![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 47 to 71 of 72. Go back in thread:
Posted by Elizabeth on June 10, 2001, at 20:41:30
In reply to Re: stuff, posted by Lorraine on June 10, 2001, at 10:55:51
> Yeah, I have given up on the SSRIs, only had a partial response and a lot of side effects.
Hmm, is that better or worse than no response and no side effects? :-)
> After this, I think there is still Provigil
(modafinil)
> Celerta (sp?)
Concerta? (a new sustained-release formulation of methylphenidate)
> and possibly Desoxyn (sp?)
methamphetamine
(good luck)> And I may go back and try Moclobemide again adding Neurontin to it this time.
Moclobemide? Jeez. I assume you're not in the USA. If you are, it's a waste of your energy (IMHO).
> Next stop, I figure is Desipramine (sp) and Parnate. Are these last two the "older" drugs you have in mind? From what I have read, these two seem to have the lowest side effect profile.
Desipramine is a tricyclic. Parnate (tranylcypromine) is a monoamine oxidase inhibitor. They're both old. They're among the more side-effect-free drugs in their respective classes.
-elizabeth
Posted by Maraschino on June 11, 2001, at 19:17:30
In reply to Re: Codeine for Depression Treatment-Elizabeth, posted by AMenz on June 5, 2001, at 11:19:40
> Codeine is supposed to be addictive. I'm already unable to get off a 1mg benzo daily.
>
> When you say an opioid is it a synthetic or a natural derivative of opium. Better yet since I do not have a science background-what is an opioid agonist, as opposed to an opiate?
>
> What is the action of codeine that it relieves depression and is the effect palliative like, eg. like benzos which wear off quickly and have to be readministered as oppossed to SSRI which and lithium which build up in the bloodstream slowly and take several days to wear off.
>
> I'm almost embarassed to write to you because you seem extremely knowledgeable. What is your background, if I may ask?
>
> > At what dosage and, since you say it's a temporary, for how many days is it safe to take this.
> >
> > How safe do you want?
> >
> > There seems to be a wide range of variability in the rates at which different people develop tolerance.
> >
> > BTW: there is no evidence or reason to suppose that opioid agonists are "cover-ups" that don't address the "root cause" of depression. (This is an argument commonly made by proponents of "talk" therapies in criticising the use of any drug at all, incidentally.)
> >
> > -elizabethIf this the same Elizabeth (Shapere) who posted on Usenet for many years, she is indeed an expert on psychopharmacology and the like. For even more of her, you can check out http://groups.google.com for Elizabeth Shapere.
Hope this helps..
Maraschino
Posted by Lorraine on June 11, 2001, at 21:32:01
In reply to Re: stuff » Lorraine , posted by Elizabeth on June 10, 2001, at 20:41:30
> > Yeah, I have given up on the SSRIs, only had a partial response and a lot of side effects.
>
> Hmm, is that better or worse than no response and no side effects? :-)I believe it's worse because you stay on the horse too long following a blind alley.
> > Celerta (sp?)
>
> Concerta? (a new sustained-release formulation of methylphenidate)No, it's Cylert (pemoline). Say have you heard anything about a time release Adderral?
>
> > and possibly Desoxyn (sp?)
>
> methamphetamine
> (good luck)Actually, it's my pdoc that suggested it. So I can get the prescription. The question is whether I want to try it or not. In my past (long ago far away--like 30 years ago), I abused drugs. But I was never addicted and I don't think I have an addictive personality generally. The question is whether it would be a good drug to try. I think I've read about energy depletion or something like that with it.
>
> > And I may go back and try Moclobemide again adding Neurontin to it this time.
>
> Moclobemide? Jeez. I assume you're not in the USA. If you are, it's a waste of your energy (IMHO).I am in the USA. My pdoc writes a prescription that is then filled by a Canadian pharmacy and mailed to me. I did this before and it's not too bad. It's not covered by insurance, but Moclobemide is cheap so who cares?
Right now all of these pharmaceutical experiments are on hold while I try Neurofeedback to see if I can stabilize some subthrehold seizure-like activity that is probably causing my physical anxiety. It would be great to have a non-drug solution to at least part of the problem. The depression might remain though. I am using EEGSpectrum for this. Susan Othmer has treated 3000 patients with various ailments and I'm sure various results. Her own son had epilepsy so she was very motivated to employ Neurofeedback with him. I don't have epilepsy, but I suspect the approach is the same--train the person to narrow the volitility and variation range of alpha, beta and theta brain waves. My pdoc is a neurologist. His reading of my QEEG confirms the reading at EEGSpectrum--namely that I have a lot of spiking activity, one or two out of range spikes every 14 seconds. Those spikes destabilize me, impacting my memory, my autonomic functions (physical anxiety)and generally wreak havoc in the brain. EEGSpectrum believes that this is why I am treatment resistent. Of course, my pdoc is trying, without success so far, to treat the problem with anti-convulsants. We really do not know a lot about the brain right now. Anyway, I'm hopeful about the feedback treatment, but also know that it is experimental and may turn out to be another blind alley for me. Of course, I expect the placebo effect to at least perk things up for a little while. I'll keep you posted on progress.
