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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 37 to 61 of 63. Go back in thread:
Posted by bsj on November 25, 2003, at 21:54:24
In reply to Re: Boy~Do I miss Vicodin!, posted by krazybirdlady on November 25, 2003, at 21:07:29
I've been through every kind of antidepressant known to man over the last five years. FIVE YEARS of my life have been more or less wasted. Yes, I'm thorughly pissed off at the charlatans who claimed they could help me. And I'm fully right to be pissed off. I have very little faith left in pyschiarty.
Someone in my situation has only a small number of options. I chose to get off my ass and try to help myself. Of course hydrocodone will fail me eventually--everything eventually fails; but for now, it works, and that's all that matters.
Posted by bsj on November 25, 2003, at 22:12:08
In reply to Re: Boy~Do I miss Vicodin!, posted by rxnurse on November 25, 2003, at 20:20:31
Ask your psych buddy what she does with severe refractory cases (besides pawning them off on someone else, as most seem to do). I'd be _very_ interested in hearing her answer (esp. when ECT hasn't worked and stimulants are contraindicated).
Posted by krazybirdlady on November 25, 2003, at 23:22:27
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 25, 2003, at 21:54:24
bsj..yes i see your excasperation. you are getting relief now...and that's all that matters at this point. are you willing to look down the road, however, and see the pitfalls? you could either be more depressed than you have ever thought you could be, or taking far too much of this drug and realizing that you have to find an off-ramp...
Posted by bsj on November 25, 2003, at 23:43:28
In reply to Re: Boy~Do I miss Vicodin!, posted by krazybirdlady on November 25, 2003, at 23:22:27
"are you willing to look down the road, however, and see the pitfalls? you could either be more depressed than you have ever thought you could be, or taking far too much of this drug and realizing that you have to find an off-ramp..."
I've pretty much accepted that suicide is in my future. One day, the medication will stop working and something will lay me so low that I'll do it; it's just a matter of time. I've had close calls before. If that seems bleak, I guess it is, but it's a reasonable conclusion. Sometimes I want so badly just to go to sleep and not wake up.
Posted by Dr. Bob on November 26, 2003, at 0:00:25
In reply to Re: please be civil, posted by bsj on November 25, 2003, at 2:31:53
Posted by krazybirdlady on November 26, 2003, at 0:05:37
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 25, 2003, at 23:43:28
i think you are smarter than to use a "self fulfilling prophecy". if i might ask (and if it's none of my business, that's fine), how old are you? how long with the depression? relationships? exhausted all other avenues? (honestly}...
Posted by Dr. Bob on November 26, 2003, at 0:07:16
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 25, 2003, at 21:54:24
> I chose to get off my *ss and try to help myself.
Hi again, please don't use language that could offend others, either. Thanks,
Bob
Posted by bsj on November 26, 2003, at 0:24:43
In reply to Re: Boy~Do I miss Vicodin!, posted by krazybirdlady on November 26, 2003, at 0:05:37
I'm 26. This thing's been killing me since age 18--or maybe before; I have a horrible memory, and I could've been depressed for most of my life and not known it.
Ahh, treatement; started in on it with high hopes, with a college counselor five years ago. I've seen half a dozen psychiatrists since then and tried enough medications to qualify for a Guiness record. I have the full list in my notes; it goes:
Zoloft
Paxil
Serzone
Effexor
Elavil
Sinequan
Augmentation of the above with lithium and thyroid hormone
Buspar
Nardil
WellbutrinOnly the Wellbutrin had a positive effect at 200mg/day; it helped me sleep less than 20 hours a day. I think my hellish encounter with the Paxil made me even worse. After that, I let them give me bilateral ECT as much as they wanted, on the hope that maybe something would go wrong and I'd die on the table (it has a 4 in 10,000 deathrate). It scrambled my brains for several months after. Finally came the Adderall--which worked; God, did it work! I took it for two years before I started having panic attacks; the Adderall always would trigger one.
So, have I traveled all known roads? It sure seems like it. My current regimie is likely to be just a warm place between the past and me dead in the bathtub some morning.
Posted by krazybirdlady on November 26, 2003, at 1:12:10
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 26, 2003, at 0:24:43
well, you have travelled an awful lot of roads. my question right now however is did you ever take anything other than the adderal. when panic attacks hit, did you stop or did you try something else in the stimulants? not that adderal is without it's dependant properties, it's just about as bad as opiates...but for some, it's a life-line. not that i'm condoning it, but you seem to slip between the cracks as far as diagnosis is concerned. well, mental illness is hit or miss as far as meds are concerned anyway...just wondering if you persued the "upper way", to it's conclusion...
Posted by bsj on November 26, 2003, at 4:55:01
In reply to Re: Boy~Do I miss Vicodin!, posted by krazybirdlady on November 26, 2003, at 1:12:10
"my question right now however is did you ever take anything other than the adderal."
We tried several different combinations of SSRI with Adderall and the Adderall alone. There was a hiatus of the Adderall there as he put me on Celexa, to tame the panic; it helped marginally...but with the re-introduction of the Adderall, the panic came right back. He finally withdrew the Adderall entirely.
