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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 8 to 32 of 33. Go back in thread:
Posted by Ilene on February 11, 2004, at 9:13:33
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
> Just wondering...as I heard some research that the 10 year mark is supposed to be the time that most people on meds find their 'optimal' treatment?? I feel like I am sometimes "close", but at many (and I *emphasize* that!) others I feel horrible and like I have gotten nowhere.
>
> JayI've been on meds for about 16 years. The first drug I tried was desipramine. It worked! I think I was still dysthymic, but not intensely depressed. I stopped taking it when I was trying to have a baby; after he was born the desipramine didn't work anymore. Then I started Prozac, which worked until I moved about 9 years ago and my life fell apart. Since then I have taken a pharmacy's worth of drugs. The only thing that works is Klonopin, but it doesn't help my depression, just my anxiety
I've never read anything about a 10-yr. mark.
I.
Posted by Sooshi on February 11, 2004, at 9:21:35
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
I'm at the 15+ year mark, and it's only getting worse. I hate for the younger set to be reading these posts, though...and the discouragement they might feel. Do you think there will be better drugs/therapies on the horizon to help them, as there was to help me compared to the generations before? (Example: my mother, who was diagnosed a schizophrenic in the 1950's [she was Bipolar] and given megadoses of antipsyhcotics and ECT, and now has severe tardive dyskenesia & organic brain damage) I can only hope things will get better. I need things to get better, for the sake of my children, who might possibly inherit this monster.....
Posted by Bill LL on February 11, 2004, at 9:30:25
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
I have. For me, AD's have been very helpful. Especially for my anxiety. Before drugs I was suicidal. Now I am reasonably happy and can enjoy life.
According to a recent Newsweek magazine article, scientists now beleive that AD's probably do not work by increasing serotonin (and other transmiters). The new thinking is that AD's work by increasing the size of a portion of the brain called the hippocampus. Depressed people tend to have a smaller than average hippocampus (I think CAT scans were used).
In other words, the AD's do in fact affect receptors for serotonin, dopamine, and norepinephrine, but that's not how they reduce depression.
The article said that scientists will try to develope new drugs with this new depression model in mind.
Posted by HenryO on February 12, 2004, at 1:45:51
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
I have made the ten year mark. I'd say its true it has taken me that long to dial in the right med. But ten years ago there was about a quarter of the meds available.
Posted by cubbybear on February 12, 2004, at 7:53:19
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
Everyone who reads this board regularly knows that i've been taking MAOI Parnate for 20 years. It's been a life-saver from the start.
Posted by terrics on February 12, 2004, at 15:40:59
In reply to Re: Who has been on meds for 10+ years??? » jay, posted by Bob on February 10, 2004, at 16:52:06
Over 20 yrs. I got worse with time, but new meds were developed or old meds were used for different disorders so since Aug. I am not too bad. I'm in my 50s so I do not think I'll ever be functioning optimally. terrics
Posted by Flipsactown on February 12, 2004, at 15:49:36
In reply to Re: Who has been on meds for 10+ years???, posted by cubbybear on February 12, 2004, at 7:53:19
Do you know if the MAOI Parnate is effective on unipolar depression? I have been on ADs for over 12 years and it appears that they all have pooped out and no longer effective. The jury is still out on lithium which was added 5 weeks ago to my prozac, remeron and lamictal cocktail. I will be getting my second blood level done tomorrow. Perhaps another increase in lithium dosage will get me to the therapeutic dosage. I am currently taking 900mg. Thanks in advance.
Flipsactown
> Everyone who reads this board regularly knows that i've been taking MAOI Parnate for 20 years. It's been a life-saver from the start.
Posted by terrics on February 12, 2004, at 16:15:31
In reply to Re: Who has been on meds for 10+ years??? » cubbybear, posted by Flipsactown on February 12, 2004, at 15:49:36
Lithium was the last thing added to my pile of meds. I never thought it would help, but it does. terrics
Posted by noa on February 12, 2004, at 19:31:08
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
I guess I'm at or over ten years now. Started and stopped Prozac twice in late 1980's when it was seen as something that could be used in a time limited way (6-12 months) to 'readjust' the system. Well, no, this didn't exactly work for me. I got better but had more recurrences afterward.
Then, medication in earnest started about 10.5 years ago. I'd say it took about 6 or 7 of those (painful) years to get a combination that worked, together with figuring out some related health problems contributing to the depression.