Posted by Elizabeth on June 12, 2001, at 1:31:37
In reply to Re: Codeine for Depression Treatment-Elizabeth » AMenz, posted by Maraschino on June 11, 2001, at 19:17:30
> If this the same Elizabeth (Shapere) who posted on Usenet for many years, she is indeed an expert on psychopharmacology and the like. For even more of her, you can check out http://groups.google.com for Elizabeth Shapere.
"Maraschino," huh? Well, thanks for the vote of confidence. :-) It's nice to be appreciated, although I would hardly call myself an expert. (How about "informed consumer?")
But I don't use my full name on Usenet. Much of what has been posted on Usenet about me (*especially* those posts that include my full name) is rather...libelous. A deranged individual ("flight of the phoenix," "alexplore," and many others) who gives mental illness a bad name has taken a dislike to me and some random people who I don't even know (and an ex-boyfriend...sad story). He believes I'm conspiring with these people. (It's not clear what I'm conspiring to do with these people I don't know and the ex who I don't even talk to.)
I haven't posted much to Usenet recently. "Alexplore" has succeeded in scaring me away, I guess. Anyway, I don't have time to sift through all the flames these days.
Thanks for this virtual place, Dr. Bob.
-elizabeth
P.S. Hey, Maraschino, should I be suspicious that you spelled my name right? And can I ask about the derivation of your alias?
Posted by Elizabeth on June 12, 2001, at 2:09:35
In reply to Re: stuff » Elizabeth, posted by Lorraine on June 11, 2001, at 21:32:01
> > > Yeah, I have given up on the SSRIs, only had a partial response and a lot of side effects.
> >
> > Hmm, is that better or worse than no response and no side effects? :-)
>
> I believe it's worse because you stay on the horse too long following a blind alley.Hmm. How about a partial response and no side effects (except very minor ones)? (Parnate)
> No, it's Cylert (pemoline).
Cylert! I took a small dose for a while in college, and it was surprisingly helpful. I feel like I should revisit it. It's very long-acting, and smoother than other psychostimulants. Its pharmacologic mechanism of action is unclear. It actually helped me get (and keep) my sleep-wake cycle back in sync with the rest of the world, because I would take it every morning and feel more alert, and then start to get tired in the evening as it wore off.
> Say have you heard anything about a time release Adderral?
Controlled release Adderall? That would be quite a task, and probably not worth the money and effort.
> > methamphetamine
> > (good luck)
>
> Actually, it's my pdoc that suggested it. So I can get the prescription.That's impressive. Pdocs hate to write for that one. I would expect it to be safer and more tolerable than dextroamphetamine, because it has a more favourable ratio of central to peripheral effects.
> The question is whether I want to try it or not. In my past (long ago far away--like 30 years ago), I abused drugs. But I was never addicted and I don't think I have an addictive personality generally.
Hmm. How do you define "abused?" (Believe it or not, the American Psychiatric Association has attempted to come up with a rigorous definition, although most psychiatrists seem to ignore that definition when they label patients "substance abusers.")
> The question is whether it would be a good drug to try. I think I've read about energy depletion or something like that with it.
Well, I don't know if the sustained-release formulation ("Gradumets") is still made. You might get a lot of highs and lows in energy as one dose wears off and then another starts to work. It's a pretty short-acting drug (I'm not a big fan of those; I want to be able to go about my business and not have to worry about my medication wearing off every few hours).
> > Moclobemide? Jeez. I assume you're not in the USA. If you are, it's a waste of your energy (IMHO).
>
> I am in the USA. My pdoc writes a prescription that is then filled by a Canadian pharmacy and mailed to me.Huh. My impression was that the by-the-book way to do this involved a lot of red tape and hassle, so I never considered it an option (especially since I didn't even respond completely to the irreversible nonselective MAOIs). If it's just a matter of finding an amenable Canadian pharmacist, though, it might well be worth it. How much does it cost? (I'm pretty sure my insurance won't cover prescriptions that are filled outside the USA, especially for drugs that aren't even approved here.)
> Right now all of these pharmaceutical experiments are on hold while I try Neurofeedback to see if I can stabilize some subthrehold seizure-like activity that is probably causing my physical anxiety.
That's interesting. I have had several EEGs that showed no or little sign of anything being wrong in that department, but I had a SPECT scan which suggested...umm, it's not clear what it suggested, but it was definitely weird.
I hope your experiment does some good. I would like to hear about it. (As with all things, I'm curious how (or if) it works.)
> I don't have epilepsy, but I suspect the approach is the same--train the person to narrow the volitility and variation range of alpha, beta and theta brain waves.
Those refer to different combinations of amplitude and frequency: for example, theta rhythm refers to low-amplitude (voltage) and moderately high-frequency (fast) waves.
