![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by TheOutsider on October 3, 2004, at 17:02:43
Apologies for any problems with spelling and punctuation, I am dyslexic (is that how its spelt?!)
My dear fellow babblers
I have not been posting much lately as I have been working full time. Some of you might remember me. I hope I have helped a few people, I’ve defiantly been helped by people on this sight, Cybercafe and King Vultan spring to mind!I’m really sorry about the length of this post, and also if I sound angry or bitter I’m really just letting of some steam.
I will be very grateful for anyone who takes the time and trouble to read it!I am twenty three years old and live in Cambridge in the UK; this is relevant because UK doctors tend to be much more conservative than US docs. There is also ‘free’ health care provided by the NHS, although one can go privately.
I have experienced problems with social anxiety, depression and possibly ADD since I was a child. I think that most of my depression/disympthia are the result of my ADD and SA.
I don’t think that most UK Pdocs take social anxiety or ADHD very seriously.To cut a long story short I have self medicated with GHB to keep my social anxiety under control for the last few years. The reason I resorted to this is because its so hard to get decent treatment in the UK. I have now run out of GHB and can't find it for sale anywere.
Last December I saw a really nice Pdoc privately who diagnosed me with ADD inattentive subtype, and prescribed Dexedrine. Unfortunately he was forced to retire, just two months after I saw him.
Last February I was assed by an NHS Pdoc named Dr Heimas who told me that stimulants were “addictive and neurotoxic” and that I probably didn’t have ADHD because I could read novels.
As you’ve probably guessed I don’t get on particularly well with Dr Heimas, but I’ve had to keep seeing him because I can’t afford to go privately, and I’m not insured.
To be fair to him he did refer me to an NHS Doctor with an interest in ADHD. This doctor said that I probably did have ADD inattentive type, and that I should be prescribed Ritalin if I did need to concentrate. Unfortunately he just referred me back to Dr Heimas, and Dr Heimas won’t prescribe stimulants....you can see were this is going…….Since February I have had two more appointment with Dr Heimas. This summer he prescribed clomipramine for my depression and social anxiety, I’ve titrated up to 150mgs of clomipramine.
Clomipramine has helped my depression but not my ADD or my social anxiety.
Last Friday I had another appointment with Dr Heimas, he put me on a waiting list for cognitive behaiveral therapy, I have to wait for a year (!)
I told him that clomipramine was helping my depression but that it is doing nothing for my SA or my ADD, he responded by telling me that I must remain on the clomipramine for another few months before changing to a different med.I really don’t know what to do in another few months I’ll go crazy! I can’t socialise or make any friends at work because of my SA, I'm also losing contact with my old friends:(
I don’t really know what to do, I think I will have to see a private doctor in London, but its such a gamble.
Any one who has any advice or comments I’d love to hear from you
Take care every one
Tom
Here is a list of the different meds and drugs I have tried and their affects on me.Citalopram: Some what helpful for depression, did not help with ADD or Social anxiety
Amisulpride: No positive or negative affects
Fluoxetine generic: Had no positive effects, caused fatigue
Selegiline: Some what helpful for ADD
Moclobemide: No positive or negative affects
Diazepam: Good for anxiety but did not help with social anxiety, made me feel foggy headed and a bit depressed.
GHB: Very helpful for social anxiety, short duration of action
Alcohol: Good for anxiety and social anxiety but makes me depressed, also I don’t want to become an alcoholic.
Remeron: Very sedating at any dose, good for sleep and anxiety, no effect on social anxiety.
Adrafinil: The best drug for me, when it worked! Helpful for ADD, anxiety and depression, helped some what with social anxiety, caused severe insomnia.
Dexedrine: Calming in low doses, good for ADD, some what helpful with social anxiety, causes insomnia if taken to late in the day. At high doses makes anxiety worse. All but impossible to get prescribed in the UK.
Clomipramine: Helpful for depression and anxiety, maybe slightly helpful for social anxiety. Bad side effects, dry mouth, sexual dysfunction e.c.t.
Posted by King Vultan on October 3, 2004, at 19:03:40
In reply to Advice please! I don't know what to do, posted by TheOutsider on October 3, 2004, at 17:02:43
You generally need something dopaminergic for ADD, and that is just not part of clomipramine's pharmacologic profile. Selegiline, dexedrine, and (probably) adrafanil are all dopaminergic, as is Ritalin. Sometimes, noradrenergic meds can also be helpful. Strattera is used in the US, but I believe it may also have a secondary dopaminergic effect. I don't know how well reboxetine works for ADD; I found the somewhat similar NE reuptake inhibitor desipramine to have some positive effects, but it falls short of something more dopaminergic, such as the Parnate I am now taking.
