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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by sadperson on October 19, 2013, at 15:42:02
I'm now entering my 9th major unipolar depression. I've tried Lithium, Depakote, Nortriptyline, Desipramine, Nardil, Serzone, unilateral and bilateral ECT, Wellbutrin, Prozac, Paxil, and Effexor. They either don't work or can't be tolerated.
I'm currently on 90 mg Remeron, 120 mg Cymbalta, 5 mg Abilify, 200 mg Lamictal, plus 1600 mg Neurontin and 2 mg Klonopin for sleep.
I'm going to see my psychiatrist next week, but would be interested in any suggestions for how to proceed.
Posted by Twinleaf on October 19, 2013, at 15:55:29
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:44:10
Does childhood neglect, abuse or trauma play any role in your depression? If so, psychodynamic psychotherapy and rTMS might be helpful to calm excess production of stress hormones.
Posted by Twinleaf on October 19, 2013, at 16:33:26
In reply to Re: I'm running out of options » sadperson, posted by Twinleaf on October 19, 2013, at 15:55:29
Just to complete the thought ...stress hormones (cortisol and glutamate) result in changes in the amygdala, hippocampus, corpus callosum and prefrontal lobes which are thought to result in depression. Other factors thought to be helpful in lowering stress hormones include exercise, meditation, massage and supportive personal relationships in general.
Posted by doxogenic boy on October 19, 2013, at 16:40:07
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:44:10
Do you have anxiety as part of the depression? Maybe Seroquel could be worth a try, it often works for depression and may help for your sleep too. Klonopin can worsen the depression.
- doxogenic
Posted by bk2va32 on October 19, 2013, at 22:51:20
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:44:10
Hi,i dont want to insult you but WOW i truly believe A your on way too much stuff and B again excuse my bluntness but its crap.
First let me adress the nardil....back in the day nardil was considered a golden standard,almost everyone was on it successfully.Then they reformulted it,and a site opened of thousands of users who went off it and complained the new now out nardil is crap.
So this is where id recomend parnate.Parnate is considered the nuc bomb of anti depressants.Its also contary to believe user frinedly to augment
the gabentin should be lowered i read anything over 600 mg and it actualy works less.
Whew i wish i knew what to say all i can say is id recomend
GHB as a script XYREM
Parnate
Gabpentin lowred
Klonopin lowered
vyanese a adhd stimulant
Posted by Lou Pilder on October 20, 2013, at 4:49:08
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:42:02
> I'm now entering my 9th major unipolar depression. I've tried Lithium, Depakote, Nortriptyline, Desipramine, Nardil, Serzone, unilateral and bilateral ECT, Wellbutrin, Prozac, Paxil, and Effexor. They either don't work or can't be tolerated.
>
> I'm currently on 90 mg Remeron, 120 mg Cymbalta, 5 mg Abilify, 200 mg Lamictal, plus 1600 mg Neurontin and 2 mg Klonopin for sleep.
>
> I'm going to see my psychiatrist next week, but would be interested in any suggestions for how to proceed.sp,
You wrote, [...interested in any suggestions for how to proceed...].
The chemicals in the drugs that you are taking could cause death via serotonin syndrome and severely impair your thinking and judgment and make concentrating very difficult. This could lead to you being persuaded easily. Since that you are wanting to know how to proceed, others could manipulate you easily. The drugs that you are taking together could also induce a mind-altered state to compel you to kill yourself and/or others and even commit mass-murder or kill your own parents and such. And to rid yourself of these drugs could put you in a state worse than you are in now as there could be a horrific withdrawal syndrome that could compel you to kill yourself or others.
You see, the chemicals in the drugs were used an era of time that I am prohibited to write about here due to prohibitions posted to me here by Mr. Hsiung. They alter the mind by reacting with the natural chemicals in your brain and could cause life-ruining conditions and addiction. When combined, the effects can be increased exponentially. Some of these drugs are benzene based and benzene was used in the commission of mass-murder.
Now to proceed at this point in your life means that you do want to know what to do now. I am prevented from posting here what IMHHO could save your life, prevent life-ruing conditions and addictions due to prohibitions posted to me here by Mr Hsiung. What I could tell you if not prohibited would come from a Jewish perspective that is prohibited by me to post here due to those prohibitions by Mr Hsiung to me.
