![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 47 to 71 of 76. Go back in thread:
Posted by jono_in_adelaide on December 27, 2012, at 20:37:44
In reply to Re: feel finished - GGG » jono_in_adelaide, posted by g_g_g_unit on December 27, 2012, at 19:21:18
In that case, it looks like your best options are either Nardil + a mood stabaliser and maybe doxepin or a benzo for sleep, or Parnate (perhaps in a higher doseage) plus a benzo for anxiety.
I'd decide which one you prefered, and push the envelope so far as dose and combinations go
What exactly do you mean by "a bit hypomanic", just more energy than usual, or somthing more serious?
Parnate (perhaps at 80mg) plus a long acting benzo such as Valium
or
Nardil plus a mood stabaliser (your guess is as good as mine here) plus either a benzo or doxepin for sleep
Dont give up, keep tryimg, keep hope
> > Sorry if my comments about side effects came across as me having a dig, it wasnt intended that way..... its just that you often get the side effects before you get any of the improvement, and its easy to say "this stiff is crap" and stop it.
> >
> > I'd consider either a high dose SSRI (Sertaline 200mg/day) or Effexor 300mg plus mirtazapine to help with the depression, OCD and anxiety, with or without a benzo
> >
> > other options are the parnate + nortriptyline i mentioned earlier with a benzo, or Nardil plus nortriptyline and a benzo, or a high dose SSRI with bupropion and a benzo, all of course depending on what you've tried in the past
> >
> > Which drug or combination of drugs has come closest to giving you relief?
>
> Unfortunately, I found nortriptyline stimulating rather than sedating, so don't think I'd be able to tolerate it with an MAOI. Same thing with clomipramine -- it produced a lot of akathisia and agitation and isn't something I'd be desperate to revisit.
>
> As I said, the closest I came to relief was on Parnate, which helped my depressive symptoms (anergia, lack of motivation, rejection sensitivity) and, to a degree, my ADD (which no other AD has done), but which didn't relieve my anxiety, and in fact may have increased it. I was only permitted to try up to 60mg, which was the minimum dose necessary for an anti-depressant response. Nardil helped too, but the insomnia was terrible and it made me a little hypomanic.
>
>
>
Posted by brynb on December 27, 2012, at 20:49:03
In reply to Re: feel finished GGG oh, also, posted by jono_in_adelaide on December 27, 2012, at 16:42:33
> If you havent tried clomipramine 150mg per day plus a benzo, try it!
>
> Clomipramine has more side effects than the SSRI's, but it is generaly the gold standard for OCD, is very effective in depression, and also is good for anxietyJono & Scott,
I feel like this could be helpful for me, too. (Sorry to make this about me, but I'm very curious.) I need something that obliterates (ok, rids) the depression and anxiety. I mentioned in a thread below that I'm contemplating Nardil (or an MAOI) cause nothing's cutting it and I've been back in bed without showering for the past week again.
OR, are there other SRIs that could be more effective than Lexapro? I've been on it forever and like how clean it is with serotonin and that it's weight neutral. What's with Viibryd and Pristiq?
I tend to get a lot more anxious and activated from meds that work on norepinephrine as well as Wellburin.
Thanks.
-b
Posted by SLS on December 27, 2012, at 20:50:54
In reply to Re: feel finished » SLS, posted by schleprock on December 27, 2012, at 18:54:42
> Thanks SLS. Found this article:
>
> http://www.ehow.com/facts_5695241_alpha-blocker-vs_-beta-blocker.html
>
> So basically one class lowers norepinephrine while one lowers epinephrine. The article manages to make the side-effects of Alphas sound much worse than Betas. Atenolol (not over 12.5 mg) I know I've been able to tolerate. Not sure what to do...
>
> Do you also believe bet blockers to be an effective adjunct treatment for anxiety\depression, or only alpha blockers?
Beta blockers seem to help some people with anxiety, but it is not as effective for PTSD and depression as is prazosin.As an analogy, think of beta blockers as working on norepinephrine and prazosin as working on serotonin and dopamine. They are totally different in the way they act in the brain.
Prazosin is generally benign. If beta blockers have not worked magic for you, I would consider trying prazosin. To minimize startup side effects, begin at 1 mg at night. You might feel somewhat dizzy and somnolent in the beginning, but these things usually disappear entirely. Studies using prazosin for PTSD with depression have used, on the average, 6 - 12 mg/day. You need to take prazosin 2 - 3 times a day. Right now, aside from the libido thing, I would never know that I was taking prazosin.
