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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by ace on February 9, 2004, at 1:42:44
I need to feel confident about reboxetine!
So please ell me your success with it!!!
Love and Peace,
Ace...
Posted by linkadge on February 9, 2004, at 7:03:19
In reply to ONLY REBOXETINE SUCCESS STORIES PLEASE!!!, posted by ace on February 9, 2004, at 1:42:44
reboxetine and nardil ??
I think thats deadly
Linkadge
Posted by KellyD on February 9, 2004, at 7:26:27
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!!, posted by linkadge on February 9, 2004, at 7:03:19
Ace,
If you remember me, I do follow your progress but haven't wrtten in a while. I don't mean to be intrusive, but could you assure me you have a doc following you on the changes you make to your mix? In this day and age of meds being a click away and their at a door (or in a mailbox), I would like to know you "run this by" an actual Dr. who's doing the RXing for you.
I know you're a student of this stuff but......I wish you the best, I just have concerns and cares for you.
Kelly
Posted by Sad Panda on February 9, 2004, at 10:12:49
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!!, posted by linkadge on February 9, 2004, at 7:03:19
> reboxetine and nardil ??
>
> I think thats deadly
>
> LinkadgeOpinions Vary :)
From http://www.psychotropical.com/notes/622.html
"A common misconception, and one that is still repeated in supposedly authoritative texts, is that tricyclic antidepressants are unsafe if combined with MAOIs; that is only true for those that are significant serotonin reuptake inhibitors, since most TCAs are not serotonin reuptake inhibitors they are safe with MAOIs. The above comments are not intended to suggest that there is much evidence that this combination is useful. However certain properties of some 'TCAs' can be utilised to good effect when combined with MAOIs eg the potent sedative effect of a small (10-20 mg) of doxepin.
The above recapitulation helps in understanding this interesting paradox:-- that MAOIs are actually safer when combined with drugs like reboxetine that act as noradrenalin reuptake inhibitors. This is because the hypertension resulting from ingestion of tyramine (the 'cheese effect') depends on tyramine being able to enter the pre-synaptic nerve. That process is enabled by the noradrenalin reuptake mechanism and that is itself blocked by those antidepressant drugs which act through noradrenalin reuptake inhibition. ie reboxetine and TCAs."
Meanwhile, I'm still looking for someone who has taken Reboxetine to say something actually nice about it.
Cheers,
Panda.
Posted by linkadge on February 9, 2004, at 10:39:15
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » linkadge, posted by Sad Panda on February 9, 2004, at 10:12:49
Posted by Maximus on February 9, 2004, at 11:16:07
In reply to ONLY REBOXETINE SUCCESS STORIES PLEASE!!!, posted by ace on February 9, 2004, at 1:42:44
Hi Ace,
I don't want to be mean by any way. However it is obvious (to me at least) that your obsessions and quest for the *perfect* combo is killing you. You change your medecine as we change underwears (often).
May i suggest that you consult a real pdoc as soon as possible to help and **guide** you.
By the way, your Roboxetine venture is a real joke. In my opinion, such norepinephrine reuptake would just trigger your comorbid anxiety.
Forgive my frankness and worries.
Sincerely.
Max.
Posted by Ilene on February 9, 2004, at 15:51:37
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » linkadge, posted by Sad Panda on February 9, 2004, at 10:12:49
>
> From http://www.psychotropical.com/notes/622.html
>Thanks for the link. That's an interesting site.
I.
Posted by Ilene on February 9, 2004, at 16:01:45
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » ace, posted by Maximus on February 9, 2004, at 11:16:07
> Hi Ace,
>
> I don't want to be mean by any way. However it is obvious (to me at least) that your obsessions and quest for the *perfect* combo is killing you. You change your medecine as we change underwears (often).
>
> May i suggest that you consult a real pdoc as soon as possible to help and **guide** you.
>
> By the way, your Roboxetine venture is a real joke. In my opinion, such norepinephrine reuptake would just trigger your comorbid anxiety.
>
> Forgive my frankness and worries.
>
> Sincerely.
>
> Max.I disagree. Many of the articles I read are critical of using response (50% improvement) as the criterion of efficacy as opposed to remission. Being satisfied with merely better, instead of well, just leaves you open to relapse. We deserve to live normal lives.
My "real pdoc" isn't terribly psychopharmaceutically sophisticated. And given the idiosyncratic way people respond to psychotropics, the pdoc's experience may not apply.