> My pdoc is a neurologist. His reading of my QEEG confirms the reading at EEGSpectrum--namely that I have a lot of spiking activity, one or two out of range spikes every 14 seconds. Those spikes destabilize me, impacting my memory, my autonomic functions (physical anxiety)and generally wreak havoc in the brain. EEGSpectrum believes that this is why I am treatment resistent.
Yeah, I got the same line about my SPECT. < g > I did get my medical records -- finally -- and plan to call up a neurologist I know to see if he can determine the clinical relevance, if any, of the abnormal SPECT scan.
> Of course, my pdoc is trying, without success so far, to treat the problem with anti-convulsants.
Isn't a lot of that due to intolerance of side effects? Which ones have you tried so far?
> We really do not know a lot about the brain right now.
Yeah. I'd sure like to know a few things about mine, in particular. < g >
Again, good luck with the neurofeedback.
-elizabeth
Posted by Maraschino on June 14, 2001, at 14:26:08
In reply to Elizabeth speaks » Maraschino, posted by Elizabeth on June 12, 2001, at 1:31:37
> > If this the same Elizabeth (Shapere) who posted on Usenet for many years, she is indeed an expert on psychopharmacology and the like. For even more of her, you can check out http://groups.google.com for Elizabeth Shapere.
>
> "Maraschino," huh? Well, thanks for the vote of confidence. :-) It's nice to be appreciated, although I would hardly call myself an expert. (How about "informed consumer?")Infromed consumer sounds good, and you really do seem very informed.
>
> But I don't use my full name on Usenet. Much of what has been posted on Usenet about me (*especially* those posts that include my full name) is rather...libelous. A deranged individual ("flight of the phoenix," "alexplore," and many others) who gives mental illness a bad name has taken a dislike to me and some random people who I don't even know (and an ex-boyfriend...sad story). He believes I'm conspiring with these people. (It's not clear what I'm conspiring to do with these people I don't know and the ex who I don't even talk to.)I wasn't aware of that, but after looking at it it a shame. Didn't you use to post theough, from aol - using Shapere? Sorry, if I'm mistaken.
>
> I haven't posted much to Usenet recently. "Alexplore" has succeeded in scaring me away, I guess. Anyway, I don't have time to sift through all the flames these days.
>
> Thanks for this virtual place, Dr. Bob.I thank him too, because there is much better info ans support here than in uUsenet groups.
>
> -elizabeth
>
> P.S. Hey, Maraschino, should I be suspicious that you spelled my name right? And can I ask about the derivation of your alias?Maraschino is just a nick.. that's all.
And thanks for your greatinfo here and on Usenet too. You give lots of different kinds of advice on depression.Maraschino
p.s sorry for the delay.. I'm not on the computer that much/
Posted by Elizabeth on June 14, 2001, at 15:19:44
In reply to Re: Elizabeth speaks, posted by Maraschino on June 14, 2001, at 14:26:08
> Infromed consumer sounds good, and you really do seem very informed.
Thank you. I try.
> I wasn't aware of that, but after looking at it it a shame. Didn't you use to post theough, from aol - using Shapere? Sorry, if I'm mistaken.
Yeah, much to my embarrassment, I did once have an AOL account. < g >
> > Thanks for this virtual place, Dr. Bob.
>
> I thank him too, because there is much better info ans support here than in uUsenet groups.There is. Thanks to people like "alexplore," a lot of the knowledgeable and supportive posters have abandoned Usenet. Moderated forums, such as this one, have proven more resilient than those that allow anyone to post anything.
> And thanks for your greatinfo here and on Usenet too. You give lots of different kinds of advice on depression.
Well, you're quite welcome. And thank *you* for taking the time to thank me. :-)
-elizabeth
Posted by Shar on June 14, 2001, at 20:05:01
In reply to Re: Elizabeth speaks, posted by Maraschino on June 14, 2001, at 14:26:08
When I post on PB or PSB or PBA, I have an expectation of anonymity to the extent that I am the one who decides what, if any, personal information to disclose.
I am pretty uncomfortable with the idea of any poster coming online and posting personal info about someone else, especially like their last name. I would not like it done to me, for sure!
This is, after all, PSYCHO-babble.....8-)
Anyhow, I wanted to voice my opinion that it seems like an invasion of privacy to reveal something the person hasn't chosen to share.
Shar
> > > If this the same Elizabeth (Shapere) who posted on Usenet for many years, she is indeed an expert on psychopharmacology and the like. For even more of her, you can check out http://groups.google.com for Elizabeth Shapere.
> >
> > "Maraschino," huh? Well, thanks for the vote of confidence. :-) It's nice to be appreciated, although I would hardly call myself an expert. (How about "informed consumer?")
>
> Infromed consumer sounds good, and you really do seem very informed.
> >
> > But I don't use my full name on Usenet. Much of what has been posted on Usenet about me (*especially* those posts that include my full name) is rather...libelous. A deranged individual ("flight of the phoenix," "alexplore," and many others) who gives mental illness a bad name has taken a dislike to me and some random people who I don't even know (and an ex-boyfriend...sad story). He believes I'm conspiring with these people. (It's not clear what I'm conspiring to do with these people I don't know and the ex who I don't even talk to.)
