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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by Andy on October 1, 1999, at 10:52:31
FYI: Based on the information I got on this board (mostly from Wayne R) I've just joined the Naltrexone club. I'm stable on 40-50 mg. Prozac but I'm at risk for another poop out and I'm already having difficulty with the side effects of prozac. I don't want to go off it but I would like to take less, and if it poops out again I can't tolerate a higher dose.
Started yesterday with the "Wayne R method" of breaking the Naltrex into small pieces. Will keep you posted to increase the fund of empirical knowledge on this.
Would those of you out there who are also doing this (John L, anyone else?) post your experience here so we can share the information.
Posted by JohnL on October 1, 1999, at 16:34:11
In reply to Naltrexone Augmentation, posted by Andy on October 1, 1999, at 10:52:31
> FYI: Based on the information I got on this board (mostly from Wayne R) I've just joined the Naltrexone club. I'm stable on 40-50 mg. Prozac but I'm at risk for another poop out and I'm already having difficulty with the side effects of prozac. I don't want to go off it but I would like to take less, and if it poops out again I can't tolerate a higher dose.
>
> Started yesterday with the "Wayne R method" of breaking the Naltrex into small pieces. Will keep you posted to increase the fund of empirical knowledge on this.
>
> Would those of you out there who are also doing this (John L, anyone else?) post your experience here so we can share the information.Andy, I am closing in on the end of week 2. First few days were small chunks. Since then 3 chunks a day for a total of 25mg a day. At first I felt energetic. Now I'm kind of blah. I am disappointed so far but have committed myself to at least a 5 week trial. If it ends up not working for me, it will in no way mean Naltrexone doesn't work. It would mean that whatever my deficiency is, it is not related to the opiate/serotonin systems. Anyway, two weeks done and three or four to go. Will hang in there and see what happens. I keep hoping. . .
Posted by ChrisK on October 2, 1999, at 4:49:26
In reply to Naltrexone Augmentation, posted by Andy on October 1, 1999, at 10:52:31
I found Naltrexone by accident. My wife brought home an article about the fight against alcoholism that said that Nalttrexone was being used succesfully so I asked my psych for it. I've now been on it for 4 weeks and haven't felt better at this time of year in a long time. I'm very med resistant so I jumped right in with 50mg a day at bedtime.Now I take Nortriptyline, Zyprexa, Naltrexone and Celexa but I'm phasing out the Celexa which was the first attempt at augmenting the Nortrip. I've always been resistant to the SSRI's for some reason.
I hope all goes well with your trial. I know it's made a noticable difference in me within the first week.
Posted by Andy on October 4, 1999, at 9:46:45
In reply to Re: Naltrexone Augmentation, posted by ChrisK on October 2, 1999, at 4:49:26
> I found Naltrexone by accident. My wife brought home an article about the fight against alcoholism that said that Nalttrexone was being used succesfully so I asked my psych for it. I've now been on it for 4 weeks and haven't felt better at this time of year in a long time. I'm very med resistant so I jumped right in with 50mg a day at bedtime.Now I take Nortriptyline, Zyprexa, Naltrexone and Celexa but I'm phasing out the Celexa which was the first attempt at augmenting the Nortrip. I've always been resistant to the SSRI's for some reason.
>
> I hope all goes well with your trial. I know it's made a noticable difference in me within the first week.Thanks. Judging from the weak response it seems there must be very few people doing this. Chris, if I may ask, was your primary reason for starting on Naltrex to reduce alcohol consumption or as an AD augmentation. Was it successful in reducing desire for alcohol?
Posted by ChrisK on October 5, 1999, at 5:50:49
In reply to Re: Naltrexone Augmentation, posted by Andy on October 4, 1999, at 9:46:45
>
> Thanks. Judging from the weak response it seems there must be very few people doing this. Chris, if I may ask, was your primary reason for starting on Naltrex to reduce alcohol consumption or as an AD augmentation. Was it successful in reducing desire for alcohol?My primary reason for starting Naltrexone was to limit alcohol consumption and cravings. It has done a good job of that. The unexpected effect was to augment my AD's. My pdoc was surprised at the result also. I had to print out a couple of pages from this website to show him it was being used successfully (at times)as an AD. I've never even seen it mentioned in some of the newsgroups dealing with depression meds.
Good Luck with it.
