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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 8 to 32 of 38. Go back in thread:
Posted by natg on February 5, 2001, at 15:02:32
In reply to Re: REQUIP - questions about dosing AndrewB » AndrewB, posted by Katz on February 5, 2001, at 0:54:22
Hi Kathy:
I can certainly relate to your situation.I wish I could help but unfortunately I am no expert in pharmacology like Andrew.
Please hang in there! I've suffered from depression and social phobia for 10 years. I, too, drank excessive amounts to medicate only to become an alcoholic.
Believe me, i know there is medication out there to help you.
I finally begged my Doctor to let me try Mirapex along with a low dose of risperdal and it has been my success story. Risperdal alone used to do the trick but it sort of pooped out on me. Then I added Mirapex and I can honestly say my life is a lot better. I, too, used to spend a lot of time in bed. I used to sleep a lot, that was my way of escaping esp. after i quit drinking.Maybe, you can try adding the Bromo. or Requip to Reboxetine.
For me personally, I have to take Risperdal and Mirapex together to get the desired effect. I went 10 days without risperdal and got severely depressed. Same with Mirapex.
I wish I could help more.
All the best and keep posting.
Nat
Posted by PhoenixGirl on February 5, 2001, at 15:18:40
In reply to Re: REQUIP - questions about dosing AndrewB » Katz, posted by natg on February 5, 2001, at 15:02:32
Hi Kathy,
I understand the hell that you're going through. I've tried many meds with only partial success with any of them. But don't give up! I'm 23, and have had serious depression and social phobia since age 12. When I was 17 I tried to kill myself, but I'm glad I didn't give up because I've made progress since then.
In your post, you said that methylphenidate helped you, and that after 6 months you hadn't developed tolerance. Why did you go off of it? Maybe you should go back on it because you are obviously suffering considerably. Hang in there, you're not the only one.PG
Hi Kathy:
> I can certainly relate to your situation.I wish I could help but unfortunately I am no expert in pharmacology like Andrew.
> Please hang in there! I've suffered from depression and social phobia for 10 years. I, too, drank excessive amounts to medicate only to become an alcoholic.
> Believe me, i know there is medication out there to help you.
> I finally begged my Doctor to let me try Mirapex along with a low dose of risperdal and it has been my success story. Risperdal alone used to do the trick but it sort of pooped out on me. Then I added Mirapex and I can honestly say my life is a lot better. I, too, used to spend a lot of time in bed. I used to sleep a lot, that was my way of escaping esp. after i quit drinking.
>
> Maybe, you can try adding the Bromo. or Requip to Reboxetine.
>
> For me personally, I have to take Risperdal and Mirapex together to get the desired effect. I went 10 days without risperdal and got severely depressed. Same with Mirapex.
>
> I wish I could help more.
>
> All the best and keep posting.
>
> Nat
Posted by Katz on February 5, 2001, at 16:00:28
In reply to Re: REQUIP - questions about dosing AndrewB » Katz, posted by natg on February 5, 2001, at 15:02:32
>HI Nat,
I was encouraged to hear of your succes with Mirapex. Did you ever try amisulpride? If so, how did it work for you? Yes, it was my plan to add Rebox back once I found another med that worked for the anhadonia and social phobia. I liked the energy boost that I got from it. I don't think you can combine rebox and bromo. If I recall correctly (and that is not always the case) you are not supposed to mix ergot derrivatives with the Rebox. Bromo falls into this category but the Requip does not.
Thankyou for your encouraging words. It helps to know that someone who has once stood in your shoes has actually found relief from their situation.
Wishing you continued success,
Kathy
Hi Kathy:
> I can certainly relate to your situation.I wish I could help but unfortunately I am no expert in pharmacology like Andrew.
> Please hang in there! I've suffered from depression and social phobia for 10 years. I, too, drank excessive amounts to medicate only to become an alcoholic.
> Believe me, i know there is medication out there to help you.
> I finally begged my Doctor to let me try Mirapex along with a low dose of risperdal and it has been my success story. Risperdal alone used to do the trick but it sort of pooped out on me. Then I added Mirapex and I can honestly say my life is a lot better. I, too, used to spend a lot of time in bed. I used to sleep a lot, that was my way of escaping esp. after i quit drinking.
>
> Maybe, you can try adding the Bromo. or Requip to Reboxetine.
>
> For me personally, I have to take Risperdal and Mirapex together to get the desired effect. I went 10 days without risperdal and got severely depressed. Same with Mirapex.
>
> I wish I could help more.
>
> All the best and keep posting.
>
> Nat
Posted by Katz on February 5, 2001, at 16:25:46
In reply to Why did you stop taking Ritalin, Kathy?, posted by PhoenixGirl on February 5, 2001, at 15:18:40
Hi PG,
I'm sorry to hear that you have suffered so long and so much. I'm happy that you are still here! You are obviously a kind and loving person willing to extend your hand to help fellow suffers. Your imput is valuable and very much appreciated. You are so young, yet so wise. Your whole life is infront of you. I hope you will find the happiness you deserve. If you don't mind my asking, what meds are you currently having success with?
Back to your question. If it were up to me, I would still be on Ritilin. I cannot find a doc in my area to prescribe it for me. Personally, I think it is a crime. Several years ago I was seeing a doc three states away who prescribed the Ritilin for me. The expense of traveling so far (gas, food, motel, etc.) became prohibitive. The doctor required that I make the journey once a month. I just couldn't do it.
Wishing you continued success,
Kathy
Hi Kathy,
>
> I understand the hell that you're going through. I've tried many meds with only partial success with any of them. But don't give up! I'm 23, and have had serious depression and social phobia since age 12. When I was 17 I tried to kill myself, but I'm glad I didn't give up because I've made progress since then.
> In your post, you said that methylphenidate helped you, and that after 6 months you hadn't developed tolerance. Why did you go off of it? Maybe you should go back on it because you are obviously suffering considerably. Hang in there, you're not the only one.
>
> PG
>
> Hi Kathy:
> > I can certainly relate to your situation.I wish I could help but unfortunately I am no expert in pharmacology like Andrew.
> > Please hang in there! I've suffered from depression and social phobia for 10 years. I, too, drank excessive amounts to medicate only to become an alcoholic.
