![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 61. Go back in thread:
Posted by Maxime on July 29, 2010, at 22:25:24
In reply to Re: Please Help, not doing well at all » Maxime, posted by Phillipa on July 29, 2010, at 20:19:48
Therapy is not free in Canada. Only medical doctors are covered.
Posted by Maxime on July 29, 2010, at 22:28:52
In reply to Re: Please Help, not doing well at all, posted by Christ_empowered on July 29, 2010, at 21:59:00
I'm not really a spiritual person. I wish I was. I do a lot of volunteer work for a literacy organization and I find it does help my mood.
I need something to help with the suicidal thoughts because I have a attempted a few times in the past and I don't want to go down that route again.
I need a med that will help me not want to stay in bed all in a vegetative state.
Posted by Maxime on July 29, 2010, at 22:30:57
In reply to Re: Please Help, not doing well at all, posted by Justherself54 on July 29, 2010, at 22:06:07
Thank you for your supportive post. There isn't any respite care I can tap into. However there is a day hospital for people with Alzheimers but my mum refuses to go. I can't force her.
Posted by Maxime on July 29, 2010, at 22:32:38
In reply to Re: Please Help, not doing well at all, posted by Zyprexa on July 29, 2010, at 20:27:27
I know that Zyprexa can help. However it makes me lactate on even the most smallest of doses. I can't handle that right now.
Posted by sigismund on July 30, 2010, at 0:17:24
In reply to Re: Please Help, not doing well at all » Zyprexa, posted by Maxime on July 29, 2010, at 22:32:38
You remember some time back (perhaps years ago now) when you were having trouble with Parnate, and iirc, you eventually said 'I have to accept that Parnate isn't helping'?
Is this like that?
And what's the mood brightener thing about? Like mood brightener as opposed to what else it is that Parnate does? (though I realise you were talking about that other drug, the name of which I forget now).
Posted by sigismund on July 30, 2010, at 0:22:37
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
Some people say they find some tricylics mood brightening, I think.
Bulldog said something about clomiprimine and Heaven (which surprised me) and Brainbeard said something similar about amitriptylline (which surprised me again).Completely impossible with Parnate I know.
Posted by europerep on July 30, 2010, at 3:37:35
In reply to Re: Please Help, not doing well at all, posted by sigismund on July 30, 2010, at 0:22:37
no it's not *completely* impossible with MAOIs.. it would obviously have to be done in a hospital, with close supervision, etc., but amitriptyline for example has proven very effective in severe TRD..
I guess there are different questions here, including what you have already taken before parnate.. if you've had "all the others", and I guess really only in that case, you would have to try to find a doc who is willing to try something "exotic/possibly dangerous".
i.e.:
- MAOIs + TCA
- MAOIs + amphetamines
- buprenorphinethat's what comes to my mind.
on a different note though, therapy isn't free in canada? that's a freakin' shame. I had such a good opinion of the canadian healthcare system.. what is that, mental health only for the wealthy? damn that makes me angry...
Posted by Maxime on July 30, 2010, at 8:04:45
In reply to Re: Please Help, not doing well at all » Maxime, posted by sigismund on July 30, 2010, at 0:17:24
Thanks for the reply. I currently take Nortriptyline with the Parnate. I don't think the Parnate has stopped working. I think my life is not working. I am under a tremendous amount of stress - unable to find a job and caring for my mum with Alzheimers. I think if anyone was living my life that they would be depressed as well.
I could switch the Nortrip with Amitryptaline. But i don't know if that is the answer.
I can't articulate about the mood brightner. I can't find the right words. Sigh.
Well, I am off to my appt.
Posted by Maxime on July 30, 2010, at 18:02:44
In reply to Re: Please Help, not doing well at all » sigismund, posted by Maxime on July 30, 2010, at 8:04:45
I am not happy. My doctor prescribed Lithium again for me. I was on it March-April and made me gain 35 pounds. I really don't want to take this med, but I promised my doctor that I would try it for a week.
Posted by bleauberry on July 30, 2010, at 18:46:51
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
I am so sorry you feel so bad. If it helps, so do I !