Posted by v on October 8, 1999, at 5:39:12
In reply to Re: Naltrexone Augmentation, posted by ChrisK on October 5, 1999, at 5:50:49
>
> My primary reason for starting Naltrexone was to limit alcohol consumption and cravings. It has done a good job of that. The unexpected effect was to augment my AD's. My pdoc was surprised at the result also. I had to print out a couple of pages from this website to show him it was being used successfully (at times)as an AD. I've never even seen it mentioned in some of the newsgroups dealing with depression meds.
>
> Good Luck with it.did the drug reduce your cravings for sugar as well? there's supposedly a link between the two as alcohol converts to sugar.
thanks,
v
Posted by ChrisK on October 8, 1999, at 8:37:08
In reply to Re: Naltrexone Augmentation/cravings, posted by v on October 8, 1999, at 5:39:12
>
>
> did the drug reduce your cravings for sugar as well? there's supposedly a link between the two as alcohol converts to sugar.
>
> thanks,
> vNo, it didn't. Every time I've quit drinking I get the sugar cravings. I've given up worrying about weight fluctuations. I'd rather be less depresseed and sober so that I can excersize more. I always get very sedentary when I'm depressed and self medicating with alcohol but when I stop drinking and with the effectiveness of my current meds I can get out more and walk off the extra chocolate.
Posted by Andy on October 8, 1999, at 9:16:09
In reply to Naltrexone Augmentation, posted by Andy on October 1, 1999, at 10:52:31
> FYI: Based on the information I got on this board (mostly from Wayne R) I've just joined the Naltrexone club. I'm stable on 40-50 mg. Prozac but I'm at risk for another poop out and I'm already having difficulty with the side effects of prozac. I don't want to go off it but I would like to take less, and if it poops out again I can't tolerate a higher dose.
>
> Started yesterday with the "Wayne R method" of breaking the Naltrex into small pieces. Will keep you posted to increase the fund of empirical knowledge on this.
>
> Would those of you out there who are also doing this (John L, anyone else?) post your experience here so we can share the information.Week One: Mild headache which passes after a couple of days. Mild nausea and fatigue caused me to cut back to 12.5 mg. Feel more "mellow". No more jitteriness from prozac. Insomnia slightly improved. Mood good. Note reduced desire for wine with dinner. Hoping to ride out the side effects, get to 25mg and then experiment with reducing the prozac dosage (currently 50 mg).
And you John L? ,Wayne R, anyone else?
Posted by JohnL on October 8, 1999, at 17:31:37
In reply to Re: Week one, posted by Andy on October 8, 1999, at 9:16:09
> Week One: Mild headache which passes after a couple of days. Mild nausea and fatigue caused me to cut back to 12.5 mg. Feel more "mellow". No more jitteriness from prozac. Insomnia slightly improved. Mood good. Note reduced desire for wine with dinner. Hoping to ride out the side effects, get to 25mg and then experiment with reducing the prozac dosage (currently 50 mg).
>
> And you John L? ,Wayne R, anyone else?Thanks for asking. :) Close to the end of week 3 now. No longer have to take chunks. Take the whole 25mg plus a little extra to boot, on top of dinner. Side effects seem gone, except maybe slight drowsiness when driving more than 30 minutes. No real benefits so far, except there is a sense of well-being, comfort, confidence, calmness. I still have complete anhedonia. I have no pleasure in anything, which is disturbing. But at least I feel sane. In my job I visit different stores and have to approach Store Managers I don't know. That has always terrified me. But now I'm just calm, relaxed, easy-going, no fear, confident, quicker-thinking. Heck, I can even get cocky at times and know when I can get away with it!
Anyway, week 3, no side effects (they DO go away), no miracles. More time. Maybe 50mg instead of 25mg? I don't know. We'll see. Hope all is well with you. Best regards, John.
Posted by Andy on October 14, 1999, at 10:55:49
In reply to Naltrexone Augmentation, posted by Andy on October 1, 1999, at 10:52:31
> FYI: Based on the information I got on this board (mostly from Wayne R) I've just joined the Naltrexone club. I'm stable on 40-50 mg. Prozac but I'm at risk for another poop out and I'm already having difficulty with the side effects of prozac. I don't want to go off it but I would like to take less, and if it poops out again I can't tolerate a higher dose.
>
> Started yesterday with the "Wayne R method" of breaking the Naltrex into small pieces. Will keep you posted to increase the fund of empirical knowledge on this.