> > Believe me, i know there is medication out there to help you.
> > I finally begged my Doctor to let me try Mirapex along with a low dose of risperdal and it has been my success story. Risperdal alone used to do the trick but it sort of pooped out on me. Then I added Mirapex and I can honestly say my life is a lot better. I, too, used to spend a lot of time in bed. I used to sleep a lot, that was my way of escaping esp. after i quit drinking.
> >
> > Maybe, you can try adding the Bromo. or Requip to Reboxetine.
> >
> > For me personally, I have to take Risperdal and Mirapex together to get the desired effect. I went 10 days without risperdal and got severely depressed. Same with Mirapex.
> >
> > I wish I could help more.
> >
> > All the best and keep posting.
> >
> > Nat
Posted by AndrewB on February 6, 2001, at 2:27:56
In reply to Re: Why did you stop taking Ritalin, Kathy? » PhoenixGirl, posted by Katz on February 5, 2001, at 16:25:46
Kathy,
I'm sorry that you've been sufferring so.
First of all, I'd like to say that you can get your life back. I'm going to give you a roadmap on how to get back on methylphenidate or another but before I do would like to say a couple of things.
One, I'm in no way an expert and have no medical training. I have however taught myself about mood and related disorders due to dysfuntion of the dopaminergic and glutaminergic system, an area largely ignored by mainstream US psychiatry unfortunately. I can offer suggestions for people who may have disorders of this nature but my best suggestion I believe is that if you have a mood disorder unresponsive to traditional ADs seek the best help out there. That usually means going to a person self-described as a psychopharmocologist.
Kathy do not do a trial with bromocriptine. It is not worth your time.
About your dizziness, the dopaminergic system has pathways that extend to the inner ear. Dopamine keeps the glutaminergic excitatation in check in the inner ear. Your dizziness due to amisulpride may be an indication of glutaminergic dysfunction (just as JohnLs tinnitus in response to so many meds may be). Dopaminergic and glutaminergic dysfunction can be very much intertwined. I can't say for sure without doing some research, but it seems that even at 25mg.s, the amisulpride is antagonizing the postsynaptic receptors rather than the desired target, the presynaptic dopamine autoreceptors.
Now a question, you tried a couple other stimulants like dexedrine, did you have any initial response to these meds that quickly faded away or were they inert upon your system from day one?
****Okay you can get methyphenidate for mood disorders or other amphetamines without too much trouble. The key is to locate the right doctor. This will require some phone calling on your part. Social phobia can make this daunting but you need to be brave because the alternative is to let let your life wind itself out amoungst the shadows.
Step 1: Write a note on this board telling people where you live and if anybody knows of a good doctor in your area who has prescribed them amphetamines.
Step 2: Call the psychiatric departments of large nearby hospitals and ask for names and contact information for psychopharmocologists. (GPs often refuse to prescribe amphetamines for mood disorders, the more knowledgeable professionals however tend to be much more willing.)
Step 3: Call the psychopharmocologists, you will usually get a receptionist or an answering machine, tell them you are prospective patient and (if the pdoc is taking patients) ask to arrange for a 5 minute phone conversation with the pdoc at a prearranged time.
Step 4: Write down what you want to say before hand if you think you will be nervous during this conversation. In the conversation, briefly describe your condition, mention your positive response to amphetamine, and ask if he would consider prescribing an amphetamine to you after he had a chance to review your case during a session with him.
You may eventually want or need to add an adjunct to your methyphenidate or try another yet another amphetamine. I will always be here to give more suggestions. But this is enough for you take take on at this time.
I'm rooting for you so please keep us informed on how it goes in locating the doctor that will meet your needs.
Best wishes,
AndrewB
Posted by PhoenixGirl on February 6, 2001, at 11:23:46
In reply to Re: Why did you stop taking Ritalin, Kathy? » PhoenixGirl, posted by Katz on February 5, 2001, at 16:25:46
Hi Kathy,
It really IS a crime that no doctor will prescribe Ritalin for you. In this country, we have such a ridiculous and paranoid attitude about drugs. Just look at our supremely unsuccessful but continued "drug war". But there must be a doctor who will prescribe it for you. You may have to build up a relationship with a doctor so that she knows that you're not a drug abuser. That's so stupid, but it might come to that. Just tell the doctor what you told us.
I was put on imipramine at 13, and have since tried Zoloft, Effexor, Luvox, Serzone, Anafranil, Celexa, trazodone, selegiline, Remeron, and now desipramine. The reason I changed meds was usually because of having only partial effectiveness. Actually everything I've ever tried was only partially effective. Many of these drugs ruin my sex life.
The desipramine seems to work a little better than others I've tried. I think that the majorly noradrenergic meds work best for me. The desipramine has sexual side effects for me, but they are less severe than with the other meds I've tried in the last few years. My next goal is to try modafinil, adrafinil, or another stimulant to see if it will allow me to reduce the desipramine. I just refuse to live like an 80 year old woman when I'm only 23.
You've tried so many ADs, like me, so a doctor must see your desperation. It sounds to me like the benefits of Ritalin outweigh its risks. There is just no excuse for prolonging your miserable so unnecessarily. I think that if you found a pdoc who was a real BIOpsychiatrist, he would be more likely to prescribe the Ritalin. Good luck, take care.
Hi PG,
>
> I'm sorry to hear that you have suffered so long and so much. I'm happy that you are still here! You are obviously a kind and loving person willing to extend your hand to help fellow suffers. Your imput is valuable and very much appreciated. You are so young, yet so wise. Your whole life is infront of you. I hope you will find the happiness you deserve. If you don't mind my asking, what meds are you currently having success with?
>
> Back to your question. If it were up to me, I would still be on Ritilin. I cannot find a doc in my area to prescribe it for me. Personally, I think it is a crime. Several years ago I was seeing a doc three states away who prescribed the Ritilin for me. The expense of traveling so far (gas, food, motel, etc.) became prohibitive. The doctor required that I make the journey once a month. I just couldn't do it.
>
> Wishing you continued success,
>
> Kathy
>
> Hi Kathy,
> >
> > I understand the hell that you're going through. I've tried many meds with only partial success with any of them. But don't give up! I'm 23, and have had serious depression and social phobia since age 12. When I was 17 I tried to kill myself, but I'm glad I didn't give up because I've made progress since then.
