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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 iris2 on July 27, 2004, at 20:04:49
I have read many posts about different medications on this sight. AndrewB and Scott have provided a lot of helpful suggestions in particular.
My current cognitive skills are poor and I am forgetting what I read promptly.
Anyway I tried to put together what I had looked at in the past year. I came up with the following:
Amisulpride
Mirapex
Requip
MilnacipranI have atypical depression. Combined with some bulimia and major anxiety. I have been lying around for about two years afraid to go out, lethargic suicidal. Four days ago I attempted an overdose (not to make anyone react!) with oxycontin and alcohol. My stomach would not tolerate the mix for very long and a good lot of it came out. Anyway obviously I am still here. So I still need to try and find a way to make what is left of this "life" tolerable.
The only meds that have helped in the past are Parnate (not anymore) reboxetine a little. Ritalin helps some so I still take it along with oxycontin for pain sometimes and also for depression. It helps a little. I also take benzo's. And occasionally 2mg perphenazine to calm me down. So much for a brief bio.
I forgot I also took amineptine briefly and it helped tremendously but each time I try it again it does not seem to work anymore.
My thoughts were to try amisulpride25-50mg perhaps with amineptine?
Or Amisulpride with mirapex?
I figured at least for now I would stay on the ritalin so I can at least get up to swallow the stuff?I do not remember my interest in the two other drugs right now. My doctor said he would read the stuff I sent but who knows when.
If I tell him to write a script he will. So I am asking for your help in deciding what to try at least first? I will tell him to send the scripts. I already told him to send one for amisulpride.
I still have amineptine and reboxetine on hand.
I have tried Provigil, adafranil and several other anti Parkinson’s drugs. For different reasons each did not work for me. For instance Provigil made me so nervous and did nothing for mood. Without detail I have tried about all of the "usual" anti-depressants.
I tend toward high anxiety low energy. I also tend to be self destructive and of course long-winded.
Sorry for the long disorganized email. I am doing my best.I would appreciate any suggestions. If anyone has need for further info. no problem.
Thank you,
iris2
Posted by SLS on July 27, 2004, at 20:50:20
In reply to Amisulpride,Mirapex,Requip...?, posted by iris2 on July 27, 2004, at 20:04:49
Hi Iris2.
It will be interesting to see what suggestions some of the newer members in the community have to offer you.
What was your experience with Effexor the very first time you tried it?
I would be very interersted to know how you respond to milnacipran. If you decide to try it, please keep us informed of your progress with it.
One drug that is not often mentioned here is sibutramine (Meridia). I know one pdoc in Princeton who swears by it. Sibutramine was originally developed as an antidepressant, but ended up being approved as an anti-obesity agent. It inhibits the reuptake of both 5-HT and NE, and exhibits properties in rat brain in vivo suggesting DA reuptake inhibition and/or release as well, most likely the result of its metabolites. A drug company was recently developing one of the enantiomers, r-sibutramine, specifically as an antidepressant. Unfortunately, it ran out of money for the project.
I have sibutramine on my list of things to try. I probably would have tried it by now if my medical insurance were to have paid for it. Meanwhile, I am waiting for Cymbalta to be approved. I'm sure you are already aware that this dual action SNRI (serotonin-norepinephrine reuptake inhibitor) antidepressant is to be decided upon by the FDA for approval in late September.
Have you ever tried adding a mood stabilizer?
- Scott
Posted by iris2 on July 27, 2004, at 20:57:15
In reply to Re: Amisulpride,Mirapex,Requip...?, posted by SLS on July 27, 2004, at 20:50:20
> Hi Iris2.
>
> It will be interesting to see what suggestions some of the newer members in the community have to offer you.
>
> What was your experience with Effexor the very first time you tried it?
>
> I would be very interersted to know how you respond to milnacipran. If you decide to try it, please keep us informed of your progress with it.
>
> One drug that is not often mentioned here is sibutramine (Meridia). I know one pdoc in Princeton who swears by it. Sibutramine was originally developed as an antidepressant, but ended up being approved as an anti-obesity agent. It inhibits the reuptake of both 5-HT and NE, and exhibits properties in rat brain in vivo suggesting DA reuptake inhibition and/or release as well, most likely the result of its metabolites. A drug company was recently developing one of the enantiomers, r-sibutramine, specifically as an antidepressant. Unfortunately, it ran out of money for the project.
>
> I have sibutramine on my list of things to try. I probably would have tried it by now if my medical insurance were to have paid for it. Meanwhile, I am waiting for Cymbalta to be approved. I'm sure you are already aware that this dual action SNRI (serotonin-norepinephrine reuptake inhibitor) antidepressant is to be decided upon by the FDA for approval in late September.
>
> Have you ever tried adding a mood stabilizer?
