![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by TemporarilyBob on September 6, 2012, at 23:32:46
Hey old-timers, it's finelinebob, the Original Bob (not Dr.) with no clue what my old password was and, thus, a new name. I'm going in to the county health board tomorrow for an evaluation -- been off meds over a year, my former psychopharmacologist died suddenly of pancreatic cancer, and there was a concern I was being overmedicated anyway ... he had little faith in anything but cures from bottles.
So, here's the challenge: I tell you the symptoms I've been presenting, the diagnoses I've been tagged with, and the former medications I've been on. You get to guess what the county mental health service will recommend for me. Closest to their recommendation gets three (3) cheers and a virtual pickle.
For a person who shall not be named, as always, you can participate since you are nearly always polite; but be aware that you will most likely be politely ignored and your standard answers hold little hope at gaining you the pickle prize. Your opinions are welcome, nonetheless.
Diagnosis: (1) Bipolar Spectrum Disorder or, for those of you who do not accept that yet, Major Depressive Disorder concomitant with Generalized Anxiety Disorder, (2) Post Traumatic Stress Disorder, (3) Attention Deficit Hyperactivity Disorder. Symptoms include inability to perform tasks such as answering the phone, opening mail, stepping outside to walk my dog, inability to sleep for 40-50 hr stretches, auditory and olfactory "hallucinations" given appropriate stimuli, among other things.
Previous medications: Nortriptyline, Klonopin, Xanax, Lamictal, Abilify and Vyvance. Yes, all at the same time and I've been off cold turkey for a year.
So, any guesses on what they're going to tell me? (A hint to those unfamiliar with BPSD--SSRIs are toxic to me. If they don't make me manic or psychotic, they make me hallucinate ... So suggesting one is a losing answer from the start!)
Posted by schleprock on September 7, 2012, at 0:25:38
In reply to Let's play psychofarmer! (Test your dx/rx chops), posted by TemporarilyBob on September 6, 2012, at 23:32:46
I would keep it simple and mayber start with clomipramine and seroquel, might take care of depression\GAD and make you sleep. Wouldn't know what to take for ADHD (ritalin?). I'd probably hire a butler for the rest.
You really should mention how you did on those previous medications and why you discontinued them for so long. Was it Lou Pilder who told you to stop taking them?
Well Lou, is this the kind of mess you want us all to fall into? This is where your "narrow road" leads?
Posted by SLS on September 7, 2012, at 0:39:52
In reply to Let's play psychofarmer! (Test your dx/rx chops), posted by TemporarilyBob on September 6, 2012, at 23:32:46
You might look into the use of prazosin and topiramate for treating PTSD.
- Scott
Posted by TemporarilyBob on September 7, 2012, at 1:03:27
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by schleprock on September 7, 2012, at 0:25:38
> I would keep it simple and mayber start with clomipramine and seroquel, might take care of depression\GAD and make you sleep. Wouldn't know what to take for ADHD (ritalin?). I'd probably hire a butler for the rest.
>
> You really should mention how you did on those previous medications and why you discontinued them for so long. Was it Lou Pilder who told you to stop taking them?
>
> Well Lou, is this the kind of mess you want us all to fall into? This is where your "narrow road" leads?Now, now .... Names not to be named.
Vyvance is almost identical to Ritalin. Without going into details, it has an "inert" isomer attached in such a way that it can only be broken down by gastric fluids, thus greatly reducing the potential for abuse that Ritalin has (through inhalation or injection).
As for why the break? I was fired because of my disability. Unemployment doesn't pay enough to cover close to $800/month of medications. Even if Social Security had not turned me down twice, you need to be on SSD for two years before you get medical benefits. And states only help the "destitute," which apparently means less than $100 to your name and your bags already on the street.