> > In your post, you said that methylphenidate helped you, and that after 6 months you hadn't developed tolerance. Why did you go off of it? Maybe you should go back on it because you are obviously suffering considerably. Hang in there, you're not the only one.
> >
> > PG
> >
> > Hi Kathy:
> > > I can certainly relate to your situation.I wish I could help but unfortunately I am no expert in pharmacology like Andrew.
> > > Please hang in there! I've suffered from depression and social phobia for 10 years. I, too, drank excessive amounts to medicate only to become an alcoholic.
> > > Believe me, i know there is medication out there to help you.
> > > I finally begged my Doctor to let me try Mirapex along with a low dose of risperdal and it has been my success story. Risperdal alone used to do the trick but it sort of pooped out on me. Then I added Mirapex and I can honestly say my life is a lot better. I, too, used to spend a lot of time in bed. I used to sleep a lot, that was my way of escaping esp. after i quit drinking.
> > >
> > > Maybe, you can try adding the Bromo. or Requip to Reboxetine.
> > >
> > > For me personally, I have to take Risperdal and Mirapex together to get the desired effect. I went 10 days without risperdal and got severely depressed. Same with Mirapex.
> > >
> > > I wish I could help more.
> > >
> > > All the best and keep posting.
> > >
> > > Nat
Posted by MarkinBoston on February 6, 2001, at 18:14:23
In reply to Re: Why did you stop taking Ritalin, Kathy?, posted by PhoenixGirl on February 6, 2001, at 11:23:46
> Hi Kathy,
>
> It really IS a crime that no doctor will prescribe Ritalin for you.Hey, you could shake down schoolkids for their Ritalin instead of lunch money! Just joking!
When you do talk to a local doc, I think its important that they know, from what I read here, that when you found yourself dependant on GHB or alchohol, you were aware of it, wanted to stop taking it, and succeeded. If you were also able to set and keep limits on the amounts of "addictive" drugs you took, that is good too.
This takes you out of the drug seeking addict for whom a doctor would be weary of prescribing a scheduled drug like Ritalin.
Your social phobia sounds like the most important thing to treat. I'm nervous at cocktail parties - I can't imagine what you've been through. You're a trooper.
Get the Ritalin if that's what works. No way should you suffer when the cure is so easy. If I had any (left), I would mail you some just to get you functional enough to leave the house and see a pdoc for a script. Screw the law. You're in a prison already. If I was on chemotherapy and the only thing that kept me from puking was pot, I'd get it and smoke it, even though I don't like the stuff. None of these drugs are as additive or deadly as cigarettes, so I have no moral objection.
Posted by Katz on February 6, 2001, at 18:22:06
In reply to Re: Kathy, posted by AndrewB on February 6, 2001, at 2:27:56
Hi Andrew,
Actually, the fact that you are not an MD is a comforting one. I have no confidence in the
medical profession where incompetence seems to reign! I'm sure there are some very good
doctors out there but finding them is like playing Russian Roulette!Addressing your question: Dexedrine was inert from day one and possibly caused depression over time. Of course the depression could have been caused because of my disappointment that it was not working. Adderall was never tried. I did cocaine on two
occasions 15 years ago. It was so good that I never did it again because I knew I would
become addicted. To steal a phrase from JohnL, Andrafinil or in my case Methylphenidate
"snuck in threw the back door". My girlfriend was the first to notice the profound change in
my personality. Question: is it possible that I will not build up a tolerance to
methylpehnidate in the same way that ADD/ADHD patients "supposedly" do not?Seeking out a doc to prescribe amphetamines is a difficult one. I will try! I will do as you say
and place a post looking for information about a pharmacology doc in my area. I have seen
pdocs at two large teaching hospitals without success. My requests for amphetamines were
denied. To them, the idea was taboo! I will call again and ask for a pharmacology doc
specifically but quite frankly I believe those where the types of docs I was seeing. I live in
Worcester,Massachusetts and my only alternative may be to go to Boston. I really don't
know if I can do that. I am phobic about Boston! But with your support and all the support
that I have been getting from this wonderful board, I just may be able to find the courage to
do that. I will gather what information I can and aim for a spring appointment. I will need
that much time to psych myself up for the task.In the meantime, do you have any other ideas as to a new med to experiment with?
Pikmileone? COMT? One of the other antiphychotics? Lithium? I believe my last doc was
about to try lithium (even though I am not bipolar). From what I have read, lithium seems
counter indicated in my case. It seems like it would really knock me out!Andrew, I have another question about biochemistry that may or may not yield another piece
to the puzzle. I have struggled with weight issues since puberty. In my early twenties I lost
the weight and kept it off for approx. 7 years using the drug Ionamin as an aid. I maintained
my weight on starvation level calories (500 or under). I remember thinking at the time that I
felt "normal" for the first time in my life. I think it was the Ionamin. But that is not the point that I am trying to get to. I am now 47. My real psychological problems began at 27 when
coincidentally, I stopped taking the ionamin. Still not the point. This is: I am unable to lose
weight despite extremely restricted diets. It is the exact same phenomena that those on SSRI's
are complaining of. "The body refuses to release it's fat." Here's the clincher: during the 5
days I was on the amisulpride, I developed a ravenous appetite and I actually lost 3 pounds!
Now, whether the amisulpride was responsible would have taken a much longer trial but I
find the coincidence fascinating. It may also be of interest to know that I never lost a pound
while on the methylpenidate.Again, I must apologize for my lengthy reply. It's just that you seem to have such a keen
grasp of biochemistry that I am almost hopeful that given enough clues, you just may be able
to unlock this mystery.I have already placed an order for sulpride and requip. Since I have nothing better to do, I
guess I will give them a try. Who knows, the sulpride may be just different enough to work.
If you have any other ideas up your sleeves, please let me know.With sincere gratitude,
Kathy
p.s.- have you heard the latest news from the medical profession that exercise is a cure for
depression. Now who' s the genius to put forth this theory? It's long been known that exercise
releases endorphins that make one "feel good". Could this jerk possibly be suggesting that
one in the depths of depression or in the grips of anhadonia implement such an impossible
undertaking? So much for medical expertise! The information I have gathered on this board is of greater value than anything any MD has ever offered.> Kathy,
>
> I'm sorry that you've been sufferring so.