>
>
> - ScottScott,
The first time IS tried effexor I thought it had the potential to work well. I started to be calmer ( less anxious) yet felt energetic. Unfortunately I am unable to take it because of a bladder desease Intersticial cystitis. I have thought for a long time this would be a great med for me. I tried it several more times to see if I could tolerate a small amount even but it was very painful.
I think I looked into Meridia once and I might have tried it. I will have to look it up again and see what iS remember.
Do you have any suggestions to try ?
thanks,
iris2
Posted by banga on July 27, 2004, at 22:35:45
In reply to Re: Amisulpride,Mirapex,Requip...?, posted by iris2 on July 27, 2004, at 20:57:15
Hi, I cant help you much on the drug side, I fully support and cross my fingers that you will find the right mix. I am also trying to activate my brain. But with your medical condition--and I wont get too into it because I know there are separate sites to seek this out--have you explored whether you have any vitamin/mineral/other deficiencies that influence the picture? I am taking a myriad of medications so Im all for meds, they have saved my life..... but I also was helped to some extent with medical conditions in taking large doses of vitamin B12 and some others for some of my cognitive/neurological symptoms. I had a disconnect between myself and the world due to a disconnect in my brain between sensory input and cognition due to B12 deficiency. I would lose half of conversations because everything went black on me. Alcohol and bad diet exascerbated this underlying condition. Just a side thought. Talk to the docs, listen to the wise posters on this board for med advice.
Hang in there dont give up, the answer is out there. Get help if things get that bad for you again.
Posted by Sad Panda on July 27, 2004, at 23:22:13
In reply to Amisulpride,Mirapex,Requip...?, posted by iris2 on July 27, 2004, at 20:04:49
Hi Iris2,
In what way did Parnate stop working?
Have you considered Selegiline? It's very similar to Parnate, but might be different enough to work when Parnate has stopped. I would also consider adding Reboxetine or a TCA to an MAOI too.
Cheers,
Panda.
Posted by iris2 on July 28, 2004, at 0:11:17
In reply to Re: Amisulpride,Mirapex,Requip...?, posted by Sad Panda on July 27, 2004, at 23:22:13
THANKS<
IVE TRIED ALL THE MAOI"S SEVERAL TIMES FOR MANY YEARS> NONE OF THEM WORK AT ALL ANYMORE>
IRIS@
Posted by iris2 on July 28, 2004, at 0:59:29
In reply to Re: Amisulpride,Mirapex,Requip...?, posted by SLS on July 27, 2004, at 20:50:20
Scott,
I donot remember why I thought Effexor would help. It might have as I described I was beginning to feel but I could not continue on it for those other reasons. The I.C. has hindered me from taking some other meds too. Most stimulants that do seem to help some I cannot take. That is why even though ritalin has little mood effect compared to others I continue to take it as I have tried at least 5 others and am unable to tolerate them.
I did look up Meridia. I remember some time ago having an interest in it. It could have been spurned by looking up things for my sister, who is obese to take to help her. But for some reason I remember having more of an interest in it. I do not believe I took it though. Would it be considered a stimulant of sorts? Something that might affect my histamine levels? There are many things I cannot take. Including a lot of vitamins and supplements, including ball the B vitamins and C accept ester c. I ordered and took several recommended on this sight and had bladder problems. I did try a couple separately. I need to try and take each one for a time on its own to see which ones I might be able to tolerate.
There is a book I have by Dr Hedeya “ The Antidepressant Survival Program: How to Beat the Side Effects and Enhance the Benefits of Your Medication " web sight http://www.wholepsych.com/HedayaBio.html. I wondered if you have interest or time if you could give a glance and see what you think?
Thanks,
iris2
Posted by iris2 on July 28, 2004, at 1:14:26
In reply to Re: Amisulpride,Mirapex,Requip...?, posted by banga on July 27, 2004, at 22:35:45
> Hi, I can’t help you much on the drug side, I fully support and cross my fingers that you will find the right mix. I am also trying to activate my brain. But with your medical condition--and I wont get too into it because I know there are separate sites to seek this out--have you explored whether you have any vitamin/mineral/other deficiencies that influence the picture? I am taking a myriad of medications so Im all for meds, they have saved my life..... but I also was helped to some extent with medical conditions in taking large doses of vitamin B12 and some others for some of my cognitive/neurological symptoms. I had a disconnect between myself and the world due to a disconnect in my brain between sensory input and cognition due to B12 deficiency. I would lose half of conversations because everything went black on me. Alcohol and bad diet exascerbated this underlying condition. Just a side thought. Talk to the docs, listen to the wise posters on this board for med advice.
> Hang in there dont give up, the answer is out there. Get help if things get that bad for you again.Hi,
Thanks for the response.
