Posted by JohnX on October 23, 2001, at 0:52:34
In reply to Looking for some advice before I see the psydoc, posted by JGalt on October 22, 2001, at 12:40:09
Here is my advice, just tell the doctor what
worked for you (Selegiline) and tell him you
didn't click to well with your prior doctor or
he died or you moved or whatever.
You can even play stupid and mispronounce
the medication, or bring in a bottle with a
prescription on it and say here "this is what
worked". If the pdoc is any good he will write
you a prescription for what you claim already
worked. If the pdoc is "stuck" on a particular
medicine path, then he/she is not a good pdoc.
Your other med picks are also good ones for
your symptoms (Wellbutrin and maybe Parnate).
Don't bring up the other stuff (the dlpa)
etc, the psych will think you are neurotic.
Also, I *don't* recommend taking the pseudo-ephedrine
or mentioning it to the doctor.Selegiline is not the most typical med for depression,
but for atypical a lot of people have had success.
I would bring up your atypical symptoms. Mention
that you would prefer not to take an addictive
stimulant as it caused you to be to irratable and
tired over time (but maybe keep your past history
on stims to yourself for the 1st few visits).
Make the doctor feel like he is in control
and curing you. You get what you
want and he gets what he wants from the transaction.
Doctors like easy to manage patients. They
charge the same amount of money for your
visit with less hassle than the tricky patients.Some people may disagree with my suggestions,
but you know what works, so I'm telling you how
to persuade the doctor in a "passive aggressive"
manner. The doctor is there to help you, you
are not there to debate with the doctor. Believe
me I know what you are feeling.On subsequent visits to the doctor, feel free
to *slowly* divulge more information in a manner
that shows your intellegence (and not neurotic)
personality. The doctor will gain more confidence
on your suggestions.PS. you are not boring. You are obviously
intelligent and we hope you will add value
to this newsgroup in the future also.good luck,
john> Hello. This is my 1st post here though I've read for hours the past few days.
>
> 2 yrs ago I started to slip into atypical depression and/or perhaps dysthymia. Lack of energy, motivation, will to live...sleeping well over 10hrs a day...usually feeling little emotion but occassionally really down, to the point of considering (on a daily basis for many weeks), and sometimes planning suicide. Also had problems w/ bulemia (not throwing up, taking illegal diet pills instead). I started to self medicate back then, beginning with every conceivable stimulant and continuing with most everything legal and illegal imaginable so long as I did not find evidence that it would harm cognitive abilities, be addictive, or kill me. Most of them worked, but the inevitable tolerance problems would eventually force me to find something new. Incidentally I'm a pharmacology major (wasn't back then), I do more than my share of studying on anything I choose to take.
>
> What I eventually found that worked was a combination of 10mg Selegiline (which I should have reduced to 5mg once I had received full MAOi-B inhibition, learned that here), Up to 500mg D-Phenylaline a day, Up to 2.5g L-Phenylaline a day, several times the FDA requirements of the B vitamins and vitamin C (you need these for the Phenylalines to be able to convert to Dopamine, PEA, etc.), as well as 1,4 Butanediol when needed (which converts to GHB, a very interesting drug) to get rid of social anxiety and for its very pleasant antidepressive effects as well as to get me to sleep if I needed help and reduce aggression(BTW, GHB+MAOi's do have a very definite potentiating effects on each other, requiring a lessening of dosage in one, or likely both, I've seen it said on this board that they don't, but remember that GHB effect endogenous amines and GABA, also affected by MAOi's), as well as occassional very low doses of caffiene+ephedrine if still managed to get tired during the day. I had been on this combo a little over the month and it was much better than any other I had ever tried. I was also just beginning to experiment with modafinil in place of the ephedrine + caffeine and seemed to be having some positive results. Using this I got rid of the depression, social anxiety, dysthmia, and also was only having to sleep 7 hrs average a night. Unfortunately I got caught with these and many other drugs I had collected over the 2 years, and so now I'm going to be seeing a psychiatrist to try to get things sorted out.
>
> What I'd like to know is, how should I approach this matter with the doc? I doubt he's going to be gung-ho for the selegiline, as I doubt many pdoc's have even heard of it used in combination w/ DLPA for atypical depression. Should I print out some medline abstracts for him or just tell him my experiences? I am unwilling to try any tricyclics due to their effects on memory and really would by far prefer to be on selegiline or perhaps experiment with Parnate (I have high blood pressure as it is so that's not an issue w/ the parnate). I would be willing to try Wellbutrin or Effexor but, still, it seems logical to go with that which worked fairly well before. Considering that the normal fatigue I have now is something I find in and of itself depressing, I am completely unwilling to try anything that is sedating. Do you think there's any good ways to get my pdoc to try the selegiline even if he never has done so before and should I come right out and tell him that's what I want to do? If Pdocs don't typically go along with that then should I perhaps lobby instead exclusively for Parnate?
>
> Hope I didn't bore everybody to death on my 1st post.
>
> Thanks in advance for advice,
> JGalt
poster:JohnX
thread:81980
URL: http://www.dr-bob.org/babble/20011015/msgs/82038.html