![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 30. Go back in thread:
Posted by rjlockhart37 on October 27, 2015, at 23:03:53
In reply to Re: so, I've been depressed for a while... » ihatedrugs1, posted by SLS on October 27, 2015, at 16:09:19
you may ask about something with serotonin increase, wellbutrin is more of NE and some dopamine but .... i don't know if a SSRI added would have any improvement, but maybe to increase serotonin levels to help the mood, you could ask about Remeron, or Prozac.....those work well with wellbutrin
Posted by SLS on October 28, 2015, at 0:17:30
In reply to Re: so, I've been depressed for a while..., posted by rjlockhart37 on October 27, 2015, at 23:03:53
> you may ask about something with serotonin increase, wellbutrin is more of NE and some dopamine but .... i don't know if a SSRI added would have any improvement, but maybe to increase serotonin levels to help the mood, you could ask about Remeron, or Prozac.....those work well with wellbutrin
Perhaps I misunderstood. I thought ihatedrugs1 was still taking Effexor. I don't think that adding another serotonergic drug would be advisable were this the case. However, adding Remeron to Effexor is a very reasonable alternative.
- Scott
Posted by Lou Pilder on October 28, 2015, at 9:22:29
In reply to Re: so, I've been depressed for a while... » rjlockhart37, posted by SLS on October 28, 2015, at 0:17:30
> > you may ask about something with serotonin increase, wellbutrin is more of NE and some dopamine but .... i don't know if a SSRI added would have any improvement, but maybe to increase serotonin levels to help the mood, you could ask about Remeron, or Prozac.....those work well with wellbutrin
>
> Perhaps I misunderstood. I thought ihatedrugs1 was still taking Effexor. I don't think that adding another serotonergic drug would be advisable were this the case. However, adding Remeron to Effexor is a very reasonable alternative.
>
>
> - ScottFriends,
Be not deceived. The poster here writes,[...adding Remeron to Effexor is a very reasonable alternative...].
The tragic results of taking these two drugs together could be coma and death. This is all because when combining mind-altering chemicals, the effects are increased exponentially. The two drugs could increase chemical levels in the brain to create a poisonous chemical destruction of the brain components resulting in the breakdown of brain functions that could cause the person to suffer a horrible death by them.
And this site is for support and education, or is it? Is it supportive to advocate combinations of drugs that could cause coma and death? Mr. Hsiung says that it is by the nature that what is posted here is supportive unless it is sanctioned by him or a deputy of record because being supportive takes precedence and worse, Mr. Hsung states here that if he leaves un supportive statements to stand, he is doing so because he thinks that it will be good for his community as a whole.
Now a reasonable reader here could think that because Mr. Hsiung is not stopping Scott from posting what could cause death to the taker of these drugs by Scott's promotion of the combination here, that he could think that if there are readers that are killed by the combination, that would be good in Mr. Hsiung's thinking for his community as a whole here. But that is the same argument to justify genocide and infanticide and slavery and segregation and discrimination. Have we not progressed after 1945 and 1865 and 1961 and 1954 to see that the argument that doing what will be good for the community as a whole does not justify crimes against humanity? Have we not seen that the world is sickened by those that that want to resurrect what was put to death many years ago?
And how many children will be drugged in collaboration with a psychiatrist after reading what Scott has posted here with impunity and take these drugs together and suffer a horrible death by them? Who will have their blood upon them? Their blood will not be upon me. Will their blood be upon you reader for being indifferent here and not speak out? Will their blood be upon the FDA? On The American Psychiatric association? Or the producers of marketing propaganda that could mislead viewers to think that taking these drugs could be safer than they really are by presenting happy people in cadence to music and happy dogs all tiptoeing through the tulips to the pharmacy that gives them a drug that could kill them? Over 40,000 people are killed yearly by these drugs.
Wake up to reality. Is death to you supportive and will death be justified by someone that has some vision of the future that death from here will make this a better community by allowing the promotion of chemicals that when combined could cause the taker to suffer a horrible death by them? Are you so persuaded to trust Mr. Hsiung as he asks in his TOS for you to try to do? Can you not see The Plain Truth the remaining posters here are still seeking a magic solution by drugs to stop depression in the taking of drugs that for thousands of years as others have tried to do the same, resulted in addiction and life-ruining conditions and death. Yet today, people are still persuaded that taking drugs will stop depression while all along those taking the drugs get addicted, get life-ruining conditions and death.
