![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by conundrum on April 27, 2010, at 19:43:51
So I saw my new psychiatrist today. She seems pretty good, been practicing for about 40 years. She seemed to think I have a mood stability problem since I was always feeling good without many bad days on prozac. She said below hypomanic. In addition when I came off prozac I was into conspiracies and into things like numerology and astrology, which I had no interest in before, or now. All of those interests faded 5 years ago and I chalk it up to some kind of rebound in dopamine from being quashed by serotonin for so long, but who knows. Also another reason she mentioned mood stability is that she said I'm treatment resistant and people with mood stability are often treatment resistant to standard antidepressants.
Right off the bat in response to my short term memory problems she suggested get a test for Lyme's disease, she also mentioned neuropsychological testing which I don't really know much about but it sounds good. She said I shouldn't be having memory problems at 27. She also prescribed lamictal I guess since she suspects a possible mood stability disorder and it could help with that and also works as an antidepressant.
So far so good for a first visit. Also for once in a long time, I didn't read all the side effects for this drug. I figure if they come I'll know it. She warned me about the risk of Steven Johnson's Syndrome and so thats enough for me. Its nice not worrying about that stuff.
Posted by Phillipa on April 27, 2010, at 20:02:02
In reply to Saw a new psychiatrist today., posted by conundrum on April 27, 2010, at 19:43:51
Congratulations great to hear of a good pdoc. And sounds like she's doing a complete assessment of you. Phillipa
Posted by 49er on April 29, 2010, at 12:57:21
In reply to Saw a new psychiatrist today., posted by conundrum on April 27, 2010, at 19:43:51
> So I saw my new psychiatrist today. She seems pretty good, been practicing for about 40 years. She seemed to think I have a mood stability problem since I was always feeling good without many bad days on prozac. She said below hypomanic. In addition when I came off prozac I was into conspiracies and into things like numerology and astrology, which I had no interest in before, or now. All of those interests faded 5 years ago and I chalk it up to some kind of rebound in dopamine from being quashed by serotonin for so long, but who knows. Also another reason she mentioned mood stability is that she said I'm treatment resistant and people with mood stability are often treatment resistant to standard antidepressants.
>
> Right off the bat in response to my short term memory problems she suggested get a test for Lyme's disease, she also mentioned neuropsychological testing which I don't really know much about but it sounds good. She said I shouldn't be having memory problems at 27. She also prescribed lamictal I guess since she suspects a possible mood stability disorder and it could help with that and also works as an antidepressant.
>
> So far so good for a first visit. Also for once in a long time, I didn't read all the side effects for this drug. I figure if they come I'll know it. She warned me about the risk of Steven Johnson's Syndrome and so thats enough for me. Its nice not worrying about that stuff.Conundrum,
Speaking of short term memory problems, I forgot your history so please forgive me.
Did you have symptoms of bipolar disorder prior to being placed on Prozac? The reason I am asking is you have had the strange reactions you described as withdrawal symptoms from tapering off of prozac, particularly if you tapered too quickly. that dies not translate to manic depression or bipolar disorder. A diagnosis can't be made based on a med reaction.
Sorry, I don't mean to rain on your parade. I know how frustrating it is to find a good doctor. But those are red flags to me and I felt I had to say something.
On what basis is she saying to get a test for Lyme's disease? Do you have specific symptoms that point in that direction?
Regarding neuropsych testing, as one who has had it to diagnose a learning disability, what it will do is test particular memory areas to see where your problem is. But you may want to think if you have had this problem prior to being placed on psych meds.
If yes, then you might want to think about what you hope neuropsych testing can offer you such as an explanation of the problem and good compensatory mechanisms.
But if this problem started after you started psych meds, I am not sure if you would still want testing since you know what the cause of your problems are. It is expensive even if insurance covers some of it and is time consuming. You have to make that call.
Obviously, you have to evaluate what is best.
Good luck.
49er
Posted by conundrum on April 29, 2010, at 15:53:03
In reply to Re: Saw a new psychiatrist today. » conundrum, posted by 49er on April 29, 2010, at 12:57:21
Thanks for the post. No I don't really put much stock in the DX. I've never had mood swings, when I was depressed before taking prozac I was just depressed no elated or euphoric moments.
While on Prozac I was in a good mood pretty much all the time, unless I had girl problems or someone in the family died. I was between 16-21 years old when I was on the med. Sometimes I'd also get down if I had nothing planned for the weekend, but nothing dramatically bad, not crying or anything. I'm just trying to think of the blue moments I had. Being on Prozac made me more confident as well and play music more. I don't know if that would have resolved on its own.
After coming off of prozac I was exposed to conspiracies and believed them. Looking back I know I wouldn't have any interest in them now. I was also very airy headed and into spiritual things like numerology and astrology. I remember towards the end of this time feeling love for the whole world.
Well for some reason oddly about a month after stopping ginkgo, which i was taking to help my memory, all these feelings stopped and I could no longer write music or feel anything towards my then g/f. All the spiritual feelings disappeared, eventually I became atheist and was able to rationally debunk the conspiracy theories. I pretty much had normal rational thought back but definitely more blunted.