"...but for some, it's a life-line."
It was definitely mine.
"just wondering if you persued the "upper way", to it's conclusion..."
I pursued it as far as the doctor would go and then some. After the Adderall was withdrawan, we tried Cylert briefly, which didn't work. He said it was a milder stimulant; yeah, so mild that it did nothing for me. Later I ordered Provigil online and took it for a month; nothing but insomnia. It wasn't like hydrocodone was the first club out of the bag; but at least it doesn't send me climbing the walls in terror.
Posted by bsj on November 26, 2003, at 12:55:07
In reply to Re: Boy~Do I miss Vicodin!, posted by rxnurse on November 25, 2003, at 20:20:31
rxnurse:
Since you seem to fancy yourself knowledgeable about matters of neuropharmacology, why not address the issues I raised, instead of personally attacking me?
Posted by rxnurse on November 26, 2003, at 15:23:53
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 26, 2003, at 12:55:07
If you are feeling attacked, I'm sorry. I understand you are frustrated with the system as a whole, not just me. I too have been suffering from major depression since my early teen years and have tried almost all of the meds you have! So, I can personally relate/understand what you have been through! Try not to take things so personally, it's just not worth the headache.
Posted by KimberlyDi on November 26, 2003, at 15:48:22
In reply to Re: Boy~Do I miss Vicodin!, posted by rxnurse on November 26, 2003, at 15:23:53
bsj:
take a chill pill dude. (just a saying, not meant literally.) i wish you could see all your posts, the big picture. angry, defensive, and then hopeless, admitting you'll end up a suicide. Rxnurse didn't personally attack you, she tried to get to know your personal experience by asking questions. Even i clicked after reading a few of your more "down" posts, realizing "I can relate to that".
You believe you can use certain drugs without risk of addiction to fix whatever chemical mix your brain has... while she believes it is too risky. One can be cool with both ideas.
:)
> If you are feeling attacked, I'm sorry. I understand you are frustrated with the system as a whole, not just me. I too have been suffering from major depression since my early teen years and have tried almost all of the meds you have! So, I can personally relate/understand what you have been through! Try not to take things so personally, it's just not worth the headache.
Posted by roundandround on November 27, 2003, at 9:19:22
In reply to Re: Boy~Do I miss Vicodin! » judy1, posted by galkeepinon on October 18, 2003, at 14:30:25
Judy;
Are you aware of the toxicity of the acetomenophen(APAP) to your liver??
I have had ongoing back problems since 2000, was taking a lot if Vic ES, then Norco... In previos years I also fostered a severe drinking problem... combine the effects of the two on my liver and, well It's inflamed. I now have to be very careful about both otc meds as well as rx meds.
And yes, the hydrocodone made me feel like superman too... the result (besides my liver) I am no longer physically able to do the work that I love so much and havev done for 18yrs. It's because when I was feeling like superman, I was further damaging my back. It sucks, but I did it.
RAR
Posted by krazybirdlady on November 27, 2003, at 20:10:37
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 26, 2003, at 0:24:43
yep...i am at a loss...but then i am only a pharmacist. i know there has to be a DR. out there who can hit on the right combination. have you consisered upping your wellbutrin? with that said, i have to also say...just keep your oxy use steady...don't increase it. see how you go...
Posted by krazybirdlady on November 27, 2003, at 20:23:48
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 26, 2003, at 4:55:01
just a question...you said you had severe withdrawls from paxil. may i ask what dosage you were taking? i have seen several people who have had sever withdrawl from paxil, but they were all taking a relatively high dose (60 mg+) per day. i took it at 20 mg per day and suffered no adverse symptoms when i stopped it. Thx...
Posted by bsj on November 28, 2003, at 22:48:43
In reply to Re: Boy~Do I miss Vicodin! » bsj, posted by krazybirdlady on November 27, 2003, at 20:23:48
I don't remember the exact Paxil dose; but I remember that we kept upping everything as it failed to work, so the dose was probably near the recommended maximum. We eventually went high on everything I took.
As for the Wellbutrin: I take 300mg, which is the highest dose pill they make. 150mg did nothing for me; 300mg at least takes away some of the lethargy. (Wellbutrin is akin to a weak amphetamine, and I had a good experience with Adderall, so it's not surprising that Wellbutrin does something; it's just not anywhere near enough. Of course, if Wellbutrin were any stronger, it would probably do the same thing to me that Adderall did.)
Posted by MOTHERNEEDHELP on November 29, 2003, at 0:13:32
In reply to Re: Boy~Do I miss Vicodin! judy1, posted by roundandround on November 27, 2003, at 9:19:22
just jumping in here b/c my husband is been on the downhill with pills for three years now and do you get any side effects with liver damage? just wondering if this could already be a problem for us. and i can understand where this guy is coming from b/c my husband will tell you in a sec that he loves these pills and he wishes that he could just have them, without going threw the trouble.
