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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 Phillipa on March 18, 2005, at 22:28:18
In responding to a Thread above this I realized that I don't even know if I'm depressed anymore. I was never able in the past to tolerate even low doses of AD's without horrible side effects. Felt like a "space cadet". I always stopped taking them and went back to subtheraputic doses of paxil or luvox, the only two I had been able to tolerate. Now I'm on l5mg of remeron and 25mg of zoloft. I'm supposed to be increasing the zoloft up to l00mg by the time I see the pdoc next week. But I haven't felt the need. I also realized that I didn't even know if remeron helped with sleep as I take l0mg of valium with it so, I cut the remeron in half and I'm sleeping the same. So now I'm wondering why I can tolerate normal doses of AD's without any effects at all, and if i really need to take them. Maybe the valium by eliminating my anxiety is also eliminating any depression. Back 30yrs ago when I had my first panic attack they always wanted me to take an AD and I refused. I took benzos, and never abused them. And I wasn't depressed. It seems as if the attempts to take AD's over the years have just made things worse. I don't understand. Do you have any ideas? Thanks, Phillipa
Posted by anodyne on March 18, 2005, at 23:23:36
In reply to I Don't Get It!, posted by Phillipa on March 18, 2005, at 22:28:18
You sound like me. I just can't take AD's unless it is at a VERY low dose. They may me feel like a space cadet as well, and I think this makes my anxiety much morse. It really doesn't help social anxiety when you feel you are not even on the same planet with those around you.
Benzos work wonders for me too but take their toll on me. Klonopin kills my libido after a couple of months, Xanax makes me sleepy, Ativan makes feel weird. I haven't taken Valium in years but I remember it making me tired. Maybe I should give it a try.
My newest venture is Xanax XR, which seems to be less sedating than the original but still makes me sleepy. I am also trying Ablify. Who knows what that will end up doing but I will keep posting.
You are right though, I don't think ADs help everyone with anxiety. I think there are many different kinds of anxiety with many different causes. Some of us may not need effects that ADs help so many others with.
-Dan
Posted by SLS on March 19, 2005, at 7:10:35
In reply to I Don't Get It!, posted by Phillipa on March 18, 2005, at 22:28:18
If you want to test if you can still use an antidepressant, you can challenge yourself with a few 5mg doses of amphetamine. If you feel better, it usually means that you will profit from an optimized treatment. Ritalin doesn't work as a challenge.
- Scott
Posted by greg diamond on March 19, 2005, at 9:00:59
In reply to Re: I Don't Get It! » Phillipa, posted by SLS on March 19, 2005, at 7:10:35
Phillipa - I completely understand your 'waffling' on the subject of AD's. when i went on them the first time it was for OCD, and zoloft did wonders = 8 hours of rumination turned to 20 minutes or so. now i am on them for both anxiety/depression as my old OCD symptoms are gone. i do know that when i am off meds and i go through a crisis (like right now - school, moving, brokenheart) i tend to obsess uncontrollably and become one big ball of anxiety and corresponding depression at the fight it entails. but now i notice side effects more (spaciness - is this due to a flood of serotonin?), and fear that when i do want to go off of them that i will have massive relapse problems. my CBT is going too slowly though, and i just care less about everything when i am on the meds.
i am waiting for an AD with no sexual side effects or metabolism alteration, this will be science working in my favour! i think if you feel well on just valium Phillipa then stick with it. and do psychotherapy too, it's a slow way to change brain chemistry, but it's free and fun when you start to see different ways to respond to life's challenges. we often rely far too much on psychopharmacology, at least those of us who don't have the more severe psychic issues. keep posting about your decisions re: zoloft. it sounds like luvox was the med for you. maybe give it a little more time to reach maximum levels and then see what happens. with my OCD it took 12 weeks. the change was slow but when it did happen it vastly improved my quality of life.
craig.
Posted by Maxime on March 19, 2005, at 12:34:07
In reply to Re: I Don't Get It! » Phillipa, posted by SLS on March 19, 2005, at 7:10:35
> If you want to test if you can still use an antidepressant, you can challenge yourself with a few 5mg doses of amphetamine. If you feel better, it usually means that you will profit from an optimized treatment. Ritalin doesn't work as a challenge.
