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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 inanimate peanut on December 23, 2009, at 14:41:33
Well, since my doc won't increase my Parnate beyond 60mg and won't add Nortriptyline, I'm still really depressed. I was hoping people could suggest somewhere to go from here based on my past meds/current meds:
Current:
Parnate- 60mg
Lamictal 400mg- not working much
Geodon- 160mg- worked great for 1.5 months now controls mixed states only; increasing it doesn't help
Topamax- 150mg- doesn't help mood; only appetite control
Fish Oil
Levothyroxine 150 mcg
Propranolol- 20mg for IBS
D3 supplement
Ambien CR
Seroquel 200mg for sleep
Ativan as neededPast:
Effexor XR
RIsperdone
Trileptal
Lithium
Lamictal
Wellbutrin XL
Celexa
Abilify
Lexapro
Ritalin
PristiqJust a note: meds tend to poop out on me alot (esp antipsychotics) and once I go off a med, it generally doesn't work for me when I try to go back on it.
I have no idea what else to try. Zyprexa would likely only work the 1.5 months that the other antipsychotics have worked and then poop out, leaving the weight gain behind, so I'm a little wary about that. But, I don't know what else to try. Any ideas?
Posted by SLS on December 23, 2009, at 14:44:14
In reply to Where do we go from here? Help and ideas please, posted by inanimate peanut on December 23, 2009, at 14:41:33
Can you describe the condition you are treating?
- Scott
Posted by inanimate peanut on December 23, 2009, at 14:47:34
In reply to Re: Where do we go from here? Help and ideas please » inanimate peanut, posted by SLS on December 23, 2009, at 14:44:14
Sorry, of course that would be helpful. I have Bipolar I, Mixed Type but usually the mixed states are pretty easily controlled by meds and it's the horrible depressions that are hard to treat
Posted by SLS on December 23, 2009, at 15:00:53
In reply to Re: Where do we go from here? Help and ideas plea, posted by inanimate peanut on December 23, 2009, at 14:47:34
> Sorry, of course that would be helpful. I have Bipolar I, Mixed Type but usually the mixed states are pretty easily controlled by meds and it's the horrible depressions that are hard to treat
Did Effexor, Lexapro, or Wellbutrin produce a partial improvement?
- Scott
Posted by inanimate peanut on December 23, 2009, at 17:23:43
In reply to Re: Where do we go from here? Help and ideas plea » inanimate peanut, posted by SLS on December 23, 2009, at 15:00:53
All of them did when I started them. I went off the Lexapro and the Effexor for various reasons and they didn't work again when I went back on them. Wellbutrin was working ok but I went of it to go on Parnate and I wonder if maybe it wouldn't follow the same pattern of not working if I tried to go back on it again.
Posted by bleauberry on December 23, 2009, at 17:36:58
In reply to Where do we go from here? Help and ideas please, posted by inanimate peanut on December 23, 2009, at 14:41:33
What about a switch to Nardil?
What about a switch to Effexor+Nortriptyline, Zoloft+Nortriptyline. Regardless of any past experience with these meds, they work distinctly different and usually a lot stronger when partnered together. For example a Nortriptyline + Effexor situation won't feel like some of the Nortriptyline stuff and some of the Effexor stuff together at the same time. It will instead feel like a totally different drug not like either one of them.
I would dump the ones that aren't doing anything significant for you. IBS can be dealt with in other ways. That med you are taking for it is counter productive for depression. Usually makes things worse. Any med or supplement that is not providing you clearcut benefit should be weaned out. There is the distinct possibility one of them is actually hindering the way the others might work better. In other words, get the underperformers out the way so the rest will have a clear path to do their thing.
In my view, infectious disease is a common unsuspected cause of psychiatric symptoms, most evident when treatment is very resistant. There is a good deal of new evidence now, along with hot debate from both sides, that D3 is NOT a good thing to be doing with infectious disease. This is counter to all the previous held notions. And thus heated debate. I am in the camp that says the average person is getting plenty of D from a little bit of sun and dairy and other foods. Fortified cereals for example, almost all of them. If there is a documented D deficiency, it is not that way due to lack of intake. One side of the debate says it is that way because it is major food for the metabolic activity of a variety of infectious organisms. D3 can worsen symptoms and dig a much deeper hole, despite a short-term boost when first starting supplementation with it. My take is in agreement with this view, primarily because two doctors I have dealt with strongly told, "try D3 but if you start to feel worse in a couple weeks STOP it". Infectious experts now use low D3 lab reports to further solidify their hunch of an hidden inner infectious situation. Low D3 says a lot, if you know what to look for.