Don't want to give too much away, but since you asked. TCAs were the first meds I responded to, Nortriptyline far more than imipramine. Benzos gave me the first relief I ever had from anxiety ... only took 35 yrs to find that out. Atypical antipsychotics lifted my baseline mood considerably (another indicator for the BPSD dx if you buy it), but some like Zyprexa shot my triglycerides up so high that the figures were meaningless (outside of having a triglyceride index > 900 meaning "impending heart attack"). I know it's a dirty little secret but Vyvance may have acted as much as a mood stabilizer as an aid to cognition and memory ... no one likes to talk about how dopamine-altering meds might be good for one's mood. Lamictal? Abilify? Lamictal came first and at first it was a breath of fresh air. Then Abilify and I got into that zone I'm sure a lot of you know where you're not quite certain if you feel good or blah, or maybe you could feel better, but there's so much haze you can't see any signposts to look for progress.
There, I've done it, said way too much. To put it succinctly, in gravitational Newtonian physics there is something called the Three Body Problem. You see, when you have two bodies you can precisely determine the gravitational effects they will have on one another. Introduce a third body and it goes to hell in a handbag. This is, in effect, a Six Body Problem.
Posted by TemporarilyBob on September 7, 2012, at 1:16:07
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops) » TemporarilyBob, posted by SLS on September 7, 2012, at 0:39:52
> You might look into the use of prazosin and topiramate for treating PTSD.
>
>
> - ScottThanks, Scott, I'll have to check into those. You always have sound advice :)
Truth be told, the most effective treatment I had for PTSD was acupuncture. My hard-core Western science top-100 internal medicine specialist of NYC was also a Chinese trained (and one of a handful licensed to teach in the US) acupuncturist. He'd give me 10 sessions over 3 weeks and the nightmares, insomnia and anxiety would vanish ... For about two months, then we'd start again. Maybe with more time there would have been some hope of retiring my brain -- neuroplasticity and all that -- but we didn't have the opportunity. He was amazing, though ... I asked how he could reconcile his hard science western training with his acupuncture, and he had no qualms, no illusions about how they were completely different treatment modalities useful for cases that often as not did not intersect or impinge upon one another.
Posted by jane d on September 7, 2012, at 2:23:08
In reply to Let's play psychofarmer! (Test your dx/rx chops), posted by TemporarilyBob on September 6, 2012, at 23:32:46
I'm way too cynical to play. I keep wanting to say that they'll come up with whatever has been most hyped in the last few months. I hope I'm wrong. Will they also provide the meds?
Good luck. Sometimes the right help comes from the damndest places.
Posted by Phillipa on September 7, 2012, at 10:05:08
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops) » TemporarilyBob, posted by jane d on September 7, 2012, at 2:23:08
If it took you 35 years to see that benzos helped you I say benzos. Seems they may be coming back into favor as the exclusion for benzos being paid for by Disability/Medicaire was the allusion that they over long term use might cause the elderly to fall and break bones which would then cost more money. But this was said to be wrong. Seems they are the only meds that don't seem to cause side effects as you name like higher cholesterol. Just as long as not abused that's my pick. Maybe the toxicity of the SSRI's is cause they just might not work for you. So I say add agoraphobia into the mix and take benzos and maybe wellbutrin if you do need an ad. I see this was written last night. So how did you make out if you've already gone to the docs? Question also as had Disablility till turned the wicked age of 65 and it switched to SSRI. But when on Disability didn't have to wait to receive meds? Is this something new? Phillipa
Posted by TemporarilyBob on September 7, 2012, at 10:14:19
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops) » TemporarilyBob, posted by jane d on September 7, 2012, at 2:23:08
> I'm way too cynical to play. I keep wanting to say that they'll come up with whatever has been most hyped in the last few months. I hope I'm wrong. Will they also provide the meds?
>
> Good luck. Sometimes the right help comes from the damndest places.Well, been thru the intake interview and convinced them to forget about their triage procedures and give me the first urgent care appointment available. I guess falling apart and not being able to do anything but mumble and shake does have an effect ... especially when it's sincere. More later.
