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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 42. This is the beginning of the thread.
Posted by SLS on November 19, 2012, at 15:51:36
In Aruba and feeling fine!
I followed a hunch and discontinued minocycline. So far, so good. Increasing my dosage of prazosin to 20 mg/day has made a remarkable difference. I am feeling better and better with each passing day. I might actually end up having fun! What an alien concept.
I'll try to post again soon.
You are all in my thoughts, feelings, and prayers.
- Scott
Posted by Twinleaf on November 19, 2012, at 17:52:44
In reply to In Aruba and feeling fine..., posted by SLS on November 19, 2012, at 15:51:36
Wonderful news! Have fun!
When you get back, could you tell us about the dosage of Prazosin? Is 20 mg. average when it is being used for depression/ PTSD? Or are you a pioneer in finding the best dosage? Do you have any difficulties with low blood pressure?
Posted by Dinah on November 19, 2012, at 19:49:30
In reply to In Aruba and feeling fine..., posted by SLS on November 19, 2012, at 15:51:36
Have a great time.
Posted by jono_in_adelaide on November 19, 2012, at 23:51:19
In reply to That's wonderful! » SLS, posted by Dinah on November 19, 2012, at 19:49:30
Sounds very nice, I'm jelous!
I'm heading to Thailand and Laos early next year for a 2 week getaway. Was meant to have gone a few weeks ago, but it work made it impossible.
Cant wait for the smells and sounds and sights of an exotic city!
Posted by Willful on November 20, 2012, at 10:36:50
In reply to In Aruba and feeling fine..., posted by SLS on November 19, 2012, at 15:51:36
Glad to hear it Scott! I too would be interested in hearing more about your meds and dosages.
Meanwhile have a great time.
Willful
Posted by SLS on November 20, 2012, at 15:13:24
In reply to Re: In Aruba and feeling fine..., posted by Twinleaf on November 19, 2012, at 17:52:44
> Wonderful news! Have fun!
>
> When you get back, could you tell us about the dosage of Prazosin? Is 20 mg. average when it is being used for depression/ PTSD? Or are you a pioneer in finding the best dosage? Do you have any difficulties with low blood pressure?I titrated the dosage of prazosin myself to the maximum recommended 20 mg/day. My doctor had no problem with this, especially because it is working. Initiating prazosin treatment is tricky because one can experience signicant dizziness at first. Even beginning at 1 mg/day, it is recommended to take it at night to avoid this. I experienced small improvements at the lower dosages, so it is not an all-or-nothing dosage-response curve. Most studies of PTSD do not use the maximum recommended 20 mg/day, despite it being safe at 40 mg/day.
Currently:
Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
lithium 300 mg
Abilify 10 mg
prazosin 20 mg
- Scott
Posted by Roslynn on November 20, 2012, at 15:30:17
In reply to In Aruba and feeling fine..., posted by SLS on November 19, 2012, at 15:51:36
Posted by SLS on November 21, 2012, at 6:54:40
In reply to Re: In Aruba and feeling fine... » Twinleaf, posted by SLS on November 20, 2012, at 15:13:24
Still doing well.
Lots of sun and sand with a constant cool breeze. Perfect weather. I am not looking forward to flying back on Sunday. It is the most heavily travelled day of the year.
I forgot to mention that I performed a quick experiment and discontinued minocycline for a few days. I did this twice. I deteriorated substantially each time. I am not happy about this, but I am grateful to find something that works at all. So...
Parnate 80 mg/day
nortriptyline 150 mg/day
Lamictal 200 mg/day
lithium 300 mg/day
Abilify 10 mg/day
prazosin 20 mg/day
minocycline 200 mg/day
- Scott
Posted by Twinleaf on November 21, 2012, at 8:03:20
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 21, 2012, at 6:54:40
Thanks for updating us. It's so good to hear that those two drugs are working so very well! Do you have any side effects from the current level of prazosin? How are your BP readings?
Would you consider reducing or eliminating any of your other medications at some point?