>
> Would those of you out there who are also doing this (John L, anyone else?) post your experience here so we can share the information.Week Two: Dropping the dose tho 12.5 mg improved side effects (nausea and fatigue) quite a bit. Trying to get up to 25mg. Feel more mellow and relaxed. Less "wired" from the prozac. Slightly spacey though. Thought the prozac was beginning to poop out yesterday, but I'm hanging at 50mg prozac (and 60 buspar) and I'm going to wait and see what happens.
Thanks for the update John L. It's a little scary that it seems to be only me and you.
Posted by Noa on October 14, 1999, at 17:41:01
In reply to Week Two, posted by Andy on October 14, 1999, at 10:55:49
It's a little scary that it seems to be only me and you.
Yes, but we are hanging on your every update...if need be, I will suggest it to my pdoc.
Posted by JohnL on October 15, 1999, at 3:16:03
In reply to Re: Week Two--to our courageous comrades, posted by Noa on October 14, 1999, at 17:41:01
> It's a little scary that it seems to be only me and you.
>Closing in on the end of week four. In Dr bob's Tips it is said by one doc that Naltrexone augmentation produces remarkable results 10% of the time and marked results a good 75% of the time. I think I must be in the other 25%. :(
I'll give it one more week to make it a solid 5 weeks, and then I might add some Nortriptyline before giving up on it. Sadly I seem remarkably resistant to Naltrexone so far. I'm glad I at least made it past the side effect barrier stage to give it a fair trial though. But, the fair trial isn't over yet...
Posted by Andy on October 15, 1999, at 11:23:50
In reply to Re: Week four, posted by JohnL on October 15, 1999, at 3:16:03
> > It's a little scary that it seems to be only me and you.
> >
>
> Closing in on the end of week four. In Dr bob's Tips it is said by one doc that Naltrexone augmentation produces remarkable results 10% of the time and marked results a good 75% of the time. I think I must be in the other 25%. :(
>
> I'll give it one more week to make it a solid 5 weeks, and then I might add some Nortriptyline before giving up on it. Sadly I seem remarkably resistant to Naltrexone so far. I'm glad I at least made it past the side effect barrier stage to give it a fair trial though. But, the fair trial isn't over yet...What are you taking besides the Naltrex John L ?
Posted by Andy on October 15, 1999, at 14:59:41
In reply to Re: Week four, posted by Andy on October 15, 1999, at 11:23:50
> > > It's a little scary that it seems to be only me and you.
> > >
> >
> > Closing in on the end of week four. In Dr bob's Tips it is said by one doc that Naltrexone augmentation produces remarkable results 10% of the time and marked results a good 75% of the time. I think I must be in the other 25%. :(
> >
> > I'll give it one more week to make it a solid 5 weeks, and then I might add some Nortriptyline before giving up on it. Sadly I seem remarkably resistant to Naltrexone so far. I'm glad I at least made it past the side effect barrier stage to give it a fair trial though. But, the fair trial isn't over yet...
>
> What are you taking besides the Naltrex John L ?Just reread your "Week Three" report John L and it sounds like you are getting a fair amount of benefit here, it's just not doing the complete job. The calmness reminds me a bit of how I felt when I added BuSpar to the Prozac. What's wrong with that?
Posted by JohnL on October 15, 1999, at 17:12:52
In reply to Re: Week four, posted by Andy on October 15, 1999, at 14:59:41
True Andy there is some benefit. But not really much more than the Prozac alone. Not enough to justify putting another drug in my body and spending the bucks. I will gladly take another drug and spend the money if there are substantial benefits. But not marginal benefits. If this is as good as it gets for me on Naltrexone, then I will continue my search. I'm not ready to settle for mediocre. I'm really frustrated this trial hasn't been more successful. As I read posts though, it is clear the magic combo for everyone is different. For WayneR it's Prozac+Natrexone. For someone else, Wellbutrin+Pindolol. For someone else, Klonopin+Selegiline. And so on. For me, don't know yet.
