Psycho-Babble Medication Thread 1121118

Shown: posts 1 to 22 of 22. This is the beginning of the thread.

 

Developing bad habits on Psycho-Babble?

Posted by SLS on November 25, 2022, at 14:01:17

ac > Have pretty severe GAD. Been on 50mg pristiq for almost a year. Hasn't done a lot. I tried 100mg and it seemed to move the needed a little, but I dropped back down to 50mg because I was getting lethargic.

I'm going to have to get a bit strong here. I don't know how long you were on 100 mg/day, but that's the dosage that gets most people well who have a genuine case of MDD (melancholic or atypical) or BD. I am not sure about GAD. I will mention here that Nardil is probably the most effective medication to treat it. Not going up to 100 mg/day of Pristiq and hanging in there for 4 weeks was likely to be a complete waste of your time.

It invariably takes 3 months for me to regain the ability to orgasm after introducing Nardil.

How long were you at 100 mg/day before you aborted the experiment? If you are working or in school, it might be difficult, or even impossible, to function with the psychiatric side effects you get from jumping up 100% in dosage. I don't recall what the lowest dose of Pristiq is. If you have to, Split 50 mg pills and try to go to 75 mg/day before increasing to 100 mg/day. You might be able to work or go to school with a less robust negative reaction. Stay at 75 mg/day for at least 2 weeks after the side effects have dissipated. If, however, you are not required to function, you could go to 100 mg/day and simply wait until the side effects disappear. Now that I think of it, jumping to 100% of your current dosage makes no sense at all for you - and perhaps everyone else as well. Because you have come to micromanage side effects, slower is better. You will be less apt to abort all of your experiments.

Is it possible that some members of the Psycho-Babble community have developed counterproductive habits and "schools of thought" that inevitably sabotage every one of their trials - simply for being here? Do people feed off each other to develop the habits that prevent them from getting well? I'm not sure, but it is a concern of mine.

"Start-up side effects" are almost inevitable with certain medications, many of which will disappear with continued treatment. Who here has heard the medical term "start-up side effects"? I wish I had begun using it on Psycho-Babble 23 years ago. That was an oversight on my part. It is very instructive to ponder the reasons why doctors and researchers use that term.

Would you trade 3 months of anaorgasmia for a lifetime of remission? I would/did. I wouldn't have known that my ability to orgasm would return had I not continued treatment for 12 weeks beyond the point of achieving of remission. That was about 2.5 years ago.

Don't immerse yourself in the horror stories of others, even when their stories really occurred. They might not do so for you. Don't spend too much of your time formulating sophisticated theories when neuroscientists remain baffled.

The practice of clinical psychiatry is still a largely empirical endeavor. That's not to say that there are a lack of facts. Quite the opposite is true. The amount of data produced by the scientific community is boundless. Unfortunately, there is a dearth of understanding that prevents the assembly of the pieces of the jigsaw puzzle. Treatment decisions are often based upon the reported experience of others in the field.

Do you want to kick depression's *ss or do you want temporary side effects to kick yours?


- Scott

 

Re: Developing bad habits on Psycho-Babble?

Posted by SLS on November 25, 2022, at 15:17:41

In reply to Developing bad habits on Psycho-Babble?, posted by SLS on November 25, 2022, at 14:01:17

Someone here put together an absolutely creative and effective combination that I had never seen nor heard of. He used the findings of researchers to help him choose his treatment strategy. It was a brilliant effort that payed off. I won't mention names.

The reason why I described this example is because this person was successful at using the data that he found in the medical literature. Were he not exposed to the results of scientific inquiry, it is unlikely that he would have found a successful treatment.

It does happen. However, it is no less critical to follow clinical guidelines.


- Scott

 

Re: Developing bad habits on Psycho-Babble?

Posted by linkadge on November 25, 2022, at 16:07:55

In reply to Developing bad habits on Psycho-Babble?, posted by SLS on November 25, 2022, at 14:01:17

In theory, I agree with what you are saying. You take an antidepressant, you slug through side effects for a few months, and then you experience this miraculous remission that makes all the side effects worth it....

The reality (for some of us) is completely different:

- 20 + years of f*rt*ng (don't know what f*rt is starred out) around with various antidepressants and antidepressant combinations.

- at least 10 antidepressants of various classes tried at a full therapeutic dose, with excellent compliance for over 2 months each

- minimal, inconsistent, or fleeting results

SLS, you have to realize that genetically, everybody is different. For example, a variation in the serotonin transporter gene alone could make SSRIs either tolerable or completely intolerable. You may have the LL version of the SERT gene and wonder why other people are whining so much about SSRIs. The experience of somebody with the low acting version might be hell on earth and wondering why ANYBODY can tolerate the drug. Some of these drugs are just simply not hitting the correct mood target of the patient involved. So, what are they left doing??? Clearly their experience of 'following medical advice' and 'being a good patient' has got them nowhere.