>
> I wasn't aware of that, but after looking at it it a shame. Didn't you use to post theough, from aol - using Shapere? Sorry, if I'm mistaken.
> >
> > I haven't posted much to Usenet recently. "Alexplore" has succeeded in scaring me away, I guess. Anyway, I don't have time to sift through all the flames these days.
> >
> > Thanks for this virtual place, Dr. Bob.
>
> I thank him too, because there is much better info ans support here than in uUsenet groups.
> >
> > -elizabeth
> >
> > P.S. Hey, Maraschino, should I be suspicious that you spelled my name right? And can I ask about the derivation of your alias?
>
> Maraschino is just a nick.. that's all.
> And thanks for your greatinfo here and on Usenet too. You give lots of different kinds of advice on depression.
>
> Maraschino
> p.s sorry for the delay.. I'm not on the computer that much/
Posted by Elizabeth on June 14, 2001, at 22:52:17
In reply to Elizabeth speaks---Anonymity?, posted by Shar on June 14, 2001, at 20:05:01
> I am pretty uncomfortable with the idea of any poster coming online and posting personal info about someone else, especially like their last name. I would not like it done to me, for sure!
I feel uncomfortable about it too. But I've already made the mistake of posting on Usenet under my real name; I don't have any expectation of anonymity here. (Even if I started posting under a new name, I'd have to avoid revealing *any* personal information, even the medications I take or have taken; and even then, I think a lot of people would be able to guess that it was me posting.)
Also, although it was something of a faux pas, Maraschino made the post in a friendly spirit. While it's not only the thought that counts, benevolent intentions do go a long way toward eliciting forgiveness.
-elizabeth
Posted by Neal on June 15, 2001, at 13:53:49
In reply to Elizabeth speaks---Anonymity?, posted by Shar on June 14, 2001, at 20:05:01
Shar,
You haven't posted on this board too often these days. I was following your med progress because we seem to have similar dx and meds, ie., Wellbutrin + augmentors. Last I heard you had success with Risperdal. Care to share your cocktail these days? Thanks --Neal
Posted by gilbert on June 15, 2001, at 16:16:18
In reply to To Shar, posted by Neal on June 15, 2001, at 13:53:49
Elizabeth,
You are a good soul. You contibute and you ar so even tempered as well as informed. The way you just handled the above postings....style and grace....
Thanks,
Gil
Posted by Elizabeth on June 15, 2001, at 17:12:11
In reply to Elizabeth,,,,, posted by gilbert on June 15, 2001, at 16:16:18
> You are a good soul. You contibute and you ar so even tempered as well as informed. The way you just handled the above postings....style and grace....
*blush*
Thank you.
-elizabeth
Posted by Shar on June 15, 2001, at 23:24:28
In reply to To Shar, posted by Neal on June 15, 2001, at 13:53:49
I am on the same drugs, but they may have been modified since I last posted.
Wellbutrin SR 400 mg.
Effexor XR 300 mg.
Risperdal .5 mg
Klonopin 1 mg. in pm
Hydroxyzine Pamoate 25 mg. for occasional anxietyThe way I take them has been modified to:
Wellbutrin SR 300 mg in morning
Effexor XR 150 mg in morning
Wellbutrin SR 100 mg in afternoon
Effexor XR 150 mg. in evening
Risperdal .5 in evening
Klonopin 1 mg in eveningWhat is your cocktail, Neal? Mine is working ok, I do feel better than I have in many months which is a great relief.
Shar
> Shar,
> You haven't posted on this board too often these days. I was following your med progress because we seem to have similar dx and meds, ie., Wellbutrin + augmentors. Last I heard you had success with Risperdal. Care to share your cocktail these days? Thanks --Neal
Posted by Lorraine on June 16, 2001, at 11:36:01
In reply to Re: subthreshold epilepsy and stuff » Lorraine , posted by Elizabeth on June 12, 2001, at 2:09:35
> > > > Yeah, I have given up on the SSRIs, only had a partial response and a lot of side effects.
> > >
> > > Hmm, is that better or worse than no response and no side effects? :-)
> >
> > I believe it's worse because you stay on the horse too long following a blind alley.
>
> Hmm. How about a partial response and no side effects (except very minor ones)? (Parnate)Partial response is a problem for me.
> > No, it's Cylert (pemoline).
>
> Cylert! I took a small dose for a while in college, and it was surprisingly helpful. I feel like I should revisit it. It's very long-acting, and smoother than other psychostimulants. Its pharmacologic mechanism of action is unclear. It actually helped me get (and keep) my sleep-wake cycle back in sync with the rest of the world, because I would take it every morning and feel more alert, and then start to get tired in the evening as it wore off.
OK, then it definately goes on the "to try" list.> > > methamphetamine
> > > (good luck)
> > The question is whether I want to try it or not. In my past (long ago far away--like 30 years ago), I abused drugs. But I was never addicted and I don't think I have an addictive personality generally.