I think though a TCA might just be the missing ingredient. The ONLY time I ever felt total euthymia was on Zoloft+Nortriptyline. But it lasted only a few days and I couldn't get it back. Sexual side effects from Zoloft were too much to tolerate anyway. But if I can duplicate that euthymia with Prozac+Nortriptyline, then maybe the Naltrexone will keep it going. Those TCAs really are kind of dirty, but they sure seem to have more ooomph than SSRIs. In the back of my mind I keep thinking how magical Nortriptyline was. Not by itself, but with an SSRI. Maybe Naltrexone would allow that magic to come back and stay. Just my thinking at the moment. We'll see.
Enough about me already. How are YOU doing???
Posted by Elizabeth on October 15, 1999, at 20:55:14
In reply to Re: Andy, posted by JohnL on October 15, 1999, at 17:12:52
> For WayneR it's Prozac+Natrexone. For someone else, Wellbutrin+Pindolol. For someone else, Klonopin+Selegiline. And so on. For me, don't know yet.
Just for the record, pindolol wouldn't do much for Wellbutrin. Pindolol only augments serotonergic antidepressants (SSRIs, Buspar, probably MAOIs).
Posted by Andy on October 18, 1999, at 12:06:57
In reply to Re: Andy, posted by JohnL on October 15, 1999, at 17:12:52
> True Andy there is some benefit. But not really much more than the Prozac alone. Not enough to justify putting another drug in my body and spending the bucks. I will gladly take another drug and spend the money if there are substantial benefits. But not marginal benefits. If this is as good as it gets for me on Naltrexone, then I will continue my search. I'm not ready to settle for mediocre. I'm really frustrated this trial hasn't been more successful. As I read posts though, it is clear the magic combo for everyone is different. For WayneR it's Prozac+Natrexone. For someone else, Wellbutrin+Pindolol. For someone else, Klonopin+Selegiline. And so on. For me, don't know yet.
>
> I think though a TCA might just be the missing ingredient. The ONLY time I ever felt total euthymia was on Zoloft+Nortriptyline. But it lasted only a few days and I couldn't get it back. Sexual side effects from Zoloft were too much to tolerate anyway. But if I can duplicate that euthymia with Prozac+Nortriptyline, then maybe the Naltrexone will keep it going. Those TCAs really are kind of dirty, but they sure seem to have more ooomph than SSRIs. In the back of my mind I keep thinking how magical Nortriptyline was. Not by itself, but with an SSRI. Maybe Naltrexone would allow that magic to come back and stay. Just my thinking at the moment. We'll see.
>
> Enough about me already. How are YOU doing???Tolerating 25mg Naltrex now with little side effect. Your experience helped me hang in there. My PDoc suggested I stop when I reported side effects. My mood is good. Slight dysphoria the first week has passed. No nausea any more. A little fatigue, but not bad.
Sleeping about 30% improved. No jitteriness from Prozac at all.
Still too early to tell but there may be something here for me. I get enormous benefit from prozac but I didn't like the trajectory I was on-- 20 for a few months pooped out and became 40 for two months which then became 50 and I had preliminary signs that it was pooping out again. I was already at the max on BuSpar to contain the side effects (without BuSpar I could not have stayed on prozac--I was jumping out of my skin) and couldn't sleep more than an hour at a time.
The real test will come in during the next month or so. I intend to soon start slowly lowering the prozac. If I can do that and still feel well it will truly be something.
Good luck to you.
Posted by Wayne R. on October 19, 1999, at 6:18:44
In reply to Naltrexone Augmentation, posted by Andy on October 1, 1999, at 10:52:31
I have been anxiously watching everyone's progress. It still drives me crazy that finding the magic combo is such a painfully slow process. However, November 7 will be a year for me and Naltrexone... it has been the best year I can remember. Still wishing everyone my miracle. Wayne
Posted by Andy on October 21, 1999, at 9:28:40
In reply to Week Two, posted by Andy on October 14, 1999, at 10:55:49
>
Things are looking good.Took 25mg week three with virtually no side effect. Spacey feeling gone. Nausea gone. A little slower waking up in the morning, but that's about it.
Feel more relaxed. Sleeping better, which may account for alot of why I feel better, but who cares. Don't need as much Ambien to counteract prozac's insomnia.
Felt for a day of two last week that the prozac was pooping out, but no longer. I'm good. Was it the Naltrex or would I have turned it around anyway ? I don't know.
I'm not making any changes the next week. I'll stick with 50mg Prozac, 60mg BuSpar, 25mg Naltrex and see if I'm still feeling this well.
Many many thanks to Wayne R and John L. I would have never known about this otherwise.