Gosh, ya know, if that cocktail isn't working, especially at that high parnate dose, I dunno, it kind of tells me the whole cocktail is off base. Earlier in this thread there was mention of ritalin and zyprexa. I agree with both of those. That said, you obviously do not have a deficiency of neurotransmitters. 100mg parnate would more than fix that. It is something else. Keep telling yourself, it is something else, and keep asking, what is it? If it isn't dopamine, serotonin, norepinephrine, what is it? I guess I am saying that through all the badness here, there is one small good side....the meds are giving you some rather loud clues.
I could suggest several places to start looking for the severe depression cause, but that's another story. The meds may actually be contributing more than helping. Actually, if you are indeed feeling suicidal, then there is no doubt about it. They are either completely doing nothing good or they are doing bad. Either way, loud clues.
Lithium has worked miracles before, so even though you are disappointed with the choice, ya never know.
Back to where I started....I like the earlier suggestions of ritalin and zyprexa. As for any weight gain on any med, screw that. This aint no time to be concerned about weight.
Posted by TriedEveryMedication on July 30, 2010, at 19:02:16
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
TCAs can make me viciously depressed... at best when on them it feels like my outlook on everything is bleak.
I just noticed this: nortriptyline can increase suicidal ideation (at least in men).
Posted by Phillipa on July 30, 2010, at 20:31:24
In reply to Re: Please Help, not doing well at all » Phillipa, posted by Maxime on July 29, 2010, at 22:25:24
What a shame. I guess the lithium for now. I know your fears of weight gain and you must eat. Phillipa
Posted by morgan miller on July 30, 2010, at 22:06:56
In reply to Re: Please Help, not doing well at all, posted by bleauberry on July 30, 2010, at 18:46:51
>Lithium has worked miracles before, so even though you are disappointed with the choice, ya never know.
I was thinking of Lithium also. Supposed to be great for suidical ideation(why are these 2 words red squiggly underlined as if they are mispelled, weird).
Or maybe a new antidepressant is in order, Parnate doesn't seem to be doing the trick anymore.
Posted by Maxime on July 31, 2010, at 19:48:51
In reply to Re: Please Help, not doing well at all, posted by morgan miller on July 30, 2010, at 22:06:56
Feeling really nauseated with the Lithium on board. WHY WHY WHY does the doctor think this medication will help me? I feel like he is torturing me.
I couldn't get out of bed today. I just stayed all day until 6:30 pm this evening. I really want to go back to bed to. I wonder if I will be able to sleep tonight? I hope so.
Stupid Lithium.
Posted by morgan miller on August 1, 2010, at 1:11:20
In reply to Re: Please Help, not doing well at all, posted by Maxime on July 31, 2010, at 19:48:51
How long have you been on Lithium? I would give it some time. Your doc gave it to you because you were feeling suicidal and Lithium is one of the first line of treatments for such a state.
Lithium may not be what you need, but try to be patient with it. Also keep in mind that you may not need Lithium a high doses that show up as "therapeutic" levels in your blood. You may get therapeutic benefit from just 300 mg. How much are you taking now?
Maybe you just need a different AD or a different combination of ADs. I've learned here that Zoloft + Nortriptyline is a good combo. Maybe you have tried this. If you are taking Parnate, I imagine you've tried quite a bit of different ADs and combinations of drugs since Parnate is usually used as a last resort by many doctors.
Sorry you are feeling so bad. I hope you start feeling better soon.
Morgan
Posted by morgan miller on August 1, 2010, at 1:13:27
In reply to Re: Please Help, not doing well at all, posted by Maxime on July 31, 2010, at 19:48:51
Ahh, just saw you are already taking Nortriptyline. Maybe increase the dose? Aren't some people taking 150 mg?
Have you been on Zoloft before, bet you have. Hmm.
Again, hope you start to feel better soon.
Morgan
Posted by bleauberry on August 1, 2010, at 13:41:27
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
Maxine I wish I had something supportive to say. I tend to side with your feelings of questioning the whole thing.
I think of the doctor, what's his name, I'm so bad with names, at psycotropical.com. Goldberg? He stopped using lithium a long time ago, after giving it a good go for many years, because he just saw such little benefit with it and too many problems from it. I look back on posts here over many years and it's hard to find anyone calling lithium their miracle. I mean, I'm sure it happens, but probably not nearly as much as doctors or literature would suggest.
i personally think lithium is best at doses usually not prescribed...ultralow...75mg to 300mg, maybe 600mg max. People say those doses are useless. I totally disagree. Those doses I found much more stimulating and antidepressant. Higher doses are dulling and depressing. Ultra low doses for depression, normal doses for manic spectrums. IMO.