Mr. Hsiung has his vision of what will be good for his community as a whole and he is allowed to post it here by using third-parties where even anti-Semitic propaganda is allowed to stand. I have had a vision also, by one other party, and that party has revealed to me what Mr. Hsiung is prohibiting me to post here. And many could die here IMHO by being prevented from hearing from me which would come from a Jewish perspective as revealed to me. This, I say, is a human tragedy.
Lou
Posted by SLS on October 28, 2015, at 9:59:09
In reply to Lou's urgent warning-death allowed as supportive » SLS, posted by Lou Pilder on October 28, 2015, at 9:22:29
You mention that when combining Effexor with Remeron, the levels of certain chemicals are increased dramatically to the point of becoming poisonous. Can you identify which chemicals in particular? I was not aware of this. Many doctors use this combination to treat their most difficult cases. One of the biggest proponents of this treatment strategy is Stephen Stahl, MD. He is very smart and always explains the biological basis of how such combinations work as well as their dangers and side effects. Remeron is not a serotonin reuptake inhibitor, although it does block certain serotonin receptors. I am not aware of any of these receptors acting as autoreceptors that would increase serotonin levels upon their blockade. 5-HT2a/c and 5-HT3 are the receptors cited as being affected by Remeron. Serotonin syndrome does not seem to be a problem, despite two reports appearing on Medline (Pubmed), one of which included the coadministration of tramadol, a known serotonin reuptake inhibitor.
Clever subject line.
:-)
- Scott
Posted by rjlockhart37 on October 28, 2015, at 12:07:34
In reply to Re: so, I've been depressed for a while..., posted by rjlockhart37 on October 27, 2015, at 23:03:53
it was for CE, he said he's taking wellbutrin 400mg, and maybe adding an SSRI would increase serotonin levels, the best two that i think to add to wellbutrin are Prozac or Remeron, or Lexepro, because i've been on wellbutrin and prozac before nad it's called "wellzac"
fluoxetine does have some side effects and is not the most effective SSRI but it does improve mood in it's own way, and it would be a good add on, but some doctors don't like using fluoxetine
Posted by ihatedrugs1 on October 28, 2015, at 15:39:19
In reply to Re: so, I've been depressed for a while... » ihatedrugs1, posted by SLS on October 27, 2015, at 16:09:19
> > > If you are still struggling by this winter, Vraylar (cariprazine) should become available. It is an Abilify-like drug that is stronger on dopamine D3 receptors than is Abilify. I am guessing that it will help more than Abilify for depression and the negative symptoms of schizoid disorders.
> > >
> > > http://bipolarnews.org/?tag=cariprazine
> > >
> > >
> > > - Scott
> > >
> > >
> > Hi Scott, I have been taking Abilify for a few years along with other antidepressants which have been switched around from one kind to another. I've been on Effexor 300 and Abilify at 2mg (higher dose gives me akathisia) and Nuvigil 250 (and other stimulants if needed) for a little over 7 months. I still feel depressed but about 5 weeks ago I began feeling better, enough to work in my yard and even go to some events. I figured it was that Effexor finally reached a therapeutic level and that perhaps I didn't need Abilify after all. So I stopped Abilify for around 10 days. I did really well for a week and then "bam" I went down the black hole again. I went back on Abilify again but this time it didn't work as fast as before and I'm still having a rough for the last three weeks. My dr. switched me to Pristiq 100mg and I still feel not well. I went off the Abilify because since I began using it I haven't been able to sit and watch a movie or go to a restaurant without feeling restless. Do you think this new medication Vraylar is a good idea for unipolar treatment resistant depression as an adjunct to Pristiq?. How about brexpiprazole, what do you think of it?
> > I've been going through a very rough time the last three years and especially this year. I am at my wits end with this illness.
>
> Do you find that the akathisia produced by Abilify gets worse at higher dosages?Yes
>
> Is there any bipolarity involved with you or your first degree relatives? Do you feel it makes sense to pursue antipsychotics with antidepressant properties, or move directly to other antidepressants?No bipolarity to speak of. Abilify pulled me from a severe episode but never enough to get close to remission. (I've taken up to 5mg).