>
> First of all, I'd like to say that you can get your life back. I'm going to give you a roadmap on how to get back on methylphenidate or another but before I do would like to say a couple of things.
>
> One, I'm in no way an expert and have no medical training. I have however taught myself about mood and related disorders due to dysfuntion of the dopaminergic and glutaminergic system, an area largely ignored by mainstream US psychiatry unfortunately. I can offer suggestions for people who may have disorders of this nature but my best suggestion I believe is that if you have a mood disorder unresponsive to traditional ADs seek the best help out there. That usually means going to a person self-described as a psychopharmocologist.
>
> Kathy do not do a trial with bromocriptine. It is not worth your time.
>
> About your dizziness, the dopaminergic system has pathways that extend to the inner ear. Dopamine keeps the glutaminergic excitatation in check in the inner ear. Your dizziness due to amisulpride may be an indication of glutaminergic dysfunction (just as JohnLs tinnitus in response to so many meds may be). Dopaminergic and glutaminergic dysfunction can be very much intertwined. I can't say for sure without doing some research, but it seems that even at 25mg.s, the amisulpride is antagonizing the postsynaptic receptors rather than the desired target, the presynaptic dopamine autoreceptors.
>
> Now a question, you tried a couple other stimulants like dexedrine, did you have any initial response to these meds that quickly faded away or were they inert upon your system from day one?
>
> ****Okay you can get methyphenidate for mood disorders or other amphetamines without too much trouble. The key is to locate the right doctor. This will require some phone calling on your part. Social phobia can make this daunting but you need to be brave because the alternative is to let let your life wind itself out amoungst the shadows.
>
> Step 1: Write a note on this board telling people where you live and if anybody knows of a good doctor in your area who has prescribed them amphetamines.
>
> Step 2: Call the psychiatric departments of large nearby hospitals and ask for names and contact information for psychopharmocologists. (GPs often refuse to prescribe amphetamines for mood disorders, the more knowledgeable professionals however tend to be much more willing.)
>
> Step 3: Call the psychopharmocologists, you will usually get a receptionist or an answering machine, tell them you are prospective patient and (if the pdoc is taking patients) ask to arrange for a 5 minute phone conversation with the pdoc at a prearranged time.
>
> Step 4: Write down what you want to say before hand if you think you will be nervous during this conversation. In the conversation, briefly describe your condition, mention your positive response to amphetamine, and ask if he would consider prescribing an amphetamine to you after he had a chance to review your case during a session with him.
>
> You may eventually want or need to add an adjunct to your methyphenidate or try another yet another amphetamine. I will always be here to give more suggestions. But this is enough for you take take on at this time.
>
> I'm rooting for you so please keep us informed on how it goes in locating the doctor that will meet your needs.
>
> Best wishes,
>
> AndrewB
Posted by Katz on February 6, 2001, at 18:37:01
In reply to Re: Why did you stop taking Ritalin, Kathy?, posted by MarkinBoston on February 6, 2001, at 18:14:23
You guys are great!!! I want to let you know that I will address both your posts individually tomorrow. I'm Currently battling it out with the husband which is causing quite a distraction and anything I would post now really would be incoherrent babbling!!! It would appear that he is jealous of all the time I am spending online and more specifically on the board.
Cheers,
Kathy
> > Hi Kathy,
> >
> > It really IS a crime that no doctor will prescribe Ritalin for you.
>
> Hey, you could shake down schoolkids for their Ritalin instead of lunch money! Just joking!
>
> When you do talk to a local doc, I think its important that they know, from what I read here, that when you found yourself dependant on GHB or alchohol, you were aware of it, wanted to stop taking it, and succeeded. If you were also able to set and keep limits on the amounts of "addictive" drugs you took, that is good too.
>
> This takes you out of the drug seeking addict for whom a doctor would be weary of prescribing a scheduled drug like Ritalin.
>
> Your social phobia sounds like the most important thing to treat. I'm nervous at cocktail parties - I can't imagine what you've been through. You're a trooper.
>
> Get the Ritalin if that's what works. No way should you suffer when the cure is so easy. If I had any (left), I would mail you some just to get you functional enough to leave the house and see a pdoc for a script. Screw the law. You're in a prison already. If I was on chemotherapy and the only thing that kept me from puking was pot, I'd get it and smoke it, even though I don't like the stuff. None of these drugs are as additive or deadly as cigarettes, so I have no moral objection.
Posted by Marie1 on February 6, 2001, at 21:13:05
In reply to Re: Kathy » AndrewB, posted by Katz on February 6, 2001, at 18:22:06
> Kathy,
I read with interest your statement that during the time you were taking Ionamin (phentermine) for weight loss, you felt "normal" for the first time in your life. I know just how you felt; I've realized for years that phentermine in combination with ssri's - Prozac - is what keeps my forever long curse of depression at bay. Last spring when I quit taking phentermine I developed major depression. Recently I began taking taking phentermine again (ostensibly for weight loss) and feel much more like my old self. This is one area in which my pdoc and I differ opinions. He thinks I have an amphetimine addiction/dependance. And maybe I do, in the same way I have a dependance on ssri's to keep me from the pits of hell. On prozac and buspar alone I don't feel suicidal, but I also don't feel energetic or enthused or motivated - important quality of life stuff. Anyway, I'm hoping you find someone to prescribe ritalin for you. Isn't it unfortunate that besides suffering from your disease the way you do, you're also made to feel like a scum of the earth addict to get what makes you feel better?>
>
Posted by AndrewB on February 7, 2001, at 1:00:00
In reply to Re: Kathy » AndrewB, posted by Katz on February 6, 2001, at 18:22:06
Kathy,
The main thing to remember about locating a pdoc to prescribe methylphenidate is to use the 5 minute phone call with them to prescreen them. Gather up a significant # of pdoc contacts and do this prescreening. Ask them if they have used amphetamine to treat depression and if they are open to doing it again. Don't make an appointment until you find a doc that gives you a very positive indication that he is comfortable prescribing amphetamines for depression.
Phentermine (Ionamin) can be purchased with ease over the internet. It is an amphetamine like substance.