There's still been some minor "tweaking" of the cocktail since then, like when I added fish oil and discovered that after a while I could lower one of my ADs because of the benefit from the fish oil, or minor changes in some of the smaller players in the cocktail.
6 or 7 years to find the med cocktail.....then the recovery could actually begin. So, yeah, now that it's 10.5, I'm feeling like I'm getting a stride back.
Posted by jerrympls on February 12, 2004, at 19:32:25
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
> Just wondering...as I heard some research that the 10 year mark is supposed to be the time that most people on meds find their 'optimal' treatment?? I feel like I am sometimes "close", but at many (and I *emphasize* that!) others I feel horrible and like I have gotten nowhere.
>
> Jay
I've been on meds since 1992. Still have refractory depression.Jerry
Posted by cubbybear on February 13, 2004, at 5:15:42
In reply to Re: Who has been on meds for 10+ years??? » cubbybear, posted by Flipsactown on February 12, 2004, at 15:49:36
> Do you know if the MAOI Parnate is effective on unipolar depression?
Forgive my ignorance, but I'm not sure what unipolar means. Does it mean that the depression does not have a manic part? If so, then I guess my depression is unipolar, since I definitely am not bi-polar or atypical. If I were to stop the Parnate, within a few months I'd plunge back down into major depression, with bad anxiety as one of the symptoms, but no manic behavior or feelings. Hope this helps.
Posted by Flipsactown on February 13, 2004, at 6:39:11
In reply to Re: Who has been on meds for 10+ years??? » Flipsactown, posted by cubbybear on February 13, 2004, at 5:15:42
Cubbybear,
You are correct. Unipolar is major depression without mania. I have heard and read about MAOI's but am uncertain how they work. Just in case the lithium, recently added to my cocktail of meds, does not provide adequate depression relief, can you please tell me more about Parnate and how it works? I do know MAOI'S adverse effects on other drugs.Flipsactown
> > Do you know if the MAOI Parnate is effective on unipolar depression?
>
> Forgive my ignorance, but I'm not sure what unipolar means. Does it mean that the depression does not have a manic part? If so, then I guess my depression is unipolar, since I definitely am not bi-polar or atypical. If I were to stop the Parnate, within a few months I'd plunge back down into major depression, with bad anxiety as one of the symptoms, but no manic behavior or feelings. Hope this helps.
Posted by Parisss on February 13, 2004, at 11:08:50
In reply to Re: Who has been on meds for 10+ years??? » Flipsactown » cubbybear, posted by Flipsactown on February 13, 2004, at 6:39:11
Cuddybear, thanks for that clarification for Flip, I am trying to catch on to the acronyms in context so that I don't ask too many questions and look stupid. You all seem to know what they all mean! I think a good post for Dr. Bob would be to explain all of them at the beginning menu of the board?
Also, I took Lithium and have to say it gave me ongoing extreme diarhea and shakes. Coming off of it (after it reached a toxicity level in my system and landed me in the ER) I had the shakes so bad for months that I could not even sign my name or hold a glass of water. Make sure your levels are done often.
Paris> Cubbybear,
> You are correct. Unipolar is major depression without mania. I have heard and read about MAOI's but am uncertain how they work. Just in case the lithium, recently added to my cocktail of meds, does not provide adequate depression relief, can you please tell me more about Parnate and how it works? I do know MAOI'S adverse effects on other drugs.
>
> Flipsactown
>
> > > Do you know if the MAOI Parnate is effective on unipolar depression?
> >
> > Forgive my ignorance, but I'm not sure what unipolar means. Does it mean that the depression does not have a manic part? If so, then I guess my depression is unipolar, since I definitely am not bi-polar or atypical. If I were to stop the Parnate, within a few months I'd plunge back down into major depression, with bad anxiety as one of the symptoms, but no manic behavior or feelings. Hope this helps.
>
>
Posted by thunder on February 13, 2004, at 15:29:52
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
I was on 70 mg of Parnate for 14+ years with no problems (took Reglan for Ortho. Hypotension and Clonazepam for sleep)before Cardiologist told me it was causing my tachycardia. Turned out my Cardiologist was wrong!
