Posted by bleauberry on January 23, 2010, at 14:17:42
A little bit long, and probably needs some creative diagnosis and thought...
Alright, no doubt, a confusing situation. Doctors give me a blank stare. I doubt any of us have an answer, I sure don't, but ya never know, someone might just spark a great idea. That's what I'm hoping for.
The only meds never tried:
Nardil
Buspar
RisperdalThe only meds that hold potential (based on the criteria that they do not make me worse, more depressed). Pretty much all other meds do make me profoundly worse.
The candidates:
Milnacipran + Pindolol
Milnacipran + Buspar
Pindolol + Buspar
Milnacipran + Pindolol + Buspar
Milnacipran + Risperdal
Milnacipran + Abilify
Parnate
Parnate + Risperdal
Parnate + Abilify
Any of the above with Ritalin
Any of the above with AmisulprideThe above are based on quality clinical evidence backing them up, case studies, small studies, and they are the only meds that meet my criteria of potentially mood-helpful in previous toe-dipping trials of low doses. Any other meds not listed above, forget it, they are out. I will not take anything that makes me worse than I already am. Anything not listed does exactly that.
Complicating factors:
Hidradenitis. This is similar to monsterous localized acne, carbuncles, furuncles, or boils. It's on the buttocks. It flares up very badly with anything noradrenergic/dopaminergic. Strange, but a doctor had me put Nystatin cream (topical or intestinal but not systemic antifungal) on it for a few weeks and it helped a lot on the outside, but not deep inside. Recently I tried a few days of Diflucan (systemic antifungal) based on a German hospital that found it cured difficult-to-treat Lyme patients who had failed other treatments. There are theories of why it worked, but only theories. I started 5mg Nortriptyline at the same time. The Nort immediately did not feel good, but the Hidradenitis was improving a lot. I thought it was the Nort. But no. With more time, after stopping Diflucan, I was hit in the face with the realization it was Diflucan doing the good. And then I realized, yeah, scratching that infected skin smells "fungal". Anyone female who's had a vaginal infection knows that smell. Same. No one knows what causes Hidradinitis. Some improve with antibiotics, some with surgery, most never. No known cure. Diflucan could be a new discovery. Long story, but the basic message here is...I generally benefit the most from certain (not all) meds that are noradrenergic, yet they worsen Hidradenitis so bad I can't even sit or walk without severe pain in the sitting area. That's a stubborn roadblock in my way to mental health.Aches and pains. I don't know why, but serotonin meds create joint and muscle pains rather severe all over the body. I can't be having an allergic reaction to everything?
Wrist tendonitis. Long ago healed with surgery. But, anything noradrenergic causes it to resurface. Even if pain doesn't get bad, the numbness and tingling of fingers is scarey. Another roadblock. The meds that make me feel the best kill the use of my hand.
Calf problems. This is hard to describe. Calf muscles only, mostly left leg, a little on the right. We're talking rock hard, extremely painful to move, painful even to the touch. Meds of all kinds seem to do this. Why just the calves? I sometimes wonder if it is some sort of a tardive complication of longterm zyprexa I used to take, but again, why just the calves? What the heck is this? Another roadblock. The meds that help me the most take my legs. The meds that make me suicidal actually make my legs feel good. Dang.
My top antidepressants based on short term trials are Milnacipran or Parnate, and for immediate life saving Ritalin (which leads to obsessional delusional jealousy suspiciousness distrust if continued). But all of the above complications stand in my way.
Amisulpride actually helped the tendonitis thing somewhat, improved my appetite somewhat, and lessened body pains...why or how I have no clue. Combined with Milnacipran it made me completely blah and lifeless, or what I called "just get it over with-ness". The opposite of what you would expect from Amisulpride.
I don't know. 3 of 5 treatment resistant patients found remission when risperdal was added to their milnacipran. All 5 had benefits. 90% of patients responded to buspar+pindolol combo. 90% experienced response beginning in one week with milnacipran+pindolol combo. We all know the potential abilify has with SSRIs, but there is nothing in literature about it with Milnacipran or Parnate.
So, you see a lot of confusing choices here. It's kind of like being stopped at a traffic signal with 8 different directions you could go, but indecisiveness in choosing one. At least all the bad choices have been eliminated already. The remaining ones all have potential, but also some rather serious complications.
Thoughts?
Lyme and chelation treatments need to continue, but dang, I'm telling you, depression itself stands in my way of doing those. Two of my favorite authors Andrew Cutler of Amalgam Illness, as well as Stephen Buhner for natural Lyme treatment, say that the right meds and/or supplements should get you feeling a lot better fairly quickly so that you can get on with your life and treatment.
What they heck are my right meds?
poster:bleauberry
thread:934789
URL: http://www.dr-bob.org/babble/20100122/msgs/934789.html