Back to the IBS, it has to be considered there is an infectious variable going on here. Why do I say that? Because almost everyone with IBS who tried the Low Dose Naltrexone protocol (1.5mg-4.5mg bedtime) experienced remission. Improved energy and mood is common too. LDN basically supercharges a weakened immune system and boosts opioid peptides several fold. Somehow IBS symptoms resolve this way.
I don't know how long you've been on Parnate. If less than 3 months, let it be and give it more time. ??? I know, hard.
Realistically and logically my gut instinct says switch to a SNRI + NRI combination, or SSRI + NRI combination. Effexor+Nortriptyline, Zoloft+Nortriptyline, Effexor+Savella, Savella+Nortriptyline, Effexor+Savella+Nortriptyline. You get the picture. I didn't mention Cymbalta because at other forums it just seems to be a loser so often, but I must admit there are enough huge success stories to warrant considering it. In every one of those cases though, it was combined with something else such as Wellbutrin, Savella, or Nortriptyline.
And get rid of the underperformers. But don't do it in a hurry. Wean off in slow tiny steps. If you don't need them, you don't need them, simple as that. If they aren't doing a ton of good, they are excess malignant baggage weighing you down, weighing your liver down, weighing everything down. Metabolizing meds is hard enough on the human body, we don't need to worsen ourselves by allowing underperformers to pollute our inner landscape. I know Seroquel is prescribed like candy and is sometimes useful in depression. Let's get some reality mixed into that. Here it is. Give an antipsychotic, any antipsychotic, the most sedating ones in particular, to anyone, for an extended period of time, and just witness what it does to them. Usually not a desirable outcome. Depression the same or worse, flatness apathy, empty, couch potato, diabetes risk, weight gain. I like antipyschotics at the right time for the right reason at the right dose. But for sleep? I'm sorry, I totally disagree with that common strategy.
Posted by Phillipa on December 23, 2009, at 20:09:04
In reply to Re: Where do we go from here? Help and ideas please, posted by bleauberry on December 23, 2009, at 17:36:58
D3 in very necessary for healthy bones. And my doc has me supplementing with it in combined calcium magnesium and vita K for osteoporosis. Got the labs today and was in middle range. Helps with depression also. Maybe the wellbutrin will again work for you since you just went off it as paxil did again work for me after being off a few months. Good luck and post. Phillipa
Posted by ihatedrugs on December 24, 2009, at 1:12:15
In reply to Re: Where do we go from here? Help and ideas please, posted by bleauberry on December 23, 2009, at 17:36:58
>
> In my view, infectious disease is a common unsuspected cause of psychiatric symptoms, most evident when treatment is very resistant. There is a good deal of new evidence now, along with hot debate from both sides, that D3 is NOT a good thing to be doing with infectious disease. This is counter to all the previous held notions. And thus heated debate. I am in the camp that says the average person is getting plenty of D from a little bit of sun and dairy and other foods. Fortified cereals for example, almost all of them. If there is a documented D deficiency, it is not that way due to lack of intake. One side of the debate says it is that way because it is major food for the metabolic activity of a variety of infectious organisms. D3 can worsen symptoms and dig a much deeper hole, despite a short-term boost when first starting supplementation with it. My take is in agreement with this view, primarily because two doctors I have dealt with strongly told, "try D3 but if you start to feel worse in a couple weeks STOP it". Infectious experts now use low D3 lab reports to further solidify their hunch of an hidden inner infectious situation. Low D3 says a lot, if you know what to look for.I was diagnosed as having very low vitamin D levels despite living in Florida. I have been taking 2000-4000mg D supplements. I seemed to have helped but lately I have been getting worse in terms of my achy body. What research are you referring to? Is it possible that supplementing with vitamin D3 could be exacerbating my symptoms as opposed to helping?
ihatedrugs
Posted by manic666 on December 24, 2009, at 11:41:13
In reply to Re: Where do we go from here? Help and ideas please, posted by bleauberry on December 23, 2009, at 17:36:58
you start off with good advice, an the go on to trigger just obout everybody on babble includeing the poster with a therory we may all have an infectiouse disease thats causeing are mental prob,s. if its infectious that means are wives ,kids ,grandkids, girlfriends ,boyfriends ect ect, must all be mentally ill after all you said its infectious, so we have given it everybody,first you went on about the sh*t in are teeth fillings killng us. then its a bug that jumps on everbody an gives us lymse .1 person in every 100,000 in england. please its christmas give us a break from your constant triggers.i feel rough enough.
