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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by cmcdougall on January 15, 2002, at 11:44:22
Dear Friends,
You have helped me so much over the past few months and now I ask help for my baby (43 yrs old) brother. He has Generalized Anxiety Disorder and also Major Depression.
For about the last 6 months he was taking 2400mg Neurontin for both the anxiety and depression. This is the first time he has tried a prescription drug for his problems. Brother is a self-medicator who was addicted to cocaine, and has also enjoyed the effects of "downers" as well. He has been off cocaine for 10 years. The Neurontin seemed to help his anxiety, but I believe it might have worsened the depression.
Now he is titrating off the neurontin and adding on Serzone. I am worried because he seems to be very emotionally fragile right now - a combination of worried and resentful, bitter and sad. Could this be withdrawal from the Neurontin?
Now I learn that Serzone has been linked to liver problems. My brother in in remission from Hep C (after 4 straight years of Interferon) and I think he needs to quit taking the Serzone immediately. What do you think? Also, while he was taking the chemotherapy he was prescribed percodan for the painful side effects. I think he enjoyed the percodan a little too much, but if it relieved some of the pain from the Interferon and enabled him to continue working, the fact that he enjoyed it should be ok, right?
What would be a good drug or combo to help w/ the GAD, depression, and lack of motivation? Maybe a tri-cyclic? Do those have the same sexual side effects as the SSRIs?
I value your input and thank you all in advance.
Carly
A devoted and concerned sister...
Posted by mr.scott on January 15, 2002, at 13:31:04
In reply to Need advice for brother w/ GAD, depression, HepC, posted by cmcdougall on January 15, 2002, at 11:44:22
I'm going to say Effexor.. Do some reseach on it.
Posted by IsoM on January 15, 2002, at 14:32:58
In reply to Need advice for brother w/ GAD, depression, HepC, posted by cmcdougall on January 15, 2002, at 11:44:22
Cindy, I can't imagine him taking Serzone with his previous liver history. Does the doctor know? And if he/she does, why do they think it okay to use? That would definitely concern me too.
As for enjoying percodan, who wouldn't when it relieves the pain? I "enjoy" my codeine when I have to take it for pain. I'm also nervous about absuing it but responsibility doesn't make it less enjoyable.
Adrafinil works for me for motivation but with his Hep C history, I'd be leery of either adrafinil or Provigil. But then, I'd be sort of leery about how his liver would handle any meds. I assume he's going to have frequent liver tests done?
Sorry, I have no other comments about the rest of your questions. Not enough experience in those areas.
> Dear Friends,
>
> You have helped me so much over the past few months and now I ask help for my baby (43 yrs old) brother. He has Generalized Anxiety Disorder and also Major Depression.
>
> For about the last 6 months he was taking 2400mg Neurontin for both the anxiety and depression. This is the first time he has tried a prescription drug for his problems. Brother is a self-medicator who was addicted to cocaine, and has also enjoyed the effects of "downers" as well. He has been off cocaine for 10 years. The Neurontin seemed to help his anxiety, but I believe it might have worsened the depression.
>
> Now he is titrating off the neurontin and adding on Serzone. I am worried because he seems to be very emotionally fragile right now - a combination of worried and resentful, bitter and sad. Could this be withdrawal from the Neurontin?
>
> Now I learn that Serzone has been linked to liver problems. My brother in in remission from Hep C (after 4 straight years of Interferon) and I think he needs to quit taking the Serzone immediately. What do you think? Also, while he was taking the chemotherapy he was prescribed percodan for the painful side effects. I think he enjoyed the percodan a little too much, but if it relieved some of the pain from the Interferon and enabled him to continue working, the fact that he enjoyed it should be ok, right?
>
> What would be a good drug or combo to help w/ the GAD, depression, and lack of motivation? Maybe a tri-cyclic? Do those have the same sexual side effects as the SSRIs?
>
> I value your input and thank you all in advance.
>
> Carly
> A devoted and concerned sister...
Posted by petey on January 15, 2002, at 15:16:13
In reply to Need advice for brother w/ GAD, depression, HepC, posted by cmcdougall on January 15, 2002, at 11:44:22
> Dear Friends,
>
> You have helped me so much over the past few months and now I ask help for my baby (43 yrs old) brother. He has Generalized Anxiety Disorder and also Major Depression.