- listening to their body
- trying the doses that seem to provide some benefit without overwhelming side effects
- trying various combinations
- suffering through side effects only to the duration they are willing to suffer.

For example, some cancer patients can take chemo. Others can't. It's highly individual. Some may only be able to tolerate a certain dose of chemo which may be better than nothing, but not truly effective.

I don't stop a med because of sexual dysfunction. I stop a med because it is making me worse day after day for weeks at a time. Or it is giving me a treatment emergent side effect (up to an including increased suicidality) that I cannot tolerate.

For some of us its not about being picky. It's the fact that little has actually *worked* in any meaningful sense, and so the faith is just not there to suffer once again through months of side effects, for some alleged benefit that never comes.

Linkadge


 

Re: Developing bad habits..no..Neurodiversity

Posted by jay2112 on November 25, 2022, at 23:39:34

In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on November 25, 2022, at 16:07:55

> In theory, I agree with what you are saying. You take an antidepressant, you slug through side effects for a few months, and then you experience this miraculous remission that makes all the side effects worth it....
>
> The reality (for some of us) is completely different:
>
> - 20 + years of f*rt*ng (don't know what f*rt is starred out) around with various antidepressants and antidepressant combinations.
>
> - at least 10 antidepressants of various classes tried at a full therapeutic dose, with excellent compliance for over 2 months each
>
> - minimal, inconsistent, or fleeting results
>
> SLS, you have to realize that genetically, everybody is different. For example, a variation in the serotonin transporter gene alone could make SSRIs either tolerable or completely intolerable. You may have the LL version of the SERT gene and wonder why other people are whining so much about SSRIs. The experience of somebody with the low acting version might be hell on earth and wondering why ANYBODY can tolerate the drug. Some of these drugs are just simply not hitting the correct mood target of the patient involved. So, what are they left doing??? Clearly their experience of 'following medical advice' and 'being a good patient' has got them nowhere.
>
> - listening to their body
> - trying the doses that seem to provide some benefit without overwhelming side effects
> - trying various combinations
> - suffering through side effects only to the duration they are willing to suffer.
>
> For example, some cancer patients can take chemo. Others can't. It's highly individual. Some may only be able to tolerate a certain dose of chemo which may be better than nothing, but not truly effective.
>
> I don't stop a med because of sexual dysfunction. I stop a med because it is making me worse day after day for weeks at a time. Or it is giving me a treatment emergent side effect (up to an including increased suicidality) that I cannot tolerate.
>
> For some of us its not about being picky. It's the fact that little has actually *worked* in any meaningful sense, and so the faith is just not there to suffer once again through months of side effects, for some alleged benefit that never comes.
>
> Linkadge
>
>
>
>
>
>
>

AWESOME post Linkadge. Just taking an antidepressant alone does not work for many, I say. For example, along with Effexor, I have to take large doses of a stimulant, Vyvanse, and a large dose of an atypical antipsychotic, Risperdal. Without ANY of these, I_CAN"T_FUNCTION!! I also take clonazepam, and am experimenting with another antipsychotic, Abilify. That IS likely because of my biological makeup. Having Asperger's, I already have a bit of a tipped up serotonin system/level. The Risperdal blocks some of that serotonin action.

POINT being, is having just read Better Than Well?: The Most Important Question Facing Psychiatry by Paul J. Fitzgerald, we all have psychiatric 'quirks' that can become distressing, and most of us require an INDIVIDUAL drug formula, often based on genetics, and neurodiversity. Better yet, read the book!

Neurodiversity means not all chemicals/drugs affect everyone the same. Stop stereotyping!! We must approach prescribing the same way.

Jay

 

Re: p.s. Suicide and antidepressants

Posted by jay2112 on November 25, 2022, at 23:57:28

In reply to Re: Developing bad habits..no..Neurodiversity, posted by jay2112 on November 25, 2022, at 23:39:34

Eli Lilly had published secret memos after Prozac was released in 1987 with explicit evidence that there were some quite strong co-relations between taking Prozac and increased suicidality. And, suicidality does NOT stop at 25 years of age, as the black boxed warning of antidepressants states.
Many researchers state simply that older patients have a bit more tolerance for suicidal thoughts, and many often have more "grounded" social and personal roots that help them, the 25 and under club don't have.

Jay

 

Re: p.s. Suicide and antidepressants » jay2112

Posted by linkadge on November 26, 2022, at 10:30:45

In reply to Re: p.s. Suicide and antidepressants, posted by jay2112 on November 25, 2022, at 23:57:28

I agree. Not to be too conspiratorial, but there are still major issues in the way that clinical trials are conducted, who is overseeing it, and what data is ultimately disclosed.

I trust some of the older drugs more because they were discovered serendipitously rather than through some purposeful engineered planning that has more to do with maximizing profits than trying to improve severe depression. The SSRIs were money makers not because they helped severe depression, but because they were tolerable enough to feed to the masses and provided some needed emotional anesthesia for the everyday destressed patient.

