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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by alchemy on June 16, 2011, at 17:11:39
Are there any successfull stories out there? The DSM questionaire asks about "changes" in mood, etc. Hello? what if it has always been that way?
The longer one is depressed, the more med failures there are, and the variation of rapid cycling = very, very bleak possibilies.
Posted by SLS on June 16, 2011, at 17:42:40
In reply to 25 years of treatment resistance = hopeless, posted by alchemy on June 16, 2011, at 17:11:39
> Are there any successfull stories out there? The DSM questionaire asks about "changes" in mood, etc. Hello? what if it has always been that way?
>
> The longer one is depressed, the more med failures there are, and the variation of rapid cycling = very, very bleak possibilies.I have been severely depressed since 1976 and rated as treatment resistant since 1982. I'll let you do the math. I am getting pretty close to gleaning a robust antidepressant response to drug treatment. Recovery is very slow, but the trend is still towards improvement. Recovery is possible. However, I don't think it is appreciated how long it can take to recover from more severe and chronic depressions.
I am going to try adding Latuda (lurasidone) to see if we can speed things up.
You have good reason to pessimistic. However, you probably have good reasons to be optimistic as well. It is difficult to believe that you have tried every conceivable drug combination using what is currently available.
Currently:
Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
lithium 300mgI will be swapping out Abilify for Latuda in an effort to speed things up.
So far, I am glad that I never gave up. It seems to be paying off.
- Scott
Posted by floatingbridge on June 16, 2011, at 17:48:57
In reply to 25 years of treatment resistance = hopeless, posted by alchemy on June 16, 2011, at 17:11:39
Alchemy, would you tell us about why you feel your rTMS isn't proving helpful?
I am sorry you're so discouraged right now. Scott is really on to something when it comes to patience and abiding. If you've hung in with 25 years trd, you've got stuff going for you, too.
fb
Posted by Christ_empowered on June 16, 2011, at 17:59:22
In reply to Re: 25 years of treatment resistance = hopeless » alchemy, posted by floatingbridge on June 16, 2011, at 17:48:57
that's really rough. On the plus side, dealing with it has probably made you a stronger person. I know that sounds cheesy, but I do think that adversity can help build character, especially if you're able+willing to persevere w/o the promise of immediate relief. When you do find relief--and I think you will, eventually--my guess would be that your persistence will be richly rewarded.
Good luck.
Posted by alchemy on June 16, 2011, at 18:45:06
In reply to Re: 25 years of treatment resistance = hopeless » alchemy, posted by SLS on June 16, 2011, at 17:42:40
Thank you Scott. I am in tears.
What do you think made the difference in this drug coctail for you? Had you already tried some of these meds?
> I have been severely depressed since 1976 and rated as treatment resistant since 1982. I'll let you do the math. I am getting pretty close to gleaning a robust antidepressant response to drug treatment. Recovery is very slow, but the trend is still towards improvement. Recovery is possible. However, I don't think it is appreciated how long it can take to recover from more severe and chronic depressions.
>
> I am going to try adding Latuda (lurasidone) to see if we can speed things up.
>
> You have good reason to pessimistic. However, you probably have good reasons to be optimistic as well. It is difficult to believe that you have tried every conceivable drug combination using what is currently available.
>
> Currently:
>
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 10mg
> lithium 300mg
>
> I will be swapping out Abilify for Latuda in an effort to speed things up.
>
> So far, I am glad that I never gave up. It seems to be paying off.
>
>
> - Scott
Posted by zonked on June 16, 2011, at 19:54:15
In reply to Re: 25 years of treatment resistance = hopeless » alchemy, posted by SLS on June 16, 2011, at 17:42:40
Scott,
I actually teared up reading your post. That you haven't given up is a testament to your character, which you have never let depression affect. You are an inspiration to everyone who suffers from mental illness, and me personally. I am truly *happy* you're finally getting the consistent relief you well deserve.
Have you ever thought about writing a book, or having your story made into a play or movie or something? You certainly know how to write. Just a random idea.
-z
Posted by zonked on June 16, 2011, at 21:57:48
In reply to 25 years of treatment resistance = hopeless, posted by alchemy on June 16, 2011, at 17:11:39
> Are there any successfull stories out there? The DSM questionaire asks about "changes" in mood, etc. Hello? what if it has always been that way?
>
> The longer one is depressed, the more med failures there are, and the variation of rapid cycling = very, very bleak possibilies.Hang in there. My case isn't as severe as yours, but I am also treatment-resistant and I have found that only Parnate and Nardil have TOUCHED the depression I have.
I think it's *inhumane* not to prescribe opiods and/or amphetamines when all other options have failed (SSRIs, SSNRIs, Wellbutrin, NaSSAs, TCAs, MAOIs). And yes, I think those two classes of drugs should be tried *before* ECT, in particular opiods like buprenorphine.
-z
Posted by Phillipa on June 17, 2011, at 0:09:20
In reply to Re: 25 years of treatment resistance = hopeless » alchemy, posted by zonked on June 16, 2011, at 21:57:48
I do agree. If my pdoc can say to me it's okay to end it if you like just don't want to see you do this why won't she give me a simple pain med for my back that has more problems than the color of m&m's? Sign a contract and that relieves the doc of responsibility the patient assumes responsibility for opiod addiction. Shoot 41 years of benzos and no abuse? Phillipa
Posted by SLS on June 18, 2011, at 4:55:45
In reply to Re: 25 years of treatment resistance = hopeless » alchemy, posted by zonked on June 16, 2011, at 21:57:48
> > Are there any successfull stories out there? The DSM questionaire asks about "changes" in mood, etc. Hello? what if it has always been that way?