>
>
> - Scott
>
>Is this true Scott? What is the theory behind it? I am almost in tears right now because for the past few days I have been beating myself over the head for start meds etc.
I have dexedrine and I use it when I have to do something. For instance today I have to meet my friend and her kids and then we are going to a movie. I took the dexedrine so I could move. Right now I feel okay ... not depressed. I know it's a false sense of well being. But if what you say is true then all these years of being on meds was needed? I know I suffer from depresssion (I am dx'd BP type 2). But I wondered if I had stayed away from meds, would things have gotten this bad?
I look forward to your reply.
Maxime
Posted by cache-monkey on March 19, 2005, at 14:08:07
In reply to Re: I Don't Get It!, posted by anodyne on March 18, 2005, at 23:23:36
Hi Dan,
First, I'm wondering where you got your board name. Is it the drug or the Uncle Tupelo album?
Second, I'd like to know more about your experience with Xanax XR. Do you take it once daily (as advertised) or whether have you had to go to twice-daily dosing due to gaps in coverage? Is it "weaker" than immediate release or about equipotent?
Please let me know when you have the chance.
Best,
cache-monkey[...]
> Benzos work wonders for me too but take their toll on me. Klonopin kills my libido after a couple of months, Xanax makes me sleepy, Ativan makes feel weird. I haven't taken Valium in years but I remember it making me tired. Maybe I should give it a try.
>
> My newest venture is Xanax XR, which seems to be less sedating than the original but still makes me sleepy. I am also trying Ablify. Who knows what that will end up doing but I will keep posting.
>
[...]
> -Dan
Posted by Minnie-Haha on March 19, 2005, at 15:09:00
In reply to Re: I Don't Get It! » Phillipa, posted by SLS on March 19, 2005, at 7:10:35
> If you want to test if you can still use an antidepressant, you can challenge yourself with a few 5mg doses of amphetamine. If you feel better, it usually means that you will profit from an optimized treatment. Ritalin doesn't work as a challenge.
Scott,
I can usually follow your posts, but not this one. Do you mean by "still use" the same as "need" or "could benefit from"? Do you mean by "optimized treatment" something like augmenting with an antidepressant.
Sorry... I must be a little dense today.
Posted by SLS on March 19, 2005, at 15:21:14
In reply to Re: I Don't Get It! » SLS, posted by Maxime on March 19, 2005, at 12:34:07
Hi Maxime.
There used to be something known as the ACT amphetamine challenge test that was used to help predict one's potential to respond to antidepressants. However, it should be noted that at the time, only tricyclics and MAOIs were used.
Which TCAs have you tried?
Which MAOIs have you tried?Have you ever combined Parnate + TCA + amphetamine?
- Scott
--------------------------------------------------
J Clin Psychopharmacol. 1988 Jun;8(3):177-83. Related Articles, Links
Amphetamine, but not methylphenidate, predicts antidepressant efficacy.Little KY.
Department of Psychiatry, University of Kentucky Medical Center, Lexington 40536-0080.
Several researchers have explored the possibility that acute stimulant response may predict eventual improvement after specific antidepressants. This review analyzes the relationship between stimulant response and nonspecific antidepressant response. In five studies, amphetamine responders were found to eventually improve after antidepressant treatment in 85% of the cases, while nonresponders improved in 43% of the cases. In contrast, acute methylphenidate responders and nonresponders eventually improved on antidepressants at equivalent rates. Amphetamine sensitivity appears to be a trait (possibly pharmacodynamic) that is independent of depressive illness but predictive of tricyclic responsiveness. Other evidence has suggested that amphetamine and methylphenidate cause similar behavioral and symptomatic effects through distinct mechanisms of potential clinical relevance. The most effective method for administering an amphetamine challenge and its appropriate clinical use remain unclear.
Publication Types:
ReviewPMID: 3288653 [PubMed - indexed for MEDLINE]
Posted by SLS on March 19, 2005, at 15:49:08
In reply to Re: I Don't Get It!, posted by Minnie-Haha on March 19, 2005, at 15:09:00
Let's try it this way:
:-)
If you want to explore whether or not you would benefit further from taking antidepressants, you can perform the amphetamine challenge test. For the test, you take several small doses of amphetamine. If you feel better, it often means that you will profit from a treatment optimized for your disorder. This often requires combinations of medications and psychotherapy.