On another note ... GSK has studies showing that 10mg of paroxetine was virtually as effective as 20mg (about 98% as effective) yet the 20mg dose was ultimately perused because ... (maybe they knew it would be harder to discontinue??) and hence helping to crystalize future profits?

Linkadge

 

Re: p.s. Suicide and antidepressants » linkadge

Posted by jay2112 on November 26, 2022, at 15:15:55

In reply to Re: p.s. Suicide and antidepressants » jay2112, posted by linkadge on November 26, 2022, at 10:30:45

> I agree. Not to be too conspiratorial, but there are still major issues in the way that clinical trials are conducted, who is overseeing it, and what data is ultimately disclosed.
>
> I trust some of the older drugs more because they were discovered serendipitously rather than through some purposeful engineered planning that has more to do with maximizing profits than trying to improve severe depression. The SSRIs were money makers not because they helped severe depression, but because they were tolerable enough to feed to the masses and provided some needed emotional anesthesia for the everyday destressed patient.
>
> On another note ... GSK has studies showing that 10mg of paroxetine was virtually as effective as 20mg (about 98% as effective) yet the 20mg dose was ultimately perused because ... (maybe they knew it would be harder to discontinue??) and hence helping to crystalize future profits?
>
> Linkadge

Good points! I am not any Szaz, or a conspiracy prone alarmist, but much info is coming out after the original marketing of the first ssri's. If they would just be 100 percent truthful, then drug companies would have a better image, I think. If drugs are used responsibly and properly, I think everyone would come out ahead.

Many antidepressants, antipsychotics, mood stabilizers, benzo's, can be some of the most successful tools out there. But, when you know more than your doctor, or even pdoc, I think we have a right to advocate for ourselves. Because, it boils down to, YOU are more aware of how any med affects you. I use a bit of science...in that I record precisely how each and ever med I have been on affects me.

Anyhow, I'd HIGHLY recommend "Better Than Well?: The Most Important Question Facing Psychiatry"
by Paul J. Fitzgerald. You can get a free trial (Normally 10 bucks a month) subscription at scribd.com and read the e-book. You will learn very modern, cutting edge research on all psychiatric drugs, especially the behaviours they produce.

Here are some interesting passages:

Regarding the subjective effects of antidepressants, how is the experience of bet- ter than well, or different from well, described by people who have taken these drugs, in addition to the comments of Kramers patients described earlier? Eliz- abeth Wurtzel, in her famous memoir Prozac Nation, wrote the Prozac didnt make her happy, just not sad. Lauren Slater, in her beautifully written memoir Prozac Diary, suggested that Prozac is Zen medicine in helping relieve her symptoms of obsessive-compulsive disorder. Stephen Braun, author of The Science of Happiness, a book that did not receive nearly as much attention as it deserved, observed that the antidepressant Wellbutrin heightened his interest in the opposite sex, and also decreased his desire to consume drinks that contain caffeine or alcohol"

Another interesting bit:
" For example, a placebo controlled study (which is a study where some people receive drug and others merely receive an inactive pill, and the persons arent aware of which treatment they were given) in which the SSRI Lexapro was given to healthy persons found that it altered moral judgments. These persons were presented with hypothetical moral dilemmas, where they were asked, for example, if they would allow an innocent person to be killed if it would save five other lives? Enhancing serotonin with Lexapro made the people in the study more likely to judge harmful actions as forbidden, but only for emotionally salient hypo- thetical harms. Another placebo controlled study of Lexapro in healthy persons examined the drugs effect on social interaction with a roommate in an apartment over several weeks, as well as subsequent interaction with a stranger. On drug, the persons were rated as less submissive by their roommates, showed a dominant pattern of eye contact and were more cooperative in interacting with the stranger in a role playing game. A third placebo controlled study of Lexapro, in healthy fe- males, where drug was given transiently in an intravenous manner, found that Lexapro selectively enhanced recognition of facial expressions of fear and happi- ness presented on a video monitor, without affecting recognition of other emo- tions. In this short-term study, Lexapro did not affect measures of mood."

Anyhow....check the book out if you can!

Jay

 

Re: Developing bad habits on Psycho-Babble? » SLS

Posted by TriedEveryMedication on November 26, 2022, at 16:24:16

In reply to Developing bad habits on Psycho-Babble?, posted by SLS on November 25, 2022, at 14:01:17

Hi Scott,

I was the one who posted trying 100mg of pristiq. I spent almost 8 weeks at 100mg before dropping to 75mg for a week then 50mg etc.

I think I give meds a fair shake, except when I cannot tolerate the initial side effects. I have a full-time job where I'm expected to be a high performer.

 

Re: Developing bad habits on Psycho-Babble? » linkadge

Posted by SLS on November 27, 2022, at 12:58:48

In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on November 25, 2022, at 16:07:55


Re: Developing bad habits on Psycho-Babble?


Hi, Linkadge.

