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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 uncouth on May 3, 2009, at 21:26:32
Yes, things have gotten bad, very bad. I didnt think things could "feel" any worse, well that was before the depression snuck its way into my "feeling" abilities themselves....if that makes any sense. I feel qualitatively worse than I did since Wed, my last ECT treatment before we decided to spread them out a bit further; my next one is on Tues. But im not sure if i'm going to make it another 24 hours, to be honest. But I think I can manage to pull together one last round of med cocktail adjustments to give me a tiny bit of HOPE. Because thats what left me the past few days...my sense of hope. You don't realize how much we as depressed people rely on hope to get through the day, and to function reasonably well. Hope embuues everything. And when it left me, my emotional, cognitive, memory, mind state, well they all qualitatively changed for the worst. Thus the WHOLE I have found myself in.
I think i can muster up the hope for onr last set of med changes. So asking for advice here, (seeing my doc on Wednesday as well).
Here's what i'm currently on:
> Ixel 100mg (milnacipran)
> Rilutek 100mg (riluzole)
> Nortriptyline 200mg
> Agomelatine 50mg
> Lithobid 600mg
> Lunesta 3mg
> Geodon 120mg
> Selegiline 4mg
> Namenda 40mg (memantine)
> Deplin 7.5mg
> Adderall 10mg
> Armour Thyroid 1 grainHere's what I'm thinking. Drop the Ixel, decrease Geodon to 80 or 60mg, drop the Rilutek.
Add in X to the Nortriptyline as my primary A/D. I should note i've only been on 150-200mg of Nortryptilne for alittle over a week now, so perhaps it hasn't had its chance to do its thing. Nevertheless, during that time, things have gotten terribly worse.
I'm thinking X could be one of the meds i've tried and had partial repsonse to in the past: Effexor at 450mg, or, and this is where I need help from you folks, Parnate at 80mg. Can someone tell me what the protocal is for MAOI + TCA combinations? I know its technically a no-no, but it has been done before. Scott, bleu? Someone?
Love,
A.V.
Posted by Zana on May 3, 2009, at 21:50:56
In reply to Ready to GO. Last cocktail I'm willing to try..., posted by uncouth on May 3, 2009, at 21:26:32
I don't know anything about your meds but I just wanted to let you know we Babblers are out here listening and hoping things get better for you soon.
Sounds like the ECT has really unsettled you. I'll bet you had a lot of hopes pinned on it working. I know I did when I was considering it. I'm in a better place right now but I watch ever shift in my mood, afraid that the depression which seems to have lifted, may be coming back. Depression can lift though. I'm sure you've had better times and there may be better times not too far off. Is there anyone you have that you can talk to? A therapist, a friend? If not just keep us posted.
Sounds like a minute can feel like a long time. Hang in there. Get some sleep if you can.
We're thinking of you.
Zana
Posted by Phillipa on May 3, 2009, at 22:21:38
In reply to Re: Ready to GO. Last cocktail I'm willing to try..., posted by Zana on May 3, 2009, at 21:50:56
Uncouth babblemail me anytime. But I feel too many meds in the cocktail. Scott gave you some advise. And he knows a lot more than I ever will. I can support you and will. Love Phillipa
Posted by ricker on May 3, 2009, at 22:38:58
In reply to Ready to GO. Last cocktail I'm willing to try..., posted by uncouth on May 3, 2009, at 21:26:32
uncouth,
Hope is a part of life that helps us move forward...life can be filled with many feelings, and yet so many of us are overcome with an overwhelming sense of "hopelessness".I would strongly suggest you seek a second opinion with regards to your current treatment. No-one here has the ability to advise you as to which meds you should adjust. We are all here for much the same reasons and that is our mental illness.
Depression is hell, many of us have experienced that terminal feeling and yet we continue to fight, I believe you will too.
A friend of mine had lost all hope.... much the same as you are feeling now. After seeking a second opinion and armed with a new treatment plan, her life again filled with sunshine.
If your list of meds are accurately listed, I truly "HOPE" you explore alternative treatment options. A second opinion may be the first step to wellness.
All the best, Rick
Posted by ricker on May 3, 2009, at 22:57:41
In reply to Ready to GO. Last cocktail I'm willing to try..., posted by uncouth on May 3, 2009, at 21:26:32
I feel qualitatively worse than I did since Wed, my last ECT treatment before we decided to spread them out a bit further; my next one is on Tues.
Here's what i'm currently on:
>
> > Ixel 100mg (milnacipran)
> > Rilutek 100mg (riluzole)
> > Nortriptyline 200mg
> > Agomelatine 50mg
> > Lithobid 600mg
> > Lunesta 3mg
> > Geodon 120mg
> > Selegiline 4mg
> > Namenda 40mg (memantine)
> > Deplin 7.5mg
> > Adderall 10mg
> > Armour Thyroid 1 grain
>Uncouth, I also wanted to add that when I went through my course of ECT in 1990, my pdoc removed 3 of the 4 meds I was taking prior to the treatment. Some were removed as they would have interfered with the ECT.... A/C and benzo, the other so as to evaluate the response to treatment.