If Ace has a problem with anxiety he can just stop taking the roboxetine. I'm sure he's smart enough to titrate up.
I.
Posted by Chairman_MAO on February 9, 2004, at 16:44:47
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » ace, posted by Maximus on February 9, 2004, at 11:16:07
>By the way, your Roboxetine venture is a real joke. In my opinion, such norepinephrine reuptake would just trigger your comorbid anxiety.
I agree. I mean, there's always a remote chance just about anything will work for anything in the ill-defined psych world, but I think reboxetine for OCD is like using Wellbutrin for panic attacks.
Why bother with reboxetine (which is probably best suited to those with drive-deficient, anergic states such as unipolar depression with ADD or melancholic depression) when there are so many other augmentation strategies that could work for you in treating OCD? One of these should work for you:
--Ever try clonazepam? Highly effective, especially with a serotonergic drug.
--inositol, up to 18g/day. Non-toxic and sometimes extremely effective for all sorts of depressive and anxiety disorders.
--pindolol (7.5mg/day)
-- risperidone (2mg/day) and olanzapine (5 -10mg/day)
--amisulpride 200-600mg/day (300mg probably)
--pimozide (but you dont want to take this unless you have to)
and there are almost certainly others, but these are the ones I could think of/find after a trivial search that I don't think would interact with an MAOI. Even amphetamine has some chance of helping you. Reboxetine probably doesn't.
Best of luck.
Posted by ace on February 9, 2004, at 18:44:32
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » ace, posted by Maximus on February 9, 2004, at 11:16:07
> Hi Ace,
>
> I don't want to be mean by any way. However it is obvious (to me at least) that your obsessions and quest for the *perfect* combo is killing you. You change your medecine as we change underwears (often).What are you talking about?...I am changing medications regularly cause none of the are up to scratch! I have been on Nardil for 14 months cause it kills, and I will be on Zyprexa for at least a year cause it is extremely effective for one part of my OCD.
>
> May i suggest that you consult a real pdoc as soon as possible to help and **guide** you."A real p-doc"? Most p-docs I have met are NUTS! And all are stabbing in the dark with meds because there is no external validating criteria for any psych disorder- ANY!
I have a wonderful relationship with my family doctor, and I myself am only 1 years away from medical school...
>
> By the way, your Roboxetine venture is a real joke. In my opinion, such norepinephrine reuptake would just trigger your comorbid anxiety.Is that why I have seen, and have IN MY POSSESION, over 30 anecdotes and 5 double-blind clinical trials on its efficacy in anxiety?
Please don't use words like 'a real joke' as I feel a little annoyed at them...
>
> Forgive my frankness and worries.
>
> Sincerely.
>
> Max.
Take Care,
Ace.
Posted by ace on February 9, 2004, at 18:52:49
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!!, posted by Chairman_MAO on February 9, 2004, at 16:44:47
> >By the way, your Roboxetine venture is a real joke. In my opinion, such norepinephrine reuptake would just trigger your comorbid anxiety.
>
> I agree. I mean, there's always a remote chance just about anything will work for anything in the ill-defined psych world, but I think reboxetine for OCD is like using Wellbutrin for panic attacks.IMO 'OCD' per se doesn't exist and everyones symptoms have different aetiologies...
>
> Why bother with reboxetine (which is probably best suited to those with drive-deficient, anergic states such as unipolar depression with ADD or melancholic depression) when there are so many other augmentation strategies that could work for you in treating OCD? One of these should work for you:
>
> --Ever try clonazepam? Highly effective, especially with a serotonergic drug.Cant do it in Australia...
>
> --inositol, up to 18g/day. Non-toxic and sometimes extremely effective for all sorts of depressive and anxiety disorders.FAR too expensive...
> --pindolol (7.5mg/day)
Might.
>
> -- risperidone (2mg/day) and olanzapine (5 -10mg/day)My doc hates it. See, to those other posters my doc does do some things. And I prefer Olanzapine.
>
> --amisulpride 200-600mg/day (300mg probably)
>Such a dose would run counter to nardil's actions on DA.
> --pimozide (but you dont want to take this unless you have to)
Too old for me!
>
> and there are almost certainly others, but these are the ones I could think of/find after a trivial search that I don't think would interact with an MAOI. Even amphetamine has some chance of helping you. Reboxetine probably doesn't.
>
> Best of luck.