- Scott
Posted by jono_in_adelaide on December 27, 2012, at 21:22:30
In reply to @ jono + SLS, posted by brynb on December 27, 2012, at 20:49:03
Clomipramine would certainly be worth trying, as would nardil, with or without a benzo. hard to say which would be best as its so individual. neither is weight neutral, but given your current condition, I think you need an effective drug, regardless of weight gain etc.
Speak to your psych and see which one s/he thisnk would be best, its obvious that what you're doing now isnt cutting it.
Posted by Phillipa on December 27, 2012, at 21:51:08
In reply to Re: @ jono + SLS - brynb, posted by jono_in_adelaide on December 27, 2012, at 21:22:30
Bryn Jono is right it's getting this bad? Phillipa
Posted by brynb on December 27, 2012, at 23:35:40
In reply to Re: @ jono + SLS - brynb, posted by Phillipa on December 27, 2012, at 21:51:08
yes, it's bad--I've spent the week in bed. I can't even cry. I'm taking my Librium all day long to sleep. to make things worse, I lost my unemployment but gained two writing jobs, only I can't get myself to work on them even though I don't need to leave my apartment to do them!
I'm also pms-ing, which sends me into a tailspin. I don't want to quit & I have hope that things will get better but it seems so far away. I'm trying so hard to keep a brave face for my family but clearly when I'm holed up sleeping & not showering, it's a hard to maintain. my pdoc hasn't called me back & I think I'm going to embark upon the arduous task of finding someone new.
what's worse is I truly believe we create our own realities & that I could really push through this right now, BUT, I just don't have it in me at the moment. I have no strength right now.
Posted by g_g_g_unit on December 28, 2012, at 6:44:44
In reply to Re: feel finished - GGG » g_g_g_unit, posted by SLS on December 27, 2012, at 20:29:37
> > Nardil helped too, but the insomnia was terrible and it made me a little hypomanic.
>
> Perhaps you could combine Nardil with a stimulant and Klonopin. Nardil is the ideal MAOI for your depression and anxiety. The stimulant would help with depression and ADD. The Klonopin would help with anxiety, insomnia, and possibly mania. The mania from Nardil usually starts early in treatment and is self-limiting. Trileptal can be used as a mood stabilizer if necessary. If insomnia is an obstacle to feeling great on Nardil, then it is incumbent on your doctor to treat that insomnia aggressively as if it were your primary illness. Failure is not an option. Use Halcion along with another benzodiazepine if you have to. Perhaps 25 - 50 mg of Seroquel? Find a way.
>
> If I recall, you have problems with antipsychotics? Saphris and Latuda are interesting drugs. Saphris can actually be energizing along with being anxiolytic.
>
>
> - ScottThanks for the suggestions. Nardil + d-amphetamine is something I would love to try, but I have very little hope of having it prescribed. As I've mentioned before, I e-mailed a self-described specialist in treatment-resistant depression who claimed he was aware of studies indicating the usefulness of the combination, but considered it far too dangerous to utilize in practice.
There is a "professorial" unit at the hospital I would be going to, so I don't know if they would be more amenable to exotic treatment ideas, but the psychiatrist I contacted was also a professor at the same university with ties to the clinic.
As far as anti-psychotics go, Seroquel induced akathisia at the lowest possible doses (prescribed for sleep), Zyprexa and Risperdal increased anxiety.
Posted by g_g_g_unit on December 28, 2012, at 6:47:46
In reply to Re: feel finished - GGG, posted by jono_in_adelaide on December 27, 2012, at 20:37:44
> In that case, it looks like your best options are either Nardil + a mood stabaliser and maybe doxepin or a benzo for sleep, or Parnate (perhaps in a higher doseage) plus a benzo for anxiety.
>
> I'd decide which one you prefered, and push the envelope so far as dose and combinations goI suppose it would ultimately depend on how far the psychiatrist in question would be willing to push things. Liberal psychiatrists seem to be a rarity in Australia.
>
> What exactly do you mean by "a bit hypomanic", just more energy than usual, or somthing more serious?More energy, a little euphoric, acted slightly out-of-character (reconciled with brother I hadn't spoken to for 4 years, though perhaps that's a good thing?) ..