Best of luck with your Requip trial. Requip is not as strong as a D3 agonist as Mirapex so it may not have the same likelihood of success. One article stated that 4.5 mg. of Mirapex equals 15mg. of Requip. If so, your ideal dose may be 5 mg. taken 3 times a day (15mg./day total). I strongly suggest that you get domperidone from Farmacia Cerati and take it with the Requip to avoid nausea as you slowly titrate up your dosage.
Let us know how it goes.
You can email me at andrewb@seanet. and I can tell you where to get something that I'm pretty sure will tide you over and give 'courage' to make all the calls you need to make.
Remember, in all likelihood there is a p-doc in your area that will prescribe the methyphenidate. You have to do some digging though, one shovelfull at a time.
AndrewB
Posted by Katz on February 7, 2001, at 15:26:11
In reply to Re: Why did you stop taking Ritalin, Kathy?, posted by PhoenixGirl on February 6, 2001, at 11:23:46
Hi Phoenix,You are absolutely right...it is a crime and I believe a case of malpractice! These doctors are playing God with peoples lives. When something works, it works. Nobody aside from that particular individual knows what's going on inside their head and the effect that a particular med is having on them. When I told this particular doc that the effexor was actually making me more depressed, she was incredulous! She actually tried to convince me that I must be mistaken. Needless to say, I ditched her fast!
I can relate to what you have said about not wanting to live like an 80 year old woman at 23. You shouldn't have to. You should give yourself lots of credit for continuing to seek the correct treatment and not giving up or losing hope. That's exactly what I did all those many years ago and as a consequence watched my youth and my life slip through my fingers. Whatever you do, don't let that happen to you! I can tell you from first hand experience that if you suffer from social phobia, the more you isolate yourself the worse the problem becomes. It is nearly impossible for me to leave the house at this point in time. I have grown more and more reclusive through the years. My condition has deteriorated from Social Phobia to Avoidant Personality Disorder. Again, please don't let this happen to you.
Have you considered trying amisulpride? It would only be a short investment in time (4 days) to discover whether or not it would work for you. Have you heard of Reboxetine. It is a reuptake inhibitor of noradrenaline specifically. I had mixed results with this one. I plan to do a retrial in the near future. It is not currently approved for use in the US but can be purchased easily overseas w/o prescription. You might want to consult with that new doc in Atlanta (when you find him/her) about a trial with either of these two along with the andrafinil that you mentioned.
I am keeping you in my prayers.
Best wishes,
Kathy
>Hi Kathy,
>
> It really IS a crime that no doctor will prescribe Ritalin for you. In this country, we have such a ridiculous and paranoid attitude about drugs. Just look at our supremely unsuccessful but continued "drug war". But there must be a doctor who will prescribe it for you. You may have to build up a relationship with a doctor so that she knows that you're not a drug abuser. That's so stupid, but it might come to that. Just tell the doctor what you told us.
> I was put on imipramine at 13, and have since tried Zoloft, Effexor, Luvox, Serzone, Anafranil, Celexa, trazodone, selegiline, Remeron, and now desipramine. The reason I changed meds was usually because of having only partial effectiveness. Actually everything I've ever tried was only partially effective. Many of these drugs ruin my sex life.
> The desipramine seems to work a little better than others I've tried. I think that the majorly noradrenergic meds work best for me. The desipramine has sexual side effects for me, but they are less severe than with the other meds I've tried in the last few years. My next goal is to try modafinil, adrafinil, or another stimulant to see if it will allow me to reduce the desipramine. I just refuse to live like an 80 year old woman when I'm only 23.
> You've tried so many ADs, like me, so a doctor must see your desperation. It sounds to me like the benefits of Ritalin outweigh its risks. There is just no excuse for prolonging your miserable so unnecessarily. I think that if you found a pdoc who was a real BIOpsychiatrist, he would be more likely to prescribe the Ritalin. Good luck, take care.
>
>
> Hi PG,
> >
> > I'm sorry to hear that you have suffered so long and so much. I'm happy that you are still here! You are obviously a kind and loving person willing to extend your hand to help fellow suffers. Your imput is valuable and very much appreciated. You are so young, yet so wise. Your whole life is infront of you. I hope you will find the happiness you deserve. If you don't mind my asking, what meds are you currently having success with?
> >
> > Back to your question. If it were up to me, I would still be on Ritilin. I cannot find a doc in my area to prescribe it for me. Personally, I think it is a crime. Several years ago I was seeing a doc three states away who prescribed the Ritilin for me. The expense of traveling so far (gas, food, motel, etc.) became prohibitive. The doctor required that I make the journey once a month. I just couldn't do it.
> >
> > Wishing you continued success,
> >
> > Kathy
> >
> > Hi Kathy,
> > >
> > > I understand the hell that you're going through. I've tried many meds with only partial success with any of them. But don't give up! I'm 23, and have had serious depression and social phobia since age 12. When I was 17 I tried to kill myself, but I'm glad I didn't give up because I've made progress since then.
> > > In your post, you said that methylphenidate helped you, and that after 6 months you hadn't developed tolerance. Why did you go off of it? Maybe you should go back on it because you are obviously suffering considerably. Hang in there, you're not the only one.
> > >
> > > PG
> > >
> > > Hi Kathy:
> > > > I can certainly relate to your situation.I wish I could help but unfortunately I am no expert in pharmacology like Andrew.
> > > > Please hang in there! I've suffered from depression and social phobia for 10 years. I, too, drank excessive amounts to medicate only to become an alcoholic.
> > > > Believe me, i know there is medication out there to help you.
> > > > I finally begged my Doctor to let me try Mirapex along with a low dose of risperdal and it has been my success story. Risperdal alone used to do the trick but it sort of pooped out on me. Then I added Mirapex and I can honestly say my life is a lot better. I, too, used to spend a lot of time in bed. I used to sleep a lot, that was my way of escaping esp. after i quit drinking.
> > > >
> > > > Maybe, you can try adding the Bromo. or Requip to Reboxetine.
> > > >
> > > > For me personally, I have to take Risperdal and Mirapex together to get the desired effect. I went 10 days without risperdal and got severely depressed. Same with Mirapex.
> > > >
> > > > I wish I could help more.
> > > >
> > > > All the best and keep posting.
