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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by borderliner21 on March 14, 2002, at 21:29:54
As you probably know, I am overly concerned about Anti-depressants and EPS. I was born with dystonia and touretts so I can't take the ssri's because they worsen my dystonia. Would serzone and lithium be a good non-EPS combo for my manic depressive illness? Does serzone have any effect on dopamine? Serzone seems right for me.
Posted by OldSchool on March 14, 2002, at 21:49:22
In reply to serzone and lithium - old school , john x2, posted by borderliner21 on March 14, 2002, at 21:29:54
> As you probably know, I am overly concerned about Anti-depressants and EPS. I was born with dystonia and touretts so I can't take the ssri's because they worsen my dystonia. Would serzone and lithium be a good non-EPS combo for my manic depressive illness? Does serzone have any effect on dopamine? Serzone seems right for me.
Bipolar is not really my thing, I dont know that much about it really. Lamictal might be a good choice as it is somewhat dopaminergic. Could you tolerate an MAOI? I have read MAOIs are supposed to be good for bipolar, plus they are dopaminergic which would be good for EPS. This is a complicated question, a little over my head.What about Wellbutrin? Thats the preferred AD for bipolar and it should be OK for EPS. If you have neurological problems in addition to psych probs, maybe you need to consult with a Neurologist in addition to a psychiatrist? Perhaps even a Neuropsychiatrist. Neuropsychiatrists are trained in both Neurology and psychiatry and can be helpful in complicated medication questions sometimes, IF you can find one as they are rare birds. Movement disorders, Tourettes...this is neuro stuff not psych stuff.
One thing I have read that is good for Tourettes is nicotine patches. If you have Tourettes do you also have OCD? This is a complicated one you have here.
Old School
Posted by borderliner21 on March 14, 2002, at 22:12:38
In reply to Re: serzone and lithium - old school , john x2, posted by OldSchool on March 14, 2002, at 21:49:22
Yes I have ocd too. I guess I just have to search for the right AD..my psychiatrist wants me to start celexa but I refuse..and he gave me seroquel for bipolar and that I am afraid to take also because of EPS.
Posted by JohnX2 on March 14, 2002, at 23:05:06
In reply to Re: serzone and lithium - old school , john x2, posted by borderliner21 on March 14, 2002, at 22:12:38
borderliner,I really think that you need to find a new psychiatrist/doctor.
Is this person well aware of your dystonia problem?
I can't comprehend why this person is pushing celexa on you when it is so obvious that it may give you a dystonia?
Anyways, Bipolar disorder is complicated to treat and I think it requires a skilled psychiatrist. A GP/neuro may be able to handle depression, but bipolar is just to tricky. Maybe a neuro should be involved to help with the dystonia.
So for the dystonia, Serzone should work out just fine. Wellbutrin should be no problem either. Wellbutrin is better for anergic depression. Serzone is better for anxiety problems. Remeron is another option.
I think Lamictal may be a good suggestion to try, particularly for bipolar. I really don't know about Lamictal and dystonia, but i can do some digging around. Anyways what is nice about lamictal is that it is a mood stabilizer/anti-depressant in one package. But usually the crummy doctors won't prescribe this one, and I think you may get push back from your guy. I take Lamictal and have had no major depression. The only sensitivity to lamictal is potential for a skin irritation when dosing the medicine. Some people report some brain fog, but I don't think it is all that common. A lot of people do really well on a lamictal + lithium duo. (you can drop the lithium dose for more lamictal and get less side effects).
any other questions. let us know.
john
> Yes I have ocd too. I guess I just have to search for the right AD..my psychiatrist wants me to start celexa but I refuse..and he gave me seroquel for bipolar and that I am afraid to take also because of EPS.
Posted by JohnX2 on March 15, 2002, at 9:41:38
In reply to Re: serzone and lithium - old school , john x2, posted by JohnX2 on March 14, 2002, at 23:05:06
Borderliner,I read your other post regarding OCD.
Is this a severe constraint?I'm not up much on OCD, but its not my understanding that Serzone is really targeted at OCD. Have you heard much on this?
hmm need best non-SSRI and non-AP meds for OCD/depression/bipolar/anti-dystonia(5ht-2a avoid).
John
>
> borderliner,
>
> I really think that you need to find a new psychiatrist/doctor.
>
> Is this person well aware of your dystonia problem?
>
> I can't comprehend why this person is pushing celexa on you when it is so obvious that it may give you a dystonia?
>
> Anyways, Bipolar disorder is complicated to treat and I think it requires a skilled psychiatrist. A GP/neuro may be able to handle depression, but bipolar is just to tricky. Maybe a neuro should be involved to help with the dystonia.
>
> So for the dystonia, Serzone should work out just fine. Wellbutrin should be no problem either. Wellbutrin is better for anergic depression. Serzone is better for anxiety problems. Remeron is another option.