> >
> > The longer one is depressed, the more med failures there are, and the variation of rapid cycling = very, very bleak possibilies.
>
> Hang in there. My case isn't as severe as yours, but I am also treatment-resistant and I have found that only Parnate and Nardil have TOUCHED the depression I have.
>
> I think it's *inhumane* not to prescribe opiods and/or amphetamines when all other options have failed (SSRIs, SSNRIs, Wellbutrin, NaSSAs, TCAs, MAOIs). And yes, I think those two classes of drugs should be tried *before* ECT, in particular opiods like buprenorphine.
>
> -z
Buprenorphine is the only drug that my doctor has refused to prescribe for me. The single study by Andrew Stoll that I showed him was not persuasive to him.
- Scott
Posted by floatingbridge on June 20, 2011, at 23:37:59
In reply to Re: 25 years of treatment resistance = hopeless » zonked, posted by SLS on June 18, 2011, at 4:55:45
Do you ever think it holds potential for you?
fb
Posted by SLS on June 21, 2011, at 5:03:57
In reply to Re: 25 years of treatment resistance = hopeless » SLS, posted by floatingbridge on June 20, 2011, at 23:37:59
> Do you ever think it holds potential for you?
>
> fb
I am not sure. However, I wouldn't eliminate buprenorphine from consideration. I wish more people on PB would describe in detail the features of their presentation and how buprenorphine helps them.
- Scott
Posted by floatingbridge on June 21, 2011, at 8:05:22
In reply to Re: 25 years of treatment resistance = hopeless » floatingbridge, posted by SLS on June 21, 2011, at 5:03:57
Jedi posted a link to a poster named Elizabeth and buperione. I still don't know how it works. I do know that like her and other people, opiates and opoids are energizing rather than sedating. My old pdoc noted that positively, back before he basically said I was a junkie of some sort in the making. Back when he had me on dex.
Life is too full of irony at the moment.
Posted by alchemy on June 26, 2011, at 12:30:01
In reply to Re: 25 years of treatment resistance = hopeless » alchemy, posted by zonked on June 16, 2011, at 21:57:48
> Hang in there. My case isn't as severe as yours, but I am also treatment-resistant and I have found that only Parnate and Nardil have TOUCHED the depression I have.
>
> I think it's *inhumane* not to prescribe opiods and/or amphetamines when all other options have failed (SSRIs, SSNRIs, Wellbutrin, NaSSAs, TCAs, MAOIs). And yes, I think those two classes of drugs should be tried *before* ECT, in particular opiods like buprenorphine.
>Thank you. I haven't tried Parnate or Nardil. But I am really scared about them making me worse. It's worth a try. But I am at the place where I need a quick round of ect first
I have tried Loratab and Oxycodeine for my headaches - no response for pain or my mood. How sad is that when opiods didn't work. But I agree. Psychiatrists should think outside the box for hard-to treat patients. Misery is worth the danger.
Posted by Bob on June 30, 2011, at 0:38:18
In reply to Re: 25 years of treatment resistance = hopeless » zonked, posted by SLS on June 18, 2011, at 4:55:45
> > > Are there any successfull stories out there? The DSM questionaire asks about "changes" in mood, etc. Hello? what if it has always been that way?
> > >
> > > The longer one is depressed, the more med failures there are, and the variation of rapid cycling = very, very bleak possibilies.
> >
> > Hang in there. My case isn't as severe as yours, but I am also treatment-resistant and I have found that only Parnate and Nardil have TOUCHED the depression I have.
> >
> > I think it's *inhumane* not to prescribe opiods and/or amphetamines when all other options have failed (SSRIs, SSNRIs, Wellbutrin, NaSSAs, TCAs, MAOIs). And yes, I think those two classes of drugs should be tried *before* ECT, in particular opiods like buprenorphine.
> >
> > -z
>
>
> Buprenorphine is the only drug that my doctor has refused to prescribe for me. The single study by Andrew Stoll that I showed him was not persuasive to him.
>
>
> - ScottMy psychiatrist will not touch it either.
Bob
Posted by floatingbridge on June 30, 2011, at 0:49:24
In reply to Re: 25 years of treatment resistance = hopeless » SLS, posted by Bob on June 30, 2011, at 0:38:18
Why not prescribe it? Does the dosage escalate? Also, doesn't the doc need to attend training to prescribe?
Posted by hyperfocus on June 30, 2011, at 10:40:21
In reply to 25 years of treatment resistance = hopeless, posted by alchemy on June 16, 2011, at 17:11:39
I've also been suffering +20 years with mental illness without and yeah there are a LOT of times when I just had no hope. Like every couple of weeks I get frustrated and angry and despondent if a change in my meds doesn't pan out. But I've seen people here with the same symptoms and conditions I have who get better, so I kept hoping. I know I'm not alone with this and I believe there are meds that can help me. It's not a hell of a lot but it is something to hold on to. I choose to stay and battle it out, if not for me then for the few people I know who love and care about me. There's a huge number of people in this world who are worse off and don't have this choice. After such a long time with minimal treatment response and an increase in the severity of my illness, the meds I'm on now are definitely making me better.
It is true that this disease changes you for the better mostly. A lot of stuff I didn't really notice or understand before I tend to now. If one day we do rejoin the land of the living then I think we're going to be better at it than most people.
All I can tell you is find the things that make you feel alive and hopeful and cherish them. Like music or films or just sitting on a park bench and watching people go by. Every second that we're alive, even if we're in pain, is a gift. Even though life gets so small that there's seemingly nothing left, there still is something there.You will find the treatment that can get you better. And if you're partial to this stuff - maybe believe everything you've gone through happened for a reason and you're going to be a better person for it and get back much more than you lost
This is the end of the thread.
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