Posted by TemporarilyBob on September 7, 2012, at 10:36:40
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by Phillipa on September 7, 2012, at 10:05:08
Tardive dyskinesia. Can't remember what med brought up the concern, but it may have been the high dosage of clonazepam.
Wellbutrin? Heh, made me borderline psychotic. I was dating a particularly argumentative, thick-skulled woman at the time (dyed-in-the-wool Freudian analyst) who would not stop arguing, even after warning her I was losing control of my temper, even after telling her I was using all my weight to keep our drawer full of kitchen knives closed ... I guess she really believed I was projecting anger against my mother onto her or something. The funny thing was that there was a time when I was titrating off of Paxil (another nightmare for me) and onto Wellbutrin when it seemed like low doses of the two brought me the greatest clarity I've ever had. Quite frankly, tho, either med at full dosage was such a nightmare I would never consider experimenting with them in dual-therapy.
As for SSD, yeah, if you are under 65 you must be on disability benefits before you qualify for medical benefits. Now, don't that just make sense? "Here! We'll give you enough money to live at the poverty line for two years while you have a medical condition that prevents you from working. If you're still alive after that, perhaps we can help you then."
Posted by TemporarilyBob on September 7, 2012, at 17:58:32
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops) » Phillipa, posted by TemporarilyBob on September 7, 2012, at 10:36:40
Schleprock gets one HUZZAH! For sticking with a TCA, Phillipa gets a double HUZZAH HUZZAH!! for the call on the benzos, since that was the pdoc's first choice. You'll have to split the virtual pickle between yourselves. Pdoc was stunned I had zero withdrawal after being on 8mg of clonazepam for so long and decided to go with what has worked in the past, at a much lower dosage. That and a quick titration up on Nortriptyline, then we'll reevaluate in a month.
And NO XANAX, thankyouverymuch....
... But I do miss my Vyvance ....
Posted by schleprock on September 7, 2012, at 20:16:41
In reply to And the winners are..., posted by TemporarilyBob on September 7, 2012, at 17:58:32
Nice... but actually I was rethinking this. Do you know if excess serotonin was what made SSI's difficult. If so, I'd probably avoid the clomimpramine and stick with nortriptyline or amitriptyline (much lower serotonin reuptake.)
I still don't understand why you don't just go back to your previous regimen, if that was what was helping; go generic, if you have to.
And why don't you just get medicaid? I found medicaid really easy to get, though I did have to say that my father was paying my monthly rent (which he was at the time.)
Posted by Phillipa on September 7, 2012, at 20:50:15
In reply to And the winners are..., posted by TemporarilyBob on September 7, 2012, at 17:58:32
Bob wow finally I won something. Pickle is up for grabs. I wonder if when went on Disability if I was using my husband's policy for meds? I sure don't remember. Makes no sense if the government wants people off Disability to deny them meds. Well there is a huge savings in the Federal Budget right there. Get you back working. One less on Medicaire. As for the female glad you kept the knives securely locked up. If not you would be getting free food, clothing, maid service, and housing, and meds in prison. Does this make sense? Committ a crime and you are covered. Phillipa
Posted by schleprock on September 8, 2012, at 1:19:58
In reply to Re: And the winners are... » TemporarilyBob, posted by Phillipa on September 7, 2012, at 20:50:15
> Bob wow finally I won something. Pickle is up for grabs. I wonder if when went on Disability if I was using my husband's policy for meds? I sure don't remember. Makes no sense if the government wants people off Disability to deny them meds. Well there is a huge savings in the Federal Budget right there. Get you back working. One less on Medicaire. As for the female glad you kept the knives securely locked up. If not you would be getting free food, clothing, maid service, and housing, and meds in prison. Does this make sense? Committ a crime and you are covered. Phillipa
He'll certainly get a lot of "pickles" in prison to, if you get my meaning.
Posted by brynb on September 8, 2012, at 5:53:09
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by TemporarilyBob on September 7, 2012, at 1:16:07
> Truth be told, the most effective treatment I had for PTSD was acupuncture. My hard-core Western science top-100 internal medicine specialist of NYC was also a Chinese trained (and one of a handful licensed to teach in the US) acupuncturist.