Posted by Phillipa on November 21, 2012, at 9:01:42
In reply to Re: In Aruba and feeling fine... Addendum. » SLS, posted by Twinleaf on November 21, 2012, at 8:03:20
Scott so glad to hear you are on vacation. But surprised you can handle the stress of airports and travel. Even if I wanted both husband & I have both said with the prices, the waits and layovers that we will never travel by plane. I did my fair share back in 80's & prior to that. Aruba is one Island I missed. Have you snorkeled or scuba dived? I hear it's a divers paradise. Phillipa
Posted by SLS on November 22, 2012, at 7:09:34
In reply to Re: In Aruba and feeling fine... Addendum. » SLS, posted by Twinleaf on November 21, 2012, at 8:03:20
> Thanks for updating us. It's so good to hear that those two drugs are working so very well! Do you have any side effects from the current level of prazosin?
Diminished sex-drive is the only side effect that I have experienced. however, it has recovered a bit as my depression has begun to remit. I don't get dizzy, even at 20 mg/day and with Parnate on board. I don't know what my BP is, though.
> Would you consider reducing or eliminating any of your other medications at some point?
My impatience betrayed me. I won't bore you with the details, but my mood has remained somewhat labile, despite restarting minocycline. What I like to call "mood drift" is likely to be a frequent phenomenon for me as I continue treatment. I am going to try to discontinue minocycline again. I don't like the prescribing protocol that makes it necessary to see my doctor once a month for a new script without refills.
I might then try to withdraw Lamictal, but I doubt I will remain well if I do. My best guess at this point is that I will need six drugs to achieve and maintain remission. That kind of sucks, but I am so grateful that remission is in sight.
- Scott
Posted by SLS on November 22, 2012, at 7:18:44
In reply to Re: In Aruba and feeling fine... Addendum., posted by Phillipa on November 21, 2012, at 9:01:42
> Scott so glad to hear you are on vacation. But surprised you can handle the stress of airports and travel.
I am responding to treatment. I am feeling and functioning significantly better. Otherwise, it would be an overwhelming experience for me. I have travelled by air during times of severe depression. It was hell.
- Scott
Posted by Phillipa on November 22, 2012, at 8:32:15
In reply to Re: In Aruba and feeling fine... Addendum. » Phillipa, posted by SLS on November 22, 2012, at 7:18:44
Scott from watched on TV I sure give you credit it looks horrible. Sure has changed since I used to fly. I'm betting you have that Carribean Tan. Use your sunscreen which I know you know. Are you doing any snorkeling? Phillipa
Posted by Phillipa on November 22, 2012, at 22:58:27
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 22, 2012, at 7:09:34
Scott I missed this post. If you can continue to get the Rx for minocycline despite a return visit and it's working why would you not want to return each month? This would also let your doc assess his opinion of your progress? Phillipa
Posted by SLS on November 23, 2012, at 12:32:10
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 22, 2012, at 7:09:34
> My impatience betrayed me. I won't bore you with the details, but my mood has remained somewhat labile, despite restarting minocycline. What I like to call "mood drift" is likely to be a frequent phenomenon for me as I continue treatment. I am going to try to discontinue minocycline again. I don't like the prescribing protocol that makes it necessary to see my doctor once a month for a new script without refills.
I am doing pretty darned well after three days without minocycline. I am not going to run back to it if I feel my mood drift. If I experience an acute relapse into severe depression, I would consider taking a 200 mg loading dose of minocycline in the hopes that it would help me get home okay. Otherwise, I am committed to going without it. I am still enjoying Aruba, and look forward to enjoying myself for the rest of my life, albeit with the otherwise normal situational mood reactions that come while navigating the realities of life.
- Scott
Posted by SLS on November 23, 2012, at 15:37:03
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 23, 2012, at 12:32:10
It appears that I will be staying in Aruba for another week. Feeling better! Woohoo!
I just need to check that I packed enough medication. I'm pretty sure I did.
- Scott
Posted by Phillipa on November 23, 2012, at 20:28:31
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 23, 2012, at 15:37:03
Scott what's the secret to two weeks in Aruba? Share? Phillipa
Posted by SLS on November 24, 2012, at 6:31:14
In reply to Re: In Aruba and feeling fine... Addendum. » SLS, posted by Phillipa on November 23, 2012, at 20:28:31
> Scott what's the secret to two weeks in Aruba? Share? Phillipa
Drugs. Positive attitude. Patience.