Who knows. I guess we only know after we try. And of course, mileage varies.
At this point, if I were in your shoes, I would be looking at pure logic, which is....
High dose parnate not doing the job....why keep it?
No good reason.
Nortriptyline not helping parnate....why keep it?
No good reason.
Where to go from here?
That's where all my focus is. Not on trying to breath life into a worthless cocktail. (extremely worthy in theory, but obviously not in this reality)Sometimes when I am critical of someone's meds, all of a sudden the next day they feel a ton better, the med kicks in, and everything I said was wrong. So I hope that happens! :-)
Posted by Maxime on August 1, 2010, at 21:25:13
In reply to Re: Please Help, not doing well at all » Maxime, posted by morgan miller on August 1, 2010, at 1:11:20
Thanks Morgan.
Parnate is my last resort drug ... next stop ECT.
I am on 300 mg of Lithium so maybe is will help at that dosage. I hope so because last time I was on Lithium (in March) I went up to 600 mg and I really had a lot of side effects (nausea, cognitive problems etc)
Thank you for your encouragement.
Posted by Maxime on August 1, 2010, at 22:23:53
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
God, I wish I would I would die in my sleep. It would be best for everyone involved.
I don't know what to do. Should I call the Crisis Centre? Should I just go to the ER? Should I call my psychiatrist in the morning? What do I do?
I took an extra sleeping pill tonight so that I would be less of a danger to myself because I will sleep longer.
I am really all alone in this.
Posted by Phillipa on August 1, 2010, at 23:51:16
In reply to Really, reallly not well :(, posted by Maxime on August 1, 2010, at 22:23:53
Maxie are you asleep? If not crisis center. Phillipa
Posted by SLS on August 2, 2010, at 4:38:42
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
I would look to increase the dosage of nortriptyline. You can get a blood test first to determine therapeutic levels. If you are a rapid metabolizer of nortriptyline, you might need as much as 150mg per day.
I apologize if this post is redundant. I don't have the mental energy to read the entire thread.
- Scott
Posted by Maxime on August 2, 2010, at 14:50:54
In reply to Re: Please Help, not doing well at all » Maxime, posted by SLS on August 2, 2010, at 4:38:42
Thank you Scott. I will ask that as a posibility when I see my doctor this Friday.
Take care.
Posted by bleauberry on August 2, 2010, at 19:51:51
In reply to Please Help, not doing well at all, posted by Maxime on July 29, 2010, at 15:10:14
A couple things to keep in mind:
1. Parnate or Adderall make some people more depressed than they were to start with. Sometimes dramatically worse.
2. Nortriptyline and other TCAs make some people very depressed.
It could be the meds themselves helping to make you feel so bad? I see that as a real possibility. The problem is that when we are on the meds, we can't tell and it is the last thing we would suspect. I could pull up hundreds of posts of people who felt better when they started to wean down on their meds, not go up higher on them.
Just for thought.
I think you need to call the doctor right away. Say screw the lithium for now, things are too bad....we gotta make some serious changes here....this is a bad road that is not showing any signs of getting better, only worse.
Posted by Maxime on August 2, 2010, at 20:27:43
In reply to Re: Please Help, not doing well at all, posted by bleauberry on August 2, 2010, at 19:51:51
I've been on the Parnate and Nortrip. since October. Even though I feel like sh*t, I think I would actually feel worse if I stopped taking these meds. Sometimes I feel like I have hit rock bottom, only to find out that it wasn't really rock bottom. It's awful.
Adderall XR helped me before and it did not make me depressed. If this Lithium doesn't help me this week, I will ask for Adderall. I wanted to ask for it last week, but I also wanted to respect his choice of meds for me and I promised to try it for one week (the Lithium).
To be honest, I don't think that anything will help me. I am broken beyond repair. I really am.
Posted by Maxime on August 2, 2010, at 20:29:46
In reply to Re: Really, reallly not well :( » Maxime, posted by Phillipa on August 1, 2010, at 23:51:16
I slept and stayed in bed until 3 pm. It was a good escape from the mental pain.
I will see how things go between now and Thursday. If I am doing the same or worse I will phone the Crisis Centre and see if I can stay there.
Go forward in 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.