Hi TB-
Curious: I live in NYC as well, and I'm always on the lookout for a great doc (particularly one who combines Western AND Eastern philosophies). Can you give me his/her name (either on this thread or through babble mail)? I'd really appreciate it.
Seems like you've got the med situation sorted out, but I was thinking that Lithium and Tramadol are worth a shot, too.
Good Luck,
-B
Posted by Lou Pilder on September 8, 2012, at 6:48:46
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by schleprock on September 7, 2012, at 0:25:38
> I would keep it simple and mayber start with clomipramine and seroquel, might take care of depression\GAD and make you sleep. Wouldn't know what to take for ADHD (ritalin?). I'd probably hire a butler for the rest.
>
> You really should mention how you did on those previous medications and why you discontinued them for so long. Was it Lou Pilder who told you to stop taking them?
>
> Well Lou, is this the kind of mess you want us all to fall into? This is where your "narrow road" leads?Friends, parents, those looking for support,
It is written here,[..Well Lou, is this the kind of..to fall into...where your narrow road leads?...].
There is a way that seems natural here, but where does it lead to? You see, the drugs listed that were taken by the innitiator of this thread were all stopped by him and he has been free from the drugs for a year.
Now I know that some here are swayed easily by an indoctrinational approach to a forum for {support} and {education}. And I am trying to reach those people and the {less-confident} people that could be influenced by an indoctrinational administration that prohibits facts yo be posted , facts that IMHO could mark the difference between you living and your death.
You see, first the drugs listed by the poster could kill you if taken together. They are central nervous system and respiratory depressants which taken together could cause death. But there is much more to this if the person taking all of those drugs together lives, such as addiction, anticholenergic syndrome, heart problems, cancer,tardive dyskinesia/dystonia and other potential life-ruining conditions.
So if you are a parent trying to deceide as to drug your son, your daughter, there is another side to this that I am prohibited to post about here due to prohibitions posted to me by Mr Hsiung.
Now if you are wanting to make a more informed decision as to take these drugs or not or have your child take them, be advised that what the poster lists here as taking is not verified. You could follow this thread and I could post what could open your eyes to as reality that is seldom heard here. A reality that (redacted by respondent). And if you read the admin baoard here, you could post there and I could respond to you there.
Now let's look at the combination of just Klonopin and Xanax. These are two benzodiazepines and can be addictive. The withdrawal from these two have been reported to be so horrific that some people in withdrawal kill themselves. Do you want that for yourself or a child of yours? Do you want your child taking any of the drugs listed? You see, just the combination of Klonopin with Xanax can cause depression. Now if someone is depressed, does it make any sense to give that person drugs that can cause depression.
Lou
http://www.ehealthme.com/klonopin-and-xanax-xr/depression
Posted by Lou Pilder on September 8, 2012, at 7:07:59
In reply to Lou's response-warning to readers » schleprock, posted by Lou Pilder on September 8, 2012, at 6:48:46
> > I would keep it simple and mayber start with clomipramine and seroquel, might take care of depression\GAD and make you sleep. Wouldn't know what to take for ADHD (ritalin?). I'd probably hire a butler for the rest.
> >
> > You really should mention how you did on those previous medications and why you discontinued them for so long. Was it Lou Pilder who told you to stop taking them?
> >
> > Well Lou, is this the kind of mess you want us all to fall into? This is where your "narrow road" leads?
>
> Friends, parents, those looking for support,
> It is written here,[..Well Lou, is this the kind of..to fall into...where your narrow road leads?...].
> There is a way that seems natural here, but where does it lead to? You see, the drugs listed that were taken by the innitiator of this thread were all stopped by him and he has been free from the drugs for a year.
> Now I know that some here are swayed easily by an indoctrinational approach to a forum for {support} and {education}. And I am trying to reach those people and the {less-confident} people that could be influenced by an indoctrinational administration that prohibits facts yo be posted , facts that IMHO could mark the difference between you living and your death.
