Posted by BobJ1961 on July 22, 2001, at 21:24:03
In reply to Re: New to Psycho-Babble » BobJ1961, posted by Elizabeth on July 11, 2001, at 1:04:48
Hi Elizabeth!
Sorry it took me so long to acknowledge your reply. And THANK YOU so much for all the good information and feedback.
When you asked if I really tried ALL the tricyclics, I must confess "No, I have not," but I've tried the vast majority. Let me think... I've been on Nortriptyline, Imipramine, Desipramine, Doxepin, Clomipramine, and Trazodone. The only one I sort of tolerated was Desipramine. The rest of them nearly KILLED me (caused extreme sedation and weakness--couldn't get out of bed for 20+ hours, even on a low dose! LOL)
Serzone worked fairly good for a while, but then it began causing nausea and some other unpleasant side effects. I had a terrible experience with Effexor (caused extreme anxiety, sleeplessness, and borderline panic). I actually felt "awake and restless" while asleep on the stuff! I felt more calm after awakening. It was a weird experience. Paxil made me obsessive and really weird too. (I referred to these experiences, loosely, as psychotic, but technically, I guess they were not < g >). Paxil too made the depression MUCH worse--it took me a few days just to recover from a single dose.
Wellbutrin did little but make me feel "stoned" and spacey. Same goes for Zoloft.
I had pretty good results with Celexa (for approximately 4 months) but then I began developing sleep problems (insomnia). That one might be worth going back on at a lower dose? (Although I think I was taking just one tablet a day as it was, and the antidepressant effects were mild at best).
I guess it might be time to carefully consider one of the MAOI's (problem is, my blood-pressure is a little on the high side, and those dietary restrictions scare me).
I agree with you that GHB isn't a good treatment for depression. For one thing, the half-life of the stuff is way too short, so you need frequent "doses" of the stuff. Of course, that just leads to problems down the road < g >. I'm happy to say that I'm no longer taking that stuff, and it wasn't difficult to give up either.
While I have past substance abuse issues, I don't think that I did it to "get high" but rather to self medicate. When my depressive symptoms are under control, I have little, if any, desire to abuse substances.
I don't think I have an unusual (addictive) affinity to pain medication either, so that might be something for me to look into. Generally speaking, I don't like medications that sedate me too much. So, in my opinion, I feel I'm unlikely to develop an addiction to pain meds. But who knows? (Thanks for the caution!)
I tried Buprenorphine (the sublingual variety) and the stuff did absolutely nothing. Maybe it was the supplier? (I purchased it from an overseas pharmaceutical company--maybe I didn't get the "real" thing?) In my experiences, a couple of Vicodin were much more effective than the Buprenorphine I tried.
Pain, for me, is certainly a problem that I have yet to manage properly. Perhaps if the pain was under control, I'd be more "mobile," get more accomplished, feel better about myself, etc., etc.
I definately need to go back to my "Lyme Doc" and get back on antibiotics. Ironically, antibiotics seemed to treat the psychiatric manifestations of my illness quite well, while "trashing" my body! LOL. So, it was like trading one set of problems for another < g >. I had to stay on the abx for an entire year before noticing any improvements, which is a real pain (costly too!)
I'm so sorry to hear you've been dealing with this nasty illness at YOUR age! You're right! You sort of "lost" the best years of your life. At least those were the best years for me (well, they were the best of times AND the worst of times! LOL)
Thanks again for your thoughtful reply!
Sincerely, Bob :)
> > Hello everyone!
>
> Welcome. It's a pleasure to meet you.
>
> > I've been reading messages on this site for a month or so now. I feel as though I've gotten to know a lot of you, even though you don't know me < g >.
>
> You're pretty sneaky, aren't you? < g >
>
> > Anyway, I came here because I suffer from severe depression. It's mostly treatment resistant too, and I've had it for 10 years now. I'm now 39 years old, and I can honestly say that I have not lived during my 30's! I guess that means that I've lost 25% of my life so far?
>
> 10 years (close to 11, really) since "official" diagnosis for me too, but I'm only 25. It's gotten a lot worse in the last few years, and I feelt like I've missed out on the best years of my life (cliche though that may be).