>
> Hmm. How do you define "abused?" (Believe it or not, the American Psychiatric Association has attempted to come up with a rigorous definition, although most psychiatrists seem to ignore that definition when they label patients "substance abusers.")Actually, I just messed around and took a lot of drugs for a couple of years in my teens. Shot speed for a month or two. The drugs I took depended on who I was around at the time and what was available.
>
> > The question is whether it would be a good drug to try. I think I've read about energy depletion or something like that with it.
>
> Well, I don't know if the sustained-release formulation ("Gradumets") is still made. You might get a lot of highs and lows in energy as one dose wears off and then another starts to work. It's a pretty short-acting drug (I'm not a big fan of those; I want to be able to go about my business and not have to worry about my medication wearing off every few hours).
> > > Moclobemide
> Huh. My impression was that the by-the-book way to do this involved a lot of red tape and hassle, so I never considered it an option (especially since I didn't even respond completely to the irreversible nonselective MAOIs). If it's just a matter of finding an amenable Canadian pharmacist, though, it might well be worth it. How much does it cost? (I'm pretty sure my insurance won't cover prescriptions that are filled outside the USA, especially for drugs that aren't even approved here.)It was very easy to do and I have the name of the pharmacy if you need it. They just put a copy of the prescription in the package that they mail to you. It can get stopped at customs if the pharmacy forgets to put a copy of the prescription in the package. When this happens, the package is returned to the pharmacy and they put the prescription in the package and remail. No a big deal, but can cause a time delay. The cost was about $1/pill. I was taking one pill a day. So it really wasn't bad. Even on the doctor's end, it's easy. They just make out the script and the client faxes it to the pharmacy. I suppose the doctor call the pharmacy and establishes his credentials before using the pharmacy for the first time.
> > Right now all of these pharmaceutical experiments are on hold while I try Neurofeedback to see if I can stabilize some subthrehold seizure-like activity that is probably causing my physical anxiety.
>
> That's interesting. I have had several EEGs that showed no or little sign of anything being wrong in that department, but I had a SPECT scan which suggested...umm, it's not clear what it suggested, but it was definitely weird.Who did you SPECT? Do you still have the "pictures"? Have you seen the images at thebrainplace.com? Or in Amen's books? Seems like you could match them up. He is pretty clear about what brain activity means what diagnosis. Amen is going to do a study with EEGSpecturm (the neurofeedback place I go to). He is going to do the SPECT before and after treatment. Sounds cool.
> I hope your experiment does some good. I would like to hear about it. (As with all things, I'm curious how (or if) it works.)
I've been to 5 sessions so far. After a couple of sessions I fell into what felt like an unmedicated depression (pretty low). I'd discontinued my lightbox about a week earlier and replugged it in that day to see if it might lift my spirits. (I really don't know if the lightbox worked. I'd decided it didn't when I left it unplugged.) At my session that day, they adjusted the dials on the brain machine (actually increased the voltage on the band of beta I was working on) and I left the session feeling really good. It lasted all that day and the next day. I was pretty excited. Then yesterday was a bit flat. (but then I was feeling over-stimulated and cut my med dose back slightly.) So, it's too early to make any judgments. Maybe the moods were affected by the feedback or maybe it was the lightbox or maybe just my mood modulations. They were not suprised that I was experiencing all of this upheaval and would make adjustments session-to-session depending on how I was feeling.
> > I don't have epilepsy, but I suspect the approach is the same--train the person to narrow the volitility and variation range of alpha, beta and theta brain waves.
>
> Those refer to different combinations of amplitude and frequency: for example, theta rhythm refers to low-amplitude (voltage) and moderately high-frequency (fast) waves.Yeah, I know, but I can't keep the terms in my head. It's like I'm allergic to these high tech words.
> > My pdoc is a neurologist. His reading of my QEEG confirms the reading at EEGSpectrum--namely that I have a lot of spiking activity, one or two out of range spikes every 14 seconds. Those spikes destabilize me, impacting my memory, my autonomic functions (physical anxiety)and generally wreak havoc in the brain. EEGSpectrum believes that this is why I am treatment resistent.
> Yeah, I got the same line about my SPECT. < g > I did get my medical records -- finally -- and plan to call up a neurologist I know to see if he can determine the clinical relevance, if any, of the abnormal SPECT scan.It's really hard to separate fact from fiction in this stuff. It's all so experimental. (although lately, I've been feeling like drug therapy is experimental. You roll the dice and hope it comes up with your number.)
>
> > Of course, my pdoc is trying, without success so far, to treat the problem with anti-convulsants.
>
> Isn't a lot of that due to intolerance of side effects? Which ones have you tried so far?Depekote--really slammed me down sedation wise. Lomictal just made me feel wierd and uncomfortable. Now it's Neurontin. There are others to try, but I don't want a lot of cognitive side effect (because my cognitive abilities are weak due to the depression anyway).