I find your essay regarding your personal experiences valuable. Remember, though, that as much as Linkadge is speaking for himself and others, so, too, is SLS. In your essay, I cant find anything that I dont already know or havent written about multiple times. So, Im going to avoid addressing that which you and I already know genetics, for example. Psychotherapy and reducing psychosocial stress being another.

Lets start out by talking about the protagonist in your essay you. You have written several things that I find important to recognize as issues, but without knowing all of the facts as they apply to the paramount thesis of this conversation the value that drugs have in treating Major Depressive Disorder and Bipolar Depressive Disorder.

1.Approximately how long ago did you post to the community the results of your 6-week trial of a standard antidepressant with or without augmentation agents?

2.Are you taking nortriptyline? You reported obtaining a 75% improvement while taking it.
3.If you are not currently taking the drug that gave you a 75% improvement, why the heck not? Why didnt you keep nortriptyline onboard indefinitely and save yourself years of work going back and repeating every single drug trial with the addition of nortriptyline a drug that gave you a 75% improvement? Nortriptyline is the mildest of tricyclics in regard to side-effects. I have yet to see you describe an intolerance to its side effects. As far as I know, nortriptyline has no contraindications when combining it with another psychiatric drug (marketed, off-label, experimental, non-tricyclic). There may be several that I am not aware of or forgot about.
4.If you havent tried a MAOI yet, then we really shouldnt use you as an example of someone who is completely refractory to old, standard antidepressant therapy.
5.What population are you using as a source of information to characterize drug reactions both good and bad?
6.Have you considered my suggestion to try Pristiq (desvenlafaxine) in place of Effexor (venlafaxine) in order to see if the side-effects you experience with Effexor might be absent with Pristiq?
7.Do you plan on adding nortriptyline to Wellbutrin and lithium?f
8.Will you switch from taking Effexor to Pristiq? The combination of either of these two drugs to Wellbutrin is often MUCH more effective globally than either agent alone.

As far as everything else is concerned, have you forgotten the person whom you are addressing? Do you really think that I needed a lecture from you or anyone else - on the hardships and torture of going through one treatment failure after another for 40.5 years? I swallowed my first pill of an antidepressant (imipramine) in the Spring of 1982. I didnt achieve remission until recently. What does that prove to everyone here? It proves that SLS got well (found a new life) by building treatment strategies centered on standard antidepressants. My disease and treatment histories for the last 23 years are in the Psycho-Babble archives.

Is my robust treatment response to antidepressants an idiosyncratic anomaly when compared to the entire extant population of people with depression? What is the difference between you and me? Well, for one thing, you havent ever taken a MAOI. Of course, this necessarily means that you have not tried the treatment that brought me to remission. Like you, decades of treatment failures serves as the backdrop from which we draw our personal conclusions and judgments.

I never found an effective treatment for depression until I did.

In retrospect, and after careful study of my words and the usage of phrases like, For me and I experienced, I dont think anyone could fail to see the implications of my story. The only thing that separates me from you is that you never tried taking what Im taking. Everything else is moot.

After answering the questions that I posed to you, do you see a pattern? Since I am not sure what your answers are at this juncture, they might be instructive for Psycho-Babble.

A competent physician would never let someone endure the unendurable for 6 weeks. Your example is a bit skewed.

I think it is worth continuing this conversation.

Linkadge: Please dont ever accuse me of not belonging to your club of treatment-resistant sufferers. As you so eloquently remind us, everyone is different, despite our similarities. I dont need lessons in this.

My guess is that both of us want the same thing to achieve remission for ourselves and help others achieve there is. Right now, I dont think you are helping. Of course, mine is but one opinion.

My main thesis here is:

Stay on lithium and nortriptyline as your core treatment around which to build. Thats pretty much a no-brainer. Why havent you done that. Any competent psychologist would have handled your case this way.


-Scott

 

Re: Developing bad habits on Psycho-Babble?

Posted by linkadge on November 28, 2022, at 14:02:49

In reply to Re: Developing bad habits on Psycho-Babble? » linkadge, posted by SLS on November 27, 2022, at 12:58:48

I apologize, but I am not going to answer all the questions.

>If you are not currently taking the drug that gave >you a 75% improvement, why the heck not?

I ended up getting severely fragmented sleep (micro-wakenings every 15 to 20 minutes). At that point, a switch to mirtazapine improved sleep, but at the expense of a slow mood relapse.

Also, SLS you have to realize I DON'T CONTROL THE PRESCRIPTION PAD! YOU MAKE SUGGESTIONS AS IF I CAN SELF PRESCRIBE WHATEVER I WANT WHENEVER I WANT. MAYBE THAT'S THE WAY IT WORKS WITH YOUR DOCTOR, BUT IT CERTAINLY DOESN'T WITH MY DOCTOR. IF I GO BACK TO A DOCTOR AND SAY I WANT NORTRIPTYLINE AGAIN, HE/SHE MAY SAY YES, OR HE/SHE MAY LOOK BACK AT THE NOTES AND SAY, WELL YOU LEFT IT BEFORE SO NO.