>
> Of course, it's not strictly chronic -- it comes and goes, in what are known as "major depressive episodes," but the frequency of these episodes (which has incereased with time) has made it very difficult for me to function. Still, I'm managing as best I can.
>
> > In the beginning, I had excellent results with Prozac (the benefits lasted about 2 years).
>
> Prozac seemed to work for me the first time I took it, but it didn't to much later on. I have trouble deciding whether the original response was mere coincidence or whether the Prozac failed to work later in life for whatever reason.
>
> After that point, it has been a neverending struggle to find SOMETHING that worked as well. Ironically, Prozac was the first drug I tried, and the LAST drug that worked! LOL
>
> > I've tried all the tricyclics, and none of those helped.
>
> *All*? In the USA, that's ten drugs. Can you list the ones you've tried? A lot of them are seldom used, and it doesn't really make sense to keep trying one after the other when they clearly don't work.
>
> > In fact, most of them made me 10x worse (suicidal!)
>
> This has been known to happen in a subgroup of depressives, particularly those with so-called "atypical depression" (a misnomer).
>
> > The newer SSRI's either caused extreme anxiety, sleeplessness, or psychosis.
>
> Psychosis defined how? Many times, the SSRIs and (to a lesser extent) the TCAs can cause increased anxiety at first (this is particularly true for people who have panic disorder).
>
> > Wellbutrin didn't work either.
>
> I'd expect this one
>
> A couple other non-SSRI newer drugs that you may not have tried are Serzone and Effexor. Serzone is particularly nice for anxiety.
>
> > I have not tried any of the MAOI's.
>
> I recommend them, especially if you do have atypical depression and/or panic disorder. They often work where every other AD has failed. Another possibility is to reconsider your diagnosis.
>
> > I even got desperate enough to try stuff that was illegal (like GHB!)
>
> Hey, it was legal a year ago or so! Anyway, the anti-GHB laws (like so many US drug laws) are just bizarre. GHB is a substance that occurs in mammalian bodies. To make it illegal would mean
> that we're all guilty of possession!
>
> I don't recommend trying to use GHB for depression. Although some people have used it in the long term (taken at bedtime) for sleep disorders without needing to increase the dose, tolerance is very common.
>
> Tryptophan might be a better choice, although it's a pretty weak AD. IMO, it's best used in conjunction with other ADs. Also, it can help to take a second drug to prevent the tryptophan from being metabolised before reaching the CNS.
>
> > I'd also like to try L-Deprenyl (because it has neural regenerative and/or protective effects on the striatal dopaminergic system). I feel this stuff might benefit me too, because I abused cocaine/crack in the early 90's. Perhaps I did some damage to my dopaminergic system?
>
> I wasn't impressed by selegiline (the American name for medical deprenyl), although dopaminergic drugs have helped me somewhat. It caused a lot of activation and worsened my sleep and appetite (which were already diminished). A more traditional MAOI (or perhaps the Parkinson's drug pramipexole/Mirapex) might be more beneficial to you. (There used to be a dopamine reuptake inhibitor, Merital (nomifensine), marketed as an AD, but it was taken off the market for dubious reasons.
>
> > I've also been reading the message threads on the use of opioids to treat treatment-resistant depression. I suffer from chronic pain too, so perhaps there's something worth looking into there as well?
>
> If you like, I can talk to you about that. Tramadol and buprenorphine seem to have less abuse potential than other opioids, but they are very helpful for many people with depression. Given your background of substance abuse, I'd approach typical (full agonist) opioids (morphine, oxycodone, fentanyl, etc.) with extreme caution.
>
> > I also have Lyme Disease (had all the classic symptoms between the ages of 10 and 14 years of age).
>
> That's no good. You need to make sure that you are getting regular treatment for the Lyme disease (like, go back on those antibiotics, and start seeing someone regularly about the Lyme disease; also, consider getting tested for neurological damage and other possible sequelae of long-term untreated Lyme disease).
>
> > When my depression is under control, all my other medical problems become more "tolerable" (and I can then engage in activities that are healthy, like eating right and getting regular exercise).
>
> Yes, that's how it often works.
>
> -elizabeth
poster:BobJ1961
thread:66847
URL: http://www.dr-bob.org/babble/20010720/msgs/71451.html