> I didn't realize you were so severely affected. I'm sorry. Have you ever tried Lamictal and Wellbutrin together in combination with Abilify? As far as Abilify is concerned, you probably need a higher dosage to get the antidepressant effect from it that it is otherwise capable of providing you with (10 mg/day). Unfortunately, you experience some akathisia with it. These drugs differ in their ratios of dopamine D3/D2 binding. The order from highest to lowest is:
>
> 1. cariprazine
> 2. aripiprazole
> 3. brexpiprazole
>
> It might be that cariprazine is the more effective for treating depression, but also the most liable to produce akathisia. Of course, my guesses could be very wrong. Only time will tell. Unfortunately, akathisia has already been observed with cariprazine during clinical trials.I can't handle Akathisia, it is as bad as depression itself for me.
>
> You really should consider trying Saphris (asenapine) as a replacement for Abilify. Akathisia isn't much of a problem with this antipsychotic, and it can produce robust antidepressant effects. There's Latuda, a antipsychotic that some doctors like for depression. It does not produce weight gain. However, if dopamine receptor partial agonism it most important for why your respond to Abilify, these other drugs may not work. That being said, I have seen Saphris produce complete remission for someone who suffered from schizoaffective disorder, predominated by depression. I tried Saphris. It had an amazing antidepressant effect for me that lasted only a week before turning foul on me. I am sure this drug will work well for a subset of people. The thing about Saphris is that you will know rather quickly whether it will be helpful to you. If it doesn't help by day 14, it probably won't. It might help within a few days.I've tried Saphris and Latuda and neither one did anything. Only Abilify works on my depression along with an AD.
>
> Maybe you don't need an antipsychotic.Before Abilify, I never used APs and was able to achieve some relief.
>
> Have you discussed Brintellix (vortioxetine) with your doctor? It is an antidepressant. Brintellix is a combination serotonin reuptake inhibitor and receptor modulator. You would want to try this in place of a SSRI or SNRI rather than using it in combination with one. It can clear up thoughts (cognition), and has a lower liability to produce sexual side effects compared to SSRIs.Tried it already. It did nothing.
>
> You might also try adding nortriptyline, desipramine, or Wellbutrin to your SNRI. For me, nortriptyline 75 mg/day made Effexor 300 mg/day work better (just not good enough). Nortriptyline can cause weight gain. A good friend of mine has found remission with a combination of Pristiq 100mg/day and Wellbutrin 300 mg/day.Have tried Wellbutrin but never with Pristiq. Perhaps a thought! I really don't want anything that causes any more weight gain (nortriptyline). I called the doctor today and she said to give Pristiq 100mg one more week. I may call her and see if I should add wellbutrin.
>
> If you do decide to try a MAOI, I think Parnate makes more sense than Nardil if anergia predominates and there is little or no anxiety.I have been on Ensam and it didn't work (up to 12 mg) but haven't taken any other MAOIs. At this point, I would have to go through a wash out period and I don't think I can go without some of the meds at this low point (the only things keeping going are either Nuvigil, Adderall or Vyvanse). I prefer Nuvigil because I don't go through a crash out hell as with the others. I have some anxiety but it is largely due to med side effects and not knowing what else to do.
>
> So...
>
> What should you try first?
>
> I would add the Saphris first without discontinuing the Abilify. If you feel significantly better, you can then try jettisoning the Abilify. If that doesn't help, I would then add Wellbutrin to the Pristiq. I would then add Lamictal if necessary.
>
> Perhaps Vraylar would help more than Abilify. However, you might want to wait for guinea pigs like me to try it first so that you can better assess how appropriate it is for you.So do you think that brexpiprazole may not necessarily be any better than Abilify. As I said before, Saphris was ineffective. So Pristiq and Wellbutrin; I've taken Lamictal before and cannot even tell if it did anything. As for other meds, I think I've tried most SSRIs, SNRIs, Remeron (40lb weight gain) but for MAOI (did try Emsam) TCAs and AP (though had a small stint with Seroquel and hated it). I also did a full six weeks of Rtms and nothing but a $12,000 bill.
