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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Ame Sans Vie on October 15, 2003, at 18:19:23
Disclaimer: Regarding the subject title, Your Mileage May Vary. :-)
Well, I took the plunge today -- saw my psychiatrist and decided this would be my last month on Ultram. I came to the appointment determined to go back on Prozac (in tandem with Wellbutrin XL) in hopes of staving off the withdrawal symptoms of Ultram that I described in a post several days ago. Boy, am I glad I did. My Ultram dose was 100mg four times daily, and before today even reducing the dose by 25mg/day was unbearable. I took 10mg fluoxetine (generic Prozac) along with my third daily dose of Ultram today -- only I cut the Ultram dose down to 50mg instead of 100mg. No withdrawal to be told of. What an enormous relief. Since I'm going to be on only 10mg Prozac this first two weeks before moving up to 20mg, as well as tapering down on the Ultram, I'm not concerned about the serotonin syndrome thing.
Normally I'd be out of my mind by this point... I was expecting the cold sweats, shakiness, brain zaps, nausea, etc. Added in a little extra DL-phenylalanine and I feel wonderful -- even having second thoughts about returning to the pain specialist on Monday. :-) I'll probably end up going though... no sense wasting an appointment that was so hard to get, and for which I recently went through the horror of MRIs... never realized I was so claustrophobic. An agoraphobic claustrophobe, lmao. Anyway, who knows if the pain or depression might rear their respective ugly mugs again sometime soon. Given my luck, probably best not to take any chances. <g>
One final thing that has me a bit more hopeful than usual is that Prozac is *the* one medication I don't feel my past doctors ever gave a fair trial. I tried it once at 20mg, experienced no side effects (though no benefit either... or perhaps there *was* benefit but I was expecting that such a miracle couldn't occur without SSRI-type side effects and just didn't realize it)... yet my doctor at the time decided after a month to switch me to Paxil instead of attempt a dose titration. Maybe Prozac will turn out to be the thing I need? Well, in addition to the other meds, of course. After all, Ultram was such a wonder for me and the actions of the two drugs are not at all dissimilar in several regards. Maybe I'll just keep a couple hundred milligrams of tramadol on hand at all times in the future as an emergency antidepressant... or more likely, methadone -- well, not a few hundred milligrams if it ends up going that route, lol.
So, I'll be sure to keep you all posted in case anyone's interested... Brad, I can't remember if you're still on the Ultram or not, but if so I highly suggest you keep this in mind should you decide to discontinue and/or choose an alternate opioid somewhere down the line. Could potentially save a *lot* of pain and suffering. I'm convinced that the 5-HT/NE properties of tramadol are more potent than currently marketed SSRIs, regardless of what any admittedly objective studies show... what does science know anyway? ;-)
God, it's good to be back.
~~Michael
10mg Prozac
150mg Wellbutrin XL
12mg Klonopin
300-350mg Ultram
60-120mg dextromethorphan HBr
60mg Dexedrine
Posted by femlite on October 17, 2003, at 8:00:13
In reply to Prozac = great for Ultram withdrawal, posted by Ame Sans Vie on October 15, 2003, at 18:19:23
I missed your wit and brains, amigo
Posted by btnd on October 17, 2003, at 8:38:01
In reply to Prozac = great for Ultram withdrawal, posted by Ame Sans Vie on October 15, 2003, at 18:19:23
Ame
You can always try using Ultram via day on/day off method (which I've done, before amisulpride) - no tolerance, very effective.
But I've seen your list of meds - you posted 60 mg of dexedrine. IMO that's pretty high amount, are there any unhealthy aspects of this dose on the liver and kidneys? What do the medical sources say and/or your pdoc? Are there *any* side-effects as far as this dosage? I'm very curious because despite my usage of NDMA antagonists I had to start using 10 mg higher Adderall amount and right now at 40 mg of Adderall I think I'm damaging my kidneys,liver and heart (that's probably because I'm paranoid from all the studies done on huge amounts of meth and rats, but who knows).
Let me know if you find time.Take care,
Brad
Posted by Ame Sans Vie on October 17, 2003, at 21:23:36
In reply to Re: Prozac = great for Ultram withdrawal, q to Ame, posted by btnd on October 17, 2003, at 8:38:01
> Ame
> You can always try using Ultram via day on/day off method (which I've done, before amisulpride) - no tolerance, very effective.Thanks for the tip, but I'm already off it completely now. :-) No sense dragging it out anyway since the tramadol was greatly worsening my fibro pain.
> But I've seen your list of meds - you posted 60 mg of dexedrine. IMO that's pretty high amount, are there any unhealthy aspects of this dose on the liver and kidneys? What do the medical sources say and/or your pdoc?
I think the max FDA-recommended dose is 45mg for DextroStat, but even up to 90mg is common in adults. The FDA dosing guidelines were designed with children in mind.
> Are there *any* side-effects as far as this dosage? I'm very curious because despite my usage of NDMA antagonists I had to start using 10 mg higher Adderall amount and right now at 40 mg of Adderall I think I'm damaging my kidneys,liver and heart (that's probably because I'm paranoid from all the studies done on huge amounts of meth and rats, but who knows).