Social anxiety is more complicated. The SSRIs do work for some people, but for others like myself, they are only mediocre at best. I believe that the three best drugs are Klonopin/clonazepam, Nardil, and Parnate, and I don't know if these are available to you. I have not tried Klonopin, but it seems to be regarded as an extremely effective anxiety med. I've tried the other two and thought they were both effective. Parnate has been the best all around med I have tried so far, and I don't believe I will need to try anything else. I probably would have gone on to selegiline next--how high a dosage did you go on this?
Todd
Posted by slinky on October 3, 2004, at 20:05:53
In reply to Advice please! I don't know what to do, posted by TheOutsider on October 3, 2004, at 17:02:43
Sorry that the docs don't take interest in ADD.
I am in the UK and often think that my bipolar diagnosis is really ADD.
I don't know of any doctors but I would suggest contacting the Maudsley psychiatric dept in Camberwell London...look up on the net.
If there is any research or help it would be there.
Good luck.
Posted by TheOutsider on October 4, 2004, at 6:27:19
In reply to Re: Advice please! I don't know what to do, posted by King Vultan on October 3, 2004, at 19:03:40
> You generally need something dopaminergic for ADD, and that is just not part of clomipramine's pharmacologic profile. Selegiline, dexedrine, and (probably) adrafanil are all dopaminergic, as is Ritalin. Sometimes, noradrenergic meds can also be helpful. Strattera is used in the US, but I believe it may also have a secondary dopaminergic effect. I don't know how well reboxetine works for ADD; I found the somewhat similar NE reuptake inhibitor desipramine to have some positive effects, but it falls short of something more dopaminergic, such as the Parnate I am now taking.
>
Hey Tod, I'm really glad to hear that Parnate is working for you!
Parnate, Nardil and Strattera are all available in the UK as is Klonopin, the problem is finding a doctor willing to prescribe them.
Posted by zeugma on October 4, 2004, at 17:27:59
In reply to Re: Advice please! I don't know what to do, posted by TheOutsider on October 4, 2004, at 6:27:19
Posted by TheOutsider on October 5, 2004, at 5:58:47
In reply to why not prescribe Strattera? (nm) » TheOutsider, posted by zeugma on October 4, 2004, at 17:27:59
I think that my doc is not willing to prescribe it because he doesn't know what it is.
I could be wrong, but doctors in the UK tend to be very conservative.
I'm getting increasingly frustrated with Clomipramine!
Posted by sunny10 on October 5, 2004, at 11:48:19
In reply to Re: why not prescribe Strattera?, posted by TheOutsider on October 5, 2004, at 5:58:47
If not Strattera, how about trying Wellbutrin XL? I was just at my pdoc this morning and while he was helping me with my med issue, we were also discussing my son. My son has ADHD and is taking Adderall XR, except that he is becoming combatant as he becomes a teenager. TOO stimulating now for him. Because of this, MY pdoc suggested that I talk to my son's pdoc about Wellbutrin XL. My son suffers from ADHD, ODD, and depression w/ anxiety. (Had I know before he was born that I suffer from most of them, too, I probably wouldn't have had a child!) Believe me, unless you're BP I and exhibit HUGE signs of mania, most docs in the USA don't recognize these disorders very well either.
My docs told me all my life that I just needed to "grow up" and "practice smiling and it will become natural to you"..... It took 'til I was 29 and obviously not a child any longer for them to really take a closer look and do ALL the tests on me!
Good luck in the UK... I don't know about the legality of crossing borders anymore with this whole cyberspace thing- maybe you can get a new doc via email and phone appointments in the US for prescribing?? Anyone know if they can do this?? Anyone tried??
Posted by Denise1904 on October 6, 2004, at 16:06:41
In reply to Advice please! I don't know what to do, posted by TheOutsider on October 3, 2004, at 17:02:43
Hi,
I can't help but I know what you mean about psychiatrists in the UK being over cautious, I've been to see about 8 in the UK on the NHS and privately and none of them would prescribe stimulants for me. I can't even get any of them to prescribe Wellbutrin (Zyban) as my last psychiatrist insists it's not used for depression. I found it really difficult to get any of them to give me Nardil and the problem is you don't know what they will give you until you spend ages to see them on the NHS or spend lots of money to see them quickly privately.
So I then tried to go to my Doctor and asked him if he could put me on Zyban saying I wanted to give up smoking and it was for that but he wouldn't either.
I have thought about trying to get stimulants or wellbutrin on the net but you never really know for sure what you're getting.
Anyway, best of luck and let me know if you do get to find an English Pychiatrist who is prepared to be a bit more innovative in his/her approach.
Denise
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.