Now I will follow you here to see how others would post what could steer you in the direction that they think is the way for you to proceed. They could tell you to take more drugs, or have seizures induced by electric shocking or a wire inserted into your brain with a battery implanted into you to cause the wire to heat a part of your brain. Or to have some type of magnets put on your head to do whatever. They could tell you to go t some type of therapist to talk to you. But the drugs could have already impaired your judgment and thinking and could have made it so difficult for you to concentrate, that your condition could be in such, that you could not understand what is being told to you.
Lou
Posted by Phillipa on October 20, 2013, at 9:55:47
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:42:02
Welcome to babble. One thing to remember is to take what some say with a grain of salt or ignore. Will you post what your pdoc suggests? Thanks Phillipa.
Posted by Jeroen on October 20, 2013, at 17:34:37
In reply to Re: I'm running out of options » sadperson, posted by Phillipa on October 20, 2013, at 9:55:47
like me
try low dose seroquel below 100 mg start with 25 mg the first day slowly build up
or try minocycline low dose 50 mg twice daily
im very much like you
Posted by Willful on October 20, 2013, at 19:36:55
In reply to Re: I'm running out of options » sadperson, posted by Phillipa on October 20, 2013, at 9:55:47
I'd like to underline what Phillipa said.
If you find any of the responding posts to be off track, or not helpful, or if they said things that upset you or lead you to profoundly question the use of any medication at all, please don't hesitate to take them with a grain of salt.
We all try to help, but some of us have very different ideas about what might help someone--so don't feel too burdened by what you may read. Take the good, and leave the unhelpful things to the side.
I'd also like to say that I noticed that you've never tried any MAOIs. I'd like to recommend that you talk to your pdoc about Emsam, most preferably, and then either nardil or parnate if that's not available. The great thing about Emsam is that at many doses, you don't have food restrictions.
Also the food restrictions on the MAOIs are often exaggerated because many lists include things that have turned out not to be general problems. So it's not as burdensome or dangerous to take them as you may have heard.
MAOIs are often effective with people who've failed to respond to other drugs-- and I hope, if your latest combination doesn't help enough, that you can try one of them.
I use Emsam and I 've found it to be an extremely effective drug--and while I take a rather high dose, and do try to keep tabs on my blood pressure, I haven't had any problems with it.
Good luck--
Posted by Lou Pilder on October 20, 2013, at 20:43:20
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:42:02
> I'm now entering my 9th major unipolar depression. I've tried Lithium, Depakote, Nortriptyline, Desipramine, Nardil, Serzone, unilateral and bilateral ECT, Wellbutrin, Prozac, Paxil, and Effexor. They either don't work or can't be tolerated.
>
> I'm currently on 90 mg Remeron, 120 mg Cymbalta, 5 mg Abilify, 200 mg Lamictal, plus 1600 mg Neurontin and 2 mg Klonopin for sleep.
>
> I'm going to see my psychiatrist next week, but would be interested in any suggestions for how to proceed.sadperson,
Now one talks here about emsam. Before you ask your doctor for this drug, I am requesting that you view the following video.
Lou
www.youtube.com/watch?v=at3Sg6qvgTE
Posted by Lou Pilder on October 20, 2013, at 20:45:23
In reply to Lou's warning-mickey, posted by Lou Pilder on October 20, 2013, at 20:43:20
> > I'm now entering my 9th major unipolar depression. I've tried Lithium, Depakote, Nortriptyline, Desipramine, Nardil, Serzone, unilateral and bilateral ECT, Wellbutrin, Prozac, Paxil, and Effexor. They either don't work or can't be tolerated.
> >
> > I'm currently on 90 mg Remeron, 120 mg Cymbalta, 5 mg Abilify, 200 mg Lamictal, plus 1600 mg Neurontin and 2 mg Klonopin for sleep.
> >
> > I'm going to see my psychiatrist next week, but would be interested in any suggestions for how to proceed.
>
> sadperson,
> Now one talks here about emsam. Before you ask your doctor for this drug, I am requesting that you view the following video.