>
> I think Lamictal may be a good suggestion to try, particularly for bipolar. I really don't know about Lamictal and dystonia, but i can do some digging around. Anyways what is nice about lamictal is that it is a mood stabilizer/anti-depressant in one package. But usually the crummy doctors won't prescribe this one, and I think you may get push back from your guy. I take Lamictal and have had no major depression. The only sensitivity to lamictal is potential for a skin irritation when dosing the medicine. Some people report some brain fog, but I don't think it is all that common. A lot of people do really well on a lamictal + lithium duo. (you can drop the lithium dose for more lamictal and get less side effects).
>
> any other questions. let us know.
> john
>
>
>
>
> > Yes I have ocd too. I guess I just have to search for the right AD..my psychiatrist wants me to start celexa but I refuse..and he gave me seroquel for bipolar and that I am afraid to take also because of EPS.
Posted by OldSchool on March 15, 2002, at 10:42:18
In reply to Re: serzone and lithium - old school , john x2, posted by JohnX2 on March 14, 2002, at 23:05:06
>
> borderliner,
>
> I really think that you need to find a new psychiatrist/doctor.
>
> Is this person well aware of your dystonia problem?
>
> I can't comprehend why this person is pushing celexa on you when it is so obvious that it may give you a dystonia?
>
> Anyways, Bipolar disorder is complicated to treat and I think it requires a skilled psychiatrist. A GP/neuro may be able to handle depression, but bipolar is just to tricky. Maybe a neuro should be involved to help with the dystonia.
>
> So for the dystonia, Serzone should work out just fine. Wellbutrin should be no problem either. Wellbutrin is better for anergic depression. Serzone is better for anxiety problems. Remeron is another option.
>
> I think Lamictal may be a good suggestion to try, particularly for bipolar. I really don't know about Lamictal and dystonia, but i can do some digging around. Anyways what is nice about lamictal is that it is a mood stabilizer/anti-depressant in one package. But usually the crummy doctors won't prescribe this one, and I think you may get push back from your guy. I take Lamictal and have had no major depression. The only sensitivity to lamictal is potential for a skin irritation when dosing the medicine. Some people report some brain fog, but I don't think it is all that common. A lot of people do really well on a lamictal + lithium duo. (you can drop the lithium dose for more lamictal and get less side effects).
>
> any other questions. let us know.
> john
If borderliner really does have movement disorder problems of any significance, he needs a Neurologist. In my experiences, most psychiatrists are inherently unreliable when it comes to any physically based medical problem and are focused almost exclusively on outward "behaviors" or "psychological" issues such as thoughts, feelings, mood, etc. In short, unless the physical medical problem is rather severe and totally noticeable to the naked eyeball, most Pdocs will probably tend to downplay it and ignore it. In fact there are even some Pdocs who might take borderliner's complants of dystonia as a psychological complaint and tell him it was "psychosomatic." Or that he was "obsessing" about it. Make him believe he is basically crazy. This is why you need a real doctor if you have physically based problems...psychiatrists DO NOT treat physical medical disorders. They only treat "psychiatric" or "behavioral" problems.
All I can say about borderliner is if this person really does have these problems he claims he does, a psychiatrist probably isnt the person to treat it.
The bottom line is psychiatrists treat psychological problems (mood, thoughts, feelings, outward behaviors). While Neurologists treat actual nervous system and brain diseases (movement disorders, stroke, etc.).
Old School
Posted by borderliner21 on March 15, 2002, at 12:20:55
In reply to Re: serzone and lithium - old school , john x2, posted by OldSchool on March 15, 2002, at 10:42:18
I told my psychiatrist about ssri's messing up my posture and he said there is no possible way that could happen. Well it happened to me. I saw my regular doctor about this and he just looked at me like I was retarted.
Posted by Ritch on March 15, 2002, at 20:58:28
In reply to Re: serzone and lithium - old school , john x2, posted by borderliner21 on March 15, 2002, at 12:20:55
> I told my psychiatrist about ssri's messing up my posture and he said there is no possible way that could happen. Well it happened to me. I saw my regular doctor about this and he just looked at me like I was retarted.
bd21,
I read John's post above about the definition of dystonia and it fits my symptoms and they are also aggravated by SSRI use. I notice when I am driving my lower back/hip twists to one side or the other for several seconds and the muscles remain contracted for several seconds, until I notice it then I try to straighten up my posture. Then a little bit later it may twist the other way and "freeze" there until I notice it again. Interestingly, when I was trying out some dexedrine last week that.. stopped. All of my back and leg muscles seemed all floppy and "dishrag" like and I had noticeably improved posture when I was walking. I wouldn't of course-advocate any amphetamine use for folks with any symptoms of psychosis-but there is definitely *something* going on that isn't right. It is mainly an annoyance, but sometimes I get some bad backaches from it (from the muscle tension). I did notice that when I was trying Serzone out that my restlessness was reduced tremendously. Also desipramine helped with that, too. I am going to try out some SAM-e (when I get a chance to buy it the next day or two) and see if it helps with that. I told Ron Hill I would post about it. Hopefully, it will help.
Mitch
This is the end of the thread.
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