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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by soulsickness1 on January 31, 2016, at 20:40:02
I need some input guys. I just got out of jail and am currently not prescribed any meds but will finally get to see a pdoc in two days and don't know what i want to ask for. I have treatment resistant depression/anxiety maybe bipolar2 and have been on every med under the sun in the last 13 years. I've been making it from day to day on leftover scripts of remeron, suboxone, gabapentin and vistaril. I've been in a fog since i went to jail about 8 months agoi can get by on an ssri/benzo combo but they wouldn't give me a benzo in there and i can't handle the anxiety of an ssri without one so i glued myself togetherish w/ wellbutrin, zyprexa, gabapentin. Point is I'm out now and need meds, but don't know how i want to approach my med regimen. I do respond to ssris and meds in general for the first time in a long time, but i want something that i can commit to for as long as necessary and not be burdened by side effects. also, effects of meds are changing and drugs like gabapentin that used to get rid of my anxiety now makes me angry and pushes my blood pressure thru the roof. i ways thinking maybe parnate and ativan as a basebut then again I've been thinking a lot of things. any help would be great
Posted by SLS on February 1, 2016, at 6:43:18
In reply to med help!, posted by soulsickness1 on January 31, 2016, at 20:40:02
> I do respond to ssris and meds in general for the first time in a long time,
You are EXTREMELY fortunate.
> but i want something that i can commit to for as long as necessary and not be burdened by side effects.
What side effects do you find most troublesome?
- Scott
Posted by soulsickness1 on February 1, 2016, at 19:39:55
In reply to Re: med help! » soulsickness1, posted by SLS on February 1, 2016, at 6:43:18
> > I do respond to ssris and meds in general for the first time in a long time,
>
> You are EXTREMELY fortunate.
>
> > but i want something that i can commit to for as long as necessary and not be burdened by side effects.
>
> What side effects do you find most troublesome?
I do have an extreme amount of gratitude for being a med responder these days, but its also a gratitude tempered by the fact i was such a robust non-responder in days past. A non-response would have been a good med trial outcome, whereas maoi psychosis hospitalization, and serving 5 years in prison for burglarizing a vet for ketamine in a drug induced dysphoric mania because it seemed like a good idea at the time were some of the less great responses I've had lol (gotta laugh or i'd surely be crying).
I just don't want ssri apathy and amotivation; last time on parnate i had such bad postural hypotension i couldn't stand; gabapentin is GIVING me anxiety these days and since paradoxical reactions seem to be the story of my life maybe i don't even know why I'm even on here for anything other than reassurance really. my worst symptoms are a terrible memory (that paradoxically benzos make better), fatigue, and anhedonia atm.
>
>
> - Scott
Posted by SLS on February 1, 2016, at 22:54:38
In reply to Re: med help!, posted by soulsickness1 on February 1, 2016, at 19:39:55
I was hospitalized more than once due to severe manic reactions to MAOIs. Aside from these few episodes, I am chronically depressed. My diagnosis is Bipolar I depression. A diagnosis of bipolar disorder is warranted when treatment with an antidepressant induces a manic state that lasts beyond drug discontinuation. If the manic state is severe or psychotic, Bipolar I is diagnosed.
You may need an antipsychotic and/or mood stabilizer to prevent future manic and psychotic episodes. I have come to like Saphris (asenapine), an antipsychotic that can produce antidepressant effects. My response to it was brief, but significant. Saphris has given a friend of mine her life back. I currently use Abilify.
If you do need a standard antidepressant, and you are most concerned with SSRI apathy and amotivation, perhaps Effexor would be worth a try. From what I can see, those side effects are usually absent. Effexor is also approved for anxiety disorders, so I would hope that you would be able to treat depression and anxiety with one drug. Some people have good results when adding Wellbutrin to Effexor when mental energy and fatigue are problems. However, anxiety and anger sometimes arise from Wellbutrin treatment.
It is not surprising that your memory should be made better by a BZD. Anxiety can crush memory and drive depression.
Have you tried Lamictal (lamotrigine) yet? An interesting strategy for people who have bipolar depression is to combine Lamictal, Abilify, and Wellbutrin.
