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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by backofclass on January 8, 2003, at 21:24:30
I think that my new doctor is a winner! He had prescribed me 100mg of Zoloft, 40mg of Matadate CD and 1mg of Klonopin, "only to be taken as needed for my panic attacks." Next visit I will ask if I could take the Klonopin everyday to releive my anticipatory anxiety and social phobia.
There aren't many reviews on Matadate CD? It is like Ritalin, the same drug that elivated my anxiety. I don't understand why I would be prescribe this when I despritly want to control my anxiety. The Zoloft can also increase anxiety but on the other hand, it is suppose to be helpful? I am concerned about being on such a high dose!
I may change my script from Zoloft/Matadate CD to Dexadrine/another AD. The Dexadrine can counter the fatigue of the Klonopin which Metadate can not match. I am assuming it is true that Dex causes the least anxiety of all stimulants? It is a shame I can't augment some Nardil with Dexadrine. How dangerous is it to use Nardil with Metadate CD/Ritalin? I would take this over Zoloft since it is the best for depression and SP, without side-effects.
I could replace the Zoloft with Effexor. Would Effexor have any added benefits when combined with a stimulant, different then an SSRI and could it be used to additionally treat the ADHD?
I read that Parnate produces a stimulating effect on the brain. Can Parnate be helpful for ADHD?
Also, I am anxious to see how good this ADHD drug Strattera will be. Do we know if it will be safe with an MAOI?
Posted by jonh kimble on January 8, 2003, at 21:48:32
In reply to ? on treatments for ADHD with SP, posted by backofclass on January 8, 2003, at 21:24:30
There is no doubt that parnate can be effective for social phobia. It is rather stimulating in most people (not myself, but I have unuasual respones to just about any drug you can name) and has been suggested to be quite helpful in add but the scares of the diet restcritions have really halted any reasearch (which I think is flat out stupid) but there you go
Posted by cybercafe on January 8, 2003, at 23:25:53
In reply to Re: ? on treatments for ADHD with SP, posted by jonh kimble on January 8, 2003, at 21:48:32
> There is no doubt that parnate can be effective for social phobia. It is rather stimulating in most people (not myself, but I have unuasual respones to just about any drug you can name) and has been suggested to be quite helpful in add but the scares of the diet restcritions have really halted any reasearch (which I think is flat out stupid) but there you go
parnate didn't work for my ADD .... but then neither is 40 mg ritalin SR
Posted by backofclass on January 8, 2003, at 23:49:40
In reply to Re: ? on treatments for ADHD with SP, posted by jonh kimble on January 8, 2003, at 21:48:32
I know that Parnate can be great for SP, but still second to Nardil. I am wondering if it can also improve ADHD, even slightly. I remember reading somewhere that it may help because Parnate has a "stimulant" effect, but can't find anything else to back this up. If Parnate did have a slight effect against ADD then I thought I could take that instead of a stumulant and also not have to take an SSRI. The SP has a more negative effect on my life or more appropriatly no life then the ADHD so I was thinking if I used the Parnate and Klonopin together I could get the best of both worlds.
Posted by backofclass on January 9, 2003, at 0:40:01
In reply to Re: ? on treatments for ADHD with SP, posted by jonh kimble on January 8, 2003, at 21:48:32
Sorry I missed you comment jonh. I may be deslexic! I would guess that the reason it is not studied is because Parnate would not be the first line of treatment for those who have ADHD. I have never been worried about the diet ristrictions. I don't eat any meat or milk anyway, but I do love tofu! I would really like to know how effective it is if anyone knows?
Posted by utopizen on January 10, 2003, at 21:17:47
In reply to Re: ? on treatments for ADHD with SP, posted by cybercafe on January 8, 2003, at 23:25:53
> parnate didn't work for my ADD .... but then neither is 40 mg ritalin SRHey- did you try Adderall, and did that work? How about Desoxyn? Desoxyn, at the right dose, is likely to work rather well... and the refractory ADD types tend to be the only ones privileged to get it.