Thank you so much for your thoughtful answer. I hope you are doing more than well.
>
> I hate drugs 2.
>
>
> - Scott
>
>
Posted by ihatedrugs1 on October 28, 2015, at 15:48:43
In reply to Re: so, I've been depressed for a while..., posted by ihatedrugs1 on October 28, 2015, at 15:39:19
Posted by SLS on October 28, 2015, at 17:29:08
In reply to Re: Scott (nm), posted by ihatedrugs1 on October 28, 2015, at 15:48:43
I am sorry that your brain is so stubborn. This is, unfortunately, a very familiar situation for me.
I think your idea of trying brexpiprazole makes sense given your lack of response to Saphris and your akathisia reaction to Abilify. Brexpiprazole may very well allow you to take dosages effective for depression without suffering akathisia. For now, let us assume that it is the dopamine receptor partial agonism that is responsible for the improvement you experience with Abilify. Prior to bexpiprazole, this was the only psychotropic drug capable of doing this. Brexpiprazole represents the second. Brexpriprazole is 8 - 10 times more potent than Abilify per milligram. For depression, you may only need 0.5 - 1.0 mg/day. 4.0 mg/day is considered the maximum dosage for treating schizophrenia.
At 1.0 mg/day, the incidence of akathisia for brexpiprazole during clinical trials was 4.0%. Unfortunately, the statistics for Abilify do not include results for different dosages. For all dosages combined, it is 10 - 14%. Ask your doctor what his impressions are regarding brexpiprazole and akathisia. How many people has he tried it on? I don't think it would hurt too much for you to try it. You would know quickly whether or not it will help with depression or cause akathisia.
I am less than well with my current treatment, but better than nothing. Thanks for asking.
I recently switched from nortriptyline to desipramine to reduce weight gain. So far, I have lost 5 lbs in less than a week. That leaves only 55 lbs more to go. I don't feel quite as well, but I am only one week into treatment. I have been on this drug before, so I don't really expect magic.
I have bipolar I depression with drug-induced mania.
I am currently taking:
Parnate 60 mg/day
desipramine 150 mg/day
Lamictal 300 mg/day
lithium 300 mg/day
Abilify 10 mg/day
prazosin 30 mg/daySome unusual things to try include prazosin, N-acetylcysteine (NAC), minocycline, resveratrol, and ketamine (intranasal). Of course, there are the botanicals (herbal medicines) for which I am not familiar enough to comment on. I think curcumin is currently receiving quite a a bit of attention. Studies on rats look good. Studies on people? I don't know.
http://www.psychiatrist.com/jcp/article/Pages/2014/v75n10/v75n1011.aspx
- Scott
Posted by ihatedrugs1 on October 29, 2015, at 11:28:59
In reply to Re: Scott » ihatedrugs1, posted by SLS on October 28, 2015, at 17:29:08
> I am sorry that your brain is so stubborn. This is, unfortunately, a very familiar situation for me.
>
> I think your idea of trying brexpiprazole makes sense given your lack of response to Saphris and your akathisia reaction to Abilify. Brexpiprazole may very well allow you to take dosages effective for depression without suffering akathisia. For now, let us assume that it is the dopamine receptor partial agonism that is responsible for the improvement you experience with Abilify. Prior to bexpiprazole, this was the only psychotropic drug capable of doing this. Brexpiprazole represents the second. Brexpriprazole is 8 - 10 times more potent than Abilify per milligram. For depression, you may only need 0.5 - 1.0 mg/day. 4.0 mg/day is considered the maximum dosage for treating schizophrenia.
>
> At 1.0 mg/day, the incidence of akathisia for brexpiprazole during clinical trials was 4.0%. Unfortunately, the statistics for Abilify do not include results for different dosages. For all dosages combined, it is 10 - 14%. Ask your doctor what his impressions are regarding brexpiprazole and akathisia. How many people has he tried it on? I don't think it would hurt too much for you to try it. You would know quickly whether or not it will help with depression or cause akathisia.
>
> I am less than well with my current treatment, but better than nothing. Thanks for asking.
>
> I recently switched from nortriptyline to desipramine to reduce weight gain. So far, I have lost 5 lbs in less than a week. That leaves only 55 lbs more to go. I don't feel quite as well, but I am only one week into treatment. I have been on this drug before, so I don't really expect magic.