>
> Parnate (perhaps at 80mg) plus a long acting benzo such as Valium
>
> or
>
> Nardil plus a mood stabaliser (your guess is as good as mine here) plus either a benzo or doxepin for sleep
>My only worry is Nardil would have no benefit on ADD (most ADD patients seem to report in exacerbating their attentional difficulties).
> Dont give up, keep tryimg, keep hope
>
>
> > > Sorry if my comments about side effects came across as me having a dig, it wasnt intended that way..... its just that you often get the side effects before you get any of the improvement, and its easy to say "this stiff is crap" and stop it.
> > >
> > > I'd consider either a high dose SSRI (Sertaline 200mg/day) or Effexor 300mg plus mirtazapine to help with the depression, OCD and anxiety, with or without a benzo
> > >
> > > other options are the parnate + nortriptyline i mentioned earlier with a benzo, or Nardil plus nortriptyline and a benzo, or a high dose SSRI with bupropion and a benzo, all of course depending on what you've tried in the past
> > >
> > > Which drug or combination of drugs has come closest to giving you relief?
> >
> > Unfortunately, I found nortriptyline stimulating rather than sedating, so don't think I'd be able to tolerate it with an MAOI. Same thing with clomipramine -- it produced a lot of akathisia and agitation and isn't something I'd be desperate to revisit.
> >
> > As I said, the closest I came to relief was on Parnate, which helped my depressive symptoms (anergia, lack of motivation, rejection sensitivity) and, to a degree, my ADD (which no other AD has done), but which didn't relieve my anxiety, and in fact may have increased it. I was only permitted to try up to 60mg, which was the minimum dose necessary for an anti-depressant response. Nardil helped too, but the insomnia was terrible and it made me a little hypomanic.
> >
> >
> >
>
>
Posted by SLS on December 28, 2012, at 7:11:39
In reply to Re: feel finished - GGG » SLS, posted by g_g_g_unit on December 28, 2012, at 6:44:44
> > > Nardil helped too, but the insomnia was terrible and it made me a little hypomanic.
> >
> > Perhaps you could combine Nardil with a stimulant and Klonopin. Nardil is the ideal MAOI for your depression and anxiety. The stimulant would help with depression and ADD. The Klonopin would help with anxiety, insomnia, and possibly mania. The mania from Nardil usually starts early in treatment and is self-limiting. Trileptal can be used as a mood stabilizer if necessary. If insomnia is an obstacle to feeling great on Nardil, then it is incumbent on your doctor to treat that insomnia aggressively as if it were your primary illness. Failure is not an option. Use Halcion along with another benzodiazepine if you have to. Perhaps 25 - 50 mg of Seroquel? Find a way.
> >
> > If I recall, you have problems with antipsychotics? Saphris and Latuda are interesting drugs. Saphris can actually be energizing along with being anxiolytic.
> >
> >
> > - Scott
>
> Thanks for the suggestions. Nardil + d-amphetamine is something I would love to try, but I have very little hope of having it prescribed. As I've mentioned before, I e-mailed a self-described specialist in treatment-resistant depression who claimed he was aware of studies indicating the usefulness of the combination, but considered it far too dangerous to utilize in practice.Perhaps he needs more practice?
Have you found and printed material indicating the safety of such combinations to show your doctors? Being on Parnate + TCA + stimulants hasn't killed me. I wish I had the name of a good doctor for you. Where do you live? Which universities are close to you? I might be able to come up with some names for you. Perhaps you can arrange for a consultation with another doctor who would then have a conversation with your current doctor?
Do you have the antipsychotic, asenapine (Saphris), there?
- Scott
Posted by g_g_g_unit on December 28, 2012, at 7:30:18
In reply to Re: feel finished - GGG » g_g_g_unit, posted by SLS on December 28, 2012, at 7:11:39
>
> Perhaps he needs more practice?I imagine so. I remember a comment from Chairman_MAO on here about how European-trained psychiatrists are far more willing to take risks, and that was the only way he managed to get an MAOI + stimulant prescribed. There is a Russian woman I saw when I first moved here who seemed extremely competent and well-researched, but she was so aggressive and confrontational that I found her impossible to work with. I've always imagined that she might be willing to try the combination, though I'm far too scared to return to her (I just left halfway through treatment and never returned).
>
> Have you found and printed material indicating the safety of such combinations to show your doctors?No, I didn't bother. It took an incredible amount of convincing to get my psychiatrist to exceed the daily threshold of 30mg of Parnate per day permitted here, so I doubt he would add a psychostimulant into the mix (plus Parnate was stimulating enough). That said, if I go inpatient, he won't be treating me.