> FYI: Based on the information I got on this board (mostly from Wayne R) I've just joined the Naltrexone club. I'm stable on 40-50 mg. Prozac but I'm at risk for another poop out and I'm already having difficulty with the side effects of prozac. I don't want to go off it but I would like to take less, and if it poops out again I can't tolerate a higher dose.
> >
> > Started yesterday with the "Wayne R method" of breaking the Naltrex into small pieces. Will keep you posted to increase the fund of empirical knowledge on this.
> >
> > Would those of you out there who are also doing this (John L, anyone else?) post your experience here so we can share the information.
>
> Week Two: Dropping the dose tho 12.5 mg improved side effects (nausea and fatigue) quite a bit. Trying to get up to 25mg. Feel more mellow and relaxed. Less "wired" from the prozac. Slightly spacey though. Thought the prozac was beginning to poop out yesterday, but I'm hanging at 50mg prozac (and 60 buspar) and I'm going to wait and see what happens.
>
> Thanks for the update John L. It's a little scary that it seems to be only me and you.
Posted by ChrisK on October 22, 1999, at 6:13:39
In reply to Re: Week Three, posted by Andy on October 21, 1999, at 9:28:40
I'm into my second month of Naltrexone and it has made quite a difference. First off I spent two years of going through SSRI's with no success. I convinced my pdoc to go back to TCA's. We agreed on Nortriptyline which I have been taking for almost a year now. I was still having suicidal ideations so we tried Zyprexa. That made a huge difference in the SI's but I wasn't completely out of the darkness. I read about Naltrexone as a treatment for alcoholism and asked if he would give that a try. At the time I wasn't aware of the augmentation scenario. I noticed a significant change within two weeks.
Right now I'm satisfied with my cocktail of Nortriptyline, Zyprexa and Naltrexone. I also spend time each morning in front of a phototherapy lamp for the SAD side of my disorder. All in all I'm doing better this October than I ever have.
Posted by JohnL on October 22, 1999, at 14:51:20
In reply to Two Months, posted by ChrisK on October 22, 1999, at 6:13:39
My update isn't so hot. End of week 5 with Naltrexone and I might as well be taking a sugar pill. No effect. No side effects either. I will finish off the bottle though, which is about another 2 weeks or so. Meanwhile, I added Nortriptyline to my Prozac a few days ago. We'll see if that can't jumpstart something here. If not, I'm back to square one again.
Not everyone is helped by Naltrexone. I must be in that camp, or I surely would have had some substantial improvements by now. I've pretty much given up hope on Naltrexone, but will finish it off. If there is any miracle, it will be a very late one.
Posted by Joe on April 13, 2000, at 22:56:48
In reply to Re: Naltrexone Augmentation, posted by Andy on October 4, 1999, at 9:46:45
Please share with me any known side-effects from taking Naltrexone.
Thankyou,
Joe.
joewild@voyagernet.com.au
Posted by JohnL on April 14, 2000, at 2:22:10
In reply to Re: Naltrexone Augmentation, posted by Joe on April 13, 2000, at 22:56:48
> Please share with me any known side-effects from taking Naltrexone.
>
> Thankyou,
> Joe.
> joewild@voyagernet.com.auAfter being on Naltrexone for about a week or so, I had no side effects at all. However, during the first week--and especially the first couple days--side effects were rather uncomfortable. General malaise, aching muscles, flu-like feeling, slight nausea. I was astounded how quickly and completely these early disconcerting side effects disappeared. Taking little chunks of the pill, instead of a full 25mg or 50mg, is a good way to get used to the drug before taking the full dose. Som people start as low as 3mg a day and work up to 25mg over a week.
Posted by ChrisK on April 14, 2000, at 6:07:36
In reply to Re: Naltrexone Augmentation, posted by Joe on April 13, 2000, at 22:56:48
I am a little bit med resistant but I didn't notice any problem when I started Naltrexone and over the last 8 or 9 months haven't had any bad side effects.
Posted by Anna P. on April 15, 2000, at 13:18:21
In reply to Re: Naltrexone Augmentation, posted by ChrisK on April 14, 2000, at 6:07:36
> I am a little bit med resistant but I didn't notice any problem when I started Naltrexone and over the last 8 or 9 months haven't had any bad side effects.
Can you please tell me what other meds do you take together with Naltrexone?
Anna P.
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