Guess what my p-doc told me today? Basically, he wants me to ignore my anxiety for the sake of keeping my ADD at bay, so I don't take anything that makes me foggy in the head.
I even told him I was only having difficulty staying on task because I need regular release of my sex. tension to focus, and that was what screwed me up because I couldn't orgasm on Effexor all last semester (and to make matters worse, it didn't do a thing for my social anxiety anyway!!)
So I just weaned off the Effexor, and now I can finally focus by having my tension relieved (and no, it's not that I'm thinking about sex, it's just that the chemicals released after orgasm keep me focused).
But because I messed up and got 1.7 GPA this semester, he's so concerned all of a sudden that if I take something like Klonopin or Soma or whatever it'll make me too foggy to deal with schoolwork. Nevermind the fact that if I never saw him, I'd never get Effexor, and I would have done just fine with my GPA.
And I explained to him Klonopin and Adderall work well together for me, but he's just a benzophobe, so now it seems he won't even give me the 15 .5mg prn he gave me every 3 months before (as if that was a lot!).
ugggg..... I was just thinking, I've been in treatment with him for over a year now, and he's not treated my anxiety. And every humiliating experience I've had in the past year was directly spurred on by my social anxiety-- from drinking and making a fool of myself to acting so nervous it's just as humiliating to face a person the next day as if they saw me drunk.
And I feel miserable as a result. And like I said, all of these things, they could have easily been avoided- I mean, they all happened while I was seeing him, and he knew Klonopin worked for me.
I mean, seriously, incredibly attractive girls I really liked (and was at first liked by) I humiliated myself in front of, all avoidable if I had Klonopin. How pathetic is that? And then the "treatment" he gives me that doesn't do anything just makes me so unfocused my GPA is two tenths above that which would have kicked me out of my Ivy-league school.
Seriously, one of these girls I would likely marry for sure, we both wanted to enter the same career, etc. That sounds silly, but I'm not out of line there. anyway, it's just pathetic. I want my wasted year back....
I don't even have any drug abuse history whatsoever. And he things the very remote chance I met get addicted to Klonopin outweight not getting treated? Guess what he gave me today? Atarax! I laughed out loud for 2 minutes before getting myself up to the door. He looked startled. I figure I may as well find some humor in his incompetence, otherwise I'd be balling my eyes out instead.
Posted by Dinah on January 10, 2003, at 22:21:54
In reply to SP/ADD/Idiot doctor ruining my life » cybercafe, posted by utopizen on January 10, 2003, at 21:17:47
I hate to be over-simplistic, but why do you keep going to a pdoc you dislike. There are plenty of them out there. Sometimes it takes a while to get a new patient appointment, so start now with several of them. If you find one you like, you can cancel the others. In the meantime you can keep seeing this one.
Or am I missing something crucial?
Posted by Ritch on January 10, 2003, at 23:17:11
In reply to SP/ADD/Idiot doctor ruining my life » cybercafe, posted by utopizen on January 10, 2003, at 21:17:47
It almost sounds like your parents have your pdoc in their back pocket or something... He wants to give you plenty of C-II stimulants so you can "get through" college, but doesn't want to prescribe you any "dumb" drugs like Klonopin. This reminds me of some satirical skit I heard on NPR a few years back where some actor said something like "Do not take any medications unless approved by your supervisor or manager". Nothing but productivity medication allowed! Your pdoc isn't looking for your best interest in my opinion. I agree with Dinah, find a way to ditch him and find someone else that will see your social anxiety as THE priority treatment perogative.
Posted by viridis on January 11, 2003, at 0:09:57
In reply to SP/ADD/Idiot doctor ruining my life » cybercafe, posted by utopizen on January 10, 2003, at 21:17:47
Hi Utopizen,
As others have pointed out, obviously this doctor isn't treating you appropriately, for whatever reason. You recognize that, yet you seem strangely dedicated/loyal to him. We had this conversation a while ago, and I thought you said were going to see a different doctor, a psychopharmacologist. Didn't that work out?
