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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Phillipa on May 6, 2012, at 10:25:39
Scott haven't seen any update from you lately was wondering how things are going. Phillipa
Posted by SLS on May 7, 2012, at 7:40:37
In reply to Scott how are you? Meds working hopefully?, posted by Phillipa on May 6, 2012, at 10:25:39
Hi Phillipa.
> Scott haven't seen any update from you lately was wondering how things are going. Phillipa
I'm okay.
Thanks for asking.
I am unhappy with the way I have felt over this last week. I expect occasional valleys, but I am disappointed in how long they last. We'll see if my doctor feels the same way when I see him in a few weeks.
- Scott
Posted by Alexei on May 7, 2012, at 14:48:43
In reply to Re: Scott how are you? Meds working hopefully? » Phillipa, posted by SLS on May 7, 2012, at 7:40:37
Hi Scott ... What do you think might be the culprit?
May I ask how the nortriptyline is treating you? My pdoc wants me to give it a shot.
Alexei
> I'm okay.
>
> Thanks for asking.
>
> I am unhappy with the way I have felt over this last week. I expect occasional valleys, but I am disappointed in how long they last. We'll see if my doctor feels the same way when I see him in a few weeks.
>
>
> - Scott
Posted by Phillipa on May 7, 2012, at 21:04:19
In reply to Re: Scott how are you? Meds working hopefully? » Phillipa, posted by SLS on May 7, 2012, at 7:40:37
Scott you have to be the most patient person I've known. But this is the right one for you. I know it feel it. Phillipa
Posted by SLS on May 7, 2012, at 21:17:52
In reply to Re: Scott how are you? Meds working hopefully? » SLS, posted by Alexei on May 7, 2012, at 14:48:43
> > I am unhappy with the way I have felt over this last week. I expect occasional valleys, but I am disappointed in how long they last. We'll see if my doctor feels the same way when I see him in a few weeks.
> Hi Scott ... What do you think might be the culprit?
A very stubborn brain that is more elastic than it is plastic.
> May I ask how the nortriptyline is treating you?
Of the tricyclics, nortriptyline works best for me. It improves energy and cognition, and brightens mood. Desipramine was not as much of a mood brightener for me. In addition, nortriptyline is relatively mild with respect to side effects. Desipramine is generally safe, but more attention must be paid to its cardiac effects. I find that the longer I take a tricyclic, the less pronounced are the side effects.
> My pdoc wants me to give it a shot.
Have you ever taken a tricyclic before? Do you have any reservations about taking nortriptyline?
Good luck with whatever you choose to do.
- Scott
Posted by SLS on May 7, 2012, at 21:25:30
In reply to Re: Scott how are you? Meds working hopefully? » SLS, posted by Phillipa on May 7, 2012, at 21:04:19
> Scott you have to be the most patient person I've known.
I am less patient than I am persistent. I wish I had more patience.
> But this is the right one for you. I know it feel it.
Although I am hoping for full remission, I look forward to going back to work before then. I need a little bit more improvement and a lot more stability in that improvement. Right now, my depressive state is very labile. I experience several oscillations throughout the day. It is quite frustrating.
- Scott
Posted by Phillipa on May 8, 2012, at 0:05:26
In reply to Re: Scott how are you? Meds working hopefully? » Phillipa, posted by SLS on May 7, 2012, at 21:25:30
Not cycling just dips in mood? Are you able to be out driving and doing stuff now? Very persistant. And that is admirable and stubborn and stubborn is good. Have you tried a mock interview? Phillipa
Posted by SLS on May 8, 2012, at 3:24:34
In reply to Re: Scott how are you? Meds working hopefully? » SLS, posted by Phillipa on May 8, 2012, at 0:05:26
> Not cycling just dips in mood?
Yes. Just random dips. The dips can last from 15 minutes to 6 hours.
> Are you able to be out driving and doing stuff now?
Yup. I felt pretty good yesterday in the late afternoon, so I took advantage of it and did some grocery shopping and payed some bills.
> Have you tried a mock interview?
Is that where you sit down with a prospective employer and hurl insults at him?
:-)
No. I hadn't thought to do that. I still plan on going back to work before the end of the year. I interview pretty well, but I have a 22 year gap in employment to explain. I'm sure I'll manage.
How are you doing?
Have you ever been tested for PTSD?
