Psycho-Babble Medication Thread 1106059

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Surprised! Got my second opinion about Nardil!

Posted by PCB on September 8, 2019, at 21:32:00

Hey Everyone!

So I saw a psychiatrist for a second opinion about alternatives to Nardil several days ago. I want to know if with my lifestyle changes, did he think I could respond to an SRNI/Lithium or any other medication combination. I also asked if changed to less stressful job and move out of the stressful city, if that would help my depression.

He skipped over all that and asked would I consider maintenance ECT. And surprisingly, I don't think its is bad idea. But I think most ECT doc want you on psych meds during ECT. And I also think they try to phase you off maintenance ECT if possible. I think it pretty rare that people get treated the rest of their lives with maintenance ECT. That is why I had not considered in before. So I think you end up being on psych meds after acute ECT and still have all the side effects.

And my three main questions he said he couldn't predicts (He said he wouldn't be able to tell if my depression would improved with 1.a SNRI/Lithium combo with my lifestyle changes, 2. a less stressful job and 3. moving to the peaceful suburbs)

What do you guys think???

Thanks everyone!

PCB

PS Unfortunately I had a bad cold and couldn't really participate in a good discussion. I still think anyone with a medical illness including depression/bipolar would do better with a less stressful job and being out of the stressful city. I see my medical clients do better all the time with their diabetes, hypertension with less stress. I am little disappointed that my psychiatrist and this psychiatrist said that they did not know if that would help or they never had a patient that did that successfully

 

Re: Surprised! Got my second opinion about Nardil!

Posted by linkadge on September 9, 2019, at 18:03:17

In reply to Surprised! Got my second opinion about Nardil!, posted by PCB on September 8, 2019, at 21:32:00

It's really hard to tell whether somebody's depression will respond to lifestyle changes. Some depression is stress induced while other forms may not be. There was a theory out there recently that treatment resistant depression may exist because many treatments are found via the stress induced rodent model of depression.

For example, you take a mouse and stress it out enough to induce depression. Then you give it an antidepressant and it recovers (faster than it would). Current antidepressants were discovered for their ability to reverse stress induced depression. However, some people's depression is not stress induced. They seem to have a low mood day or night, rain or shine.

For example, I was just off for 2 months. Despite having nothing to do, my depression seemed to actually get worse. I failed to implement a routine and had virtually no social interaction. My job was, at least, forced social interaction.

Left to my own devices I seem to just descend.

However, it's hard to tell because many forms of depression are cause (or made worse) by stress.

Linkadge

 

Re: Surprised! Got my second opinion about Nardil!

Posted by PCB on September 9, 2019, at 18:21:13

In reply to Re: Surprised! Got my second opinion about Nardil!, posted by linkadge on September 9, 2019, at 18:03:17

Hey Linkage!

I swear we read the all same articles. I was just reading about the arguments against the stress diathesis models of depression and the whether the forced swim tests on mice was accurate. I am a mess many weekends without the structure of work or a girlfriend. I think we could open a psychiatric literature research businesses. I use to sit in the library and read all the psych journals from cover to cover.

Great advise Linkage! I really appreciate it . Hope you are well.

PCB

 

Re: Must Read, My Most Sincere Post! Linkage

Posted by PCB on September 9, 2019, at 19:09:59

In reply to Re: Surprised! Got my second opinion about Nardil!, posted by linkadge on September 9, 2019, at 18:03:17

Hey Linkage!

But honestly, what I was thinking was turning a lifestyle change to a job. Sound crazy, but why not become a yoga teacher and write a blog. Really, why can't we do this Linkage. Yoga and journaling is amazing for depression.

And I know I mentioned the stress model of depression, but how about I really just look at the raw data. I know medicine and sometime teaching get ranked as occupations with high rates of depression, suicide. I should not try rationalization with obscure internet data articles. My/Our jobs are known to associated with depression period.

So really why shouldn't we just be honest, go against tradition and do what is right for our "organic brain disease." We would not ask a paralyzed patient to work as a doorman. Why would we stress our fragile and penultimate vital organ, our brain with these jobs? Some time I think I wasted my life practicing medicine and contributed to my own treatment resistance. It is really sad and is making me tear up right this second. I destroyed my brain!

Well, no more! No more!

PCB

 

Re: Must Read, My Most Sincere Post! Linkage

Posted by PCB on September 9, 2019, at 19:12:48

In reply to Re: Must Read, My Most Sincere Post! Linkage, posted by PCB on September 9, 2019, at 19:09:59

And I will not let any far fetched website or psychiatrist debate me other wise. It is just common sense to me. I apologize if I have offended anyone.

PCB

 

Re: Must Read, My Most Sincere Post! Linkage » PCB

Posted by linkadge on September 10, 2019, at 18:23:54

In reply to Re: Must Read, My Most Sincere Post! Linkage, posted by PCB on September 9, 2019, at 19:09:59

I completely agree with you. I've lost all faith in my career and am (passively at the moment) looking for a change.