So, if your pdoc is administering ECT with the list of meds you have provided...... please, get a second opinion.Regards, Rick
Posted by desolationrower on May 3, 2009, at 23:35:50
In reply to Ready to GO. Last cocktail I'm willing to try..., posted by uncouth on May 3, 2009, at 21:26:32
> Yes, things have gotten bad, very bad. I didnt think things could "feel" any worse, well that was before the depression snuck its way into my "feeling" abilities themselves....if that makes any sense. I feel qualitatively worse than I did since Wed, my last ECT treatment before we decided to spread them out a bit further; my next one is on Tues. But im not sure if i'm going to make it another 24 hours, to be honest. But I think I can manage to pull together one last round of med cocktail adjustments to give me a tiny bit of HOPE. Because thats what left me the past few days...my sense of hope. You don't realize how much we as depressed people rely on hope to get through the day, and to function reasonably well. Hope embuues everything. And when it left me, my emotional, cognitive, memory, mind state, well they all qualitatively changed for the worst. Thus the WHOLE I have found myself in.
>
> I think i can muster up the hope for onr last set of med changes. So asking for advice here, (seeing my doc on Wednesday as well).
>
> Here's what i'm currently on:
>
> > Ixel 100mg (milnacipran)
> > Rilutek 100mg (riluzole)
> > Nortriptyline 200mg
> > Agomelatine 50mg
> > Lithobid 600mg
> > Lunesta 3mg
> > Geodon 120mg
> > Selegiline 4mg
> > Namenda 40mg (memantine)
> > Deplin 7.5mg
> > Adderall 10mg
> > Armour Thyroid 1 grain
>
> Here's what I'm thinking. Drop the Ixel, decrease Geodon to 80 or 60mg, drop the Rilutek.
>
> Add in X to the Nortriptyline as my primary A/D. I should note i've only been on 150-200mg of Nortryptilne for alittle over a week now, so perhaps it hasn't had its chance to do its thing. Nevertheless, during that time, things have gotten terribly worse.
>
> I'm thinking X could be one of the meds i've tried and had partial repsonse to in the past: Effexor at 450mg, or, and this is where I need help from you folks, Parnate at 80mg. Can someone tell me what the protocal is for MAOI + TCA combinations? I know its technically a no-no, but it has been done before. Scott, bleu? Someone?
>
> Love,
> A.V.
by "X" do you mean mdma, or ixel, or something else?tca+MAOI combo is ok if its not a serotonergic TCA, usually nortryptaline or desipramine is used. when initiating it, monitor blood pressure.
-d/r
Posted by bleauberry on May 4, 2009, at 20:17:47
In reply to Ready to GO. Last cocktail I'm willing to try..., posted by uncouth on May 3, 2009, at 21:26:32
> Ixel 100mg (milnacipran)
> Rilutek 100mg (riluzole)
> Nortriptyline 200mg
> Agomelatine 50mg
> Lithobid 600mg
> Lunesta 3mg
> Geodon 120mg
> Selegiline 4mg
> Namenda 40mg (memantine)
> Deplin 7.5mg
> Adderall 10mg
> Armour Thyroid 1 grainThat's a long list man.
It's the meds making you sick.
Bodies and brains were not built to handle that kind of assault.
This will sound ridiculous, and I can already hear people screaming at me, but that's ok.
Wean off all the meds.
Increase Milnacipran to 150mg for one month, then if needed, add Paxil to it. Set a boundary of adding only one other med for a total of three maximum.
Or, wean off all meds, and go to Nardil or Parnate.
Why do you feel so bad? It's those meds.
Posted by uncouth on May 4, 2009, at 20:26:18
In reply to Re: Ready to GO. Last cocktail I'm willing to try..., posted by bleauberry on May 4, 2009, at 20:17:47
You sound like my mother.
I'm already stopping the Rilutek and Ixel (for now).
New treatment strategy is, in order of priority:
Nortriptyline
Parnate (parnate alone was already tried, at up to 100mg, a few mos ago. partial response)
Geodon (i'm at 120mg right now which I think might be too high of a dose, and given that i'm not seeing remission, i'm not sure whether i should even stay on this)
Lithobid (i think EVERYONE should be on low dose lithium 300-600mg)
Namenda (taking right now as i'm in the middle of ECT...will probably go down to 10mg for hte long term...supposed to help with poop-out right?)
Deplin
Agomelatine (maxed this out at 50mg for a few weeks...didn't see remission...it's not the miracle drug people have been making it out to be, so I may just dump it. however it does seem to be pretty clean and have low side effect profile and is sleep-enhancing, so i'm not sure how much it's really HURTING)
SOmething for sleep (either trazadone, low dose seroquel, or lunesta)
depending on how all that goes...maybe add in selegiline and thyroid if necessary.GOd damnit F it all. i'm so sick of this sh*t. i feel like this has become my primary hobby...f*cking amateur psychopharmacology...how sad. :(
Posted by Meltingpot on May 10, 2009, at 10:23:18
In reply to Ready to GO. Last cocktail I'm willing to try..., posted by uncouth on May 3, 2009, at 21:26:32
Hi,
Just wanted to say, since Christmas when my depression/anxiety started to get worst every time I open one of your posts I feel as though I'm reading my own thoughts :-)
I really hope you find some sort of solution, if you do then please let us know because I'm feeling pretty hopeless lately and to see you've made a recovery would give me something to hang on to.
Denise
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