I currently take:
Parnate 80 mg/day
desipramine 300 mg/day
Lamictal 300 mg/day
lithium 300 mg/day
Abilify 10 mg/dayI am not in remission, but these drugs help enough to continue taking them.
- Scott
Posted by Lamdage22 on February 2, 2016, at 11:39:02
In reply to Re: med help!, posted by soulsickness1 on February 1, 2016, at 19:39:55
Tough story.
Posted by soulsickness1 on February 2, 2016, at 23:46:22
In reply to Re: med help!, posted by SLS on February 1, 2016, at 22:54:38
> I was hospitalized more than once due to severe manic reactions to MAOIs. Aside from these few episodes, I am chronically depressed. My diagnosis is Bipolar I depression. A diagnosis of bipolar disorder is warranted when treatment with an antidepressant induces a manic state that lasts beyond drug discontinuation. If the manic state is severe or psychotic, Bipolar I is diagnosed.
>
> You may need an antipsychotic and/or mood stabilizer to prevent future manic and psychotic episodes. I have come to like Saphris (asenapine), an antipsychotic that can produce antidepressant effects. My response to it was brief, but significant. Saphris has given a friend of mine her life back. I currently use Abilify.
>
> If you do need a standard antidepressant, and you are most concerned with SSRI apathy and amotivation, perhaps Effexor would be worth a try. From what I can see, those side effects are usually absent. Effexor is also approved for anxiety disorders, so I would hope that you would be able to treat depression and anxiety with one drug. Some people have good results when adding Wellbutrin to Effexor when mental energy and fatigue are problems. However, anxiety and anger sometimes arise from Wellbutrin treatment.
>
> It is not surprising that your memory should be made better by a BZD. Anxiety can crush memory and drive depression.
>
> Have you tried Lamictal (lamotrigine) yet? An interesting strategy for people who have bipolar depression is to combine Lamictal, Abilify, and Wellbutrin.
>
> I currently take:
>
> Parnate 80 mg/day
> desipramine 300 mg/day
> Lamictal 300 mg/day
> lithium 300 mg/day
> Abilify 10 mg/day
>
> I am not in remission, but these drugs help enough to continue taking them.
>
>
> - Scott
>Thank you very much for your time and advice, Scott. I've long admired your posts for their poise and clarity. And since you stopped posting your med regimen with your signature years ago you helped me with the personal curiosity of "what is scott taking these days?" But i am sorry u r not in remission. I've tried all meds that you suggested and was also considering lamictal heavily, but really my main concern is getting a benzo prescribed first because then i know whatever i decide to try as the AD i will be able to tolerate. I'm sorry i'm low on energy atm and anxious about seeing this parole/ reentry APRN tomorrow and whether the guy is even going to listen. Ah life in a mad mad world :-)
Posted by soulsickness1 on February 2, 2016, at 23:48:46
In reply to Re: med help!, posted by Lamdage22 on February 2, 2016, at 11:39:02
> Tough story.
>PB: Where tough stories come to roost
Posted by Lamdage22 on February 3, 2016, at 14:16:27
In reply to Re: med help!, posted by soulsickness1 on February 2, 2016, at 23:48:46
Absolutely:)
I have done 3 days because of MAOI psychosis.
Posted by Meltingpot on February 5, 2016, at 4:12:56
In reply to med help!, posted by soulsickness1 on January 31, 2016, at 20:40:02
Hi,
Sorry, I know this isn't relevant but I can't believe you got five years for that! I would have thought they would have been more lenient because of your mental health condition. Did you actually have to do five years?
Denise
Posted by Lamdage22 on February 5, 2016, at 7:54:39
In reply to Re: med help!, posted by Meltingpot on February 5, 2016, at 4:12:56
America is pretty punitive. Just a personal observation.
Posted by babbler20 on February 8, 2016, at 15:36:05
In reply to med help!, posted by soulsickness1 on January 31, 2016, at 20:40:02
Hi, I've been on antidepressants for 23 years. I'm getting off my last pill in a week. My advice to you is to give up on taking meds if you haven't found something after 13 years. I wish I had given up 10 years ago. These drugs have never helped me, they have only made things worse. Who knows what long-term damage they may have done as well. Up until 7 years ago, I never had insomnia and all of a sudden insomnia started to ruin my life. The only thing that could have caused this is long-term damage from antidepressants
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