![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 119. Go back in thread:
Posted by ed_uk2010 on December 5, 2011, at 16:56:57
In reply to Re: Effexor 450 mg? » SLS, posted by sigismund on December 5, 2011, at 16:43:39
>What you have described (what I have paid attention to) sounds like chronic fatigue.....a slowed down state which affects all of you, your mind and body.....
I suppose what I was thinking is that chronic fatigue and slowness are among the symptoms most likely to be aggravated by continuous psych medication. For me at least, tiredness has been a side effects of almost everything that I've taken. Even if it hasn't initially been a problem, it has been after months/years of treatment. On stopping offending medication, I've sometimes felt more tired for a while while I adjusted, but better in the long run. I still take medication but much less than I did.
Posted by Phidippus on December 5, 2011, at 17:16:29
In reply to Re: Effexor 450 mg?, posted by jono_in_adelaide on December 4, 2011, at 22:41:46
> Effexor 300 mg
> nortriptyline 150 mg
> Lamictal 200mg
> Abilify 10 mg
> lithium 300 mg>I'm pretty much out of ideas.
Let's do this:
900 mg Lithium
150 mg Clomipramine
80 mg LatudaSee how you feel :)
Eric
Posted by Phidippus on December 5, 2011, at 17:18:44
In reply to Re: Effexor 450 mg? » Phidippus, posted by SLS on December 5, 2011, at 7:33:09
Ketamine might be a good option for you. It shown to be a powerful antidepressant.
DBS is tricky...You might want to opt for VNS.
Eric
Posted by Phillipa on December 5, 2011, at 18:07:55
In reply to Effexor 450 mg?, posted by SLS on December 1, 2011, at 12:20:25
Living in the NE could lymes disease possibly be a factor as when I was diagnosed had no idea been bitten by a tic. Just a thought. Phillipa
Posted by Bob on December 5, 2011, at 23:34:48
In reply to Re: Effexor 450 mg? » SLS, posted by Phidippus on December 5, 2011, at 17:18:44
> Ketamine might be a good option for you. It shown to be a powerful antidepressant.
>
> DBS is tricky...You might want to opt for VNS.
>
> Eric
Why do you say DBS is tricky?
Posted by SLS on December 6, 2011, at 17:34:28
In reply to Re: Effexor 450 mg? » Phidippus, posted by Bob on December 5, 2011, at 23:34:48
My doctor acceded to my request to raise the dosage of Effexor to 450 mg. I'm not expecting miracles, but perhaps it will help enough so that I could return to work. He also prescribed prazosin, thinking that there might be a PTSD thing going on. I don't think there is, but I'll go along with it for now.
- Scott
Posted by SLS on December 6, 2011, at 17:39:23
In reply to Re: Effexor 450 mg? » SLS, posted by Phidippus on December 5, 2011, at 17:18:44
> Ketamine might be a good option for you. It shown to be a powerful antidepressant.
I would love to try ketamine. It might fill a role so as to "kick-start" other antidepressants.
- Scott
Posted by SLS on December 6, 2011, at 17:49:46
In reply to Re: Effexor 450 mg? » SLS, posted by sigismund on December 5, 2011, at 16:43:39
> The other thing that I am not clear about is the nature of your depression. What you have described (what I have paid attention to) sounds like chronic fatigue.
Yeah. It's like having a combination of CFS and Alzheimer's.
> At least you do not seem to suffer from despair (except at treatment options!) or terrible distress, but rather a slowed down state which affects all of you, your mind and body.
>
> Is that right?Perfect explanation.
Anergia
Psychomotor retardation
Anhedonia
Flat affect
Cognitive slowing
Memory impairment
Intrusive thoughts (offset by CBT)
Negative thinking (offset by CBT)
Depressed mood (offset by CBT)
- Scott
Posted by SLS on December 6, 2011, at 17:59:44
In reply to Re: Effexor 450 mg?, posted by jono_in_adelaide on December 5, 2011, at 16:25:37
> Which drugs/combinations have you responded to in the past?
A combination of Parnate + desipramine led to an extended remission lasting 9 months. The doctor had me discontinue both drugs when mania developed. I am no longer responsive to this combination.
I have experienced "blip" responses to quite a few drugs that comprise 1-3 days of improvement followed by relapse.
- Scott
Posted by Phillipa on December 6, 2011, at 18:22:52
In reply to Re: Effexor 450 mg? » jono_in_adelaide, posted by SLS on December 6, 2011, at 17:59:44
Scott and you are positive that thyroid okay as those symtoms are also of thyroid. Have you had ANA tested and thyroid antibodies? Phillipa
Posted by Phidippus on December 7, 2011, at 14:56:13
In reply to Re: Effexor 450 mg? » Phidippus, posted by SLS on December 6, 2011, at 17:39:23
I thinkk you just need tro strip everything down and start from scratch.
Eric
Posted by Phidippus on December 7, 2011, at 14:58:00
In reply to Re: Effexor 450 mg? » Phidippus, posted by Bob on December 5, 2011, at 23:34:48
Placement of stimulators is very hit and miss, where as VNS stimulation targets only the Vagal Nerve.
Eric
Posted by Phidippus on December 7, 2011, at 15:05:32
In reply to Re: Effexor 450 mg? » SLS, posted by Phillipa on December 5, 2011, at 18:07:55
Lymes ends up being a systemic problem. NE isn't going to rock the boat.
