dose of 60 mg/day. At lower doses, I cycled back and forth between euthymia and depression. I also experienced some manic symptoms when I first became psychotic about a year and a half ago. So, I've had some experiences with mania since my depressive symptoms first emerged eight years ago, but far more experience with depression.
> What about Lamictal? Wellbutrin + Lamictal is a combination my doctor favors, even for unipolar depression.
I think that Lamictal might be worth considering, especially in combination with something like Wellbutrin. I had a partial antidepressant response to Wellbutrin+lithium years ago, so Wellbutrin+Lamictal makes some sense. Thank you for the suggestion.
Tomatheus
Posted by Bob on August 7, 2008, at 20:05:35
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
> Make three lists and see what you come up with.
>
> 1. Drugs that have helped with depression, regardless of time or magnitude.
>
> 2. Drugs that made your depression worse.
>
> 3. Drugs that were neutral but tolerable.
>
>
> - Scott
I might make those lists when I feel more energetic, but for now I'd like to make the comment that Abilify would be a good drug for me to include in the helpful but intolerable category (no.4?). It started to lift me depression but caused intolerable insomnia, then anger, and then most unacceptably, joint pains. I wish to God that last one hadn't happened 'cause it was a showstopper. I was staying awake more, getting out of bed earlier, and somewhat more active. Oh well.
Posted by atmlady on August 7, 2008, at 21:36:26
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
1. Drugs that have helped with depression, regardless of time or magnitude = Lexapro, Wellbutrin, Ixel
2. Drugs that made your depression worse = Ambien (crazy, but true)
3. Drugs that were neutral but tolerable = Trazodone, Effexor
My feeling is that something like Emsam would work well for me, as I seem to need a boost of all three neurotransmitters, but looks like I'll need to jump through the hoops (15 million other meds) before anyone will prescribe for me :-(
Your thoughts, SLS?
Posted by SLS on August 7, 2008, at 22:18:59
In reply to Re: Make three lists. » SLS, posted by atmlady on August 7, 2008, at 21:36:26
> 1. Drugs that have helped with depression, regardless of time or magnitude = Lexapro, Wellbutrin, Ixel
>
> 2. Drugs that made your depression worse = Ambien (crazy, but true)
>
> 3. Drugs that were neutral but tolerable = Trazodone, Effexor
>
> My feeling is that something like Emsam would work well for me, as I seem to need a boost of all three neurotransmitters, but looks like I'll need to jump through the hoops (15 million other meds) before anyone will prescribe for me :-(
>
> Your thoughts, SLS?
All I can say is that I know one person who is doing dramatically better on a combination of Wellbutrin 300mg and Lexapro 40mg. She had been depressed for over 20 years. It might be worth considering.
- Scott
Posted by chiron on August 7, 2008, at 23:59:34
In reply to Re: Make three lists., posted by SLS on August 7, 2008, at 22:18:59
1. Drugs that have helped with depression: SSRIs (Zoloft, Prozac, Celexa), Wellbutrin, Xanax, Adderall(wonderful for a week), I think Effexor helped. Lamictal - I think some stabalizing effect...?
2. Drugs that made your depression worse:
a) some cycling: Zoloft, Wellbutrin, Emsam, Adderall, Cymbalta
b) bad: Seroquel, Zyprexa, Lithium, Trileptal, Serzone
c) verrry bad: Adderall w/ Abilify, Geodon, Topomax, Depakote, Neurontin3. Drugs that were neutral but tolerable = can't think of any
Posted by SLS on August 8, 2008, at 5:39:32
In reply to Re: Make three lists., posted by chiron on August 7, 2008, at 23:59:34
> 1. Drugs that have helped with depression: SSRIs (Zoloft, Prozac, Celexa), Wellbutrin, Xanax, Adderall(wonderful for a week), I think Effexor helped. Lamictal - I think some stabalizing effect...?
>
> 2. Drugs that made your depression worse:
> a) some cycling: Zoloft, Wellbutrin, Emsam, Adderall, Cymbalta
> b) bad: Seroquel, Zyprexa, Lithium, Trileptal, Serzone
> c) verrry bad: Adderall w/ Abilify, Geodon, Topomax, Depakote, Neurontin
>
> 3. Drugs that were neutral but tolerable = can't think of anyWellbutrin + (Lexapro or Zoloft) + Lamictal?
Are you bipolar? Can you describe your cyclic fluctuations?
What would be your choice of a combination?
Of course, you could consider an MAOI like Parnate.