The problem is that nothing works consistently for me.


Linkadge



 

Re: Developing bad habits on Psycho-Babble?

Posted by SLS on November 28, 2022, at 22:28:16

In reply to Re: Developing bad habits on Psycho-Babble? » SLS, posted by TriedEveryMedication on November 26, 2022, at 16:24:16

> Hi Scott,
>
> I was the one who posted trying 100mg of pristiq. I spent almost 8 weeks at 100mg before dropping to 75mg for a week then 50mg etc.

What does that indicate to you?

>
> I think I give meds a fair shake, except when I cannot tolerate the initial side effects. I have a full-time job where I'm expected to be a high performer.

I addressed that situation in my prior posts. I don't know what to suggest. After 1990, I didn't have those kinds of responsibilities. That was a moot point, as I was so impaired that I could not read beyond two sentences word-for-word. I became a skimmer. This allowed me get through more than two sentences. I was so cognitively impaired, that I had to figure out how to operate the same automobile interior door handle every Sunday evening on the way to dinner. The NIH research clinician overseeing my case called my efforts to survive "heroic". The doctor treating me at New York University (NYU), after the end of my initial visit, called my condition "horrendous". I cried instantly because I finally heard the words that I needed to hear. I felt vindicated.

I always found what Mark Schmidt, MD of the NIH said to me regarding the existential nature of depression. He demonstrated extraordinary insight for someone who was spared a depressive illness. He said that there is a "timelessness" to depression. When you are in the middle of it, it never had a beginning nor will it have an end. Over the last 20 years, I haven't kept track of the number of pharmacological treatment regimes I have tried. I think the total number of antidepressants I've tried is close to 60. That includes Wellbutrin while it was still investigational. I tried a series of three investigational pro-serotonergic compound. They were being studied by Pharmuka Pharmaceuticals, Inc. Indalpine exerted both reuptake inhibition and release of serotonin. I found the pure releaser the cleanest of the three with respect to side effects. Indalpine was the first pro-serotonergic drug approved in the world as far as I can tell. The first SSRI to be approved for use anywhere in the world was zimelidine (Zelmid), a French drug. Very soon after its introduction, it was recalled and removed from market due to reports of GuillainBarré, a fatal neurological disorder.

I have taken more than 50 drugs and untold numbers of drug combinations. I used to list them, but the whole thing got old, and I stopped taking notes and filling out mood rating forms.

I was treatment-resistant until I wasn't. Right? I was always treatable. Only one doctor had the poor judgment to say that I would never got well, and that something was f*ck*d up with my receptors. This guy was the protege of Nathan Klein at NYU. Nathan Klein is considered the father of psychopharmacology. Shopsin was one of the earliest investigators and advocates for lithium treatment. He also wrote a book describing a new syndrome that they called "schizo-affective disorder". These are some of the brains I picked. There are many more. My questions were endless.

We all have stories.

Linkadge, what is so different about you that you should separate yourself from me, a person who tried and failed at least 100 treatments before finding one that brought me to remission? Which drug trial left you in a fetal position beside my parents, audibly whimpering for three days (moclobemide)? Have you ever curled up and whimpered due to experiencing intense psychic pain? I don't know. Yeah - You had side effects, too. Could it be that my side effects were worse than yours? Hell is hell. Unfortunately, we both know it intimately.

I think you might be sacrificing remission for palliative measures.

By the way, in 1983, after seeing my first investigative psychiatrist at Columbia-Presbyterian, I was told that they could do nothing more for me. In other words, I was told that I was untreatable. I refused to take them at their word. If no one in the world could cure me, I set out to cure myself. It was simple logic that I had no choice. I'm sure my doctor thought me presumptuous. It really wasn't presumption. It was survival. So, I set out to cure myself. After 2 weeks of passionate, intense research using several book indices of medical journals, and in the absence of the Internet, I returned to my doctor with my theory as to what might be the neurobiological underpinnings of my illness specifically. I suspected that the biology of suffers were probably heterogeneous. My conclusion is that my brain was deficient in dopamine. I found only one author that proposed a dopamine deficit in depression. I don't remember his first name, but I think he operated out of the University of Chicago. There were a couple of drugs I wanted to try based upon my suspicions. Nomifensine, amineptine, brupropion, and bromocriptine were the ones I was most interested. When I proposed bromocriptine, my doctor laughed and replied, "Yeah, sure, if you want to puke all day long."