Posted by janejane on December 24, 2009, at 13:57:19
In reply to bleauberry always hands on the trigger, posted by manic666 on December 24, 2009, at 11:41:13
I think everyone should have a voice, particularly if they have a unique viewpoint to share. I've personally learned a lot from Bleauberry, stuff I would never have thought about before. Remember that there are many things that were previously rejected by the medical establishment that are now accepted. People like Bleauberry are often way ahead of the curve.
Posted by bleauberry on December 24, 2009, at 16:08:35
In reply to bleauberry always hands on the trigger, posted by manic666 on December 24, 2009, at 11:41:13
Oh my good friend you are so misinformed and so grossly misinterpret things I say, but that's ok.
To think everyone here has Lyme is insane. We are here to share information and give support. With that in mind, information and support involves these statistics:
1. 1 in 10 infected people are diagnosed, 9 are not.
2. Most infected people have difficult to treat psych symptoms.
3. An estimated 30% of psych patients have Lyme.Put those together, and it means that, if nothing else, a whole lot more people than we think have a real problem. That is worth knowing. Whether someone wants to consider that variable or not, their choice. I simply mention it for knowledge, because you are likely to miss it otherwise.
Mercury is the second most potent toxic substance to the nervous system on the planet. Its vapor can be seen rising from an amalgam. Dentists have a test...take a saliva sample, then chew a piece of gum, then take another saliva sample...to lab measure the amount of mercury free in the mouth. Whether someone considers that variable or not, their choice. But it is worth knowing. Practically everyone with documented elevated mercury and/or lead levels has difficult to treat psych symptoms. Hey, the mercury they remove from your mouth has to go to a hazardous waste dump, but it's ok to be in your mouth? Ok, whatever. Worth knowing, period.
For someone who attends here frequently, they see these kinds of comments frequently. That's because posts expire and new ones are born continuously as things rotate daily, with new sets of viewers and new people. They aren't going to see the Lyme or mercury post I wrote a week ago or a month ago. So it "appears" I am banging on it, but that is not the case. It is intended for anyone new or anyone interested. If you don't like the topic, then when you see "bleauberry" just don't click on it. Simple as that.
I saw the article discussing testing methods, inaccuracies, and statistics of Lyme in England. The number 1 in 100,000 is meaningless in light of the whole story. Whatever the real numbers are, 5000 new cases are diagnosed each year. But of course, that only happens to "other" people, not us. If the rate is anything like USA, then it is closer to 50,000 (10X), not 5000. The entire picture is based on estimates and not, in my opinion, wise to use as a bible for anything.
Best wishes to you.
> you start off with good advice, an the go on to trigger just obout everybody on babble includeing the poster with a therory we may all have an infectiouse disease thats causeing are mental prob,s. if its infectious that means are wives ,kids ,grandkids, girlfriends ,boyfriends ect ect, must all be mentally ill after all you said its infectious, so we have given it everybody,first you went on about the sh*t in are teeth fillings killng us. then its a bug that jumps on everbody an gives us lymse .1 person in every 100,000 in england. please its christmas give us a break from your constant triggers.i feel rough enough.
Posted by Dr. Bob on December 25, 2009, at 0:02:59
In reply to Re: bleauberry always hands on the trigger, posted by bleauberry on December 24, 2009, at 16:08:35
> you start off with good advice, an the go on to trigger just obout everybody on babble
>
> manic666> you are so misinformed and so grossly misinterpret things I say
>
> bleauberryPlease don't post anything that could lead others to feel accused or put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're bad people, and I'm sorry if this hurts you.
