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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Clearskies on July 1, 2019, at 17:40:33
Hi, sorry I havent posted about the continuation of the Ketamine in the nasal spray, five sprays every three days.
It now has a very subtle lifting effect - and does nothing for my anxiety, which is soaring, as the nurse put me up to 450mg Wellbutrin XR.
I have an appointment with a new pdoc, in September. Im really tired and sleep a lot.
Posted by linkadge on July 4, 2019, at 16:37:06
In reply to Ketamine nasal spray followup, posted by Clearskies on July 1, 2019, at 17:40:33
The higher dose of wellbutrin may not be helping. Has wellbutrin helped in the past (i.e. on its own)?
Linkadge
Posted by Clearskies on July 4, 2019, at 17:03:31
In reply to Re: Ketamine nasal spray followup, posted by linkadge on July 4, 2019, at 16:37:06
> The higher dose of wellbutrin may not be helping. Has wellbutrin helped in the past (i.e. on its own)?
>
> LinkadgeI have only ever taken it as an adjunct with another medication. I think the higher dose is inducing higher anxiety.
Posted by linkadge on July 5, 2019, at 7:32:30
In reply to Re: Ketamine nasal spray followup » linkadge, posted by Clearskies on July 4, 2019, at 17:03:31
Unless it is helping with your depression, you might back off on the dose.
Wellbutrin can increase the blood levels of DXM. I wonder if there is any interaction with ketamine.
Linkadge
Posted by Clearskies on July 5, 2019, at 14:37:59
In reply to Re: Ketamine nasal spray followup, posted by linkadge on July 4, 2019, at 16:37:06
> The higher dose of wellbutrin may not be helping. Has wellbutrin helped in the past (i.e. on its own)?
>
> LinkadgeIt has always had a brightening effect on my depression, but I havent been on this high a dose before. Xanax prn has been added to help. Ditching this nurse practitioner.
Posted by linkadge on July 5, 2019, at 16:01:24
In reply to Re: Ketamine nasal spray followup » linkadge, posted by Clearskies on July 5, 2019, at 14:37:59
I would just be clear that the higher dose is making things worse. See if you can agree to a lower dose (or at least a slower titration).
Linkadge
Posted by Clearskies on July 9, 2019, at 0:32:51
In reply to Re: Ketamine nasal spray followup, posted by linkadge on July 5, 2019, at 16:01:24
> I would just be clear that the higher dose is making things worse. See if you can agree to a lower dose (or at least a slower titration).
>
> LinkadgeI am not even going to return for a consult. This nurse practitioner in a psych practice never once was able to write a scrip for me without looking the details up in a book. A book. (How old is this book? Looked like a textbook to me.) Im sorry - but this is your JOB. It is all you do, your speciality. I have not been on any odd med combos, or even high dosages. This nurse has no confidence, and at this point, neither do I.
I had a weekend of ideation.
My new pdoc has been ableto get me in on Thursday. More news then.
Posted by linkadge on July 9, 2019, at 9:13:43
In reply to Re: Ketamine nasal spray followup » linkadge, posted by Clearskies on July 9, 2019, at 0:32:51
Hey,
While you might be right about your decision to leave this nurse, you want to do so with some specific goals about where you want your treatment to go (I know this is hard to do at times). For example, if the dose is too high, you can talk about how much worse you feel after the dose was raised.
I have not taken wellbutrin, but I get the impression that many people don't respond to it as a monotherapy. Have you tried it in combination with an SSRI?
Linkadge
Posted by SLS on July 9, 2019, at 9:25:43
In reply to Re: Ketamine nasal spray followup » linkadge, posted by Clearskies on July 9, 2019, at 0:32:51
> My new pdoc has been ableto get me in on Thursday. More news then.
Good luck.
- Scott
This is the end of the thread.
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