I asked to try Wellbutrin, an investigational that was close to approval. It was touted as being dopaminergic. I asked my doctor and her boss, Frederick Quitkin, for them to get Wellbutrin on a compassionate usage basis. They said no - not without leaving the program and having six months of psychotherapy. I said that I would be happy to see any psychological in Manhattan for an *evaluation*, but that I would not commit to a therapy for which there is no diagnostic evaluation for first. So, I left the program, but not without some very assertive language on my part regarding their lack of belief in their own descriptions of the origin of affective disorders. This, with Ronald R. Fieve's door right down the hall! I was incredulous. I left her in tears. The word that elicited her emotional reaction was "autonomous". This was the existential character of major depressive disorders. I was an ultra-rapid cycler, a pattern that was well described in the book "Mood Swing" written my - Ronald R. Fieve. It was my reading it and comparing my ultra-cyclicity to the anecdotes about his patients. I would not have sought treatment without it.

I left the program voluntarily. I found a researcher listed as a clinical investigator of Wellbutrin named Donald Sweeney. I told him about my theory and my focus on dopamine. This was what sparked my attention on Wellbutrin, as it was described then as a robust dopamine reuptake inhibitor. Sweeney told me that Wellbutrin was a good drug, but it didn't do what I thought it did. In reality, scientists remain baffled when it comes to explaining the pharmacology / mechanisms of action of Wellbutrin. He told me that Baron Shopsin was working with it. So, I found him and became a patient of Shopsin's (Nathan Klein's protege). After failing to respond to 900 mg/day of Wellbutrin, I asked him for nomifensine. He denied me. He said that it was "a piece of sh*t". I began crying in front of him. He relented. Nomifensine (Merital) was a potent dopamine reuptake inhibitor that was used around the world as the gold standard for dopamine research as a probe to study dopamine pharmacology. It was the only drug that he ever saw me have a robust improvement. He was chased out of New York for the inappropriate use of investigation drugs and failure to account for the absence of the pills he was supposed keep track of. He failed an audit of drug amounts compared to the size of his declared research population. I chased him out into the parking lot. As he was passing me in his Maserati, he opened his window and said one word to me: periactin.

There's more - of course.

I'm really not sure what impelled me to describe some of my experiences.

We all have stories.


- Scott

 

Re: Developing bad habits on Psycho-Babble?

Posted by linkadge on November 29, 2022, at 6:31:59

In reply to Re: Developing bad habits on Psycho-Babble?, posted by SLS on November 28, 2022, at 22:28:16

Don't feel compelled to suggest anything.

Linkadge

 

Re: Developing bad habits on Psycho-Babble? » linkadge

Posted by SLS on November 29, 2022, at 9:28:46

In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on November 29, 2022, at 6:31:59

> Don't feel compelled to suggest anything.
>
> Linkadge

Linkadge, your mind cannot fathom mine. The converse is true, of course. That's a good thing.

I don't feel compelled to do anything in life but to survive and follow my passions and perceived duties. Don't worry too much about my motives. I guarantee that they are altruistic.

Your journey has not been influenced by me at all. Almost, though. This was a few months ago.

1. For God's sake, avoid drugs that inhibit the reuptake of serotonin 5-HT for THREE months. This is the second time that I offered the same advice as conveyed to me by people with letters after their last names - for what value you place on that. That you are still bent on retrying Effexor again right now -, after your describing one failure after another using this drug - demonstrates a major lack of critical thinking when it comes to your treatment attempts and your personal theories and the use of personal experiments. Einstein was right. My guess is that your competence in critical thinking operates flawlessly in every other aspect of your life. At this point, neglecting the treatment that experts render in TRD as reported by me is tantamount to ignoring the suggestions of experts that you will never have access to.

2. You continue to neglect the use of nortriptyline - a drug that gives you a 75% improvement? Why? You just don't get it. You are not likely to find remission without applying the expertise and clinical wisdom that I learned through my interactions of a long series of seasoned experts. Getting people well does not depend on knowing the psychopharmacology of Effexor as compared with that of Pristiq. There are very obvious differences in their CLINICAL behaviors.

3. I don't know what treatment will ultimately free you from being chained to the bottom of a murky ocean. Yours has obviously failed. Those of mine and TRD experts failed up until two years ago. I never bothered with the palliative crap that has not brought people to remission.

Good luck.


- Scott

 

Re: Developing bad habits on Psycho-Babble?

Posted by linkadge on November 29, 2022, at 10:15:12

In reply to Re: Developing bad habits on Psycho-Babble? » linkadge, posted by SLS on November 29, 2022, at 9:28:46

Again,

The critical factor is this. It is not *my* inability to think outside the box, or to recognize patterns. It is down to what my psychiatrist thinks.

If it were up to me...

- phenelzine 45mg or parnate 20-30mg
- quetiapine 50mg
- clonidine or beta blocker as needed
- lorazepam, as needed

But, again *none* of these will fly with my psychiatrist. Most patients don't get the meds that work. They get the meds that doctors are willing to prescribe.

This site is great for ruminating on possibilities, but that's really it. Unless, SLS, you want to go and get a medical degree, or provide me with black market meds (** note this is not a solicitation for such).