Amphetamines don't generally seem to pose a threat to the cardiovascular, renal, or hepatic systems except in very high abuse doses. You have nothing to worry about. It's methylphenidate that's dangerous this way (especially to the heart).
As far as side effects at 60mg dextroamphetamine, I can't say I've noticed any. Unless you consider greatly increased motivation and interest in life to be side effects. :-)
Actually though, I think I'm switching to Adderall (immediate-release) when I see my pdoc again in a couple weeks. I found a 30mg Adderall XR just laying around on the floor (go figure -- it's been more than a year since I last took the stuff, lol) the other day and after crushing up the beads and just parachuting the powder, I found that it was soooo much better than dextroamphetamine. I used to pick on Adderall because of the added peripheral effects of l-amphetamine, but it turns out that added physical energy was just what I needed, lol. Hell -- it even reduced my fibromyalgia pain by about HALF! Who woulda thunk?
Posted by MamaB on October 18, 2003, at 7:10:33
In reply to Re: Prozac = great for Ultram withdrawal, q to Ame » btnd, posted by Ame Sans Vie on October 17, 2003, at 21:23:36
A quote from a Adult ADHD/Dextrostat info website
http://www.adult-adhd.com/Drugs/dextrostat.html
"Do not crush, chew, or open any "once-daily" tablets or capsules--swallow them whole. Do not take Dextrostat (dextroamphetamine) in the evening; this medication can cause insomnia".
One can know everything there is to know about neurophysiology, and pharmacology but abusing is abusing and I don't think it should be bragged about on this forum! Parachuting! You have obviously been "around the block" on illegal as well as abusing legal drugs! I hope Dr, Bob reads this one.
Posted by Ame Sans Vie on October 18, 2003, at 10:45:05
In reply to Re: Prozac = great for Ultram withdrawal, q to Ame, posted by MamaB on October 18, 2003, at 7:10:33
You're new here, so I forgive your ignorance to my situation. I know very well that the prescribing information says not to crush the beads in the capsules, as that breaks the time release. Well guess what -- my doctor encouraged me to try it. So please, leave the high horse at home if you would.
Posted by Ame Sans Vie on October 18, 2003, at 16:53:20
In reply to AME SANS VIE -IT'S GOOD TO HAVE YOU BACK!!! » Ame Sans Vie, posted by femlite on October 17, 2003, at 8:00:13
Gee, thanks a lot. :-) Glad someone missed me, lol. Thank you so much for the compliment as well, amiga. :-)
Posted by MamaB on October 18, 2003, at 17:21:37
In reply to Re: AME SANS VIE -IT'S GOOD TO HAVE YOU BACK!!! » femlite, posted by Ame Sans Vie on October 18, 2003, at 16:53:20
AME SANS VIE,
I apologize for the tone of my last sentence. I have read your back posts and know a fair amount about you from those.
Did your psychiatrist also tell you HOW TO TAKE the "drug". (you may have noticed that I make a distinction between the words "medication" and "drug" My field is dual diagnosis, and it is important to do that with clients. (probably not a bad idea all 'round) actually.
Posted by Ame Sans Vie on October 18, 2003, at 19:32:56
In reply to Re: AME SANS VIE -IT'S GOOD TO HAVE YOU BACK!!!, posted by MamaB on October 18, 2003, at 17:21:37
It's okay, I understand you're in the medical field and misinterpreted what I meant because you're right, "parachuting" is a term drug users employ. Poor choice of word on my part. I abused benzodiazepines several years ago and still occasionally use some other illicit drugs like cannabis and mushrooms for legitimate religious purposes -- of course you know there's a difference between abuse and responsible use. Anyway, a lot of the lingo kinda stuck with me. When I said parachuting, I didn't mean the usual wrapping the powder in tissue paper and swallowing... yuck, lol. I put it back in the capsule. I've learned that regional illicit drug-speak is all different, and down here "parachuting" refers to any way at all of taking crushed pills orally. My doctor told me to either mix it with applesauce, put it back in the gelcap, or insufflate it like cocaine. lol Kidding -- sorry, couldn't resist. :-)
Posted by MamaB on October 19, 2003, at 5:58:23
In reply to Re: AME SANS VIE -IT'S GOOD TO HAVE YOU BACK!!! » MamaB, posted by Ame Sans Vie on October 18, 2003, at 19:32:56
Yes, you are right, I get pretty hard-nosed where drug abuse is concerned. If you worked with my client population -- Schizophrenics "medicating" on cocaine, bolar folk who treat themselves with pot and alcohol, depressed people who think massive doses of street-bought stimulants are the answer -- I think you might understand my sensitivity. Not to mention that I have an addictive history myself (over 20 years ago, but still a history)Trust me, I have seen some wild, weird, and dangerous drug interactions in my time!
I still think your psychiatrist could get into hot water. Even though it's not off-label prescribing, telling you to use an improper route of administration amounts to the same thing, perhaps even worse. But you are there, and I am here, so I will just pray for you. I think we both have a better understanding of all of this. Thanks
This is the end of the thread.
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