> You see, first the drugs listed by the poster could kill you if taken together. They are central nervous system and respiratory depressants which taken together could cause death. But there is much more to this if the person taking all of those drugs together lives, such as addiction, anticholenergic syndrome, heart problems, cancer,tardive dyskinesia/dystonia and other potential life-ruining conditions.
> So if you are a parent trying to deceide as to drug your son, your daughter, there is another side to this that I am prohibited to post about here due to prohibitions posted to me by Mr Hsiung.
> Now if you are wanting to make a more informed decision as to take these drugs or not or have your child take them, be advised that what the poster lists here as taking is not verified. You could follow this thread and I could post what could open your eyes to as reality that is seldom heard here. A reality that (redacted by respondent). And if you read the admin baoard here, you could post there and I could respond to you there.
> Now let's look at the combination of just Klonopin and Xanax. These are two benzodiazepines and can be addictive. The withdrawal from these two have been reported to be so horrific that some people in withdrawal kill themselves. Do you want that for yourself or a child of yours? Do you want your child taking any of the drugs listed? You see, just the combination of Klonopin with Xanax can cause depression. Now if someone is depressed, does it make any sense to give that person drugs that can cause depression.
> Lou
> http://www.ehealthme.com/klonopin-and-xanax-xr/depression
>
> friends,
Many of you already know that what the poster wrote about me here is {redacted by respondent}.
You see the poster stopped all drugs. He did not say which road he went on after that at all.
Now the combination of the drugs listed could induce many life-ruining conditions. Diabetes in for one. And the chances are:
Lou
http://www.ehealthme.com/abilify-and-xanax-xr/type-2-diabetes-melitus
>
Posted by TemporarilyBob on September 8, 2012, at 9:30:47
In reply to Re: And the winners are..., posted by schleprock on September 7, 2012, at 20:16:41
> Nice... but actually I was rethinking this. Do you know if excess serotonin was what made SSI's difficult. If so, I'd probably avoid the clomimpramine and stick with nortriptyline or amitriptyline (much lower serotonin reuptake.)
>
> I still don't understand why you don't just go back to your previous regimen, if that was what was helping; go generic, if you have to.
>
> And why don't you just get medicaid? I found medicaid really easy to get, though I did have to say that my father was paying my monthly rent (which he was at the time.)Yeah, we are sticking with the nortrip.
Not going back to the old regimen because that was the path to zombie land. Something wasn't quite right with it. Besides, my new Pdoc thinks mixing clonazepam and Xanax is pure insanity.
Looking to get onto Medicaid, but that's a different case worker for a different day.
Posted by TemporarilyBob on September 8, 2012, at 9:36:00
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops) » TemporarilyBob, posted by brynb on September 8, 2012, at 5:53:09
I'll send you a babble mail. He's very tight about who he uses acupuncture on, tho. Overall, he's incredible. Can't recall which magazine it is that rates NYC doctors, but he's regularly in the top 100 for his field.
Tried lithium. Bad, bad trip that....
Posted by TemporarilyBob on September 8, 2012, at 9:41:27
In reply to Lou's response-warning to readers » schleprock, posted by Lou Pilder on September 8, 2012, at 6:48:46
Listened to, even welcomed, and still politely ignored.
You've had your say, now please move along. Don't be rude by spamming over and over. That's hardly civil behavior.
Posted by TemporarilyBob on September 8, 2012, at 9:52:45
In reply to Lou's response-warning to readers-diabetes, posted by Lou Pilder on September 8, 2012, at 7:07:59
As I said, you had your opportunity. Do not presume you can speak for me, nor speculate on how my life has been while off medication. If you would use the intelligence you seem to aspire to in making such leaps of logic, then you would have to conclude logically that my life for the last year has been worse, not better, for being off medication.