I don't have all the answers. There is so much to know. And different opinions as to what works or even what to try.
I essentially got rid of all the debilitating pain and other symptoms of I.C. with diet and supplement regimen that I followed to the tee for over 8 months. I generally stay completely away from alchol and eat okay. But recently I have been so down I just do not care so much.That was as long as the supplement regimen was supposed to last. I still follow most of the diet although I am less restrictive because not everything bothers everyone and after a complete elimination diet for 6 to 8 months I am trying out one thing at a time to see what I might be able to eat. As far as many vitamins and supplements go I cannot take a lot of them. For instance none of the vitamin B's. There are several I have tried fro depression that I cannot take because of my bladder to include medications. Have you heard of Dr Hedeya I have his book sighted onhttp://www.wholepsych.com/HedayaBio.html.
I am curious what others think?
My doctor will not proceed unless I show him some research. I just do not have the cognitive skills to research it all to do a few tests.Anyway thanks. Glad to hear you are doing well.
iris2
Posted by banga on July 28, 2004, at 1:50:48
In reply to Amisulpride,Mirapex,Requip...?, posted by iris2 on July 27, 2004, at 20:04:49
Intriguing reference, can't comment until I look over it. I certainly believe in a wholistic view, but it's next to impossible to find people who accept and are willing to look at ALL the parts, instead of being either MEDS have the science and nutritionists are bosh, or nutrition and clean environment is IT and medicine is a money-hungry machine etc. It took me ages to get to the B12 deficiency diagnosis, I wont even get into all the humiliation and hypochondriasis bit..somehow I got a neurologist, psychiatrist and my own research into micronutrition (regular docs were booted out of the picture being nocompliant with micronutrition)to slowly come together for me...my med profile is still Frankenstein-like. I dont suppose you can take Coenzyme Q10, acetyl carnitine? for energy? One of those improved me *drastically* and I am not one to respond to supplements like that ( Im NOT a person that usually takes a tiny vitamin or an herb and says the very next day gee! what a difference!)
anyways Ill get the book you refer to when I can i'm intrigued.Wish I could help you with the meds, all I can say is that we all need to continue trying to mix up the miracle potion. Its hellish in the meantime.
Take care, B.
Posted by pablo1 on July 28, 2004, at 13:17:11
In reply to Amisulpride,Mirapex,Requip...?, posted by iris2 on July 27, 2004, at 20:04:49
> [can't remember why]
Amisulpride
Mirapex
Requip
MilnacipranAll but the last are pure dopamine [DA] drugs. Also looked interesting to me because I took wellbutrin (norepenephrine [NE]) and really disliked it. Ritalin & Adderall have a significant NE component also and they seemed to give me an edgy discomfort so I guess I was thinking a stimulant without the NE might help. Or maybe I'm just looking for a good high? It was mentioned here that Adrafinil (as a cheaper substitute for amineptine) combined with amisulpride worked well. Amisulpride is actually an anti-dopamine drug (though it is stimulating) so I don't know if it was some kind of balancing act using the two in small doses. Here's a couple links to that discussion below. The guy has since disappeared from here and was accused of being too experimental with potentially abusable drugs. Frankly I'd go out & get some cocaine if I thought it would help but when I tried some once, it was similar to ritalin & nothing special for me. Cocaine has NE also, not pure dopamine.
http://www.dr-bob.org/babble/20000411/msgs/30535.html
http://www.dr-bob.org/babble/20010714/msgs/70706.htmlThe other end of the spectrum is something like Xyrem which works on GABA. It's terribly expensive and has a very sedative euphoric effect. Neurontin sounds like a milder version of that GABA effect. GABA is what many of the anticonvulsants/mood stabilizers work on. Effexor gave me a nice peaceful antianxiety effect that I associate with the descriptions of some of these though it was limited and the mood dampening wasn't what I wanted. I want to have feelings, it's just the anxiety needs to be turned off. I've tried some of the more sedating opiate type anti-anxiety drugs in the past and was not attracted to them really. Alcohol has an impact on GABA and helps me with that same relaxation so maybe that's another clue that GABA is part of what clicks for me. Nardil is an MAOI that works against GABA for anxiety. Sometimes the opposite effect happens with these things... so strange.
Hmm, if I don't like NE maybe there is a NE buster that would help? I've been looking at this chart I downloaded & searched "NE antagonist" with no results but "DA antagonist" gave the following:
amitriptyline + perphenazine (comorbid depression with (agitation or anxiety)) which sounds like you. That works on a bunch of neurotransmitters though so is pretty messy. loxapine is another one with simple NA antagonism described as an anti-psychotic. mesoridazine, oh, a bunch of antipsychotics... hmm, ever tried those?Well, maybe this helps clear up some of your thoughts on the topic. Good luck with it.
This is the end of the thread.
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