> Lou
> www.youtube.com/watch?v=at3Sg6qvgTEcorrection:
http://www.youtube.com/watch?v=at3Sg6qvgTE
Posted by Phillipa on October 20, 2013, at 20:58:17
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:42:02
I feel Willful's suggestion of Ensam is a very good one. I wanted to also take this medication. As being in a patch form. I always thought that If I had a problem I could remove the patch. The psychological aspect of knowing no more of the med was entering my system was extremely reassuring. To this day I feel I would have done well on a lose dose of it. Have you heard of this med. In patch form? Phillipa
Posted by b2chica on October 22, 2013, at 13:53:26
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:42:02
i'm on Gabapentin (neurontin) currently only 3-600mg/day, however i've been up to around 2100/day. but i use it for anxiety. i do think anything over 1800 just kinda numbed me out but didn't fully get rid of my anxiety sot hats when i needed to pick up perphenazine (2-4mg/bid) for that.
however, i have also known persons to take about 200mg/day and work greatdepends on your metabolism rate, i tend to need higher doses of meds due to fast absorption rate and fast metabolism.
you've been on a nice selection of standards, but not many 'off-label' ones.
if you don't mind an AAP i would strongly suggest Zyprexa. it does however cause some metabolic issues. but was a life saver for me on several occasions. i tend to take it on an as needed basis, typically start around oct/nov and stay on it through february. some need to be on it all the time. Depends on your situation.
also, i like the idea someone mentioned to try an ADHD med. honestly the one med that has consistently worked great for me is my Adderall. if i can't take it, i'm down for the count.
depending on where you live also will provide you with other options. are you US based?
the last thing(s) i'd like to add is that if you can do it, try a combination of cardio workout and weight lifting. it does truly aid in recovery. but i understand its part of the chicken and the egg issue. (if you had the energy to exercise you wouldn't be depressed, of you weren't depressed you wouldn't need to exercise! )
also, do try some talk therapy, even if its only for about 6 weeks or so. maybe they can get a better basis how your depression effects you and could offer some other suggestions?just remember no one knows your body better than you.
take ALL information with a grain of salt (even pdocs) and make the best decision you can at the time.b2c
Posted by rockerchick46 on November 2, 2013, at 14:38:41
In reply to I'm running out of options, posted by sadperson on October 19, 2013, at 15:42:02
Saphris?
Tam
Posted by Ruby2 on November 4, 2013, at 7:05:21
In reply to Re: I'm running out of options » sadperson, posted by Twinleaf on October 19, 2013, at 15:55:29
TMS has been a life-saver for me. Been in and out of treatment resistant depressions for most of my life. Have been on so many meds to no result. In a rough patch now and in the past three weeks, I've been on Pristiq (too much norepenephrine), Viibryd (horrific diarrhea) and now trying Latuda (headache and diarrhea). Been on Lamictal 3x (rash each time), Wellbutrin (severe short term memory loss), Gabapentin, Lexapro, Effexor....can't remember what all to be honest.
Had a round of ECT.
The only thing that has worked for me in any significant way, that didn't have negative side effects, is TMS. Always have had left-sided rTMS. Right now, I'm getting both left and right sided protocols.
I wish you the best as you explore your options!
Ruby
Posted by SLS on November 4, 2013, at 7:15:02
In reply to Re: I'm running out of options, posted by Ruby2 on November 4, 2013, at 7:05:21
Hi Ruby.
Thank you for taking the time to post your case history. I am becoming interested in the deep TMS treatment for myself.
- Scott--------------------------------------------
> TMS has been a life-saver for me. Been in and out of treatment resistant depressions for most of my life. Have been on so many meds to no result. In a rough patch now and in the past three weeks, I've been on Pristiq (too much norepenephrine), Viibryd (horrific diarrhea) and now trying Latuda (headache and diarrhea). Been on Lamictal 3x (rash each time), Wellbutrin (severe short term memory loss), Gabapentin, Lexapro, Effexor....can't remember what all to be honest.
>
> Had a round of ECT.
>
> The only thing that has worked for me in any significant way, that didn't have negative side effects, is TMS. Always have had left-sided rTMS. Right now, I'm getting both left and right sided protocols.
>
> I wish you the best as you explore your options!
>
> Ruby
Posted by Ruby2 on November 4, 2013, at 7:40:55
In reply to Re: I'm running out of options, posted by SLS on November 4, 2013, at 7:15:02
Hi Scott--
If I can help in any other way, let me know. If you have specific questions about TMS, ask away. I've become a kind of spokesperson for TMS at my pdoc's office, and I'm always happy to help out. Wondering where you live. I've recommendations in NYC on the chance you happen to live in there.
The other thing that has helped me is the Fisher-Wallace device--have you heard of it or checked it out? It was a great adjunct to the TMS, but then for some odd reason it started "zapping" me which is almost unheard of. Two different devices did this and I can't use it anymore. Definitely an anomaly. Too many times docs and pdocs have said to me that I am the "1%" and have the rarest reactions to meds, etc.
Anyway, don't hesitate to ask questions in or out of the forum.
Ruby
This is the end of the thread.
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