> Again, good luck with the neurofeedback.Thanx.
Lorraine
Posted by Neal on June 16, 2001, at 13:06:56
In reply to Neal - My cocktail update, posted by Shar on June 15, 2001, at 23:24:28
Shar - Nice to hear from you. Mine goes like this:
Wellbutrin - 400mg (200 2x/day)
Remeron - 30mg night, 15mg afternoon
Neurontin - 3600mg (divided throughout day).
Klonopin - 1mg night, .5mg afternoonIt works ok. I was taking 2mg Klonopin, I liked it, but it caused libido problems, as it sometimes does in men, so am tapering down.
The Neurontin works on GABA, as does Klonopin, so it helps with anxiety/social anxiety, and is reputed to have no addictive qualities.
Shar - what is Hydroxyzine Pamoate? Haven't heard of that one before.
Posted by Zo on June 16, 2001, at 21:10:33
In reply to Elizabeth,,,,, posted by gilbert on June 15, 2001, at 16:16:18
> Elizabeth,
>
> You are a good soul. You contibute and you ar so even tempered as well as informed. The way you just handled the above postings....style and grace....
>
> Thanks,
>
> GilAfter following that link to Usenet (!) I have to second Gil's post. . .I've really got to hand it to you, Elizabeth. . .Grace under pressure.
Admiringly,
Zo
Posted by Shar on June 17, 2001, at 0:49:50
In reply to Shar - Cocktail, posted by Neal on June 16, 2001, at 13:06:56
It is the generic form of Vistaril. V is supposed to be a tranq but I find it does not have a strong effect on me. I take it for strong anxiety that I sometimes have, and it is ok for that. It's also an antihistimine, anti-nausea, sleep inducing, etc.
Shar
> Shar - Nice to hear from you. Mine goes like this:
>
> Wellbutrin - 400mg (200 2x/day)
> Remeron - 30mg night, 15mg afternoon
> Neurontin - 3600mg (divided throughout day).
> Klonopin - 1mg night, .5mg afternoon
>
> It works ok. I was taking 2mg Klonopin, I liked it, but it caused libido problems, as it sometimes does in men, so am tapering down.
>
> The Neurontin works on GABA, as does Klonopin, so it helps with anxiety/social anxiety, and is reputed to have no addictive qualities.
>
> Shar - what is Hydroxyzine Pamoate? Haven't heard of that one before.
Posted by Neal on June 18, 2001, at 1:09:28
In reply to Neal - My cocktail update, posted by Shar on June 15, 2001, at 23:24:28
Shar-
My first post disappeared, so I'll try again.Wellbutrin 200mg 2x/day
Remeron 45mg
Neurontin 3600mg, throughout the day
Klonopin 1.5mg, but am tapering down--Neal
Posted by Elizabeth on June 25, 2001, at 7:18:29
In reply to Re: subthreshold epilepsy and stuff » Elizabeth, posted by Lorraine on June 16, 2001, at 11:36:01
[re Cylert:]
> OK, then it definately goes on the "to try" list.Good luck with it! Lots of people seem to think it's no good because it's milder than the amphetamine-type stimulants, but I found it quite helpful.
[re drug abuse:]
> Actually, I just messed around and took a lot of drugs for a couple of years in my teens. Shot speed for a month or two. The drugs I took depended on who I was around at the time and what was available.So you were a "garbage-head," in other words?
What you're describing sounds like it would probably qualify as abuse, but it sounds like it was just a youthful transgression, so I wouldn't worry too much about it.
[re moclobemide:]
> It was very easy to do and I have the name of the pharmacy if you need it.No thanks. I tolerate Parnate fine, and moclobemide doesn't have a very good reputation. It's not worth the time, effort, money, red tape, etc. to me.
> Who did you SPECT? Do you still have the "pictures"?
I must have been unclear. I had a SPECT scan done of my own brain while I was in the hospital. I didn't get any pretty pictures, just a written report. It's consistent with classic depression, from what I know of brain anatomy and functional imaging. In other words, it didn't tell me anything that I haven't known for a decade! I really believe functional imaging has a place in the future, but the idea that it's very useful in making psychiatric diagnoses right now is pretty far-fetched.
> > Those refer to different combinations of amplitude and frequency: for example, theta rhythm refers to low-amplitude (voltage) and moderately high-frequency (fast) waves.
>
> Yeah, I know, but I can't keep the terms in my head. It's like I'm allergic to these high tech words.I had to memorise them for two classes I took: that's my excuse. Hey, what's so high-tech about Greek letters? < g >
> It's really hard to separate fact from fiction in this stuff. It's all so experimental.
Exactly! Until quite recently, SPECT and PET were strictly research tools, and they still don't have even a rudimentary understanding of how these images relate to psychiatric disorders.
> (although lately, I've been feeling like drug therapy is experimental. You roll the dice and hope it comes up with your number.)
Definitely true if you have anything other than "classic" mental illness. You just have to resign yourself to being a guinea pig.
> Depekote--really slammed me down sedation wise.