Your making assumptions of how my life is better now as constrained by your own view of things is rude and insulting. Your use of me as an example, particularly how little you know of my situation, is presumptuous and insulting. I will not allow you to use me as an example to further your own agenda. I have been the victim of much abuse over the last year, and you are furthering that abuse. I ask that you stop it immediately and refrain from further posting on this thread, or I will ask the administrators to take appropriate action.
I hope I have made myself clear.
Posted by TemporarilyBob on September 8, 2012, at 10:07:00
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops) » TemporarilyBob, posted by brynb on September 8, 2012, at 5:53:09
Or maybe mine was. I just turned mine on ... Can you check yours and send me a test message? I'll reply with my doc's name.
Posted by bleauberry on September 8, 2012, at 16:22:03
In reply to Let's play psychofarmer! (Test your dx/rx chops), posted by TemporarilyBob on September 6, 2012, at 23:32:46
Opinions to discard or consider at your will. I don't care for the pickles thank you.
I do not buy the diagnosis. It's a bunch of fancy sounding mumbo jumbo that basically says, "We don't know what it is, it's just a bunch of weird stuff." The name provides very little help in choosing treatment, so to me it is worthless. Maybe fun for armchair quarterbacking or discussions, but not very helpful for therapuetic purposes.
The symptoms do point to antipsychotics. If that is the case, the only choice as I see it is the really good one, Zyprexa. The other copycats don't have the magic Zyprexa has. So if they prescribed you an antipsychotic, it would be consistent with your symptoms and with my own opinions.
That said, your whole bizarre picture also responds profoundly to drugs that are not psychiatric at all. Such as antibiotics for lyme-like presentations. Since your care is low level, I doubt seriously an infectious issue will be considered. Too bad. If someone does not believe that a chronic hidden low/medium level infectious organism can cause all that bizarre brain stuff, then they have zero knowledge of the potency of the toxins involved.
So in this imaginary diagnosis thing you have presented, I throw the diagnostic words in the trash, I instead take a look at the actual symptoms as each one of them tells a story, and then I use drugs to help lessen the symptoms while I focus on finding and treating the real hidden problem.
Assume for a minute that all the diagnostic names you have been given are real and accurate. I don't, but ok, let's assume. In that situation, the single best med for each and all, is in my opinion, Zyprexa.
The SSRI toxicity thing you mentioned is a HUGE clue. I know what causes that.
Posted by schleprock on September 8, 2012, at 17:03:36
In reply to Lou's response-warning to readers-diabetes, posted by Lou Pilder on September 8, 2012, at 7:07:59
> > > I would keep it simple and mayber start with clomipramine and seroquel, might take care of depression\GAD and make you sleep. Wouldn't know what to take for ADHD (ritalin?). I'd probably hire a butler for the rest.
> > >
> > > You really should mention how you did on those previous medications and why you discontinued them for so long. Was it Lou Pilder who told you to stop taking them?
> > >
> > > Well Lou, is this the kind of mess you want us all to fall into? This is where your "narrow road" leads?
> >
> > Friends, parents, those looking for support,
> > It is written here,[..Well Lou, is this the kind of..to fall into...where your narrow road leads?...].
> > There is a way that seems natural here, but where does it lead to? You see, the drugs listed that were taken by the innitiator of this thread were all stopped by him and he has been free from the drugs for a year.
> > Now I know that some here are swayed easily by an indoctrinational approach to a forum for {support} and {education}. And I am trying to reach those people and the {less-confident} people that could be influenced by an indoctrinational administration that prohibits facts yo be posted , facts that IMHO could mark the difference between you living and your death.
> > You see, first the drugs listed by the poster could kill you if taken together. They are central nervous system and respiratory depressants which taken together could cause death. But there is much more to this if the person taking all of those drugs together lives, such as addiction, anticholenergic syndrome, heart problems, cancer,tardive dyskinesia/dystonia and other potential life-ruining conditions.
> > So if you are a parent trying to deceide as to drug your son, your daughter, there is another side to this that I am prohibited to post about here due to prohibitions posted to me by Mr Hsiung.
