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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by sdjeff on April 29, 2004, at 22:45:11
I have gone through more than a dozen drugs over a very wide spectrum. I've had tolerance issues with:
paxil
zoloft
amitriptyline
desimpremine
prozac
neurontin
lithium
lexapro
tegrtol
abilify
Maybe Nortriptyline
Maybe geodon
and othersThe Nortriptyline and/or geodon triggered dysphoria and mixed states I'm still dealing with. I take 5 mg. Zyprexa and .25 mg Halcion at night but it's not enough. The Zyprexa works, but I can't take it during the day because it makes me a zombie.
I'm wondering how it is possible to have tolerance problems with so many different drugs, and if anyone else has had similar experiences.
Posted by Flipsactown on April 29, 2004, at 23:10:12
In reply to A lot of failed drug trials, posted by sdjeff on April 29, 2004, at 22:45:11
I have been taking AD's for over 13 years mostly SSRI's and TCA's and finally decided to try something different. I am finishing my 3rd week of Nardil which is an MAOI and so far so good, that is I am getting good relief from unipolar depression. In another 3 weeks, I should know the full effectiveness and hoping it will not poop out like the others.
FST
> I have gone through more than a dozen drugs over a very wide spectrum. I've had tolerance issues with:
>
> paxil
> zoloft
> amitriptyline
> desimpremine
> prozac
> neurontin
> lithium
> lexapro
> tegrtol
> abilify
> Maybe Nortriptyline
> Maybe geodon
> and others
>
> The Nortriptyline and/or geodon triggered dysphoria and mixed states I'm still dealing with. I take 5 mg. Zyprexa and .25 mg Halcion at night but it's not enough. The Zyprexa works, but I can't take it during the day because it makes me a zombie.
>
> I'm wondering how it is possible to have tolerance problems with so many different drugs, and if anyone else has had similar experiences.
Posted by Keith Talent on April 30, 2004, at 2:36:45
In reply to Re: A lot of failed drug trials » sdjeff, posted by Flipsactown on April 29, 2004, at 23:10:12
You could go back on Zoloft or Prozac with a stimulant to counter some of the side effects.
Posted by HappyGirl on April 30, 2004, at 23:48:37
In reply to A lot of failed drug trials, posted by sdjeff on April 29, 2004, at 22:45:11
Hi sdjeff:
It sounds to me like you have 'sensitivity' issue to 'SSRIs'/almost all of SSRIs and other psycho.-meds. with some 'stimulant' effect that exactly falls on 'Geodon' and 'Abilify.' Lithium is made mostly of 'salt'/sodium componetns/substances, ... in my knowledge from the reading and personal experience because of the thirst urge almost 24 hours' period, ... then your system/body is certainly rejectiing to all of those 'foreign' substances.
As you might have known about most of psycho. meds. they seem to have 'potent' issues in order to work for or assimilate good to the chemical of our brains. For that reason, some has 'strong' rejection to those meds., ... then the med. resistance like your case needs more than psycho-pharmacologist, if your pdoc. not able to handle it.
The place where I live, ... one of the biggest cities in USA, there is something like 'experimental med. program' (I just cannot remember the name for this momentarily tho' ...), then you may ask your pdoc. straightforwardly whether your case is available to a program/similar to this or any other place/authority, because as you are already admitting, it seems very hard for you and your pdoc. to find the right med./med. combo.
Just my suggestion through my personal knowledge as to psycho. meds. through the years.
H.G.
Posted by sdjeff on May 1, 2004, at 1:05:24
In reply to Re: A lot of failed drug trials, posted by HappyGirl on April 30, 2004, at 23:48:37
Thanks all for your input.
My last few threads may seem a bit much but I tend to obsess over my issues. Even my pdoc can't explain my hypersensetivity to all of these drugs. He is the director of a very large inpatient facility and has never had a patient like me. Oh, the joy if it.
Posted by allisonm on May 1, 2004, at 9:12:47
In reply to A lot of failed drug trials, posted by sdjeff on April 29, 2004, at 22:45:11
I can empathize. Since 1998, I have tried zoloft, remeron, effexor, serzone, lithium, neurontin, celexa, and wellbutrin. I had particular sensitivity with the SSRIs and effexor. The others just could not do the job alone or in combination. After going through the side effects of each for 6 or 8 weeks and then several months (or more) at increased doses to see whether they worked, I eventually would get switched to something else.
Wellbutrin seemed to be the only one that really helped, but it couldn't fix things on its own. Running out of options (other than MAOIs, which I didn't want to try), I opted to go back to Zoloft (the one I tried first). The side effects of Z were troublesome when I first started ADs, but they were nothing compared with the side effects of some of the others. When I tried Z again, this time I endured the side effects because I knew they eventually would go away. I find that Z and Wellbutrin have been the best combo so far.
Hang in there. It can take awhile to find the right one(s). Good luck.
Posted by HappyGirl on May 1, 2004, at 9:26:47
In reply to Re: A lot of failed drug trials, posted by sdjeff on May 1, 2004, at 1:05:24
Hi sdjeff:
'Hypersensitivity' is, ... you might have known, but this is one of Bp symptoms, if not 'major,' probably next to it. Then, you don't need to surprise to have one, 'Hypersensitivity' issue.
Before I got the Bp fairly stabilized, I was VERY MUCH upset over even trivial things, like talking about things I have or do. For this problem, your Bp MUST be, at least, half-way stabilized.