Posted by krazybirdlady on November 29, 2003, at 16:50:15
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 28, 2003, at 22:48:43
yep, i have to agree...300mg of wellbutrin is max. it seems you have tried everything under the sun and turned to opiates as a last resort. if it is working, who am i to challenge that. if it works, it works. do keep your usage steady, however, as i know you know the "pitfalls". and as for the medical profession having a pre-existing opinion, of course they do. that is because so many of them have seen people fall into the depths of dependancy. i think you are smart enough to see a clearer picture though. and by the way, you are right, they DO see a difference between physical pain and mental pain. with all the strides in understanding mental illness, you'd think they should know better..many, many numbers of people have been on opiates for the long term without any problem for physical pain. why is emotional pain any different? because they can't see the blood. they can't back themselves up with an MRI. no proof to exonerate them. but i'm sure you know this...
Posted by krazybirdlady on November 29, 2003, at 16:55:44
In reply to Re: Boy~Do I miss Vicodin! judy1, posted by MOTHERNEEDHELP on November 29, 2003, at 0:13:32
liver damage occurs because of the APAP (tylenol) in these products. if you are abusing this drug and taking more than 4000mg of APAP a day, you run the risk of liver toxicity. leading to liver failure in the long term. if you drink alchol or take other meds at the same time, the risk is even higher.
Posted by bsj on November 29, 2003, at 18:06:51
In reply to Re: Boy~Do I miss Vicodin!, posted by krazybirdlady on November 29, 2003, at 16:50:15
"and as for the medical profession having a pre-existing opinion, of course they do. that is because so many of them have seen people fall into the depths of dependancy"
As I said in a message below, it's not really the threat of pyshcological dependence as much as it is the _irrational fear_ of it. Doctors see those who are sick, those who've gone over the edge; what they _don't_ see are the many who, like me, take these drugs and have no problems at all. We never appear on their radars. As a consequence, their entire picture of the addiction phenomenon is warped. Sure, goblins high on bathtub meth are a problem; but there are thousands of a narcoleptics and ADDers who have quietly taken amphetamines for years.
A thorough study of drug use in this country will be impossible as long as the social stimga and legal consequences of use remain. Studies of drug use now focus on addicts; and they are a minority of users, and not represenative.
Posted by krazybirdlady on November 29, 2003, at 19:03:00
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 29, 2003, at 18:06:51
we are from different countries...i am from Canada. DR's still do have the upper hand. however, without a clear cut (i'm off the hook) acceptance of this reason for prescription, then it's not going to happen. maybe if you find a DR. who actually sits down and reviews your entire history AND understands it, it is possible to find sympathy to your cause. doubt it will ever happen though. no matter how much they sympathize with you, they feel that their hands are tied. you'd be better to fall down and go "OWWW" my back hurts. then you'd have an "accepted" course of action...
Posted by bsj on November 29, 2003, at 19:48:33
In reply to Re: Boy~Do I miss Vicodin! » bsj, posted by krazybirdlady on November 29, 2003, at 19:03:00
"you'd be better to fall down and go "OWWW" my back hurts. then you'd have an "accepted" course of action"
Well, we can't let doctors off the hook completely--they're as much to blame for opiophobia as the DEA. The AMA can be a powerful lobby when it wants to be, and if enough doctors wanted to increase prescription of opiates, the DEA (or similar agencies in other countries) would not be able to stop them.
Right now, I don't need a psychiatrist to prescribe my pills; you can (apparently legally) buy up to 60 doses of hydrocodone every 25 days at online pharmacies. This fits my needs perfectly. Of course, in recent months the DEA has been trying like mad to close these places down. A balancing factor to this is that pain study that came out a few weeks ago--the one pointing out how untreated pain has huge economic costs; hopefully that will exert some pressure on the DEA to allow online pharmacies to continue selling hydrocodone. We'll see. (The U.S. has to be most paternalistic and paranoid country where drugs are concerned; e.g., in the UK you can buy Tylenol with codeine OTC. Over here, if you have pain that demands even a weak opiate, you have to go shell out cash for an office visit, and probably some x-rays; that just seems silly to me.)
Posted by bsj on November 29, 2003, at 21:27:30
In reply to Re: Boy~Do I miss Vicodin! » bsj, posted by krazybirdlady on November 29, 2003, at 19:03:00
I think an excellent treatment strategy would be for those who can't find help to step in front of semis on the highway. If you die, your problems are over; and if you survive, you're guaranteed to have the requisite physical agony to justify painkillers for the rest of your life. Perhaps JAMA should conduct a study on the efficacy of this course compared to SSRIs and ECT.
Posted by rxnurse on November 29, 2003, at 23:10:31
In reply to Re: Boy~Do I miss Vicodin!, posted by bsj on November 29, 2003, at 21:27:30
Hey BSJ:
I'm glad you have a sense of humor about all of this. I agree that mental illness and how it manifests itself is truly individual. It is hard to explain to anyone how you truly feel inside your head, and it is even harder to find the right meds for you. Whatever keeps you above ground, even opiates! I will discuss this topic further with my colleauges at the hospital.
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