Linkadge


 

Re: Developing bad habits on Psycho-Babble? » SLS

Posted by jay2112 on November 29, 2022, at 11:31:16

In reply to Re: Developing bad habits on Psycho-Babble? » linkadge, posted by SLS on November 29, 2022, at 9:28:46

Scott:

Some of us, like you and I, are lucky to have, shall we say, 'liberal' minded psychiatrists, who are open to patient's suggestions. Mine has addressed this with me, and is like "..I don't do this with ANY other patient, you know Mr. Jay!!"...and maybe, you or I have a certain type of personality that is comfortable being quite assertive. I have been fired by a few psychiatrists because of this!..lol.

But, for some, (many??) this is not the case. We HAVE to understand that. Plus, we can't diagnose by proxy. Suggestions, sure, but we are limited in that we don't quite know the interpersonal angle of what another patient is composed about via the internet. There are MANY behavioural effects of neurotransmitters (NT's), and they are NOT all universal.

So, let's let Linkadge go where and how he wishes, and what he is comfortable with. It may take some time for him to develop more of a dynamic relationship with his pdoc.

One area, and I know you aren't keen on, we can suggest is some alternative and complimentary treatments that even top researchers are looking into.

IMHO, a full-on, norepinephrine approach ignores some NT's that MAY be important, including cholinergic, gaba, and some different approaches to serotonin, and as well as the cannabinoid system.

Let's just be gentle, kind (like you are Scott...very kind, IMHO) and take our time.

<Smiles> Jay

 

Re: Developing bad habits on Psycho-Babble? » jay2112

Posted by SLS on November 29, 2022, at 13:42:45

In reply to Re: Developing bad habits on Psycho-Babble? » SLS, posted by jay2112 on November 29, 2022, at 11:31:16

> Scott:
>
> Some of us, like you and I, are lucky to have, shall we say, 'liberal' minded psychiatrists, who are open to patient's suggestions. Mine has addressed this with me, and is like "..I don't do this with ANY other patient, you know Mr. Jay!!"...and maybe, you or I have a certain type of personality that is comfortable being quite assertive. I have been fired by a few psychiatrists because of this!..lol.
>
> But, for some, (many??) this is not the case. We HAVE to understand that. Plus, we can't diagnose by proxy. Suggestions, sure, but we are limited in that we don't quite know the interpersonal angle of what another patient is composed about via the internet. There are MANY behavioural effects of neurotransmitters (NT's), and they are NOT all universal.
>
> So, let's let Linkadge go where and how he wishes, and what he is comfortable with. It may take some time for him to develop more of a dynamic relationship with his pdoc.
>
> One area, and I know you aren't keen on, we can suggest is some alternative and complimentary treatments that even top researchers are looking into.
>
> IMHO, a full-on, norepinephrine approach ignores some NT's that MAY be important, including cholinergic, gaba, and some different approaches to serotonin, and as well as the cannabinoid system.
>
> Let's just be gentle, kind (like you are Scott...very kind, IMHO) and take our time.
>
> <Smiles> Jay


Well, I really don't know how to handle people who decide to interrupt my threads and lecture me, especially by people who post so assertively that antidepressants are "rubbish". This person was obviously wrong - very wrong. I don't know what would enter the mind of someone who is depressed and knows the horrors to tell others that antidepressants are "rubbish".

Sorry. As of this moment, I have little gentleness for a recidivist saboteur of others' mental health.

Jay, I haven't totally forgotten the pain and frustration, although forgetting is easy to do after attaining remission and entering a normal state of consciousness. State-specific memory probably enters the equation. Even if I have absolutely recollection of depression, that does not leave the information and recommendations I post any less valuable.

No. A Psycho-Babble member who has a 25-year history of pronouncing antidepressants to be no more effective than placebo does not curry the gentleness I show others. Like it or not, to spend so much time exploring treatments that confer little more than mild palliative relief is a dead end. No remission.

So, prior to two years ago, I was affected by severe depression and an interminable history of treatment failures. SLS was therefore in a position exactly the same as so many members of the Psycho-Babble community. So, what separates me from others? Nothing. Just striking gold.

Not everyone has found an effective treatment yet - even after decades of trying. For God's sake, how could I not recognize that? That's pretty insulting.

I have nothing better to do with my time but to help and pray for peoples' healing. I am trading with Psycho-Babble my wealth of knowledge and experience for its having helped me prevent committing suicide. Of course, I would like to return the favor, even if I can't produce ideas to help them achieve remission. If I can contribute to someone's finding a new and pleasurable life, I prefer to give more than I took. Antidepressants are not "rubbish" just because someone hasn't responded to them - YET.

I think one should take advantage of a resource. I gave a cursory review of my first 10 years of treatment failures and what I either researched or learned through conversations with some of the doctors most involved in treating difficult, TRD cases.

http://www.dr-bob.org/babble/20220917/msgs/1121139.html


- Scott


Logic: SLS was in a position no different than people with the most severe course of treatament resistant of sufferers.

 

Re: Developing bad habits on Psycho-Babble?