Posted by Bob on February 13, 2004, at 19:05:27
In reply to Re: Who has been on meds for 10+ years???, posted by thunder on February 13, 2004, at 15:29:52
> I was on 70 mg of Parnate for 14+ years with no problems (took Reglan for Ortho. Hypotension and Clonazepam for sleep)before Cardiologist told me it was causing my tachycardia. Turned out my Cardiologist was wrong!
Are you male or female? Did the Parnate shut you down sexually?
Posted by thunder on February 13, 2004, at 20:01:13
In reply to Re: Who has been on meds for 10+ years??? » thunder, posted by Bob on February 13, 2004, at 19:05:27
> > I was on 70 mg of Parnate for 14+ years with no problems (took Reglan for Ortho. Hypotension and Clonazepam for sleep)before Cardiologist told me it was causing my tachycardia. Turned out my Cardiologist was wrong!
>
> Are you male or female? Did the Parnate shut you down sexually?
>
I'm male and the parnate didn't shut me down, but the timing had to be right. Generally in the morning before my morning dose (40mg)(30mg early afternoon).
Posted by profiles on February 16, 2004, at 2:21:51
In reply to Re: Who has been on meds for 10+ years???, posted by Bill LL on February 11, 2004, at 9:30:25
Going beyond prozac:
http://msnbc.msn.com/id/3606205/
> I have. For me, AD's have been very helpful. Especially for my anxiety. Before drugs I was suicidal. Now I am reasonably happy and can enjoy life.
>
> According to a recent Newsweek magazine article, scientists now beleive that AD's probably do not work by increasing serotonin (and other transmiters). The new thinking is that AD's work by increasing the size of a portion of the brain called the hippocampus. Depressed people tend to have a smaller than average hippocampus (I think CAT scans were used).
>
> In other words, the AD's do in fact affect receptors for serotonin, dopamine, and norepinephrine, but that's not how they reduce depression.
>
> The article said that scientists will try to develope new drugs with this new depression model in mind.
>
>
Posted by sobeit on March 12, 2004, at 21:01:06
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
> Just wondering...as I heard some research that the 10 year mark is supposed to be the time that most people on meds find their 'optimal' treatment?? I feel like I am sometimes "close", but at many (and I *emphasize* that!) others I feel horrible and like I have gotten nowhere.
>
> Jay
It's been 17 years since I began taking an MAOI (Nardil), initially for social phobia, but now primarily for recurrent atypical depression. It is the only med that has proved successful for me. Biggest battle has been surviving the numerous periods of experimentation with newer, "safer" meds that psychiatrists always want to try due to their fear of a mishap with the MAOI. The most recent attempt a year ago to transfer to a newer medication lead to an incredible episode of depression, resulting in a trial of ECT (that cost me $13,000 out of my own pocket) - it provided no relief at all. Two months later I was allowed to continue the MAOI, resulting in a return to a positive mood in less than two weeks. It would be incredibly interesting to know more about why individuals respond to specific meds -- what neurological characteristics, using fMRI or PET, are evident between someone responding to paxil vs. someone responding to parnate, and so on.
Posted by Flipsactown on March 12, 2004, at 22:35:06
In reply to Re: Who has been on meds for 10+ years???, posted by sobeit on March 12, 2004, at 21:01:06
I have been on ADs (Zoloft, Paxil, Celexa, Effexor, Wellbutrin...for over 12 years. I am currently on Prozac, Remeron,Lamictal and Lithium. I have a pdoc appointment next week and I will ask to be put on Nardil. I have read several good comments about it. Why is it that pdoc shy away from MAOI? I know about watching what you eat and something about it interacting with other medication. At this point in my life (fifties) and still experiencing unipolar depression, I will take my chances and just be vigilant in what I ingest.
FST
> > Just wondering...as I heard some research that the 10 year mark is supposed to be the time that most people on meds find their 'optimal' treatment?? I feel like I am sometimes "close", but at many (and I *emphasize* that!) others I feel horrible and like I have gotten nowhere.
> >
> > Jay
>
>
> It's been 17 years since I began taking an MAOI (Nardil), initially for social phobia, but now primarily for recurrent atypical depression. It is the only med that has proved successful for me. Biggest battle has been surviving the numerous periods of experimentation with newer, "safer" meds that psychiatrists always want to try due to their fear of a mishap with the MAOI. The most recent attempt a year ago to transfer to a newer medication lead to an incredible episode of depression, resulting in a trial of ECT (that cost me $13,000 out of my own pocket) - it provided no relief at all. Two months later I was allowed to continue the MAOI, resulting in a return to a positive mood in less than two weeks. It would be incredibly interesting to know more about why individuals respond to specific meds -- what neurological characteristics, using fMRI or PET, are evident between someone responding to paxil vs. someone responding to parnate, and so on.