Looknig back I think this period after prozac while taking ginkgo was a period of dopamine rebound. The time when I stopped ginkgo was also two years after I first stopped prozac so maybe it took awhile for the dopamine to go back down? I know that paranoia and religous feelings depend on dopamine.
So the psych thought this might indicate a mood stability problem and she said its not Bipolar just something below that.
The reason she suggested the Lyme test was because I mentioned joint pains.
I know the drugs made my memory worst, it was always great before then, but either way it might help me find something to help? I dunno. Atleast I can prove to my skeptical family that something is wrong.
49er I know you're against psych drugs to an extent, but do you know if any drugs can improve cognitive problems? Before last year I was off prozac for about 6 years and was deteriorating. I hate it.
Posted by floatingbridge on April 29, 2010, at 18:40:03
In reply to Saw a new psychiatrist today., posted by conundrum on April 27, 2010, at 19:43:51
How's the lamictal titrate going?
I was diagnosed as BP nos for many years. I do exhibit mood lability. Much less on my new cocktail.
My latest pdoc dropped the BP after year of observation.
Dx'ing is tricky. I think docs are often safer to assume a BP issue until proven otherwise.
I think the lyme test is a great idea. So far, your doc sounds good. So no more prozac? (I forgot what your signature said.
Posted by 49er on April 30, 2010, at 8:48:13
In reply to Re: Saw a new psychiatrist today. » 49er, posted by conundrum on April 29, 2010, at 15:53:03
> Thanks for the post. No I don't really put much stock in the DX. I've never had mood swings, when I was depressed before taking prozac I was just depressed no elated or euphoric moments.
>
> While on Prozac I was in a good mood pretty much all the time, unless I had girl problems or someone in the family died. I was between 16-21 years old when I was on the med. Sometimes I'd also get down if I had nothing planned for the weekend, but nothing dramatically bad, not crying or anything. I'm just trying to think of the blue moments I had. Being on Prozac made me more confident as well and play music more. I don't know if that would have resolved on its own.
>
> After coming off of prozac I was exposed to conspiracies and believed them. Looking back I know I wouldn't have any interest in them now. I was also very airy headed and into spiritual things like numerology and astrology. I remember towards the end of this time feeling love for the whole world.
>
> Well for some reason oddly about a month after stopping ginkgo, which i was taking to help my memory, all these feelings stopped and I could no longer write music or feel anything towards my then g/f. All the spiritual feelings disappeared, eventually I became atheist and was able to rationally debunk the conspiracy theories. I pretty much had normal rational thought back but definitely more blunted.
>
> Looknig back I think this period after prozac while taking ginkgo was a period of dopamine rebound. The time when I stopped ginkgo was also two years after I first stopped prozac so maybe it took awhile for the dopamine to go back down? I know that paranoia and religous feelings depend on dopamine.
>
> So the psych thought this might indicate a mood stability problem and she said its not Bipolar just something below that.
>
> The reason she suggested the Lyme test was because I mentioned joint pains.
>
> I know the drugs made my memory worst, it was always great before then, but either way it might help me find something to help? I dunno. Atleast I can prove to my skeptical family that something is wrong.
>
> 49er I know you're against psych drugs to an extent, but do you know if any drugs can improve cognitive problems? Before last year I was off prozac for about 6 years and was deteriorating. I hate it.
>
>
>
>
Hi Conundrum,Your explanations make sense and I am glad to hear you're not putting much stock in her diagnosis.
I am sorry to hear that meds have worsened your memory. If you feel that neuropsych testing would be helpful as far as getting your family to understand, I definitely understand why it would appeal to you.
As far as drugs helping cognitive problems caused by psych meds, I honestly don't know of any. I know that Wellbutrin is thought of as one such drug but I feel that drug was a main culprit in my memory issues. Interestingly, a Georgia psychiatrist, agrees.
http://www.eveningpsychiatrist.com/side-effects.htm
What can be done for clouded thinking or reduced memory?
These symptoms do not usually go away by just waiting for the patient to get used to it. Reducing the dose or changing the medicine is usually the only solution. Literally, any of the medications can cause it. However, lithium and Wellbutrin are the most common medicines to cause these symptoms. There are multiple medicine alternatives to Lithium and Wellbutrin, if reducing the dose does not resolve the side effects or the reduction causes worsening of the condition that these medicines are treating.
And to be honest, it is trial and error with supplements as I have not found anything that is consistent in helping. It does seem that when I take fish oil capsules with higher DHA than EPA, that helps. But nothing spectacular.
I hope you find something that helps.
49er
Posted by conundrum on April 30, 2010, at 11:23:47
In reply to Re: Saw a new psychiatrist today. » conundrum, posted by 49er on April 30, 2010, at 8:48:13
I've never benefited much with fish oil. I'll think about it again. It can't hurt to take them again.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.