Posted by SLS on November 29, 2022, at 15:16:59

In reply to Re: Developing bad habits on Psycho-Babble? » jay2112, posted by SLS on November 29, 2022, at 13:42:45

SSRIs work by numbing emotions?

Really?

What a bunch of unenlightened crap.

When SSRIs produce remissions, they quicken thought speed, bring clarity of thought, makes anergia disappear, reduces or eliminates anhedonia, makes foods taste better, makes music sound better. Colors are noticeably more saturated. Sighing and "air hunger" disappear. Impairments in reading speed and comprehension disappear. People regain their unimpaired intelligence and excel when they return to school. Memory impairments wane, although they are probably the last capacity to return. Critical thinking improves. People suddenly find work or matriculate in school for the first time in decades. People smile, tell jokes, and laugh.

Numbing emotions as the mechanism of action for SSRIs?

Let that crap be peddled elsewhere.


- Scott

 

Re: Developing bad habits on Psycho-Babble? » linkadge

Posted by SLS on November 29, 2022, at 15:18:17

In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on November 29, 2022, at 10:15:12

I don't need a medical degree to recognize the obvious.


- Scott

 

Re: Developing bad habits on Psycho-Babble?

Posted by linkadge on November 29, 2022, at 16:12:57

In reply to Re: Developing bad habits on Psycho-Babble?, posted by SLS on November 29, 2022, at 15:16:59

>Numbing emotions as the mechanism of action for >SSRIs?

>Let that crap be peddled elsewhere.

The incidence of emotional detachment on SSRIs is very high. SSRIs probably work best in individuals with high emotionality and anxiety. Apathy a problem noted particularly in youth and the elderly. In one study, SSRI use in elderly was 'highly predictive' of apathy.

>When SSRIs produce remissions, they quicken >thought speed, bring clarity of thought, makes >anergia disappear, reduces or eliminates >anhedonia, makes foods taste better, makes music >sound better.

You sound like Sigmund Freud in his initial impression of cocaine. The description you provide above it not typical (IMHO). Yes, some do get relief from depression on SSRIs (5-10 percentage points more than placebo). Side effects often crop up, and poop out is surprisingly common as other neurotransmitters become disregulated.

When I first took citalopram, I got the above improvement, but really only for the first few months. After that, it stabilized to an acceptable apathy. The apathy was welcome as it was better than the stress I was experiencing at the time. Over time, however, I began to feel lobotomized. Higher doses just made things worse.

Quite a few studies hint at this notion - that SSRIs are really more anxiolytic than antidepressant.

Dopaminergic drugs improved my color and taste perception, as well as interest in previously enjoyed activities. SSRIs just made me 'less depressed' in a numb way.

Linkadge

 

Re: Developing bad habits on Psycho-Babble? » linkadge

Posted by Phillipa on November 29, 2022, at 20:54:51

In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on November 29, 2022, at 16:12:57

SSRI's never did a thing for me. Since anxiety has always been my problem benzos in low doses work for me. SSRI's never did in any dose amounts. I'm sorry your doctor will not give you the ativan cause you know it works for you. Phillipa

 

Re: Developing bad habits on Psycho-Babble?

Posted by linkadge on December 3, 2022, at 12:17:52

In reply to Re: Developing bad habits on Psycho-Babble? » linkadge, posted by Phillipa on November 29, 2022, at 20:54:51

This past week I have been doing better with the following:

Lithium 300mg
Methylphenidate 10mg
Mirtazapine 1-3mg
Agmatine 10mg
DHA 500mg
Ginger root
Gamma linoelic acid
Probiotic

Ritalin honestly helps. I take a very low dose and it doesn't make me high at all. It calms me down and allows me to complete daily tasks and get some sense of accomplishment from my day. I have held off on the effexor, as it seems make me feel disconnected, and perhaps destabize my mood.

Linkadge


 

Re: Developing bad habits on Psycho-Babble?

Posted by SLS on December 3, 2022, at 13:27:13

In reply to Re: Developing bad habits on Psycho-Babble?, posted by linkadge on December 3, 2022, at 12:17:52

> This past week I have been doing better with the following:
>
> Lithium 300mg
> Methylphenidate 10mg
> Mirtazapine 1-3mg
> Agmatine 10mg
> DHA 500mg
> Ginger root
> Gamma linoelic acid
> Probiotic
>
> Ritalin honestly helps. I take a very low dose and it doesn't make me high at all. It calms me down and allows me to complete daily tasks and get some sense of accomplishment from my day. I have held off on the effexor, as it seems make me feel disconnected, and perhaps destabize my mood.


That looks good to me. You know what my *current* beliefs are about your current difficulties with taking SRIs. Anything that keeps you away from SRIs for awhile is worth trying.'

What is agmatine? Exposing your brain to something that is novel to it is a good move. I hope you don't react badly to it. That would be demoralizing and perhaps dissuade you from trying things that are different from those that your are familiar with.

Good luck.


- Scott


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