How's that?
- Scott
Posted by Minnie-Haha on March 19, 2005, at 19:11:00
In reply to Re: I Don't Get It! » Minnie-Haha, posted by SLS on March 19, 2005, at 15:49:08
> Let's try it this way:
>
> :-)
>
> If you want to explore whether or not you would benefit further from taking antidepressants, you can perform the amphetamine challenge test. For the test, you take several small doses of amphetamine. If you feel better, it often means that you will profit from a treatment optimized for your disorder. This often requires combinations of medications and psychotherapy.
>
> How's that?
>
>
> - ScottYer a peach. Thanks.
Posted by anodyne on March 19, 2005, at 20:49:04
In reply to Re: I Don't Get It! » anodyne, posted by cache-monkey on March 19, 2005, at 14:08:07
> Hi Dan,
>
> First, I'm wondering where you got your board name. Is it the drug or the Uncle Tupelo album?Borrowed it from UT. It is one of my favorites and the name seemd so fitting. Great catch!
> Second, I'd like to know more about your experience with Xanax XR. Do you take it once daily (as advertised) or whether have you had to go to twice-daily dosing due to gaps in coverage? Is it "weaker" than immediate release or about equipotent?
So far I am still experiementing. I have a prescription for .5 mg twice a day. This (.5 mg)is a bit less than the equivilant amount of Klonopin I usually take so once a day is a step down. I have done the once a day once and found it hit just as quickly although more subtly, with less of the euphhoric feel and did last for about 24 hours, but as I said with less effect than the Klonopin I take. I will have to try taking 1 mg all at once. It did make me tired but was more tolerable than the immediate realease version.
I have been taking benzos in one form or another on and off for 10 years so I know the nuaces (sp) and will update you when I have a better feel.
I also just started Abilify 5 mg so I am not sure what that is doing. It seems to be lowering the effect of all the benzos as I can not sleep very well. I am hoping this goes away!
Take care,
Dan> Please let me know when you have the chance.
>
> Best,
> cache-monkey
>
> [...]
> > Benzos work wonders for me too but take their toll on me. Klonopin kills my libido after a couple of months, Xanax makes me sleepy, Ativan makes feel weird. I haven't taken Valium in years but I remember it making me tired. Maybe I should give it a try.
> >
> > My newest venture is Xanax XR, which seems to be less sedating than the original but still makes me sleepy. I am also trying Ablify. Who knows what that will end up doing but I will keep posting.
> >
> [...]
> > -Dan
>
>
Posted by Maxime on March 19, 2005, at 22:03:11
In reply to Re: I Don't Get It! » Maxime, posted by SLS on March 19, 2005, at 15:21:14
Very interesting.
Yes, I was on Parnate, Adderall and Surmontil.
Damn! Everything we downhill when they took Adderall XR off the shelves in Canada!!! I can't take Ritalin because I get rebound depression at the end of the day and I crash. I have tried the SR version and the regular tabs. The Dexedrine also did the same thing. I felt good until the Dexedrine started to wear off and then I was cutting my arm with a blade. I haven't had a chance to try the spansules of dexedrine because I couldn't obtain them. The pharmacies were ordering them once the Adderall XR was pulled because they did not have enough on hand.
I hate all of this. I hate it so #%@#%@^ much!
I wish I would just die.
Maxime
I was taking the TCA without my doctors knowledge. I did it for one month. Just a small amount of Surmontil that I had on hand. I was taking 25 mg which is the lowest dosage (well 12.5 mg is). I don't know if it made me feel better. I didn't notice a difference. Only the Adderall made a difference.
> Hi Maxime.
>
> There used to be something known as the ACT amphetamine challenge test that was used to help predict one's potential to respond to antidepressants. However, it should be noted that at the time, only tricyclics and MAOIs were used.
>
> Which TCAs have you tried?
> Which MAOIs have you tried?
>
> Have you ever combined Parnate + TCA + amphetamine?