What dose did you start on, and what was your serum level?
> Lomictal just made me feel wierd and uncomfortable.
Can you be more specific? (I found Lamictal to be free of all effects, even at the highest doses.)
> Now it's Neurontin. There are others to try, but I don't want a lot of cognitive side effect (because my cognitive abilities are weak due to the depression anyway).
I think the cognitive impairment is secondary to the depression: if you treat the depression adequately, the brain fog will follow.
-elizabeth
Posted by Lorraine on June 25, 2001, at 9:36:57
In reply to Re: subthreshold epilepsy 'n' stuff » Lorraine, posted by Elizabeth on June 25, 2001, at 7:18:29
> [re drug abuse:]
> > Actually, I just messed around and took a lot of drugs for a couple of years in my teens. Shot speed for a month or two. The drugs I took depended on who I was around at the time and what was available.
>
> So you were a "garbage-head," in other words?LOL. Well, I hadn't thought of it that way. but, now that you mention it, yes.
> No thanks. I tolerate Parnate fine, and moclobemide doesn't have a very good reputation. It's not worth the time, effort, money, red tape, etc. to me.Parnate doesn't cause sexual dysfunction with you? It is on my list of "to trys"
> > Depekote--really slammed me down sedation wise.
>
> What dose did you start on, and what was your serum level?Well, yeah, like i had a doctor who believed in serum levels--I was just on it a week or so. I couldn't stand it. I felt very stoned, druggy, unable to concentrate.
>
> > Lomictal just made me feel wierd and uncomfortable.
>
> Can you be more specific? (I found Lamictal to be free of all effects, even at the highest doses.)Lomictal just made me feel funny. I can't recall exactly. I think it made me feel unpleasantly aroused--kind of edgy. I may not have given it an adequate trial to tell you the truth. I know that adequate trials take time, but time is all I have and I feel it trickling away while I watch the parade from behind the glass wall.
>
> > Now it's Neurontin. There are others to try, but I don't want a lot of cognitive side effect (because my cognitive abilities are weak due to the depression anyway).
> I think the cognitive impairment is secondary to the depression: if you treat the depression adequately, the brain fog will follow.Maybe, but then sometimes you take a med and you start to forget things
I'm glad your back, elizabeth.
> -elizabeth
Posted by may_b on June 26, 2001, at 11:35:14
In reply to Re: subthreshold epilepsy 'n' stuff » Lorraine, posted by Elizabeth on June 25, 2001, at 7:18:29
Hi Elizabeth
> No thanks. I tolerate Parnate fine, and moclobemide doesn't have a very good reputation. It's not worth the time, effort, money, red tape, etc. to me.
I am just starting a trial with moclobemide (1 week). Feel horribly anergic, without focus etc. Please explain what have you heard about Moclobemide's reputation? I have been culling through the postings and found very little.
Nice to have you back. :)
may_b
Posted by Elizabeth on June 27, 2001, at 7:18:59
In reply to Re: subthreshold epilepsy 'n' stuff, posted by Lorraine on June 25, 2001, at 9:36:57
> > So you were a "garbage-head," in other words?
>
> LOL. Well, I hadn't thought of it that way. but, now that you mention it, yes."A person who uses any drugs that happen to be around." < g >
> Parnate doesn't cause sexual dysfunction with you? It is on my list of "to trys"
That's right, no sex problems from Parnate for me (but keep in mind, I *never* had that side effect from any antidepressant, even the SSRIs). Some people do get sexual side effects from Parnate, but it seems to be much more tolerable than Nardil in that regard.
[re Depakote:]
> Well, yeah, like i had a doctor who believed in serum levels--I was just on it a week or so. I couldn't stand it. I felt very stoned, druggy, unable to concentrate.Jeez. I'm sorry, that sounds awful. What dose did he give you, if you remember?
> Lomictal just made me feel funny. I can't recall exactly. I think it made me feel unpleasantly aroused--kind of edgy. I may not have given it an adequate trial to tell you the truth. I know that adequate trials take time, but time is all I have and I feel it trickling away while I watch the parade from behind the glass wall.
Edginess is a really common initial side effect of antidepressants (and Lamictal seems to be something of an antidepressant). The only good way to deal with it is to start on a very low dose (25 mg, in the case of Lamictal) and use benzodiazepines as needed while you're waiting for it to work. (It's a good idea to be moderate with the benzos -- take them when you need to, but don't overuse them, especially if you had problems with drugs in the past.)
> > I think the cognitive impairment is secondary to the depression: if you treat the depression adequately, the brain fog will follow.
>
> Maybe, but then sometimes you take a med and you start to forget thingsHeh. It's true: sometimes it's hard to separate out the side effects of the meds from the symptoms of depression or anxiety. It becomes especially complicated if you switch medications frequently, start taking multiple medications at once, etc.
> I'm glad your back, elizabeth.
Thank you. :-) I'm glad to be back.