>
Thanks mate. Trust me, i have STUDIED for HOURS AND HOURS augmentation with Nardil.I still have a few things up my sleeve...Clonidine, Pindolol, Wellbutrin, High dose Zyprexa, and more...
But I have seen very good results with reboxetine...only here i see none...
Cheers,
Ace.
Posted by ace on February 9, 2004, at 18:59:01
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!!, posted by KellyD on February 9, 2004, at 7:26:27
> Ace,
> If you remember me,
Yep, you were on Zyprexa I bellieve, i do remember you.
I do follow your progress but haven't wrtten in a while. I don't mean to be intrusive, but could you assure me you have a doc following you on the changes you make to your mix?Absolutely, and I will be a doc in a few years! My doc dissallows Risperidone- i just say this too exemplify that I do have a caring doc.
In this day and age of meds being a click away and their at a door (or in a mailbox), I would like to know you "run this by" an actual Dr. who's doing the RXing for you.
To be hones, I am really in charge...and he knows I know a lot about the pharmacological propertoes of psych meds and what not. But I need HIS signature at the end of the day...he wont let me hurt myself.
For example with reboxetine, I am going to take my first dose in his office to be safe...
> I know you're a student of this stuff but......
>
> I wish you the best, I just have concerns and cares for you.
>
> KellyGod Bless Kelly! keep in touch!
Ace.
Posted by ace on February 9, 2004, at 19:04:27
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » linkadge, posted by Sad Panda on February 9, 2004, at 10:12:49
> Meanwhile, I'm still looking for someone who has taken Reboxetine to say something actually nice about it.On just about every other site apart from this, I have heard it as being a WONDER drug! I can provide links...just cause the EVIL FDA doesn't approve people think its bad...not so.
Ace.
>
> Cheers,
> Panda.
>
>
>
>
Posted by KellyD on February 9, 2004, at 19:12:14
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » KellyD, posted by ace on February 9, 2004, at 18:59:01
> > Ace,
> > If you remember me,~~~I'm the Klonopin Babe... exclusively... you always had good words for me with that being my decision and I've been grateful for that. You don't always find that support for the benzo choice here. I will probably be a K Babe for life... it's my nirvana.
> Absolutely, and I will be a doc in a few years! My doc dissallows Risperidone- i just say this too exemplify that I do have a caring doc.
But I need HIS signature at the end of the day...he wont let me hurt myself.
>
> For example with reboxetine, I am going to take my first dose in his office to be safe...~~~See, now I feel much better about your situation.
> God Bless Kelly!God Bless you, too, Ace... I think that's already happening.
Posted by Chairman_MAO on February 9, 2004, at 19:59:47
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » Chairman_MAO, posted by ace on February 9, 2004, at 18:52:49
If you've heard good things about reboxetine and want to try it, by all means, give it a shot--sure doesn't hurt to try. If it works for OCD I will be shocked and stand corrected. I agree with you, by the way, about symptom etiologies. As much as it wishes otherwise, psychiatry usually is working with BEHAVIOR and not neurotransmitters, and the people doing the prescribing don't even see you all that often, so really almost anything goes ... that's why you should be allowed clonazepam! :(
That said, re: amisulpride, hampering the dopaminergic effect of the phenelzine may not be clinically relevant. After all, phenelzine increases dopamine levels at all synapses through MAO-B inhibition; it's not as if the antagonism of the amisulpride--at certain DA receptors, not all--would completely negate that. On the contrary, it may provide a 'stabilizing' effect. You could try it in the low dose where it acts preferentially at the autoreceptors and then increase it if you have no response.
If you ever stop taking an MAOI, I'd consider tramadol (or better opiates if you can get a script). As I'm sure you know, treating OCD without SRIs is pretty hard. Another thing you might wish to try that would be a crapshoot is adding a dopamine agonist such as pramipexole or bromocriptine. Could make it better, could make it worse.
Let me know how it goes!
Posted by crazychickuk on February 10, 2004, at 10:08:23
In reply to Re: ONLY REBOXETINE SUCCESS STORIES PLEASE!!! » ace, posted by Chairman_MAO on February 9, 2004, at 19:59:47
HI ace, i took reboxatine for anxiety was on it for about 6 weeks, it was horrible for me, made me way to manic the worst manic states than what effexor caused, must be something to do with the noph affect? i dunno, dont take it if you are riddled with manic states and high anxiety... other wise you should be ok, up to you and your doc, if you both feel its safe combo with nardil then go for it...
Take care
Donna
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