On the other hand, financial stress can be a major stressor which, by itself, could cause depression. I'm in a position where I could live for a few years (at least) without income, but am still concerned about the longer term implications. I would need to keep working in some form.

It is true that it is easier to get a job, if you have a job. Some of this is confidence. In the summers (when I'm doing nothing) I feel pretty useless and this filters into my whole presentation.

Really, I just want a mundane, boring 8 hour job. The best time in my life was when I was sweeping floors at the local car plant.

Linkadge

 

Re: Must Read, My Most Sincere Post! Linkage » PCB

Posted by linkadge on September 10, 2019, at 18:29:17

In reply to Re: Must Read, My Most Sincere Post! Linkage, posted by PCB on September 9, 2019, at 19:12:48

No I think you're right.

There is lots to be said for crappy life conditions (job, food, air quality, water quality etc) on depression symptoms. That being said, I do believe there can be a genetic component (which interacts with the environment).

My mother has severe bipolar and can be pretty bad at times. She left her job (teaching) but still suffered several severe mood episodes afterwards. Some of this was having children. However, she's 70 now and still only sleeps about 4 hours a night. The other 20 hours are spent cleaning, or gardening (very little rest).

Linkadge

 

Re: Sorry, a bit melodramatic

Posted by PCB on September 10, 2019, at 19:09:41

In reply to Re: Must Read, My Most Sincere Post! Linkage » PCB, posted by linkadge on September 10, 2019, at 18:29:17

Sorry to hear about your mothers condition. I truly am. My father as I may have mentioned had bipolar as well. During a hypomanic phase, he lost his job and my mother divorced him. He was a little better afterward, but never fully functional in society. It seem may of us with bipolar parents are treatment resistant and as you mentioned this is could be largely genetic. Heck, I dont see some of my treatment responsive patients needing to meditate, avoid coffee, avoid all EtOH and quit their jobs to feel marginally better like many of here feel.

I guess I was being melodramatic last night. In my late 40s, I feel like this is my last chance to take a big treatment gamble to finally feel close to normal, integrate partially back into society. But I know the odds are against me.

Maybe I should play devils advocate with my paralyzed doorman analogy. I wouldnt ask a someone with a psychotic affective disorder to stop their meds and just do yoga. Or my hypertensive patients to throw their meds away and just get good sleep. Lifestyle maybe is far from the panacea. Maybe this is the answers to my question and I have to accept any treatment gambles will ruin the 25 years of small gains I have achieved :(

Sorry

PCB

 

Re: Surprised! Got my second opinion about Nardil! » linkadge

Posted by undopaminergic on December 9, 2019, at 12:18:19

In reply to Re: Surprised! Got my second opinion about Nardil!, posted by linkadge on September 9, 2019, at 18:03:17

> There was a theory out there recently that treatment resistant depression may exist because many treatments are found via the stress induced rodent model of depression.
>

That is a potentially very important observation. The problem is that it is hard to find appropriate experimental animal models of depression that truly generalises to human depression. There are so many different kinds of depressions, responding to differing treatment. For example, there are people who respond to SSRIs! Nonsense in my case... and that of many others.

My depression is temporally linked to overwork and insomnia. It *was* typical/textbook burnout syndrome, but it has evolved. Early in it, I would feel worthless and cry, and now, I feel very little of anything at all, beyond some frustration and, if it is a feeling, apathy. Haven't cried for at least many months. I did not react to the passing (suicide) of my best friend, which suggests I haven't processed it emotionally, but how can I when I don't have emotions?

-undopaminergic

 

undopaminergic: Nardil augmentation with diazapam

Posted by greg rizzo on January 9, 2020, at 21:14:45

In reply to Re: Surprised! Got my second opinion about Nardil! » linkadge, posted by undopaminergic on December 9, 2019, at 12:18:19

AUGMENTING NARDIL STRATEGIES with diazepam Valium)
Response to Phenelzine WITH Diazepam,
Results of a Nine Hospital Collaborative Study Allen Raskin, PhD; Joy G. Schulterbrandt, MS; Natalie Reatig; et alThomas H. Crook, MA; Arch Gen Psychiatry. 1974;30(1):66-75.
-A total of 325 depressed patients from nine hospitals were randomly assigned to treatment with either diazepam, phenelzine, or a placebo. Dosages were 30 mg of diazepam and 45 mg of phenelzine.
The findings were that there was a significant number of anxious-depressive patients who were diazepam responders--their symptoms subsided on this treatment and became worse when this drug was discontinued.
-----------------------------------------------
Yes you're supposed to get a script, but if you've ever seen the movie Shawshank Redemption, Red (morgan Freeman) states: "I'm a man who can get things from time to time." Normal channels sometimes bypassed. Ditto here.


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