>Being on Parnate + TCA + stimulants hasn't killed >me. I wish I had the name of a good doctor for >you. Where do you live? Which universities are >close to you? I might be able to come up with >some names for you. Perhaps you can arrange for a >consultation with another doctor who would then >have a conversation with your current doctor?
I live in Melbourne, Australia. We have Melbourne University, Monash University and Deaken University here. If you could come up with any names, that would be great. I have done my best -- emailing heads of departments etc. -- though typically I don't receive a response.
My psychiatrist did, at one point, refer me to a professor he frequently utilizes for second opinions. The doctor in question recommended a high dose SSRI + high dose anti-psychotic (despite my lackluster response to both) and said I couldn't possibly have ADD (though I don't know how he discerned that after a single one-hour interview). He also recommended ECT over MAOIs. I kind of lost faith in other specialists after that. My own psychiatrist has been extremely accommodating a pleasure to work with, but doesn't, I think, have the research background to toy with more exotic combinations. He tends to treat fairly straightforward ADHD cases, from my understanding. I stick with him for his patience and goodwill and unparalleled bedside manner.
>
> Do you have the antipsychotic, asenapine (Saphris), there?
>A cursory google search seems to suggest we do ..
>
> - ScottThanks, as always.
Posted by g_g_g_unit on December 29, 2012, at 1:41:32
In reply to Re: feel finished - GGG » g_g_g_unit, posted by SLS on December 28, 2012, at 7:11:39
Hey SLS, I'm not sure whether you'll be able to answer this or not, but I'm not currently on any meds -- and my psychiatrist only returns from vacation in three weeks -- so I kind of have some room to experiment.
Anyway, I have a bunch of Memantine lying around. I tried it in doses varying from 2.5 - 15mg, but found that it increased my anxiety/OCD and caused agitation.
I read a post from phiddipus stating that 5-HT3 affinity increases at 20mg, and thus it enhances GABA activity and becomes more anxiolytic. I can't find anything that confirms that and haven't read of anyone noticing a subjective difference in effect with different doses -- in fact, my adverse reaction seems to be quite out of the ordinary. Overall, from studies etc., it seems to be a really well-tolerated drug, which is why my response confused me.
That said, do you think it would be worth experimenting with taking 20mg a day for a little while and seeing how I respond? Do you know of many people who have experience with the drug and possibly responded better at a higher doses? Is it possible to speculate whether the increased NMDA antagonism etc. could possibly be more beneficial?
It's hard to know whether attempting to self-medicate when feeling so out-of-control etc. might be worse for me -- and whether it might be better to just secede control over to the hospital -- but I also thought I might get lucky (for once) and didn't have anything to lose, other than some transient discomfort.
Posted by SLS on December 29, 2012, at 7:44:17
In reply to question for SLS » SLS, posted by g_g_g_unit on December 29, 2012, at 1:41:32
I spent about an hour researching 5-HT3 receptors and am now more confused now than before I started. I had begun to write a long-winded explanation, but quickly found that the subject would require more study to offer any meaningful understanding at this time. 5-HT3 receptor function and dynamics are complex and variable, and depends upon the neuroal circuits they appear in and the species being studied.
As far as I can see, memantine acts as an antagonist of serotonin 5-HT3 receptors at concentrations comparable to those producing NMDA antagonism. However, any small difference in the numbers observed in the lab might translate to a significant difference in therapeutic dosage. Phiddipus might be right. I can't be sure. However, because memantine can help with OCD, I think this might be reason enough for you to try it again. I don't think you can evaluate memantine until you can establish a dosage of 20 mg/day. If anxiety prevents you from doing this, I would discontinue it. From what I gather, antagonism of 5-HT3 receptors in the amygdala can lead to a reduction in the activity of GABA neurons there. This might account for the anxiety you experience. It might dissipate with continued treatment, though, as I believe the presynaptic membrane becomes desensitized quickly. If it doesn't dissipate, this may be a clue into what is going on with you - amygdala hyperactivity. How do you react to Neurontin (gabapentin)? Perhaps prazosin would help.
What if you were to attack the ADD, anxiety, and OCD first? Do you think the depression would resolve?