I'm glad to know that your attending/current pdoc. sounds like one of the best pdocs. in the region where you live. Keep telling him how your moods is on daily basis. Eventually, he will find the right med. combo. for your problems. Just it might take time, ... because in my knowledge with the pdoc. for the past five years, ... most of pdocs. need some 'experiment' or 'research' for those who have 'tolerance' issues.
H.G.
Posted by SLS on May 1, 2004, at 9:27:51
In reply to Re: A lot of failed drug trials, posted by sdjeff on May 1, 2004, at 1:05:24
> Even my pdoc can't explain my hypersensetivity to all of these drugs. He is the director of a very large inpatient facility and has never had a patient like me. Oh, the joy if it.
Tell me about it.
- Scott
Posted by bobbiedobbs on May 2, 2004, at 23:31:00
In reply to Re: A lot of failed drug trials, posted by SLS on May 1, 2004, at 9:27:51
I'm earlier on in the failed-drug test stage than you but also frustrated. I've tried - and been unable to tolerate - Prozac, Risperdal, Lexapro (more benign but not efficacious), and most recently, Luvox. Best experience was with Nardil (therapeutically, but side effects became impossible to handle). Problem is OCD but of most important, acute social anxiety. How have
Effexor, Zoloft and Marplan (which I doubt anyone has taken) worked re exhaustion, weight gain and uber-spaciness, compared to the others. These are the current drug try finalists for me. Much appreciated. Phil P.S.
Posted by chemist on May 3, 2004, at 0:06:47
In reply to Re: a lot of failed drug tests, posted by bobbiedobbs on May 2, 2004, at 23:31:00
> I'm earlier on in the failed-drug test stage than you but also frustrated. I've tried - and been unable to tolerate - Prozac, Risperdal, Lexapro (more benign but not efficacious), and most recently, Luvox. Best experience was with Nardil (therapeutically, but side effects became impossible to handle). Problem is OCD but of most important, acute social anxiety. How have
> Effexor, Zoloft and Marplan (which I doubt anyone has taken) worked re exhaustion, weight gain and uber-spaciness, compared to the others. These are the current drug try finalists for me. Much appreciated. Phil P.S.
>
chemist here....are you in denmark? marplan has been deep-sixed by roche, as far as i know....an MAOI with some nasty side-effects....for social anxiety, paxil has tooted its horn, but i personally do not like the drug. the standard - well, it seems to be - for social anxiety is klonopin (clonazepam). your effexor and zoloft are overstimulating taken concurrently. my opinion is that reducing one of the 2 antidepressants (in addition to dumping marplan, which when taken with zoloft and/or effexor can lead to hypertension, although i am not aware if marplan is reversible, or A or B, so please correct me if i am wrong) would be a step in the right direction.....all the best, chemist
Posted by bobbiedobbs on May 6, 2004, at 20:03:52
In reply to Re: a lot of failed drug tests » bobbiedobbs, posted by chemist on May 3, 2004, at 0:06:47
Wow, Chemist, you misread my post. No way am I taking Marplan, Effexor AND Zoloft - these are the individual drugs I am CONSIDERING for a next step. My question was/is, given the experience I have stated above, which one of the three would be a good next step: Marplan (by itself), Effexor, or Klonopin with Adderol (assuming Klonopin makes me sleepy). I tend to hear positive things about Klonopin, but am tempted by Effexor because of its different profile (while scared of all the withdrawal horror stories), Marplan is the third idea because of how well Nardil once worked. By the way, my therapist has suggested Geodon or Zyprexa but everything I read and hear says no - the weight gain, my experience with other anti-psychotics.
Phil
Posted by chemist on May 6, 2004, at 23:18:35
In reply to Re: a lot of failed drug tests, posted by bobbiedobbs on May 6, 2004, at 20:03:52
> Wow, Chemist, you misread my post. No way am I taking Marplan, Effexor AND Zoloft - these are the individual drugs I am CONSIDERING for a next step. My question was/is, given the experience I have stated above, which one of the three would be a good next step: Marplan (by itself), Effexor, or Klonopin with Adderol (assuming Klonopin makes me sleepy). I tend to hear positive things about Klonopin, but am tempted by Effexor because of its different profile (while scared of all the withdrawal horror stories), Marplan is the third idea because of how well Nardil once worked. By the way, my therapist has suggested Geodon or Zyprexa but everything I read and hear says no - the weight gain, my experience with other anti-psychotics.
> Philhi phil, i apologize for the misunderstanding....my predisposition is for the klonopin/adderall combo, as it is similar to my xanax/dexedrine cocktail that - after years and years, and drug after drug - has turned out to be the best for me. i will defer the zoloft and effexor questions to Sad Panda, SLS, or King Vultan: they are more schooled than i am with these meds. i did take parnate - an MAOI - for a while, but it didn't work out in the long run. marplan seems to be a ``safer'' MAOI, but - as is the case with effexor and zoloft - i will direct you to the 3 abovementioned individuals (Sad Panda and SLS are the most appropriate, in my opinion, for this med). zyprexa and geodon are another story. i had a brief go with geodon, but it lasted all of 1 day, as soon as i got wind of the prolonged QT interval. zyprexa appears to be very effective in most cases, but weight-gain is a major problem. the klonopin will not knock you out like valium or dalmane or restoril: once you get up to the right dose, it's pretty smooth sailing. liked it fine, but had breakthrough panic (most likely due to the parnate i was taking at the time), and i went back to xanax after a long while. so, i suggest you post a note for the folks i mentioned, and also take what you will from my history with a combo similar to what your proposed one is most alike.....kepp us all posted, and all the best, chemist
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