>
>
> - Scott
>
>
> --------------------------------------------------
>
>
> J Clin Psychopharmacol. 1988 Jun;8(3):177-83. Related Articles, Links
>
>
> Amphetamine, but not methylphenidate, predicts antidepressant efficacy.
>
> Little KY.
>
> Department of Psychiatry, University of Kentucky Medical Center, Lexington 40536-0080.
>
> Several researchers have explored the possibility that acute stimulant response may predict eventual improvement after specific antidepressants. This review analyzes the relationship between stimulant response and nonspecific antidepressant response. In five studies, amphetamine responders were found to eventually improve after antidepressant treatment in 85% of the cases, while nonresponders improved in 43% of the cases. In contrast, acute methylphenidate responders and nonresponders eventually improved on antidepressants at equivalent rates. Amphetamine sensitivity appears to be a trait (possibly pharmacodynamic) that is independent of depressive illness but predictive of tricyclic responsiveness. Other evidence has suggested that amphetamine and methylphenidate cause similar behavioral and symptomatic effects through distinct mechanisms of potential clinical relevance. The most effective method for administering an amphetamine challenge and its appropriate clinical use remain unclear.
>
> Publication Types:
> Review
>
> PMID: 3288653 [PubMed - indexed for MEDLINE]
>
Posted by Phillipa on March 19, 2005, at 22:18:44
In reply to Re: I Don't Get It!, posted by Maxime on March 19, 2005, at 22:03:11
Maxime, Why can't you come to the US and see a pdoc and get your Adderal. It's not that far. Fondly, Philllpa
Posted by Maxime on March 19, 2005, at 23:52:21
In reply to Re: I Don't Get It! » Maxime, posted by Phillipa on March 19, 2005, at 22:18:44
> Maxime, Why can't you come to the US and see a pdoc and get your Adderal. It's not that far. Fondly, Philllpa
You are right I could do that. However, I can't afford it right now. I have 10 dollars to my name. 10 dollars!!! ACK! There is no one I can borrow the money from and I don't want to borrow money either.
The Adderall was expensive in Canada. I wonder how much 30 days at 30mg a day costs in the U.S.?
Anyone?
Maxime
Posted by Phillipa on March 20, 2005, at 0:02:00
In reply to Re: I Don't Get It!, posted by Maxime on March 19, 2005, at 23:52:21
I don't know, but have you checked the internet pharmacies? Fondly, Phillipa
Posted by cache-monkey on March 20, 2005, at 0:47:29
In reply to Re: I Don't Get It!cache-monkey, posted by anodyne on March 19, 2005, at 20:49:04
> > First, I'm wondering where you got your board name. Is it the drug or the Uncle Tupelo album?
>
> Borrowed it from UT. It is one of my favorites and the name seemd so fitting. Great catch!Awesome. I just picked up Anodyne after moving my way backward through Wilco for the last year. Acuff-Rose is probably among the top 5 played songs in my iTunes library right now.
>
> > Second, I'd like to know more about your experience with Xanax XR. Do you take it once daily (as advertised) or whether have you had to go to twice-daily dosing due to gaps in coverage? Is it "weaker" than immediate release or about equipotent?
>
> So far I am still experiementing. I have a prescription for .5 mg twice a day. This (.5 mg)is a bit less than the equivilant amount of Klonopin I usually take so once a day is a step down. I have done the once a day once and found it hit just as quickly although more subtly, with less of the euphhoric feel and did last for about 24 hours, but as I said with less effect than the Klonopin I take. I will have to try taking 1 mg all at once. It did make me tired but was more tolerable than the immediate realease version.
>
> I have been taking benzos in one form or another on and off for 10 years so I know the nuaces (sp) and will update you when I have a better feel.I've been RX'd 0.5 mg Xanax XR twice a day as well, after being on Klonopin 0.5 twice a day for the last couple of months. I found that I did better on 1 mg of IR Xanax spread out over the day, with less sedation, so we're switching back. I'm hoping the XR doesn't sedate me, which has been one of the problems with Klonopin. I'm probably going to do a little experimentimenting, too: 0.5 mg twice a day versus 1 mg all at once. (The latter being more cost effective.) I'll update also with my results.
Best,
cache-monkey
This is the end of the thread.
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