> > > >
> > > > Nat
Posted by Katz on February 7, 2001, at 15:35:57
In reply to Re: Why did you stop taking Ritalin, Kathy?, posted by MarkinBoston on February 6, 2001, at 18:14:23
Hi Mark,
LOL! Shaking down those school kids is not a bad idea. I'd probably be doing them a favor. Half of them shouldn't be on the stuff anyway!
Are you really from Boston? I'm from Worcester, MA. Do you know of a good pdoc in the area who would be willing to prescribe the ritilin for depression? I'm really phobic about traveling to Boston. I always get lost in that damn city and there's never any parking. But, if I must bite the bullet to get better, I must. If all else fails, I will travel to Boston for treatment.
Thanks for all you support,
Kathy
Hi Kathy,
> >
> > It really IS a crime that no doctor will prescribe Ritalin for you.
>
> Hey, you could shake down schoolkids for their Ritalin instead of lunch money! Just joking!
>
> When you do talk to a local doc, I think its important that they know, from what I read here, that when you found yourself dependant on GHB or alchohol, you were aware of it, wanted to stop taking it, and succeeded. If you were also able to set and keep limits on the amounts of "addictive" drugs you took, that is good too.
>
> This takes you out of the drug seeking addict for whom a doctor would be weary of prescribing a scheduled drug like Ritalin.
>
> Your social phobia sounds like the most important thing to treat. I'm nervous at cocktail parties - I can't imagine what you've been through. You're a trooper.
>
> Get the Ritalin if that's what works. No way should you suffer when the cure is so easy. If I had any (left), I would mail you some just to get you functional enough to leave the house and see a pdoc for a script. Screw the law. You're in a prison already. If I was on chemotherapy and the only thing that kept me from puking was pot, I'd get it and smoke it, even though I don't like the stuff. None of these drugs are as additive or deadly as cigarettes, so I have no moral objection.
Posted by Katz on February 7, 2001, at 16:10:49
In reply to Re: Kathy/Ionamin, posted by Marie1 on February 6, 2001, at 21:13:05
Hi Marie,
Many people on this board with depression have found the addition of simulants greatly beneficial. If your doc is making you feel "like the scum of the earth", perhaps you should seek treatment elsewhere. First hand experience dictates that many of these "go by the book" pdocs consider stimulants for depression taboo! They are wrong!
Phentermine is readily available over the internet. The unfortunate part about that is that they're getting ten times more than what you would pay at a regular drugstore if you had a script.
Can't you go to your regular GP and ask for a script for weightloss? I just wonder though if adding phentermine to SSRI's could result in the same kind of heart problems that the fen/phen combinatin created. I think this is a question that AndrewB would be able to offer some guidence with.
Thank you for your encouraging words. Finding this board is the best thing that has happened to me in a longtime. All the encouragement I am receiving from fellow babblers is giving me the courage to seek the treatment that I need and not to stop until I find the right doctor. I hope you will do the same.
Best wishes,
Kathy
Kathy,
> I read with interest your statement that during the time you were taking Ionamin (phentermine) for weight loss, you felt "normal" for the first time in your life. I know just how you felt; I've realized for years that phentermine in combination with ssri's - Prozac - is what keeps my forever long curse of depression at bay. Last spring when I quit taking phentermine I developed major depression. Recently I began taking taking phentermine again (ostensibly for weight loss) and feel much more like my old self. This is one area in which my pdoc and I differ opinions. He thinks I have an amphetimine addiction/dependance. And maybe I do, in the same way I have a dependance on ssri's to keep me from the pits of hell. On prozac and buspar alone I don't feel suicidal, but I also don't feel energetic or enthused or motivated - important quality of life stuff. Anyway, I'm hoping you find someone to prescribe ritalin for you. Isn't it unfortunate that besides suffering from your disease the way you do, you're also made to feel like a scum of the earth addict to get what makes you feel better?
>
> >
> >
Posted by MarkinBoston on February 7, 2001, at 16:14:12
In reply to Re: Why did you stop taking Ritalin, Kathy? » MarkinBoston, posted by Katz on February 7, 2001, at 15:35:57
Kathy, send some email to me: jfcl36@hotmail.com
I live just outside Boston and my Pdoc is in Lexington and has free parking. I don't want to post her name and phone number here. Its partly out of fear that some government peon looking for a promotion or a little press might go after her, not caring how good she is at helping people, and partly because I want to be able to get an appointment in a reasonable amount of time when I need one!
She has evening appointments up to 7pm on some weekdays. I'll give you her name and number.
She does not use meds not approved in the US, but may use approved drugs for any use she deems fit. With stimulants and thyroid, she has used them as adjuncts to antidepression meds.
> Hi Mark,
> Are you really from Boston? I'm from Worcester, MA
Posted by PhoenixGirl on February 7, 2001, at 18:05:47
In reply to Re: Why did you stop taking Ritalin, Kathy? » PhoenixGirl, posted by Katz on February 7, 2001, at 15:26:11
Hi Kathy,
I was going to refer you to MarkInBoston, but it looks like he already told you that he has a doc that prescribes amphetamines for him.
You're so right about social phobia getting worse the more you isolate yourself. I had it so bad for years, and then I got very good therapy called "cognitive behavioral therapy". I highly, highly recommend this to you. In this therapy, you practice talking to people in a group. You "act out" the situations that scare you the most. You build up to that, starting with baby steps. Also, the therapist helps you to see the irrationality of your social phobic thoughts. I did regular talk therapy for years to no avail, and doing this therapy helped me immensely in a few months. Mind you, it's difficult because you're taking on your fears, but please, please try it if you haven't yet. I did my therapy at the Psychology Clinic at the U. of Georgia, where they were studying this technique. The doctor who headed is named Dr. Nadir Amir, and the phone number is 706-542-1173 If you call him, he could probably tell you of a doctor in your area who practices this type of therapy. There must also be an organization like the National Alliance for the Mentally Ill who could point you toward a therapist. I know it will be difficult for you to reach out, but if I could do it you can do it. I truly believe that this therapy saved my life. I still have difficulties, but they're so much less and they don't rule me like before.
About me. I've considered taking amisulpride -- does it increase or inhibit dopamine? I'm considering trying reboxetine too, so there will be less serotonin action and so theoretically less sexual dysfunction. Talk to you later.