- Scott
Posted by SLS on November 24, 2012, at 6:40:39
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 23, 2012, at 12:32:10
I am on my fourth day without minocycline, and have not experienced any acute depressive mood swings. There is some mood drift, but I have come to expect this as part of the pathway to remission. I will continue with my present treatment regime, as it appears that I have ascertained the optimum dosages of a set of drugs that work for me. At this time, I doubt that any other set of currently available drugs would produce a robust antidepressant response. I am very lucky that I had a doctor who pushed prazosin down my throat.
- Scott
Posted by Willful on November 24, 2012, at 10:58:08
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 24, 2012, at 6:40:39
It's great to hear that your response is still so clear and palpable. I hope it's something you come to take for granted and don't think about, except in the way we all remember that without our meds, we would be in a really different place.
I too am very grateful to my pdoc for having the fortitude to try various things with me, and for being very flexible and well-informed
Posted by Phillipa on November 24, 2012, at 20:36:21
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 24, 2012, at 6:40:39
No more antibiotics? I have to wonder if a latent infection was gotten rid of by the minocycline helping you to get better. Phillipa
Posted by SLS on November 25, 2012, at 6:13:47
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 24, 2012, at 6:40:39
Just a quickie.
I am happy with the way I am feeling without the minocycline.
Just to recap, I began taking minocycline a few months ago in an effort to accelerate the rate of improvement that I gleaned from adding prazosin 12 mg/day. It worked. However, I then discovered that I felt significantly better when I increased the dosage of prazosin to 20 mg/day. It was a logical move for me to discontinue the minocycline to see if I still needed it. I was not hesitant to restart it if I were to deteriorate. Unfortunately, my desire to feel well while on vacation prompted me to restart the minocycline when I felt even the slightest bit worse. So, I discontinued minocycline and restarted it twice because my impatience and need to remain improved. However, my logic got the best of me, so I discontinued minocycline a third time an committed to not restarting it unless I deteriorated such that I would not be able to function well enough to get home via air travel. Despite some mood drift, I have remained more than well enough to enjoy the rest of my vacation. In this state, I will have no trouble making it home.
Yay!
Feeling better and more confident that I am to achieve remission within a year. I know that sounds like a long time, but I was a very sick puppy, and there is an enormous amount of ground to cover.
My best regards to everyone.
- Scott
Posted by Teresa167 on November 26, 2012, at 21:13:00
In reply to Re: In Aruba and feeling fine... Addendum., posted by SLS on November 25, 2012, at 6:13:47
>Hi Scott,
Just a question:
why did you discountinued Monocycline if it was helping you?Does Prazosin has the antidepressant effect on you?
Thanks,
Teresa
Posted by SLS on November 27, 2012, at 7:03:31
In reply to Re: In Aruba and feeling fine... Addendum., posted by Teresa167 on November 26, 2012, at 21:13:00
Hi Teresa.
> >Hi Scott,
>
> Just a question:
> why did you discountinued Monocycline if it was helping you?The main reason that I discontinued minocycline is that I don't want to take a drug that I don't really need. There would be no reason to risk developing side effects from long-term use. Increasing the dosage of prazosin has helped greatly, and might be sufficient. Also, I have a problem getting refills. My doctor wants me to come in every month for a new prescription. If I do not feel MUCH better in a few weeks, I will start minocycline again to see if it helps.
Prazosin feels exactly like an antidepressant to me. The improvement it is producing seems to be lasting for a long time.
Are you depressed? Do you have anxiety? What drugs are you taking?
My diagnosis is bipolar disorder, depressive subtype.
Currently, I am taking:
Parnate
nortriptyline
Lamictal
lithium
Abilify
Prazosin
- Scott
Posted by SLS on December 2, 2012, at 7:17:17
In reply to Re: In Aruba and feeling fine... Addendum. » Teresa167, posted by SLS on November 27, 2012, at 7:03:31
My time in Aruba draws to a close. I have enjoyed my stay here. The weather has been great, and each day concludes with a beautiful sunset. I would say that I have had my fill, though. Time to come home. Thankfully, I am feeling well enough to travel. Today will be a long one, but I doubt that I will feel overwhelmed at any point.
Better living through polypharmacy...
I thank everyone on Psycho-Babble for being themselves.
- Scott
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