-elizabeth
Posted by Elizabeth on June 27, 2001, at 7:31:55
In reply to Re: subthreshold epilepsy 'n' stuff, posted by may_b on June 26, 2001, at 11:35:14
> Hi Elizabeth
Hi there.
> I am just starting a trial with moclobemide (1 week). Feel horribly anergic, without focus etc.
Is that the depression, or does the moclobemide seem to be causing it (or making it worse)?
> Please explain what have you heard about Moclobemide's reputation? I have been culling through the postings and found very little.
Since it's not marketed in the USA, a lot of people don't have the opportunity to try it. What I've heard is that it is a first-line antidepressant (along with the SSRIs) in some countries, but that it doesn't share the (often seemingly miraculous) effectiveness of the irreversible MAOIs (Nardil, Parnate, Marplan, nialamide, etc.) for people who have already tried a lot of other things without success.
A lot of people seem to have problems with agitation on moclobemide, especially when they first start taking it. Antidepressants in general can cause this (tricyclics, Nardil, Serzone, trazodone, and Remeron are probably the least problematic). Since you've already started taking moclobemide (and particularly if you're in the US and went to all the trouble of procuring it!), you should try to sit it out, as this side effect usually subsides with time. Some people need benzodiazepines when they first start an antidepressant; used judiciously, these can make the experience much easier until you are able to tolerate the antidepressant without them.
Moclobemide seems to be a "hit-or-miss" type of treatment: a few people get very good results, but for others it doesn't work at all. (A lot of the more "selective" drugs are like that -- I'm thinking in particular of Serzone and BuSpar.)
> Nice to have you back. :)
Thanks! :)
-elizabeth
Posted by may_b on June 27, 2001, at 10:02:58
In reply to moclobemide » may_b, posted by Elizabeth on June 27, 2001, at 7:31:55
Hi Elizabeth
Thanks for your helpful response.
> Is that the depression, or does the moclobemide seem to be causing it (or making it worse)?The anergia, loss of focus was present before, but much worse after starting Moclobemide.
> > Please explain what have you heard about Moclobemide's reputation? I have been culling through the postings and found very little.
>that it doesn't share the (often seemingly miraculous) effectiveness of the irreversible MAOIs (Nardil, Parnate, Marplan, nialamide, etc.) for people who have already tried a lot of other things without success.This explains a lot. I had one morning where i thought there was movement but it was followed by many very bad days -- worse than before I started it. Spiralling down. Emotional fragility -- overreactive to the least frustration, poor cognitive functioning. I am wondering how much time to give it, since I have much work to do for which I need my noggin.
> A lot of people seem to have problems with agitation on moclobemide, especially when they first start taking it.I tend to have this response to any and all ADs I have tried (tricyclics, SSRI's, SNRI's).
>Since you've already started taking moclobemide (and particularly if you're in the US and went to all the trouble of procuring it!), you should try to sit it out, as this side effect usually subsides with time.
I am in Canada. No problem to obtain it here. Would you still think it worth pursuing?
> Some people need benzodiazepines when they first start an antidepressant-
This is a helpful clue. Yesterday was my first day of disabling anxiety.
> Moclobemide seems to be a "hit-or-miss" type of treatment: a few people get very good results, but for others it doesn't work at all.
Thanks so much for your excellent feedback.
:)
may_b
Posted by Elizabeth on June 27, 2001, at 23:44:04
In reply to Re: moclobemide, posted by may_b on June 27, 2001, at 10:02:58
> Hi Elizabeth
>
> Thanks for your helpful response.You don't know how gratifying it is to be told that I've been "helpful." Thanks :-)
> The anergia, loss of focus was present before, but much worse after starting Moclobemide.
Gosh. I'd give it a chance, but if this hasn't at least started to clear up in a couple weeks, it probably won't be worth it (IMO).
> This explains a lot. I had one morning where i thought there was movement but it was followed by many very bad days -- worse than before I started it. Spiralling down. Emotional fragility -- overreactive to the least frustration, poor cognitive functioning. I am wondering how much time to give it, since I have much work to do for which I need my noggin.
The "emotional fragility" you describe is *exactly* the kind of thing that classic MAOIs help with. Tricyclics have been known to make it worse. SSRIs can too, in the short term, although they often help if you are able to tolerate them long enough.
You know, there is an irreversible, type-A-selective MAOI -- clorgyline -- but I don't think it was ever used clinically. I wonder how it would compare to Nardil and Parnate, in terms of side effects, efficacy, and interactions with foods and drugs.
> I am in Canada. No problem to obtain it here. Would you still think it worth pursuing?
Depending on your situation -- can you afford to be feeling crappy for a couple more weeks? It might subside, and if it did and the Manerix turned out to work, that would be a blessing.
> > Some people need benzodiazepines when they first start an antidepressant-
>
> This is a helpful clue. Yesterday was my first day of disabling anxiety.I really recommend that you try to get some Rivotril or the like, then.
> Thanks so much for your excellent feedback.
You're very welcome. I'm glad I can help.
best wishes & hopes,
-elizabeth
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.