- Scott
Posted by Alexei on May 8, 2012, at 12:37:16
In reply to Re: Scott how are you? Meds working hopefully? » Alexei, posted by SLS on May 7, 2012, at 21:17:52
Thank you for the input. I know what you mean re: gaps in employment. That can require some "creativity", lol.
That is good to hear re: nortriptyline. It was either that or desipramine. Yes, I have been on tricyclics before ... except I never titrated correctly ... so SE's were rough. I actually think TCA's are better than nearly all the newer drugs (AD's).
Nortriptyline is primarily NRI with some SRI and 5ht2a antagonism, correct? I know it hits some other 5ht... Maybe 5ht1a or 5ht2c?
No, I have no reservations about it. My regime needs to be adjusted. Does nortriptyline help with sleep?
Hope u start to feel better
Alexei
> Of the tricyclics, nortriptyline works best for me. It improves energy and cognition, and brightens mood. Desipramine was not as much of a mood brightener for me. In addition, nortriptyline is relatively mild with respect to side effects. Desipramine is generally safe, but more attention must be paid to its cardiac effects. I find that the longer I take a tricyclic, the less pronounced are the side effects.
>
> > My pdoc wants me to give it a shot.
>
> Have you ever taken a tricyclic before? Do you have any reservations about taking nortriptyline?
>
> Good luck with whatever you choose to do.
>
>
> - Scott
Posted by Phillipa on May 8, 2012, at 18:52:06
In reply to Re: Scott how are you? Meds working hopefully? » Phillipa, posted by SLS on May 8, 2012, at 3:24:34
Scott the doc that got Disability did a lot of PTSD. Lots of Veterans as patients. Problem is at first he was and OD then when passed medical boards for psych he totally changed. But he said I had it. He would have one of the school taught massage therapists first give full massage, do some manipulations himself. Then an hour of talking with him. Ended up he was bilking the insurance companies and FBI seized records. Still practicing in New Bern NC. At first he was a great doc. Weekly visits also. Thanks for asking. Kind of sounds like mood and energy swings. Will you go into research with NIMH? As that would be so perfect for you. And if PTSD what are your personal recommendations for meds. Thanks Phillipa
Posted by SLS on May 9, 2012, at 5:09:22
In reply to Re: Scott how are you? Meds working hopefully? » SLS, posted by Phillipa on May 8, 2012, at 18:52:06
> Scott the doc that got Disability did a lot of PTSD.
I wonder if prazosin would be a drug that would help treat your type of anxiety/depression.
How well do you sleep? Do you ever have nightmares?
- Scott
Posted by SLS on May 9, 2012, at 7:01:52
In reply to Re: Scott how are you? Meds working hopefully? » SLS, posted by Alexei on May 8, 2012, at 12:37:16
Hi Alexei.
> Thank you for the input. I know what you mean re: gaps in employment. That can require some "creativity", lol.
>
> That is good to hear re: nortriptyline. It was either that or desipramine. Yes, I have been on tricyclics before ... except I never titrated correctly ... so SE's were rough. I actually think TCA's are better than nearly all the newer drugs (AD's).I agree. Most all of the side effects have completely disappeared for me. The two tricyclics that produce more persistent side effects are clomipramine and amoxapine.
> Nortriptyline is primarily NRI with some SRI and 5ht2a antagonism, correct?
That is an accurate summary.
> I know it hits some other 5ht... Maybe 5ht1a or 5ht2c?
Linkadge would know some of the other properties of nortriptyline.
> No, I have no reservations about it. My regime needs to be adjusted. Does nortriptyline help with sleep?Sometimes, but not as reliably as amitriptyline, trimipramine, or doxepin. Nortriptyline can be soporific at first. This usually disappears within the first few weeks. It is probably best to take it at night begin with.
> Hope u start to feel better
Thanks, Alexei. Yesterday was an unusually good day. I remain optimistic that I will improve enough to return to work.
- Scott
Posted by Phillipa on May 9, 2012, at 20:29:54
In reply to Re: Scott how are you? Meds working hopefully? » Phillipa, posted by SLS on May 9, 2012, at 5:09:22
I now sleep fine wake about four hours later take synthroid and 2.5mg valium and back to sleep. As for nightmares. I don't know if you would call them true nightmares. In other words not about past events. Just aging and people I knew kind of like saying goodbye working through past relationships. Not my childhood though. Phillipa
This is the end of the thread.
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