- Scott
Posted by Down on the Upside on August 9, 2008, at 2:53:19
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
1. Survector(amineptine), Stablon (tianeptine), Dogmatil (sulpiride), amitriptyline, alprazolam, lorazepam, clonazepam.
2. Dogmatil (sulpiride), amitriptyline (both dose dependent) fluoxetine.
3. Effexor,BuSpar,Risperdal,Reboxetine,WellbutrinRight now I'm feeling better on amitriptyline 300mg, sulpiride 50mg and tianeptine 12.5mg x 3
> Make three lists and see what you come up with.
>
> 1. Drugs that have helped with depression, regardless of time or magnitude.
>
> 2. Drugs that made your depression worse.
>
> 3. Drugs that were neutral but tolerable.
>
>
> - Scott
Posted by X-ray on August 12, 2008, at 4:05:00
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
Hi,
Here's my short list:
1. Remeron
2. Prozac
3. ElavilBest regards,
X-ray
Posted by Cecilia on August 15, 2008, at 21:04:23
In reply to Make three lists., posted by SLS on August 6, 2008, at 18:40:16
1. Drugs that helped with depression for a short time: Xanax
2. Drugs that made depression worse: None that made depression per se worse, but many that made life worse, see
list 4.3. Drugs that were neutral but tolerable: Celexa, Lexapro, Tianeptine, Zoloft, Paxil, St. John's Wort, Clonazepam, Diazepam, Serzone, Trazodone, Gabapentin, Lamicital, Pregabalin, Buspar, 5-HTP
4. Drugs that had no effect on depression but made life worse because of side effects: Nardil, Parnate, Emsam, Marplan, Effexor, Prozac, Desipramine, Nortriptyline, Sam-E, Wellbutrin, Remeron, Lithium, Olanzapine, Moclobemide, Cymbalta, Milnacipran, Reboxetine. Imipramine
Cecilia
Posted by SLS on August 15, 2008, at 22:15:27
In reply to Re: Make three lists., posted by Cecilia on August 15, 2008, at 21:04:23
Hi.
You have been on an incredible number of drugs.
Which ones have you combined?
What was your reaction to Wellbutrin that it disrupted your life?
- Scott
Posted by SLS on August 15, 2008, at 22:26:05
In reply to Re: Make three lists., posted by Cecilia on August 15, 2008, at 21:04:23
I forgot about adinazolam (Deracyn). It is a benzodiazepine derivative of the triazolobenzodiazepine series. It is a sister drug to Xanax that possesses significant antidepressant properties. I tried it when it was being investigated in the US in the mid 1980s. Even at the top dosage, I did not experience any sedation at all. Baron Shopsin, MD was very surprised when he saw his patients respond favorably to it.
You might want to visit Google to see if adinazolam is available anywhere in the world. I have a feeling it would help you given your response to Xanax.
- Scott
Posted by Cecilia on August 16, 2008, at 2:27:03
In reply to Re: Make three lists. » Cecilia, posted by SLS on August 15, 2008, at 22:15:27
> Hi.
>
> You have been on an incredible number of drugs.
>
> Which ones have you combined?
>
> What was your reaction to Wellbutrin that it disrupted your life?
>
>
> - ScottCombinations:
Serzone plus Buspar (shouldn't be combined but serzone was new then and apparently pdoc didn't know that)
Zoloft plus lithium (couldn't tolerate the side effects of the lithium)
Zoloft plus Nortriptyline (small doses)
Celexa plus Buspar
Celexa plus Wellbutrin (lots of unpleasant side effects from Wellbutrin, dizzyness, nausea, headaches, insomnia, tachycardia/palpitations, sweating/hot flashes, blurry vision, dry mouth-by starting at a tiny dose and gradually increasing I was able to get up to a therapeutic dose of Wellbutrin but no benefits and side effects never got better.
Celexa plus Gabapentin
Trazodone plus clonazepam plus briefly Reboxetine
Trazodone plus Celexa plus clonazepam
Trazodone plus Lamictal plus clonazepam
Trazodone plus Celexa plus Lamictal plus clonazepam
Lexapro plus pregabalin plus clonazepam
Take a chemical soup of other meds too, levothryroxine, metformin, atenolol, pravastatin, ambien most nights, lots of vitamins and supplements, fish oil. Xanax prn but mainly take only if wake up in the middle of the night and can't get back to sleep. Amazing when I first tried it though, I was benzo naive and it was the only psych med I'd ever tried that actually helped. Didn't last unfortunately.
Cecilia
Posted by Phillipa on August 16, 2008, at 19:34:31
In reply to Re: Make three lists., posted by Cecilia on August 16, 2008, at 2:27:03
Ceclia sounds like me. First Valium mepbrobamate and ativan and xanax all solo for many years. Phillipa
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