Posted by Bob on March 13, 2004, at 0:26:14
In reply to Re: Who has been on meds for 10+ years???, posted by sobeit on March 12, 2004, at 21:01:06
Hey Sobeit, are you a male? Are you able to have any sort of sex on Nardil?
Thanks,
Bob
Posted by sobeit on March 13, 2004, at 1:28:28
In reply to Re: Who has been on meds for 10+ years??? » sobeit, posted by Bob on March 13, 2004, at 0:26:14
> Hey Sobeit, are you a male? Are you able to have any sort of sex on Nardil?
>
> Thanks,
>
> BobMale/41 yrs old. The sexual problems (drive and performance) have also been dose-dependent for me. The more Nardil, the less sexual drive and ability to reach orgasm, although erection is not a problem. For me, 60mg creates delayed orgasm (which can be a good thing), whereas 75mg results in frequent anorgasmia. Knowing my response to the dosage this well, I can anticipate a successful episode by reducing dosage by 15mg over the duration of a week and safely remain there for 1-2 weeks. Takes some of the spontaneity out, but I can live with that. As for the previous post (I forgot the name), the reason the Psychiatrists have been reluctant to leave me on the Nardil is two-fold: 1)the risk of a hypertensive reaction from eating/drinking items high in tyramine (I've been fortunate never to experience this); and 2)a desire to try the latest med on the market that's surely got to be better than an MAOI from the fifties. I thought the same thing for the first 10 years, but perfectly happy to remain on Nardil until I see proof that others responding to Nardil have consistently found success with a new agent.
Posted by Questionmark on March 13, 2004, at 2:50:48
In reply to Re: Who has been on meds for 10+ years??? » lepus, posted by Bob on February 10, 2004, at 19:32:29
> > Too young to throw in the towel I suppose, but too old to hope for a normal life.
> >
> > When are the drugs companies going to look for something new??? I still think psychiatry is in an age of barbarism.
> >
>
>
> God, I know what you mean. One of the hardest things for me to deal with on a daily basis is the tremendous loss. I look at all the people around me, and all those I know, and realize I will never get that back. Heck, even if I was completely better tomorrow (about a 1 in 1 billion chance or worse), I'm just way too far behind the game.
>
> I too have felt that recently, the new drugs have fallen WAY off. In the nineties there was always something new out there, it seemed. Then it turned into promises of something right around the corner. Now, practically nothing. Heck, even the "me-too" drugs like Reboxetine are getting crushed. The drug companies won't look for something novel until they cannot make mad money on the current SSRI hypothesis anymore. It's too risky to try developing compounds about which almost nothing is known. It's a waste of money for them. I wouldn't be surprised if we don't have a breakthrough for decades, or even longer.
>
> BobBob, that paragraph you wrote on loss and what not really hits home. i'm only 23 but i feel strongly...-- am afraid-- that that is the case for me. Regret now runs my life and thoughts. If only there were something to get back time.
But anyway, on a brighter note, your (Bob's) subsequent paragraph is a great point, but probably inaccurate now-- hopefully/fortunately. Just look at this link (which someone on here posted on psychobabble recently).
http://www.neurotransmitter.net/newdrugs.html
Posted by Bob on March 13, 2004, at 11:10:32
In reply to Re: Who has been on meds for 10+ years???, posted by sobeit on March 13, 2004, at 1:28:28
> > Hey Sobeit, are you a male? Are you able to have any sort of sex on Nardil?