Eric
Posted by Bob on December 7, 2011, at 17:07:05
In reply to Re: Effexor 450 mg? » Bob, posted by Phidippus on December 7, 2011, at 14:58:00
> Placement of stimulators is very hit and miss, where as VNS stimulation targets only the Vagal Nerve.
>
> Eric
Yes, but then the question becomes, what areas of the brain is the Vagal nerve affecting? Obviously if there is any benefit at all, then at least one of the innervated areas is responsible.I haven't heard much at all about VNS lately.
Posted by hyperfocus on December 7, 2011, at 17:19:24
In reply to Re: Effexor 450 mg? » jono_in_adelaide, posted by SLS on December 5, 2011, at 7:05:45
What meds were you taking immediately before you started with the Parnate/desipramine?
Posted by Bob on December 7, 2011, at 17:40:13
In reply to Re: Effexor 450 mg?, posted by SLS on December 6, 2011, at 17:34:28
> My doctor acceded to my request to raise the dosage of Effexor to 450 mg. I'm not expecting miracles, but perhaps it will help enough so that I could return to work. He also prescribed prazosin, thinking that there might be a PTSD thing going on. I don't think there is, but I'll go along with it for now.
>
>
> - Scott
>
>
Scott -What can you tell me about prazosin? How does it work and what are your experiences with taking it? Is this drug widely used for PTSD? Are there other drugs out there meant for the treatment of PTSD?
Bob
Posted by huxley on December 7, 2011, at 21:53:11
In reply to Effexor 450 mg?, posted by SLS on December 1, 2011, at 12:20:25
Hi Scott,
I went up to 600mg of effexor.
Did nothing it did't do at 200mg.
Posted by SLS on December 8, 2011, at 7:30:04
In reply to Re: Effexor 450 mg?, posted by huxley on December 7, 2011, at 21:53:11
> Hi Scott,
>
> I went up to 600mg of effexor.
>
> Did nothing it did't do at 200mg.
Thanks for the input, Huxley.Did you experience any side effects?
- Scott
Posted by SLS on December 8, 2011, at 7:34:09
In reply to Re: Effexor 450 mg? » SLS, posted by hyperfocus on December 7, 2011, at 17:19:24
> What meds were you taking immediately before you started with the Parnate/desipramine?
I had been drug-free for almost a year prior to treatment. Baron Shopsin had recommended that I stay "clean" as much as possible. Unfortunately, my depression became too severe not to treat.
- Scott
Posted by SLS on December 8, 2011, at 7:36:22
In reply to Re: Effexor 450 mg? » SLS, posted by Phidippus on December 7, 2011, at 14:56:13
> I thinkk you just need tro strip everything down and start from scratch.
My baseline depression is too severe for me to live independently.
What did you have in mind?
Thanks.
- Scott
Posted by SLS on December 8, 2011, at 8:04:36
In reply to Re: Effexor 450 mg? » SLS, posted by Bob on December 7, 2011, at 17:40:13
> > My doctor acceded to my request to raise the dosage of Effexor to 450 mg. I'm not expecting miracles, but perhaps it will help enough so that I could return to work. He also prescribed prazosin, thinking that there might be a PTSD thing going on. I don't think there is, but I'll go along with it for now.
> What can you tell me about prazosin? How does it work and what are your experiences with taking it? Is this drug widely used for PTSD? Are there other drugs out there meant for the treatment of PTSD?
Prazosin is a specific alpha-1 NE receptor antagonist. It is supposed to help improve sleep and reduce nightmares. I really don't think it is an appropriate treatment for me. I do have occasional dreams of being bullied in high school. I don't know...
Topamax is an effective treatment for PTSD. It helps with re-experiencing and avoidance. I don't know what dosages are used. One study I came across used 100 mg.
- Scott
-----------------------------------
Posted by SLS on December 8, 2011, at 8:07:51
In reply to Re: Effexor 450 mg? » SLS, posted by ed_uk2010 on December 5, 2011, at 16:01:41
> Perhaps to taper off all or most of your medication over a period of a few months??
That is an appealing idea.
Thanks for sharing your knowledge and support.
- Scott
Posted by SLS on December 8, 2011, at 8:08:36
In reply to Re: Effexor 450 mg? » SLS, posted by ed_uk2010 on December 5, 2011, at 16:01:41
> Perhaps to taper off all or most of your medication over a period of a few months??
That is an appealing idea.
Thanks for sharing your knowledge and support.
- Scott
Posted by ed_uk2010 on December 8, 2011, at 8:44:42
In reply to Re: Effexor 450 mg? » ed_uk2010, posted by SLS on December 8, 2011, at 8:08:36
>That is an appealing idea.
I'm not sure how appealing it is (!) but it is possible that a period on less medication could make you more responsive to ADs again.
After being on a substantial combination of psych meds over a prolonged period, it is impossible to know how you would feel on less medication without actually trying it. Even though most of your current medications produced some benefit initially, who knows what they are doing for you right now? Obviously, you would have to reduce one medication at a time, and you would have to reduce gradually enough to avoid any rebound symptoms.
Posted by Phidippus on December 8, 2011, at 13:56:43
In reply to Re: Effexor 450 mg? » SLS, posted by ed_uk2010 on December 8, 2011, at 8:44:42
Go for it. I've done it on more than one occasion. Always worked out for the best.
Eric
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.