> > Now if you are wanting to make a more informed decision as to take these drugs or not or have your child take them, be advised that what the poster lists here as taking is not verified. You could follow this thread and I could post what could open your eyes to as reality that is seldom heard here. A reality that (redacted by respondent). And if you read the admin baoard here, you could post there and I could respond to you there.
> > Now let's look at the combination of just Klonopin and Xanax. These are two benzodiazepines and can be addictive. The withdrawal from these two have been reported to be so horrific that some people in withdrawal kill themselves. Do you want that for yourself or a child of yours? Do you want your child taking any of the drugs listed? You see, just the combination of Klonopin with Xanax can cause depression. Now if someone is depressed, does it make any sense to give that person drugs that can cause depression.
> > Lou
> > http://www.ehealthme.com/klonopin-and-xanax-xr/depression
> >
> > friends,
> Many of you already know that what the poster wrote about me here is {redacted by respondent}.
> You see the poster stopped all drugs. He did not say which road he went on after that at all.
> Now the combination of the drugs listed could induce many life-ruining conditions. Diabetes in for one. And the chances are:
> Lou
> http://www.ehealthme.com/abilify-and-xanax-xr/type-2-diabetes-melitus
> >
>
>Lou, the man can't even walk his dog. What goddamn road do you think he's on?
Posted by schleprock on September 8, 2012, at 17:10:05
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by bleauberry on September 8, 2012, at 16:22:03
> Opinions to discard or consider at your will. I don't care for the pickles thank you.
>
> I do not buy the diagnosis. It's a bunch of fancy sounding mumbo jumbo that basically says, "We don't know what it is, it's just a bunch of weird stuff." The name provides very little help in choosing treatment, so to me it is worthless. Maybe fun for armchair quarterbacking or discussions, but not very helpful for therapuetic purposes.
>
> The symptoms do point to antipsychotics. If that is the case, the only choice as I see it is the really good one, Zyprexa. The other copycats don't have the magic Zyprexa has. So if they prescribed you an antipsychotic, it would be consistent with your symptoms and with my own opinions.
>
> That said, your whole bizarre picture also responds profoundly to drugs that are not psychiatric at all. Such as antibiotics for lyme-like presentations. Since your care is low level, I doubt seriously an infectious issue will be considered. Too bad. If someone does not believe that a chronic hidden low/medium level infectious organism can cause all that bizarre brain stuff, then they have zero knowledge of the potency of the toxins involved.
>
> So in this imaginary diagnosis thing you have presented, I throw the diagnostic words in the trash, I instead take a look at the actual symptoms as each one of them tells a story, and then I use drugs to help lessen the symptoms while I focus on finding and treating the real hidden problem.
>
> Assume for a minute that all the diagnostic names you have been given are real and accurate. I don't, but ok, let's assume. In that situation, the single best med for each and all, is in my opinion, Zyprexa.
>
> The SSRI toxicity thing you mentioned is a HUGE clue. I know what causes that.Since it look's like he might be sticking with a TCA, I'm not sure Zyprexa would be a great idea. There's a very scary contraindication on drugs.com specifically mentioning Zyprexa with a TCA (I would have given it a try, were it not for that.) Besides, I've been warned that seroquel has a very sedating effect, which might help his sleep. When I was on straight nortriptyline, the best I could manage was waking up every 4 hours. Then for some reason it became every 2 hours. At least I was sleeping, but I would hardly call nortriptyline sedating by itself. At least that was my experience.
Posted by TemporarilyBob on September 8, 2012, at 17:52:38
In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by bleauberry on September 8, 2012, at 16:22:03
Zyprexa ... been there, done that. Was very effective except for one thing: it put my triglycerides over 900, a number which my doc said was way beyond a reliably measurable figure. A walking timebomb. Call dx's what you will, atypical antipsychotics apparently work for me where SSRIs are toxic. It's just a shame that Zyprexa, as some other AA's, play such havoc on my blood chemistry as well.
This is the end of the thread.
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