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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Geezer on September 7, 2002, at 18:38:59
I would appreciate any comments and experiences pbabblers may have had using Concerta to augment SSRIs or norep. ADs. I have TRD (treatment refractory would be closer to the point) Major Depression but the sever atypical type. No anxiety but very lethargic.
Current Meds.
Serzone 300mg.
Wellbutrin 400mg.
Klonopin .5mg (for sleep)
Ambien 10mg.The above meds. provide no relief at all. I have tried most of the SSRIs with no effect. I suppose Parnate would be the best choice but don't know how to get there from here.
I welcome all comments.
Thank you,
Geezer
Posted by henryO on September 11, 2002, at 2:56:37
In reply to Augmentation with Concerta, posted by Geezer on September 7, 2002, at 18:38:59
I take Concerta and Prozac, they helped me for years but I was still just hanging on and suffering. Then after many other trials my doctor added Pindolol (a.k.a. Visken ) as an augmentation. Soon after that we added Resperdal, .5mg and sometimes less. They both help significantly. I had some hang-ups at first with the idea of taking four meds as my "cocktail" but have come to see it merely as a packaging issue. It works for me.
I just started taking 1gm. of EPA a day about a month ago. Its part of the whole Omega 3 fish oil thing. That seems to help too. I'm still evaluating it. Keep trying, don't give up.
Posted by Geezer on September 11, 2002, at 14:43:14
In reply to Re: Augmentation with Concerta, posted by henryO on September 11, 2002, at 2:56:37
>henryO,
Thank you for the post. How well I remember the wonderful days when Prozac was working. It was the only AD to prove really effective for me, after two years it pooped out and I have had no relief from any AD since that time. The current mix of Serzone 250, Wellbutrin 400, Klonopin .5, and Ambien 10 leaves me in a stupor with little to no relief from depression (sever, refractory, atypical type). Since I have pushed the serotonin and norep. too the limit the only other way to go is dopamine. Since the FDA does not allow the marketing of dopamine ADs my only other thought was stims. (have an early history of abuse with Dexadrine but not Ritlan). I have tried only one AP-Geodon, this resulted in a sever anxiety attack which I corrected with 1mg. of Klonopin (I have never been so terrified-felt like panic??). Seems like the whole mess got worse when I quit smoking.I may end up with another AP trial and/or ECT. Not a pleasent future. Thank you so much for your thoughtful response, I will discuss this further with pdoc.
Best regards,
Geezer
I take Concerta and Prozac, they helped me for years but I was still just hanging on and suffering. Then after many other trials my doctor added Pindolol (a.k.a. Visken ) as an augmentation. Soon after that we added Resperdal, .5mg and sometimes less. They both help significantly. I had some hang-ups at first with the idea of taking four meds as my "cocktail" but have come to see it merely as a packaging issue. It works for me.
>
> I just started taking 1gm. of EPA a day about a month ago. Its part of the whole Omega 3 fish oil thing. That seems to help too. I'm still evaluating it. Keep trying, don't give up.
Posted by mashogr8 on September 12, 2002, at 19:45:50
In reply to Augmentation with Concerta, posted by Geezer on September 7, 2002, at 18:38:59
Geezer,
Your experience with ADs sounds too familiar. I've been there and tried that. some minor success with a few meds. Prozac and parnate included.
I have just recently (six weeks now)
added Concerta to the multiple bottle family on my nightstand.
currently taking 350 Wellbutrin (Slowly tapering down to nothing eventually even though I really like the energizing effect of the Well. But pdoc and I are not really happy).Celexa 60mg
Cytomel .025
Ritalin (previously up to 45mg. Concerta takes its place)I am very happy with the calm, even effect of Concerta. That much Ritalin made my upper arms tense and I was, at times, edgy.
The Concerta helped me stay focused during my work day. In spite of the stimulant aspect, I was still tired at the end of the day and generally I had no difficulty sleeping. I believe the lethargy was relieved by the Concerta and that has taken away the worry of getting nothing done at work.
As far as relief from TRD, only minimal improvement is noted, which is why my pdoc is reducing the medication. He intends to try monafrinal, I think.
Personally, in all these years the meds which have been most helpful have been Wellbutrin, Paroxitene and the best of all was Parnate. The incredible fifty pound weight gain which was an unsolicited gift from Parnate was more depressing and still remains fifteen years later. I did take Prozac for six years with much success. So much success that I eventually weaned myself off of it, quite slowly and no uncomfortable side effects. I was fine for about six months and then the inevitable crash came. I went back on Prozac and never achieved close to the relief I had had earlier. Coming off the Prozac the second time was nigh impossible and I thought I would die just from body shock.
My advice is: If you ever find something that works, trust that meds are forever. It may never work the same the second time around.
Bottom line: Concerta helped me
Parnate helped me, but really watch the weight issue, besides the dietWhen something works suck it up and tke it forever or forever you'll be looking for something to work
Good luck and much peace and relief to you.
MA
Posted by Geezer on September 13, 2002, at 15:10:44
In reply to Re: Augmentation with Concerta, posted by mashogr8 on September 12, 2002, at 19:45:50
Hi mashogr8,
Although I am very sorry you have this terrible TRD curse, it is a comfort to find someone with real understanding.
Prozac was the best AD I ever took....pooped out after 2 years and I have never been able to get any benefit from it since. I am currently tapering down from 400mg. of Wellbutrin to nothing (will maintain Serzone 250 for now). The Wellbutrin, like SSRIs, had no effect what so ever. Might as well be taking jelly beans.
I hope to start Concerta soon. In my case it will be a struggle with the new pdoc because I have a history of Dexadrine abuse from 20 years ago. Have taken Ritalin years back with no abuse. Its very difficult to explain to a pdoc the difference between Dex. and Rit. Dex. produced great euphoria (for me), Rit does not. Very difficult to explain to a "normal" person (pdoc) about addiction, one must go there to understand it - not a pleasent ride.
Anyhow, thank you. My next move will be to Concerta - after that to Parnate, after proper wash out. The comments are much appreciated.
Geezer
Posted by mashogr8 on September 13, 2002, at 20:14:52
In reply to Re: Augmentation with Concerta » mashogr8, posted by Geezer on September 13, 2002, at 15:10:44
This is the end of the thread.
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