>
> I have bipolar I depression with drug-induced mania.
>
> I am currently taking:
>
> Parnate 60 mg/day
> desipramine 150 mg/day
> Lamictal 300 mg/day
> lithium 300 mg/day
> Abilify 10 mg/day
> prazosin 30 mg/day
>
> Some unusual things to try include prazosin, N-acetylcysteine (NAC), minocycline, resveratrol, and ketamine (intranasal). Of course, there are the botanicals (herbal medicines) for which I am not familiar enough to comment on. I think curcumin is currently receiving quite a a bit of attention. Studies on rats look good. Studies on people? I don't know.
>
> http://www.psychiatrist.com/jcp/article/Pages/2014/v75n10/v75n1011.aspx
>
>
> - ScottI spoke with my doctor and she said that we should give brexpiprazole a try. She is waiting to get 'samples for me to try. Today, I feel a little better as in not sobbing in bed. What gets me most about the last three years is that before, when I had depression, I could still do things, socialize, go out etc... Now I'm such a recluse. I don't like to go anywhere like I used to. I don't enjoy anything nor have any motivation. If I do something I have to force myself and tell myself is for the better. I actually noticed this feature turning more pronounced when I started Abilify. However, each time I stop it, I go into a major depressive state. I also think that this may have something to do with taking amphetamines to help me get going. But who knows. Maybe is just a progression of the disease.
Anyway, today is a beautiful day in Florida. I may force myself to get out. Thanks for everything.
ihatedrugs
Posted by SLS on October 29, 2015, at 13:32:50
In reply to Re: Scott » SLS, posted by ihatedrugs1 on October 29, 2015, at 11:28:59
> I spoke with my doctor and she said that we should give brexpiprazole a try.
That's a great idea. I really hope it works for you. Please keep us informed how you respond to it.
One step at a time.
I understand completely what you are experiencing. Our illnesses sound very much the same. The severity of my depression has increased with the passage of time. I attribute it to the progression of the illness, and, possibly, to multiple drug exposures. My memory and cognitive function have always been affected, but it is much more so now. I don't have much depressed mood anymore. It is more of an energy/interest/motivation/cognitive/memory thing. Again, I believe this to be an aspect of the progression of the illness and changes in its characteristics. In the elderly, depression looks a lot like dementia, which is why it has been nicknamed "pseudodementia". When you hit the right treatment, none of that stuff will matter. I find that when I responded to antidepressants in the past, energy and libido would return first. Next, would be mood and overall function. Interestingly, memory was the last thing to return. I guess there is a delay while the hippocampus grows back neurons, which might take some time.
I made an adjustment to my dosage of Parnate, and I feel a bit better.
- Scott
Posted by Lamdage22 on October 29, 2015, at 14:24:35
In reply to Re: Scott » ihatedrugs1, posted by SLS on October 29, 2015, at 13:32:50
What does Vraylar and Brexpiprazole say about Akathisia incidence compared to Abilify?
Posted by SLS on October 29, 2015, at 15:17:39
In reply to Re: Scott, posted by Lamdage22 on October 29, 2015, at 14:24:35
> What does Vraylar and Brexpiprazole say about Akathisia incidence compared to Abilify?
>
>All three drugs produce akathisia according to the drug companies. Brexpiprazole is a bit better than the other two. I think in your case, brexpiprazole would be a better choice than Vraylar. My guess is that it will be somewhat better to treat psychosis while retaining some antidepressant properties and efficacy to treat negative symptoms. As I mentioned in another reply to you posted earlier, you can either sit back and see how others react to these drugs first, or try them anyway. Once you reach a therapeutic dosage, it should not take more than a week for akathisia to develop, so you would have your answer quickly. If you don't like it, just stop taking it immediately. Akathisia is dosage-dependent and gets worse with increasing doses.
The first time I tried Abilify, my starting dose was a full 20 mg/day, which is actually okay to do in some circumstances. I experienced an uncomfortable restlessness that was probably a mild version of akathisia. It disappeared within a week.
- Scott
Posted by Lamdage22 on October 29, 2015, at 15:28:30
In reply to Re: Scott » Lamdage22, posted by SLS on October 29, 2015, at 15:17:39
Well right now my trail is Nortriptyline.
