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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by AlexCanada on October 21, 2008, at 21:22:43
Tiny bit about me... I have severe treatment resistant depression and some anxiety. Some may call it A-typical.
I have severe Anhedonia, Dysthymia, low mood, tiredness, low drive, low motivation, difficult to ever feel happy, low enjoyment of anything, SEVERE inability to concentrate*****, cloudy mind, Extremely poor memory, low sex drive, burning head pains,
I take ritalin daily, and clonazepam... and here are some options I looked into... Ensam, Nardil, Abilify(not available in canada), Solian, Lyrica,
Something stimulating could be best...
Can anyone offer any insight of what might be better suited for my symptoms? I dont want emotional bluntening. I have tried over 20 medications and one of the only things that have helped are amphetamines (a lot but diminished effect), Vivarint (off the market except in France), paxil to a degree, and risperdal to a small degree. Most meds made me worse and also caused me to feel like my SKULL is on fire.
I have tried many SSRI's, and SNRI's, and many of the ''popular'' meds. So now I feel an MAOI for the first time could be in order. But which might be best for me? Or any meds that are non typical in their nature.
Please offer me any advice, insight, suggestions, questions, or your own experiences. Please... It has been over 6 years and sometimes I feel like things will never get any better.
Posted by azalea on October 21, 2008, at 22:39:13
In reply to Stopped Paxil, any advice PLEASE? Some options..., posted by AlexCanada on October 21, 2008, at 21:22:43
Have you tried Wellbutrin (bupropion)? It is an activating antidepressant that works on norepinephrine and dopamine, quite different from the SSRIs.
> Tiny bit about me... I have severe treatment resistant depression and some anxiety. Some may call it A-typical.
>
> I have severe Anhedonia, Dysthymia, low mood, tiredness, low drive, low motivation, difficult to ever feel happy, low enjoyment of anything, SEVERE inability to concentrate*****, cloudy mind, Extremely poor memory, low sex drive, burning head pains,
>
> I take ritalin daily, and clonazepam... and here are some options I looked into... Ensam, Nardil, Abilify(not available in canada), Solian, Lyrica,
>
> Something stimulating could be best...
>
> Can anyone offer any insight of what might be better suited for my symptoms? I dont want emotional bluntening. I have tried over 20 medications and one of the only things that have helped are amphetamines (a lot but diminished effect), Vivarint (off the market except in France), paxil to a degree, and risperdal to a small degree. Most meds made me worse and also caused me to feel like my SKULL is on fire.
>
> I have tried many SSRI's, and SNRI's, and many of the ''popular'' meds. So now I feel an MAOI for the first time could be in order. But which might be best for me? Or any meds that are non typical in their nature.
>
> Please offer me any advice, insight, suggestions, questions, or your own experiences. Please... It has been over 6 years and sometimes I feel like things will never get any better.
Posted by healing928 on October 21, 2008, at 23:39:39
In reply to wellbutrin? » AlexCanada, posted by azalea on October 21, 2008, at 22:39:13
Wellbutrin helps balance to the levels of two of these neurotransmitters called dopamine and norepinepherine.
Wellbutrin is great if you have low energy, need to lose weight, and if you want to stop smoking. I stopped taking it, but going to start when i go back to the doc.
Healing
Posted by Phillipa on October 22, 2008, at 0:26:08
In reply to Re: wellbutrin?, posted by healing928 on October 21, 2008, at 23:39:39
It's very activating or was to me. Phillipa
Posted by softheprairie on October 22, 2008, at 1:47:21
In reply to Stopped Paxil, any advice PLEASE? Some options..., posted by AlexCanada on October 21, 2008, at 21:22:43
I hear you -- I have similar issues. It seems like a catch-22 to me -- that stimulating meds for depression and attention increase anxiety or make the heartrate soar, while meds to help anxiety contribute to the severe fatigue problem.
I decided the thing I wanted to treat the most was the depression (I also have OCD and more). Desipramine has finally been the antidepressant to break through to help my depression! For me it gave too much heart racing when combined w/ generic adderall, and even when off the stim. the heartrate was outrageous, so my primary care dr. put me on a betablocker (nebivolol, I love it). I'm also augmenting with thyroid replacement hormone (the psychiatrist allowed me to have it when I asked, after so many other trials not going so well). I'm also on the antipsychotic perphenazine at night and PRN, which helps my anxiety and crying spells. I also take the herb rhodiola; I'm not sure if I'm getting any benefit from it.
In the past I got some relief from MAOI selegeline, but not as much as from the TCA desipramine now. You mentioned Nardil if you go the MAOI route -- you might try Parnate first if you're wanting a stimulating antidepressant.
Posted by rskontos on October 22, 2008, at 11:47:44
In reply to Stopped Paxil, any advice PLEASE? Some options..., posted by AlexCanada on October 21, 2008, at 21:22:43
I was going to ask if you have had your thyroid functions checked. I know softheprairie spoke that he/she is taking a thyroid hormone to help when all AD's did not help.
I also noted several suggested Wellbutrin. I am currently on Wellbutrin. For me it helped somewhat but not the activation most everyone else speak about. My doc checked my neurotranmittor levels admittedly the only way is through a urine test and my dopamine levels were not as high as you'd expect when on Wellbutrin. So I expect I could go up but when my thyroid levels were checked they were very out of whack. So are my adrenal functions. So sometimes a more thorough testing of physical functions for things such as adrenal fatigue and thyroid function is something that might be helpful as the symptoms you describe are the same ones that are caused by either of these two glands not functioning properly. Or if you have been taking so much it was explained that sometimes these drugs can alter the functioning of these glands. A catch 22 if you will.
Now I am not saying this is your problem but it would not be outside the realm to check this. Several prominent docs I have read their research says for symptoms such as "low mood, tiredness, low drive, low motivation, difficult to ever feel happy, low enjoyment of anything, SEVERE inability to concentrate*****, cloudy mind, Extremely poor memory, low sex drive, burning head pains," it should be a matter of practice to check the functions of the thyroid and adrenal glands to make sure they are not an underlying cause or part of the problem.
Sometimes it is an age related problem with these glands but as one doc put it stress or trauma or just life experiences can put incredible strain on these glands that regulate most organs and their gradually breakdown can really mess up the body's systems. So then it is not always an age thing.
Hope this helps. If not forgive my ramble.
rsk
Posted by Phillipa on October 22, 2008, at 19:51:22
In reply to Re: Stopped Paxil, any advice PLEASE? Some options... » AlexCanada, posted by rskontos on October 22, 2008, at 11:47:44
Rsk I fully agree as that has happened with me. So a very helpful post wish more docs would pay attention to these issues. Phillipa
Posted by chinooktoe on October 23, 2008, at 1:36:46
In reply to Stopped Paxil, any advice PLEASE? Some options..., posted by AlexCanada on October 21, 2008, at 21:22:43
You could try an experimental treatment that worked for me (after three decades of just about every treatment offered by medical science for major depression). It is not a medication, not talk therapy, non-invasive, cheap, quick, sounds too good to be true I know, a little scary at first, but instead of a can of pepper spray in the wilderness to ward off grizzly bears, this treatment is like an AK47. For details, I'm at chinooktoe@gmail.com
Good luck
Neil
Posted by AlexCanada on October 24, 2008, at 5:12:53
In reply to Re: wellbutrin?, posted by healing928 on October 21, 2008, at 23:39:39
I made a new post regarding me about to start Parnate soon. Wellbutrin was a good suggestion but I have already tried it with no success.
Parnate seems well suited for my symptoms and never tried an MAOI yet.
This is the end of the thread.
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