More information about posting policies and tips on alternative ways to express yourself, including a link to a nice post by Dinah on I-statements, are in the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Thanks,
Bob
Posted by willey on December 25, 2009, at 1:45:50
In reply to Re: bleauberry always hands on the trigger, posted by bleauberry on December 24, 2009, at 16:08:35
Let me say,blueberry for example i am not a fan of the direction you seemed to have turned in terms of natural remedies,however you have contributed so much to this board its amazing.With the knowledgeable advice and experiances you shared,as well as the swift responses you always seem to provide,you just in my view deserve a lot of respect here,you are an asset to the board,and i am glad you continue to post.
Posted by hyperfocus on December 25, 2009, at 14:16:36
In reply to Re: bleauberry always hands on the trigger, posted by bleauberry on December 24, 2009, at 16:08:35
Everybody reacts to posts in a particular way, and I'm not invalidating how manic feels. But bleauberry I think you're an extremely valuable voice on PB. There's nothing "alternative" or "natural" about your recommendations - it's just empirical science. When I took a three-day course of Zithromax for something unrelated and my depression seemed to improve, I immediately thought about you. An proper antibiotic trial is in my playbook if the conventional meds don't work out.
I have personally observed somebody with multiple sclerosis improve dramatically taking a course of probiotic yogurt. There are a number of scientists who are looking at mental illness as some type of inflammation - brain or body. We think we know a lot about how our bodies work but there's a huge amount we don't know and are now discovering. I'm glad that we have you to share these cutting-edge theories with us.
Posted by morganator on December 25, 2009, at 23:05:11
In reply to Re: bleauberry always hands on the trigger, posted by bleauberry on December 24, 2009, at 16:08:35
>. An estimated 30% of psych patients have Lyme.
I think lyme is a major issue and I believe that most people with it go undiagnosed. I have a hard time believing that 30% of psych patients have Lyme. I know this is just an estimation. I would believe more like maybe 10%.
I guess it makes sense when you look at the fact that 1 out of 9 people with Lyme go undiagnosed and many people with Lyme suffer from depression. Still, 30% sounds very high to me.
Posted by bleauberry on December 26, 2009, at 15:10:13
In reply to Re: bleauberry always hands on the trigger, posted by morganator on December 25, 2009, at 23:05:11
The 30% was determined from doing a random screening of the psychiatric ward in the hospital. Obviously the numbers will vary up or down from region to region, but the trend is what is important to be aware of I think.
> >. An estimated 30% of psych patients have Lyme.
>
> I think lyme is a major issue and I believe that most people with it go undiagnosed. I have a hard time believing that 30% of psych patients have Lyme. I know this is just an estimation. I would believe more like maybe 10%.
>
> I guess it makes sense when you look at the fact that 1 out of 9 people with Lyme go undiagnosed and many people with Lyme suffer from depression. Still, 30% sounds very high to me.
Posted by Dr. Bob on December 28, 2009, at 12:20:49
In reply to Re: please be civil » manic666 » bleauberry, posted by Dr. Bob on December 25, 2009, at 0:02:59
> Follow-ups regarding these issues should be redirected to Psycho-Babble Administration.
Here's a link:
http://www.dr-bob.org/babble/admin/20091103/msgs/931235.html
Thanks,
Bob
Posted by floatingbridge on December 30, 2009, at 11:18:32
In reply to Re: bleauberry always hands on the trigger, posted by morganator on December 25, 2009, at 23:05:11
> >. An estimated 30% of psych patients have Lyme.
>
> I think lyme is a major issue and I believe that most people with it go undiagnosed. I have a hard time believing that 30% of psych patients have Lyme. I know this is just an estimation. I would believe more like maybe 10%.
>I don't know about percentages, but it's crossed my mind that lymes might be the syphilis of our times.
fb
Posted by Phillipa on December 30, 2009, at 20:17:31
In reply to Re: bleauberry always hands on the trigger, posted by floatingbridge on December 30, 2009, at 11:18:32
fb when a Western blot tests for lymes syphylis is also positive. It's the bands that help diagnose. Phillipa
Posted by Jeroen on January 13, 2010, at 2:57:17
In reply to Where do we go from here? Help and ideas please, posted by inanimate peanut on December 23, 2009, at 14:41:33
hi, i responded to amantadine and seroquel
amantadine has a simular anti depressant effect then seroquel but seroquel is much better :)
it's an anti virus agent amantadine, i initially took it for my muscle spasms, and i felt better on amantadine (due to it's dopaenergetic effect?)
later on i took Seroquel and it worked for 2 months
yes maybe i have your lyme disease, who's gonna tell me?!!
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