As always, it would be nice to have your doctor support you during a treatment experiment. However, if it were me, I would probably try the memantine again and push the dosage to 20 mg/day or higher. Take things one step at a time, though. See if the startup anxiety is tolerable using the recommended titration schedule. If the inceased anxiety persists for two weeks or is otherwise intolerable, I would stop taking it. Your amygdala might be hyperactive. If you do manage to establish a dosage of 20 mg/day without adverse effects, you might as well leave it on board as you try adding Nardil, Viibryd, or clomipramine.
Nardil + Focalin + memantine might be interesting.
Recommended NAMENDA dosing schedule:Week 1: Starting on Day 1. Take one 5 mg tablet in the morning, each day.
Week 2: Starting on Day 8. Take one 5 mg tablet in the morning and one 5 mg tablet at night, each day.
Week 3: Starting on Day 15. Take one 10 mg tablet in the morning and one 5 mg tablet at night, each day.
Week 4: Starting on Day 22. Take one 10 mg tablet in the morning and one 10 mg tablet at night, each day.
- Scott
Posted by g_g_g_unit on December 29, 2012, at 21:46:10
In reply to Re: question for SLS » g_g_g_unit, posted by SLS on December 29, 2012, at 7:44:17
Thanks so much for your reply Scott.
For the record, I *did* recently try Memantine in a dose range from 2.5mg-15mg and only experienced an increase in anxiety and agitation. At 10mg, and again 15mg, I gave each dose two weeks to adjust, but the increased anxiety never dissipated, which is what forced me to discontinue.
I thought perhaps that 20mg might yield some alternate effects, so was considering just starting directly at 20mg without titrating, though if I reacted badly to lower doses, perhaps it isn't worth my time?
> I spent about an hour researching 5-HT3 receptors and am now more confused now than before I started. I had begun to write a long-winded explanation, but quickly found that the subject would require more study to offer any meaningful understanding at this time. 5-HT3 receptor function and dynamics are complex and variable, and depends upon the neuroal circuits they appear in and the species being studied.
>
> As far as I can see, memantine acts as an antagonist of serotonin 5-HT3 receptors at concentrations comparable to those producing NMDA antagonism. However, any small difference in the numbers observed in the lab might translate to a significant difference in therapeutic dosage. Phiddipus might be right. I can't be sure. However, because memantine can help with OCD, I think this might be reason enough for you to try it again. I don't think you can evaluate memantine until you can establish a dosage of 20 mg/day. If anxiety prevents you from doing this, I would discontinue it. From what I gather, antagonism of 5-HT3 receptors in the amygdala can lead to a reduction in the activity of GABA neurons there. This might account for the anxiety you experience. It might dissipate with continued treatment, though, as I believe the presynaptic membrane becomes desensitized quickly. If it doesn't dissipate, this may be a clue into what is going on with you - amygdala hyperactivity. How do you react to Neurontin (gabapentin)? Perhaps prazosin would help.
>
> What if you were to attack the ADD, anxiety, and OCD first? Do you think the depression would resolve?
>
> As always, it would be nice to have your doctor support you during a treatment experiment. However, if it were me, I would probably try the memantine again and push the dosage to 20 mg/day or higher. Take things one step at a time, though. See if the startup anxiety is tolerable using the recommended titration schedule. If the inceased anxiety persists for two weeks or is otherwise intolerable, I would stop taking it. Your amygdala might be hyperactive. If you do manage to establish a dosage of 20 mg/day without adverse effects, you might as well leave it on board as you try adding Nardil, Viibryd, or clomipramine.
>
> Nardil + Focalin + memantine might be interesting.
>
>
> Recommended NAMENDA dosing schedule:
>
> Week 1: Starting on Day 1. Take one 5 mg tablet in the morning, each day.
>
> Week 2: Starting on Day 8. Take one 5 mg tablet in the morning and one 5 mg tablet at night, each day.
>
> Week 3: Starting on Day 15. Take one 10 mg tablet in the morning and one 5 mg tablet at night, each day.
>
> Week 4: Starting on Day 22. Take one 10 mg tablet in the morning and one 10 mg tablet at night, each day.
>
>
> - Scott
Posted by SLS on December 29, 2012, at 22:24:58
In reply to Re: question for SLS » SLS, posted by g_g_g_unit on December 29, 2012, at 21:46:10
> I thought perhaps that 20mg might yield some alternate effects, so was considering just starting directly at 20mg without titrating, though if I reacted badly to lower doses, perhaps it isn't worth my time?