I have been taking 50mg instead of 25mg that my doctor approved of :(
Posted by Bob on October 30, 2015, at 14:02:18
In reply to Re: Scott » ihatedrugs1, posted by SLS on October 29, 2015, at 13:32:50
> > I spoke with my doctor and she said that we should give brexpiprazole a try.
>
> That's a great idea. I really hope it works for you. Please keep us informed how you respond to it.
>
> One step at a time.
>
> I understand completely what you are experiencing. Our illnesses sound very much the same. The severity of my depression has increased with the passage of time. I attribute it to the progression of the illness, and, possibly, to multiple drug exposures. My memory and cognitive function have always been affected, but it is much more so now. I don't have much depressed mood anymore. It is more of an energy/interest/motivation/cognitive/memory thing. Again, I believe this to be an aspect of the progression of the illness and changes in its characteristics. In the elderly, depression looks a lot like dementia, which is why it has been nicknamed "pseudodementia". When you hit the right treatment, none of that stuff will matter. I find that when I responded to antidepressants in the past, energy and libido would return first. Next, would be mood and overall function. Interestingly, memory was the last thing to return. I guess there is a delay while the hippocampus grows back neurons, which might take some time.
>
> I made an adjustment to my dosage of Parnate, and I feel a bit better.
>
>
> - Scott
Your description of the disease course fits me perfectly as well. I am doing worse now than in the past in many of the same ways you claim and my response to medecines is not as good as in the past.Bob
Posted by SLS on October 30, 2015, at 16:10:02
In reply to Re: Scott » SLS, posted by Bob on October 30, 2015, at 14:02:18
> > > I spoke with my doctor and she said that we should give brexpiprazole a try.
> >
> > That's a great idea. I really hope it works for you. Please keep us informed how you respond to it.
> >
> > One step at a time.
> >
> > I understand completely what you are experiencing. Our illnesses sound very much the same. The severity of my depression has increased with the passage of time. I attribute it to the progression of the illness, and, possibly, to multiple drug exposures. My memory and cognitive function have always been affected, but it is much more so now. I don't have much depressed mood anymore. It is more of an energy/interest/motivation/cognitive/memory thing. Again, I believe this to be an aspect of the progression of the illness and changes in its characteristics. In the elderly, depression looks a lot like dementia, which is why it has been nicknamed "pseudodementia". When you hit the right treatment, none of that stuff will matter. I find that when I responded to antidepressants in the past, energy and libido would return first. Next, would be mood and overall function. Interestingly, memory was the last thing to return. I guess there is a delay while the hippocampus grows back neurons, which might take some time.
> >
> > I made an adjustment to my dosage of Parnate, and I feel a bit better.
> >
> >
> > - Scott
>
>
> Your description of the disease course fits me perfectly as well. I am doing worse now than in the past in many of the same ways you claim and my response to medecines is not as good as in the past.
>
> BobHow frustrating, demoralizing, and agonizing.
Sometimes, I don't know why I still have hope to find a treatment that will bring remission, but I do.
- Scott
Posted by Lamdage22 on November 2, 2015, at 15:33:18
In reply to Re: Scott » Bob, posted by SLS on October 30, 2015, at 16:10:02
Scott,
maybe this is for you
ALKS-5461 in 2016!
Would it mix well with your other medications? http://www.drugs.com/drug_interactions.html
Posted by SLS on November 2, 2015, at 15:46:02
In reply to Re: Scott, posted by Lamdage22 on November 2, 2015, at 15:33:18
> Scott,
>
> maybe this is for you
>
> ALKS-5461 in 2016!
>
> Would it mix well with your other medications? http://www.drugs.com/drug_interactions.htmlThanks, Lamdage22.
I am very interested in this drug. I couldn't get my doctor to go with straight buprenorphine over the years. Maybe he will be open to this new drug. I am guessing that he would want me to come off of Parnate. Ouch. I'll be in a world of pain if I have to do that, but what better choice do I have if it is only of minimal help and represents a dead end?
I'm sorry to hear that you had a bad experience with Brintellix. That's another drug that I am sitting around waiting to see how others respond to. If it looks really, really good, I might opt to discontinue Parnate for it. I could actually make room for trying both new drugs while off of Parnate.