Posted by Sulpicia on February 7, 2001, at 18:08:52
In reply to Email me! » Katz, posted by MarkinBoston on February 7, 2001, at 16:14:12
Hi Everyone --
I've been following this thread with great interest and perhaps some of you may find my own experience useful.
I've suffered from chronic depression since the age of 13; I've been successfully treated with tofranil 3x, or so I thought.
About a year ago my son was tested for ADD/HD and for everything that we said "no" to for him, I said "yes" to for myself. A month later I was evaluated and diagnosed with ADD inattentive type [no hyperactivity].
I was prescribed adderall and I cannot even begin to explain how my life, to say nothing of my mood, has changed for the better.
After my evaluation with the pdoc he told me that adult ADD/HD is widely underdiagnosed and very, very often co-morbid with depression. Females especially tend not to be evaluated because they have the inattentive type and so get written off as "daydreamers."
I was sceptical at first because although I had a spotty academic career at one point, I was smart enough to compensate for my ADD. In fact if it had not been for my slow reading speed making me crazy in grad school, I might never have pursued diagnosis and treatment.I'm NOT suggesting that people rush out and *look* for a diagnosis of ADD/HD. I merely wish to point out that many adults are diagnosed in their 30s and 40s.
If you search for the ADD site at About.com there are some online tests and descriptions of symptoms etc. Some of it may click with you. This doesn't mean that it will be easy to find a clinician to evaluate you and prescribe appropriate meds and therapy.
The CHADD web site is also very good for adult ADD/HD.Just thought I would share this because I've been dramatically helped by accurate dx and tx.
S.
ps -- if you search Dr. Bob's psychopharmacology tips [stimulants] you'll find some interesting discussion of pdocs who use stims as an add-on for tx of depression.
Posted by natg on February 7, 2001, at 18:46:39
In reply to Re: Why did you stop taking Ritalin, Kathy? » MarkinBoston, posted by Katz on February 7, 2001, at 15:35:57
Dear kathy:
I've been reading this thread with great interest.
I agree that it is a great crime that Doctors will not prescribe stimulants for depression.
I relate to your struggle. I had the most difficult time finding a doctor that was open enough to try something other than Prozac, Paxil, etc. It's been a huge task. To make matters worse, there was only one Psychiatrist in the city I live in that was even taking new patients and I had to wait 6 weeks to see him.
It is crazy!At the end, i went to the ER and found a semi- decent Doctor. He's not a psychiatrist but he has been very open- minded. I think he got sick and tired of seing me in his office every other week.
Anyway, I wish you all the luck in the world. I know it will work out for you.
Don't give up, no matter what. As long as you are willing to keep trying, I believe you will find the right Doctor.Please keep posting.
Good Luck to you,
Nat
Posted by Katz on February 7, 2001, at 23:32:08
In reply to Re: Why did you stop taking Ritalin, Kathy?, posted by PhoenixGirl on February 7, 2001, at 18:05:47
>Whoa girl!!! That's moving a little too fast for me. I have to try and straighten out my brain chemistry before I attempt "cognitive behavioral therapy". The suggestion is a good one however. I have heard of this before and I will certainly keep it in mind for later on down the line. It will be a good adjunctive treatment to chemo and a good way to acclamate myself back into society.
I believe amisulpride increases dopamine at specific receptor sites. AndrewB is the one to ask for a full explaination of the actual nerochemistry of the whole thing. I just did a four day amisulpride trial that resulted in failure. It has helped many others and I think it's worth a try.
Reboxetine sounds great on paper but for many on this board has not lived up to expectations. I have mixed feelings about it. It started out very promising and then kind of whimped out on me. If I am unable to get the ritilin, I plan to give the Reboxetine another go with a longer trial. Reboxetine may be most effective combined with something else. Take care,
Hugs,
Kathy
Hi Kathy,
>
> I was going to refer you to MarkInBoston, but it looks like he already told you that he has a doc that prescribes amphetamines for him.
> You're so right about social phobia getting worse the more you isolate yourself. I had it so bad for years, and then I got very good therapy called "cognitive behavioral therapy". I highly, highly recommend this to you. In this therapy, you practice talking to people in a group. You "act out" the situations that scare you the most. You build up to that, starting with baby steps. Also, the therapist helps you to see the irrationality of your social phobic thoughts. I did regular talk therapy for years to no avail, and doing this therapy helped me immensely in a few months. Mind you, it's difficult because you're taking on your fears, but please, please try it if you haven't yet. I did my therapy at the Psychology Clinic at the U. of Georgia, where they were studying this technique. The doctor who headed is named Dr. Nadir Amir, and the phone number is 706-542-1173 If you call him, he could probably tell you of a doctor in your area who practices this type of therapy. There must also be an organization like the National Alliance for the Mentally Ill who could point you toward a therapist. I know it will be difficult for you to reach out, but if I could do it you can do it. I truly believe that this therapy saved my life. I still have difficulties, but they're so much less and they don't rule me like before.
> About me. I've considered taking amisulpride -- does it increase or inhibit dopamine? I'm considering trying reboxetine too, so there will be less serotonin action and so theoretically less sexual dysfunction. Talk to you later.
Posted by Katz on February 7, 2001, at 23:41:05
In reply to Pstims and depression: to all, posted by Sulpicia on February 7, 2001, at 18:08:52
Thank you for passing the information along. I have checked out the ADD website on About Com. and found it very interesting and informative. I was just wondering if it is possible to have ADD yet not suffer from concentration problems. It seems that Anhadonia and ADD share many similar symptoms.
> Hi Everyone --
> I've been following this thread with great interest and perhaps some of you may find my own experience useful.
> I've suffered from chronic depression since the age of 13; I've been successfully treated with tofranil 3x, or so I thought.
> About a year ago my son was tested for ADD/HD and for everything that we said "no" to for him, I said "yes" to for myself. A month later I was evaluated and diagnosed with ADD inattentive type [no hyperactivity].
> I was prescribed adderall and I cannot even begin to explain how my life, to say nothing of my mood, has changed for the better.
> After my evaluation with the pdoc he told me that adult ADD/HD is widely underdiagnosed and very, very often co-morbid with depression. Females especially tend not to be evaluated because they have the inattentive type and so get written off as "daydreamers."