I had thought to suggest that you restart memantine at 20 mg/day so that you can test your idea. However, I am reluctant to encourage anyone else to try it under the premise that they would find the drug as tolerable as I did.
I once started memantine right at 20 mg/day. For me personally, I am not afraid of memantine, and would probably restart it at 20 mg/day again if I wanted to add it to my present treatment regime. The worst thing that I would anticipate happening is a transient feeling of brain-fog and perhaps drunkeness along with nausea and headache.
I am not aware of any dangerous reactions to 40 mg/day of memantine.
I guess I haven't really helped you out with this post.
Sorry.
- Scott
Posted by g_g_g_unit on December 30, 2012, at 1:11:07
In reply to Re: question for SLS » g_g_g_unit, posted by SLS on December 29, 2012, at 22:24:58
Hey Scott -- no that's okay, I suppose I'm really just looking for external license to experiment, whereas it should originate from me. I realize it's probably not possible for you to speculate on what 20mg will do based on my reaction to lower doses.
I think I'll skip the titration process and just try 20mg for at least a week or so. The worst I can expect is increased anxiety and agitation, in which case I'll stop.
> > I thought perhaps that 20mg might yield some alternate effects, so was considering just starting directly at 20mg without titrating, though if I reacted badly to lower doses, perhaps it isn't worth my time?
>
> I had thought to suggest that you restart memantine at 20 mg/day so that you can test your idea. However, I am reluctant to encourage anyone else to try it under the premise that they would find the drug as tolerable as I did.
>
> I once started memantine right at 20 mg/day. For me personally, I am not afraid of memantine, and would probably restart it at 20 mg/day again if I wanted to add it to my present treatment regime. The worst thing that I would anticipate happening is a transient feeling of brain-fog and perhaps drunkeness along with nausea and headache.
>
> I am not aware of any dangerous reactions to 40 mg/day of memantine.
>
> I guess I haven't really helped you out with this post.
>
> Sorry.
>
>
> - Scott
Posted by g_g_g_unit on December 30, 2012, at 1:17:03
In reply to Re: question for SLS » g_g_g_unit, posted by SLS on December 29, 2012, at 22:24:58
Hey Scott -- no that's okay, I suppose I'm really just looking for external license to experiment, whereas it should originate from me. I realize it's probably not possible for you to speculate on what 20mg will do based on my reaction to lower doses.
I think I'll skip the titration process and just try 20mg for at least a week or so. The worst I can expect is increased anxiety and agitation, in which case I'll stop.
> > I thought perhaps that 20mg might yield some alternate effects, so was considering just starting directly at 20mg without titrating, though if I reacted badly to lower doses, perhaps it isn't worth my time?
>
> I had thought to suggest that you restart memantine at 20 mg/day so that you can test your idea. However, I am reluctant to encourage anyone else to try it under the premise that they would find the drug as tolerable as I did.
>
> I once started memantine right at 20 mg/day. For me personally, I am not afraid of memantine, and would probably restart it at 20 mg/day again if I wanted to add it to my present treatment regime. The worst thing that I would anticipate happening is a transient feeling of brain-fog and perhaps drunkeness along with nausea and headache.
>
> I am not aware of any dangerous reactions to 40 mg/day of memantine.
>
> I guess I haven't really helped you out with this post.
>
> Sorry.
>
>
> - Scott
Posted by SLS on December 30, 2012, at 5:08:29
In reply to Re: question for SLS » SLS, posted by g_g_g_unit on December 30, 2012, at 1:17:03
> Hey Scott -- no that's okay, I suppose I'm really just looking for external license to experiment, whereas it should originate from me. I realize it's probably not possible for you to speculate on what 20mg will do based on my reaction to lower doses.
>
> I think I'll skip the titration process and just try 20mg for at least a week or so. The worst I can expect is increased anxiety and agitation, in which case I'll stop.I know what it is like to fear never knowing for sure whether or not a treatment idea would work. It would forever nag at you had you not tried this now.
Phiddipus was insistent that dosages above 20 mg/day worked magic.
Good luck.