>
> For about the last 6 months he was taking 2400mg Neurontin for both the anxiety and depression. This is the first time he has tried a prescription drug for his problems. Brother is a self-medicator who was addicted to cocaine, and has also enjoyed the effects of "downers" as well. He has been off cocaine for 10 years. The Neurontin seemed to help his anxiety, but I believe it might have worsened the depression.
>
> Now he is titrating off the neurontin and adding on Serzone. I am worried because he seems to be very emotionally fragile right now - a combination of worried and resentful, bitter and sad. Could this be withdrawal from the Neurontin?
>
> Now I learn that Serzone has been linked to liver problems. My brother in in remission from Hep C (after 4 straight years of Interferon) and I think he needs to quit taking the Serzone immediately. What do you think? Also, while he was taking the chemotherapy he was prescribed percodan for the painful side effects. I think he enjoyed the percodan a little too much, but if it relieved some of the pain from the Interferon and enabled him to continue working, the fact that he enjoyed it should be ok, right?
>
> What would be a good drug or combo to help w/ the GAD, depression, and lack of motivation? Maybe a tri-cyclic? Do those have the same sexual side effects as the SSRIs?
>
> I value your input and thank you all in advance.
>
> Carly
> A devoted and concerned sister...Carly,
My older brother was also diagnosed hep. c. You said your brother was in remission. What did he do to get in remission? I am very interested because we are so worried about him. Also, what were his symptoms? Thank you in advance.
Petey
Posted by cmcdougall on January 15, 2002, at 22:06:51
In reply to Re: Need advice for brother w/ GAD, depression, HepC, posted by petey on January 15, 2002, at 15:16:13
Dear Petey,
Fifteen years ago my brother Joe was diagnosed w/ hepatitis. As far as I know, there was no test for Hepatitis C at that time. I don't recall exactly what the dr. did then, but my brother seemed to recover.
Ten years ago, Joe came down w/ hepatits again and this time they diagnosed it as "c". His symptoms were coffee colored urine, pale stool, general malaise and fatigue. He was sent to a specialist who told him he'd be dead in ten years. Needless to say, we were devastated.
Later that same year, Joe's wife saw an advertisement in the newspaper for a study to investigate Interferon in the treatment of HepC. It was done at a university in Seattle. Joe was accepted into the program and all his treatment was free. He gave himself injections of Interferon (in the flesh of his belly) 3 times per week for about 6 months. The side effects of this treatment are brutal. Many of the study participants dropped out because of them. Side effects included severe headache and muscle aches like the flu. It also gave Joe panic attacks that would wake him up at night. He said it felt like he was dying.
After the first 6 months of treatment Joe was in remission for 6 months but then the hep came back. This time he took the Interferon for 1 year w/ the same horrible side effects. He again went into remission and this time it lasted a year. Joe says the worst part of it is the liver biopsies he had to endure. A biopsy in the only definative way to make sure he's in remission. The biopsy in done w/ only a local anesthetic, and w/ a local they can only numb the skin - OUCH!
Joe's last treatment was w/ Interferon and Ribovarin. When he took it it was still experimental. I think it is an approved treatment now. VERY VERY expensive. Anyway, Joe took this for 4 years. He has been in remission over 3 years now. His blood tests negative for any hepatitis and the liver biopsy is completely clean. His dr. said its as if he never had it. My family feels so blessed that Joe seems to have recovered.
The Interferon treatment seems to work for some people, but it has to be taken for a long time and more than half of the users cannot tolerate the side effects. Another treatment is a liver transplant. Living donor transplants (from a parent or sibling) are being used more and more now. The small lobe of the liver is removed from the donor and transplanted. Amazingly, the donor's liver grows a new small lobe within 8 weeks.
Good luck to you and your brother. If you have any further questions, please ask.
Carly
> Carly,
> My older brother was also diagnosed hep. c. You said your brother was in remission. What did he do to get in remission? I am very interested because we are so worried about him. Also, what were his symptoms? Thank you in advance.
> Petey
This is the end of the thread.
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