> I was sceptical at first because although I had a spotty academic career at one point, I was smart enough to compensate for my ADD. In fact if it had not been for my slow reading speed making me crazy in grad school, I might never have pursued diagnosis and treatment.
>
> I'm NOT suggesting that people rush out and *look* for a diagnosis of ADD/HD. I merely wish to point out that many adults are diagnosed in their 30s and 40s.
>
> If you search for the ADD site at About.com there are some online tests and descriptions of symptoms etc. Some of it may click with you. This doesn't mean that it will be easy to find a clinician to evaluate you and prescribe appropriate meds and therapy.
> The CHADD web site is also very good for adult ADD/HD.
>
> Just thought I would share this because I've been dramatically helped by accurate dx and tx.
>
> S.
> ps -- if you search Dr. Bob's psychopharmacology tips [stimulants] you'll find some interesting discussion of pdocs who use stims as an add-on for tx of depression.
Posted by Sulpicia on February 7, 2001, at 23:51:33
In reply to Re: Pstims and depression: to all » Sulpicia, posted by Katz on February 7, 2001, at 23:41:05
> Katz -- as far I can remember, the diagnosis is made by a certain number of symptoms on a list. I don't believe that there is one criteria in particular that must be present, rather a majority of symptoms.
As for concentration, there are neuropsych tests for this. The fact that you don't think you have a problem with concentration may simply be due to a lack of a reference point. I never thought about my reading speed [actually a concentration problem] until I saw how much faster others dealt with the identical material.
Testing might be useful for you.Take care -- anhedonia sounds like a proper bitch.
S.
Posted by Katz on February 8, 2001, at 0:23:44
In reply to Re: Why did you stop taking Ritalin, Kathy?, posted by natg on February 7, 2001, at 18:46:39
>Hi Nat,
Funny, you're the second person today that said you were reading this thread with interest. I was afraid that my posts were long and rambling and that I was monopolizing the board. Thank you for all your kind words and encouragement. Everyone on this board has been so wonderful. I feel like I have found a whole new family.
If I remember correctly, you are taking Risperdal and Mirapex. What is Risperdal? Is it stimulating? How long have you been on the Mirapex and how long did it take to notice it's effects? Are your meds currently being prescribed by the ER doc? Did you ever make that appointment with the psychiatrist?
I'm hanging in there and am determined not to give up. Hopefully one day I will report back to you with a success story.
With warm wishes for your continued success,
Kathy
Dear kathy:
> I've been reading this thread with great interest.
> I agree that it is a great crime that Doctors will not prescribe stimulants for depression.
> I relate to your struggle. I had the most difficult time finding a doctor that was open enough to try something other than Prozac, Paxil, etc. It's been a huge task. To make matters worse, there was only one Psychiatrist in the city I live in that was even taking new patients and I had to wait 6 weeks to see him.
> It is crazy!
>
> At the end, i went to the ER and found a semi- decent Doctor. He's not a psychiatrist but he has been very open- minded. I think he got sick and tired of seing me in his office every other week.
>
> Anyway, I wish you all the luck in the world. I know it will work out for you.
> Don't give up, no matter what. As long as you are willing to keep trying, I believe you will find the right Doctor.
>
> Please keep posting.
>
> Good Luck to you,
> Nat
Posted by Marie1 on February 8, 2001, at 7:58:14
In reply to Re: Why did you stop taking Ritalin, Kathy? » natg, posted by Katz on February 8, 2001, at 0:23:44
> Could someone please explain to me whats so terrible about adding stims like phentermine to the depression cocktail, especially if it works???? Most anti-depressants are sedating, correct? Why not try to counteract that? I realize there is the potential for addiction/abuse, but do doctors withhold pain medication from people who need it for the same reason? Shame on them, if they do! I'm only trying to improve my quality of life here. I want to get back the person I was before mental illness. I really don't think that's asking so much. Sorry for the rant. Basically, my question to anyone who may know the answer - why are psychiatrists so unwilling to prescribe stimulants to people with depression?
Posted by PhoenixGirl on February 8, 2001, at 9:03:17
In reply to Katz, MarkinBoston, et al, posted by Marie1 on February 8, 2001, at 7:58:14
I believe that part of the reason is that some people become addicted to stimulants and/or abuse them, and doctors are afraid of being sued for this. Money is often these bastards' main motivation. Same with doctors in general.
> Could someone please explain to me whats so terrible about adding stims like phentermine to the depression cocktail, especially if it works???? Most anti-depressants are sedating, correct? Why not try to counteract that? I realize there is the potential for addiction/abuse, but do doctors withhold pain medication from people who need it for the same reason? Shame on them, if they do! I'm only trying to improve my quality of life here. I want to get back the person I was before mental illness. I really don't think that's asking so much. Sorry for the rant. Basically, my question to anyone who may know the answer - why are psychiatrists so unwilling to prescribe stimulants to people with depression?
Posted by MarkinBoston on February 8, 2001, at 12:03:31
In reply to Docs who won't prescribe stims for depression, posted by PhoenixGirl on February 8, 2001, at 9:03:17
I got really pissed off at a big "Special Report" on WWW.MSNBC.COM called "Meth's deadly buzz". Its media buzz that didn't say anything about methamphetemine deaths, despite being 33% of the title. The DEA propaganda machine doesn't address death rates from various drugs. If they did, thinking folks might compare those numbers to how many Americans die every year from smoking cigarettes (430,700 according to the American Heart Association) and question the $billions spent on the war on drugs versus benefit (reduction in deaths). Thinking folks may also wonder why people go to jail for using drugs that are less addictive and less deadly than tobacco, which is legal.
The story focuses on some individuals who were addicted to meth and the consequences. Rather than saying these people were predisposed to addiction and meth was the drug they happened to use, they implied that meth is highly addictive. Many people become addicted to alchohol, but they are a small minority compared to all the people who regularly consume alchohol and aren't addicted. I don't find amphetemines addictive, or alchohol, or pot, or cocaine, or codiene, or oxycodone, or any drug I've tried or taken.
One interesting point they made was that chronic meth abusers lose dopamine transmitters, while cocaine users don't. For long term use, cocaine may be safer than amphetemines. They explained that cocaine was a dopamine reuptake inhibitor while meth is an agonist and might have something to do with it.
Go forward in thread:
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