> >
> > Thanks,
> >
> > Bob
>
> Male/41 yrs old. The sexual problems (drive and performance) have also been dose-dependent for me. The more Nardil, the less sexual drive and ability to reach orgasm, although erection is not a problem. For me, 60mg creates delayed orgasm (which can be a good thing), whereas 75mg results in frequent anorgasmia. Knowing my response to the dosage this well, I can anticipate a successful episode by reducing dosage by 15mg over the duration of a week and safely remain there for 1-2 weeks. Takes some of the spontaneity out, but I can live with that. As for the previous post (I forgot the name), the reason the Psychiatrists have been reluctant to leave me on the Nardil is two-fold: 1)the risk of a hypertensive reaction from eating/drinking items high in tyramine (I've been fortunate never to experience this); and 2)a desire to try the latest med on the market that's surely got to be better than an MAOI from the fifties. I thought the same thing for the first 10 years, but perfectly happy to remain on Nardil until I see proof that others responding to Nardil have consistently found success with a new agent.Seems like you've got the sex thing somewhat under control. I can definitely relate to the temptation to find something better than what we are all on. Each new drug that comes out seems to promise the world (although that seems to have lessened recently). I tried topomax and lamictal awhile back and went off the SSRIs I was on. It very well almost resulted in a disaster of the suicidal nature. Still, I'm not happy with the Lithium, Celexa, and Welbutrin I'm on and am not completely sure I wouldn't try another new drug if it was very promising. Dumb, eh?
Posted by sl on March 15, 2004, at 19:22:48
In reply to Who has been on meds for 10+ years???, posted by jay on February 10, 2004, at 16:43:02
I've been on Wellbutrin for most of 10 years.
What I've done is learned to live with my side effects and personal limitations, cuz nothing has been any better.
(Actually have been thinking about writing a book about how to do it, too.)Wish my hair wasn't falling out tho...that's especially lousy for a 29 year old woman. :/
Posted by sobeit on March 16, 2004, at 20:45:50
In reply to Re: Who has been on meds for 10+ years??? » sobeit, posted by Bob on March 13, 2004, at 11:10:32
> > > Hey Sobeit, are you a male? Are you able to have any sort of sex on Nardil?
> > >
> > > Thanks,
> > >
> > > Bob
> >
> > Male/41 yrs old. The sexual problems (drive and performance) have also been dose-dependent for me. The more Nardil, the less sexual drive and ability to reach orgasm, although erection is not a problem. For me, 60mg creates delayed orgasm (which can be a good thing), whereas 75mg results in frequent anorgasmia. Knowing my response to the dosage this well, I can anticipate a successful episode by reducing dosage by 15mg over the duration of a week and safely remain there for 1-2 weeks. Takes some of the spontaneity out, but I can live with that. As for the previous post (I forgot the name), the reason the Psychiatrists have been reluctant to leave me on the Nardil is two-fold: 1)the risk of a hypertensive reaction from eating/drinking items high in tyramine (I've been fortunate never to experience this); and 2)a desire to try the latest med on the market that's surely got to be better than an MAOI from the fifties. I thought the same thing for the first 10 years, but perfectly happy to remain on Nardil until I see proof that others responding to Nardil have consistently found success with a new agent.
>
> Seems like you've got the sex thing somewhat under control. I can definitely relate to the temptation to find something better than what we are all on. Each new drug that comes out seems to promise the world (although that seems to have lessened recently). I tried topomax and lamictal awhile back and went off the SSRIs I was on. It very well almost resulted in a disaster of the suicidal nature. Still, I'm not happy with the Lithium, Celexa, and Welbutrin I'm on and am not completely sure I wouldn't try another new drug if it was very promising. Dumb, eh?
>
>
Bob,
I can relate to your near suicidal disaster when switching meds. Just over a year ago, my pdoc once again wanted me to try a new medication (Lexapro) with the intention of discontinuing the Nardil for good. I went along with the idea and had no response after 6 weeks, at which time Lithium was added. In a matter of another 4 weeks my life fell apart - I had absolutely no energy (when people would talk to me, my mind would respond but I didn't have the energy to say the words), I stopped going to work, socializing with family and friends, eating, sleeping 14-18 hours per day and having suicidal thoughts. When I managed to attended a psych appointment, the pdoc hospitalized me and I guess I agreed to ECT. Three weeks of ECT did nothing but alter my memory. I came out of the hospital on three different meds that provided no relief. When I returned to work, I couldn't recall fellow employee's names, how to use my computer, or the projects I'd been working on for several years. My boss told me to return to the hospital and get some help before returning to work. When following up with my pdoc, I demanded to go back on Nardil. Within ten days, I was feeling good enough to return to work. Due to the ECT, I've lost much of my recollection of events going back as far as a year - my family and friends have filled in the events of my life over this period. Unfortunately, I think people in our situation have to continue trying different meds until we find the one that's efficacious - that allows for a sense of fulfilment from life. I hope you, too, find the combination that kicks arse!
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