- Scott
Posted by Lamdage22 on November 2, 2015, at 16:05:45
In reply to Re: Scott » Lamdage22, posted by SLS on November 2, 2015, at 15:46:02
I am guessing that he would want me to come off of Parnate. Ouch. I'll be in a world of pain if I have to do that, but what better choice do I have if it is only of minimal help and represents a dead end?
>
> I'm sorry to hear that you had a bad experience with Brintellix. That's another drug that I am sitting around waiting to see how others respond to. If it looks really, really good, I might opt to discontinue Parnate for it. I could actually make room for trying both new drugs while off of Parnate.
>
>
> - ScottI am in a world of pain now because i am all insecure of this unipolar/bipolar thing.. I cant figure it out and it hurts my brain to think about it.
Posted by Lamdage22 on November 2, 2015, at 16:12:18
In reply to Re: Scott » Lamdage22, posted by SLS on November 2, 2015, at 15:46:02
Choices...
they hurt but they need to be made.
Posted by Horse on November 3, 2015, at 11:07:49
In reply to Re: Scott » Lamdage22, posted by SLS on November 2, 2015, at 15:46:02
> > Scott,
> >
> > maybe this is for you
> >
> > ALKS-5461 in 2016!
> >
> > Would it mix well with your other medications? http://www.drugs.com/drug_interactions.html
>
> Thanks, Lamdage22.
>
> I am very interested in this drug. I couldn't get my doctor to go with straight buprenorphine over the years. Maybe he will be open to this new drug. I am guessing that he would want me to come off of Parnate. Ouch. I'll be in a world of pain if I have to do that, but what better choice do I have if it is only of minimal help and represents a dead end?
>
> I'm sorry to hear that you had a bad experience with Brintellix. That's another drug that I am sitting around waiting to see how others respond to. If it looks really, really good, I might opt to discontinue Parnate for it. I could actually make room for trying both new drugs while off of Parnate.
>
>
> - ScottI don't recall anything that would necessitate dc except that it's new and unproven with maoi's.
Posted by SLS on November 19, 2015, at 7:13:21
In reply to Re: Scott, posted by Horse on November 3, 2015, at 11:07:49
Hi Horse.
I appreciate your input.
> I don't recall anything that would necessitate dc except that it's new and unproven with maoi's.I agree. However, I don't have a prescription pad. I'm not going to bring it up just yet.
- Scott
Posted by phidippus on December 3, 2015, at 23:31:55
In reply to so, I've been depressed for a while..., posted by Christ_empowered on October 27, 2015, at 12:43:21
Remeron
eric
Posted by SLS on December 5, 2015, at 17:07:13
In reply to Re: so, I've been depressed for a while... » Christ_empowered, posted by phidippus on December 3, 2015, at 23:31:55
> Remeron
>
> ericWhat are your reasons for suggesting Remeron?
I hope that school is going well for you.
- Scott
Posted by phidippus on December 7, 2015, at 4:07:28
In reply to Re: so, I've been depressed for a while... » phidippus, posted by SLS on December 5, 2015, at 17:07:13
I suggested Remeron because Christ empowered stated SSRIs were not good for him over the long haul. I considered recommending an SNRI but they're similar in action to SSRIs. I suppose I could recommend a TCA like Imipramine...
Posted by SLS on December 7, 2015, at 7:10:53
In reply to Re: so, I've been depressed for a while... » SLS, posted by phidippus on December 7, 2015, at 4:07:28
> I suggested Remeron because Christ empowered stated SSRIs were not good for him over the long haul. I considered recommending an SNRI but they're similar in action to SSRIs. I suppose I could recommend a TCA like Imipramine...
Thanks.
Perhaps a combination of SNRI + Remeron, especially if there is a partial response to SRIs?
Back in the old days before Remeron and Effexor, Andrew Nierenberg suggested to me that I consider combining TCA + yohimbine, a NE alpha2a autoreceptor antagonist. This rationale may apply to TCA + Remeron, a combination treatment that I have never seen proposed. I suppose imipramine or clomipramine would yield the best chances of producing a positive response.
Any thoughts?
- Scott
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