- Scott
Posted by SLS on December 30, 2012, at 6:50:22
In reply to Re: question for SLS » SLS, posted by g_g_g_unit on December 30, 2012, at 1:17:03
I'll see if I can find more, but these doctors would be worth contacting - if not for a consultation, then you can ask them for some referrals:
----------------------------------------------
Berk, M
Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, Victoria, Australia
----------------------------------------------
Dodd, S
Department of Clinical and Biomedical Sciences, University of Melbourne, Community and Mental Health, Barwon Health, Swanston Centre, Geelong, Victoria, Australia.
----------------------------------------------
- Scott
Posted by g_g_g_unit on December 30, 2012, at 7:17:19
In reply to Re: question for SLS » g_g_g_unit, posted by SLS on December 30, 2012, at 6:50:22
Wow Scott, thank you so much for that. Do you mind me asking how you came across their names?
Professor Berk is one of the psychiatrists I contacted who mentioned using doses of Parnate that exceed 60mg. Unfortunately, he failed to reply to my follow-up e-mail regarding referrals and I didn't want to pester him further, though when I called the clinic I was told he's currently overseas.
> I'll see if I can find more, but these doctors would be worth contacting - if not for a consultation, then you can ask them for some referrals:
>
> ----------------------------------------------
>
> Berk, M
>
> Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, Victoria, Australia
>
> mikebe@barwonhealth.org.au
>
> ----------------------------------------------
>
> Dodd, S
>
> Department of Clinical and Biomedical Sciences, University of Melbourne, Community and Mental Health, Barwon Health, Swanston Centre, Geelong, Victoria, Australia.
>
> seetald@barwonhealth.org.au
>
> ----------------------------------------------
>
>
> - Scott
Posted by g_g_g_unit on December 30, 2012, at 7:23:03
In reply to Re: question for SLS » g_g_g_unit, posted by SLS on December 30, 2012, at 5:08:29
> I know what it is like to fear never knowing for sure whether or not a treatment idea would work. It would forever nag at you had you not tried this now.Yeah, you're right ..
>
> Phiddipus was insistent that dosages above 20 mg/day worked magic.Are you sure? The last post of his I could find on the matter suggested it did nothing for him in doses up to 40mg.
>
> Good luck.
>Thank you.
Posted by SLS on December 30, 2012, at 8:17:09
In reply to Re: question for SLS » SLS, posted by g_g_g_unit on December 30, 2012, at 7:23:03
> > Phiddipus was insistent that dosages above 20 mg/day worked magic.
> Are you sure?No.
Now that I have reviewed the archives, it seems that some people experienced more anxiety at 20 mg/day than they did at 15 mg/day. I tried 40 mg/day, but I didn't like how it affected me. I experienced some cognitive changes that reminded me of being intoxicated with alcohol or MJ. Other people report experiencing dissociation.
- Scott
Posted by SLS on December 30, 2012, at 8:18:39
In reply to Re: question for SLS » SLS, posted by g_g_g_unit on December 30, 2012, at 7:17:19
> Wow Scott, thank you so much for that. Do you mind me asking how you came across their names?
I found them on Medline/PubMed.
- Scott
Posted by elanor roosevelt on December 30, 2012, at 23:44:15
In reply to feel finished, posted by g_g_g_unit on December 26, 2012, at 7:48:12
The days are getting longer a little bit at a time. not a solution but perhaps a help.
no grooming, no exercise, junk food and no sense of future. These are symptoms--not who you are.
There are other meds that are not ssri's there are choices out there for you.
You are not at the end.
You're at the beginning.While you are figuring out your next step remember to take warm baths and to get out in the sun(not at the same time).
Hang in there
Posted by Meatwood_Flack on December 31, 2012, at 6:00:47
In reply to Re: feel finished, posted by elanor roosevelt on December 30, 2012, at 23:44:15
> The days are getting longer a little bit at a time. not a solution but perhaps a help.
>
> no grooming, no exercise, junk food and no sense of future. These are symptoms--not who you are.
>
> There are other meds that are not ssri's there are choices out there for you.
>
> You are not at the end.
> You're at the beginning.
>
> While you are figuring out your next step remember to take warm baths and to get out in the sun(not at the same time).
> Hang in thereGood advice...
Posted by SLS on December 31, 2012, at 7:20:59
In reply to Re: feel finished, posted by elanor roosevelt on December 30, 2012, at 23:44:15
Hi Elanor.
I hope you are in a good place these days.
> no grooming, no exercise, junk food and no sense of future. These are symptoms--not who you are.Wise.
I try to remember this every single day. Thinking this way becomes habit after awhile and helps protect my sense of self-esteem.
- Scott
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