It's not unusual to have doctors/psychiatrists who don't know how to treat you (or just won't, due to fear of certain types of drugs, etc.). Many of us have been through plenty of those, and the only solution is to move on until you find one who listens to what you say and acts accordingly. From what I understand, you're in a position to do this, so why don't you? Or, at the very least, seek a second opinion.
No matter how much you might feel "tied' to this doctor, it isn't worth the suffering to stay with someone who sounds so narrow-minded, especially since you've already figured out what meds seem to work for you. In that sense, you're really ahead of the game; now you just need someone who'll help you get on with your life.
BTW, I wouldn't dwell on past embarassments, especially at your age -- there will be lots of other opportunities, believe me.
Posted by utopizen on January 11, 2003, at 8:31:27
In reply to Re: SP/ADD/Idiot doctor ruining my life, posted by viridis on January 11, 2003, at 0:09:57
Hey, I finally gave myself a dope slap after reading the posts.
I just scheduled an appointment for this Monday for a new doctor. Yahoo! Some old guy who graduated Harvard Med in '52. Got psychiatry achievement award in '98. How cool is that? and he's a 1/2 mile away from my school.
Posted by IsoM on January 11, 2003, at 15:01:40
In reply to Re: SP/ADD/Idiot doctor ruining my life, posted by utopizen on January 11, 2003, at 8:31:27
I'm glad to hear you've made an appointment with a new pdoc. Just a pointer for you (probably already know this though) but I want this to turn out well for you..
Present a calm, rational demeanour when you talk with this doctor. That doesn't mean you want to act as if you're completely fine & need no meds, but if you come across as a reasonable person in need of psychiatric/medical help who's educated themself about meds, he'll be more likely to consider your views.
This new doctor's an older guy so he's bound to be more traditional in his manner of patient/doctor interaction. You'll want to be courteous & respectful. It'll help with building a rapport with him. Many older people are in despair over the lack of traditional courtesies that once was commonplace. You won't believe how far a friendly hand shake & thank you's & please's go. (Not that I'm imply you're not a friendly courteous guy, but the concept of what's courteous with diff generations can be quite different to each.)
It may also be helpful in future visits to print out information for him from reputable web sites - e.g. NIHM (National Institute of Mental Health)or perhaps university sites. I'm sure you know this, utopizen, but in case you're not aware, I'll mention something. By typing in site:edu or site:org or site:gov (along with the other terms you wish to find info) on in the search box on Google, you'll get info from specific sites this way. Edu are university sites, org are organisation sites, & gov are governmental sites. It eliminates a lot of dross & commercial nonsense that tends to show up.
Good luck in getting the help you need!
Posted by utopizen on January 11, 2003, at 17:21:21
In reply to new doctor » utopizen, posted by IsoM on January 11, 2003, at 15:01:40
Well, lol, I've already gotten the tactfulness down (it's just my personality to be tactful, and state any negative as a positive. Friends think it's funny sometimes because often things are hilarously understated, especially when I've very upset about a thing anyone would else would likely explode in rage over).
He seemed surprised that I wanted to switch doctors, so he asked why. I simply stated, "I'd like to focus more on my anxiety right now." My idea is that if you're bad-mouthing a doc to another doc, they'll assume you'd do the same to them later. Anyone, he gave the, "oh, ok" expression, so he found it reasonable.
Sadly, another doc who seemed like he'd be great said he couldn't help, but said "good luck" about finding another. Any doctor who expresses sympathy in finding a new doc is likely a sympathetic one.
Posted by IsoM on January 12, 2003, at 0:14:50
In reply to Re: new doctor, posted by utopizen on January 11, 2003, at 17:21:21
I can see I didn't need to advise you. Glad you've got it down pat. I'm surprised at how little thought many people give to how they come across. Let us know how this doctor works out - & I hope it's good.
This is the end of the thread.
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