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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 floatingbridge on August 17, 2009, at 20:59:32
So I asked my pdoc/T today just what he thought my dx was. Over a year ago, when he first dx'd me, he said BP nos. Today he said recurrent major depressive disorder, treatment resistant (of course).
Well, the prognosis for that is not great. He said we have to get you in remission and keep you there. Lithium at low doses was a possible nueroprotector--but he also said most ad's like pristiq also have some of that quality.
I'm in shock right now, with new reading to do. I don't even understand what depression is, really. In reading Wikipedia, seems I've moved from a younger atypical, to now, as I've gotten older, a melancholic depression.
Two questions:
1) How long can one treat depression with 55mg of dexedrine a day? (plus klonopin + pristiq)
2) Do MAOI's provide any neuroprotection? Even healing? (I've been depressed a long, long time)
There's today's update. Any input would be greatly appreciated!
thanks a bunch for being here!
fb
Posted by Phillipa on August 17, 2009, at 23:42:24
In reply to my new Dx, posted by floatingbridge on August 17, 2009, at 20:59:32
FB had a feeling that depression would be the diagnosis. Do some reading on thyroid and depression and anxiety too as all interconnected to peri menopause and menopause also and then after the change things get better. Now that should make you smile a tiny bit. You seem to have a lot of inner energy as you write late at night too. And that's a compliment!!!! Got something for you. love Phillipa
Posted by SLS on August 18, 2009, at 6:02:21
In reply to my new Dx, posted by floatingbridge on August 17, 2009, at 20:59:32
> Well, the prognosis for that is not great. He said we have to get you in remission and keep you there. Lithium at low doses was a possible nueroprotector--
> but he also said most ad's like pristiq also have some of that quality.
Yes, but I believe that this occurs ONLY when they work. In fact, when they work, they seem to reverse much of the tissue loss that the illness is responsible for. If I am wrong about the neuroprotection, perhaps Linkadge can correct me and shed some more light on this.
> I'm in shock right now, with new reading to do. I don't even understand what depression is, really.
Either sadness or lack of interest is considered necessary for MDD to be diagnosed if one goes by the DSM IV. Personally, I think the diagnostic protocol suggested by the DSM is primordial for depressive disorders when compared to the personality disorders that it describes. It is disgraceful.
In your case, I am not sure that it really matters if you are MDD or BD, the treatment is not terribly different. Even the use of "mood stabilizers" can be justified in MDD if it is refractory to treatment. Your illness might fit somewhere in the bipolar spectrum. There are presentations of bipolar disorder where it is only depression that emerges. You will see this as a diagnostic subtype in the next DSM.
MDD is not a death sentence. It tends to be more treatable than BD.
> In reading Wikipedia, seems I've moved from a younger atypical, to now, as I've gotten older, a melancholic depression.
I was taught that it was the other way around.
> Two questions:
>
> 1) How long can one treat depression with 55mg of dexedrine a day? (plus klonopin + pristiq)I am not sure what you are asking here. Do you have any specific concerns?
> 2) Do MAOI's provide any neuroprotection? Even healing? (I've been depressed a long, long time)Again, this probably depends upon whether or not it works to resolve the depression. I don't know where I heard this, but I was once told that MAOIs can actually slow down the aging process. I'm not sure what was meant by that, though. Apoptosis perhaps?
- Scott
Posted by zana on August 18, 2009, at 9:03:34
In reply to Re: my new Dx » floatingbridge, posted by SLS on August 18, 2009, at 6:02:21
Dear FB,
I really agree with Scott that the DX is not that important. It may help in choosing meds but a DX is really just a description of symptoms and they change. I don't know that one is easier or harder to treat than the other, BP or MDD I mean. Sounds like your doc said being depressed makes your brain matter die? I have never heard that but I am going to google it.
Hang in there. Getting on the right meds is the important thing. And I wouldn't worry too much about the dex, though I know you do. It seems to me a good thing if it helps even though I know stimulants in general are a double edged sword since you kind of crash off them.
Be well. This isn't a death sentence and remember, you are the same person you were yesterday.
Zana
Posted by floatingbridge on August 18, 2009, at 12:41:00
In reply to Re: my new Dx, posted by zana on August 18, 2009, at 9:03:34
My pdoc said the prognosis for mmd was not as good as for BP, (I didn't tell him about my bp friends here who are having difficulties!), and he seemed in his manner more concerned for me than before--spooked me. He was the one who had originally said to me, like Scott and Zana above, that Dx is less important than response. However, he said a major piece for me was going to be therapy. I know that no pill can address that.
However, today I am optimistic. Read last night a newsletter that Phillipa sent about treating depression patients w/ hashimoto's with dexedrine w/ great success.
I am very glad I have my pdoc/T, and I am so glad to have found Babble!
fb
Posted by SLS on August 18, 2009, at 13:25:50
In reply to Re: my new Dx » floatingbridge, posted by SLS on August 18, 2009, at 6:02:21
> I don't know where I heard this, but I was once told that MAOIs can actually slow down the aging process. I'm not sure what was meant by that, though. Apoptosis perhaps?
Selegiline (-deprenyl; Emsam; Eldepryl) has long been recognized as being ant-apoptotic presumably through its influence on mitochondria function. However, someone told me about this anti-aging thing a long time ago referring to the older MAOIs. After doing some snooping on Medline, I was unable to find anything that would corroborate this.
MAOI-B activity accelerates with age, leading some investigators to theorize that it is this phenomenon that produces late-onset depression. Perhaps the older MAOIs prevent the excessive oxidative H2O2 (peroxide) that this enzyme would produce, thus slowing the aging process.
- Scott
Posted by SLS on August 18, 2009, at 13:31:54
In reply to Tanks for response! rallying today! » zana, posted by floatingbridge on August 18, 2009, at 12:41:00
> My pdoc said the prognosis for mmd was not as good as for BP,
Again, it is usually considered to be the other way around. Bipolar depression had been considered to be more difficult to treat than MDD. Interesting. I wonder why your doctor said that? I know he is very good, and I would love to know his reasons for saying this. Perhaps he was trying to get you prepared for doing some more psychotherapeutic work.
- Scott
Posted by SLS on August 18, 2009, at 13:33:00
In reply to Tanks for response! rallying today! » zana, posted by floatingbridge on August 18, 2009, at 12:41:00
Oh yeah, I forgot.
I'm glad you are feeling better!
:-)
- Scott
Posted by Maxime on August 18, 2009, at 14:26:54
In reply to my new Dx, posted by floatingbridge on August 17, 2009, at 20:59:32
I just know that you are going to find something that makes you feel better. You haven't tried a lot of meds I don't think. I also think it's great that you are considering therapy because that is always helpful no matter what the dx.
Stay optimistic!
This is the end of the thread.
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