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Dr. Bob is Robert Hsiung, MD,
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Posted by 4WD on August 20, 2005, at 12:40:39
In reply to Re: Remeron blocks SSRI side effects » 4WD, posted by ed_uk on August 20, 2005, at 11:11:54
> Hi Marsha,
>
> >The only reason I haven't gone back is the dry mouth issue.
>
> Medication is available which should reverse the dry mouth.
>
> ~ed
What's it called? & why don't pdocs generally suggest it?marsha
Posted by ed_uk on August 20, 2005, at 14:11:14
In reply to Re: Remeron blocks SSRI side effects » ed_uk, posted by 4WD on August 20, 2005, at 12:40:39
Hi Marsha,
>What's it called?
Pilocarpine. It's a cholinergic agonist. Theoretically, it should reduce the dry mouth caused by anticholinergic drugs such as TCAs.
>why don't pdocs generally suggest it?
It's not approved for the relief of dry mouth caused by TCAs.
http://www.rxlist.com/cgi/generic3/salagen_ids.htm
Kind regards
~Ed
Posted by linkadge on August 20, 2005, at 16:01:19
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by SLS on August 20, 2005, at 7:45:17
>ziprasidone or aripiprazole,
I don't think are available in canada.
>? Do you think gepirone might produce a >therapeutic action as a partial agonist at these >sites,Buspar has some AD action. I think that its d2 antagonist properties reduce some of its AD effects. Some doctors have used it more sucessfully in much higher doses. As an adjunct it is perhaps better. Yes, a more potent, and selective 1a agonist might proove usefull.
----------------------------------------------I've just been thinking a lot about suicide lately.
Linkadge
Posted by linkadge on August 20, 2005, at 16:02:35
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by ed_uk on August 20, 2005, at 11:08:03
The crashing isn't worth it.
Linkadge
Posted by ed_uk on August 20, 2005, at 16:14:18
In reply to Re: Remeron blocks SSRI side effects, posted by linkadge on August 20, 2005, at 16:02:35
Link,
Do you crash after a single dose?
You might prefer Concerta, you could take it on bad days.
~Ed
Posted by linkadge on August 20, 2005, at 16:22:52
In reply to Re: Remeron blocks SSRI side effects, posted by ed_uk on August 20, 2005, at 11:09:41
From all over the place.
5-ht2c agonists as anticonvulsants:
-----------------------------------
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15638778Seizure prone 5-ht2c knockout mice:
-----------------------------------
http://www.nature.com/nature/journal/v374/n6522/abs/374542a0.html;jsessionid=9BECE231CF19B4F2C9552C0A6DFFEAEE5-ht2c antagonists can produce seizures
----------------------------------------
http://www.columbia.edu/~rh95/constitutive.html"In addition, the mutant mice (5-ht2c knockout) displayed a lowered threshold for metrazol-induced seizures. Interstingly, this effect could be mimicked in wild-type animals with a non-selective 5-HT2C receptor antagonist"
5-ht2a and short term memory
----------------------------
http://www.nootropics.com/genes/index.htm
-----------------------------------------
"The neurotransmitter serotonin is better known for its involvement in depression, but drugs that block a particular serotonin receptor in the brain, 5HT2a, are known to also block short-term memory."
Linkadge
Posted by linkadge on August 20, 2005, at 16:30:33
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by ed_uk on August 20, 2005, at 16:14:18
I am taking a long acting version. Methylphenedate SR.
It lasts from the morning till about 5 pm.
Still, the crash then is just not worth it.
If you did a mood/time graph you'd see that the area above the baseline mood is eqal to the area beneith the baseline mood.
Linkadge
Posted by ed_uk on August 20, 2005, at 16:52:05
In reply to Re: Remeron blocks SSRI side effects, posted by linkadge on August 20, 2005, at 16:22:52
Perhaps you could try a smaller dose - the crash might be milder.....
~Ed
Posted by linkadge on August 20, 2005, at 17:01:21
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by ed_uk on August 20, 2005, at 16:52:05
Oh it will be milder, but then less effect.
I'd just rather not. Stimulants are dead ends for me. Extrordinarily helpfull, but dead ends none the less.
Linkadge
Posted by 4WD on August 20, 2005, at 22:16:53
In reply to Re: Remeron blocks SSRI side effects » 4WD, posted by ed_uk on August 20, 2005, at 14:11:14
> Hi Marsha,
>
> >What's it called?
>
> Pilocarpine. It's a cholinergic agonist. Theoretically, it should reduce the dry mouth caused by anticholinergic drugs such as TCAs.
>
> >why don't pdocs generally suggest it?
>
> It's not approved for the relief of dry mouth caused by TCAs.
>
> http://www.rxlist.com/cgi/generic3/salagen_ids.htm
>
> Kind regards
>
> ~EdThanks, Ed. I've always had in the back of my mind that imipramine would be there as a last resort but I could only resort to it as truly a last resort. I have a lot of dental issues (from former bulimia and a lifetime of dry mouth from medications) so the dry mouth thing wasn't just an annoyance - it was potentially a major problem.
Knowing that there is a potential solution to this issue somehow makes me feel safer. It gives me one more option, you know? So thank you.I think I might actually have Sjogren's disease since I also have also always had dry eyes and problems with dryness of other mucous membranes which I won't go into...
Marsha
Posted by 4WD on August 20, 2005, at 22:51:12
In reply to Re: Remeron blocks SSRI side effects, posted by linkadge on August 20, 2005, at 0:28:12
> I'd try it, but I really just don't care anymore.
>
>
> Linkadge
But I care. And Ed cares. And Scott cares. And Phillipa cares. And about a hundred other people on this board care. I know you can't feel it emotionally but can you think it intellectually that you are too young to give up? That there are still options and that getting better might be in the future? Maybe even the really near future? Is is possible you are going through a particularly bad time, one so bad that it seems like it's always been this way and will always be this way? I've felt that way so many times in the past and when I get like that I can't find it in myself to believe it will or could ever possibly get better. Or even if it could, that I just wasn't willing to wait for it.But please try to be willing to wait. Something has kept you holding on this long. There is something in you that doesn't want to give up or you wouldn't still be on this board, trying to help other people. You wouldn't still be considering possibilities and reading here. There is still hope even if you can't feel it right now. I am praying for you that even if you can't feel hope, you will believe that other people feel it for you and that maybe that will be enough to let you hang on and keep trying. And I will be praying for you to feel better. To get well. It can happen, Linkadge. But not if you check out. Is there anyone you can cry to? I mean someone you can just open up to and tell them how bad you feel and just cry and let it all out with complete abandon? If you don't have anyone like that you can do it with me. You can babblemail me. I will listen and not try to fix you or get all smarmy and sunshiny optimistic. Sometimes it has helped me just to let it all go.
If there is anything I can do, I will. You can call me collect and I will listen as long as you want to talk.Marsha
Posted by linkadge on August 21, 2005, at 1:04:59
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by 4WD on August 20, 2005, at 22:51:12
Thanks for the offer.
Linkadge
Posted by ed_uk on August 21, 2005, at 5:52:52
In reply to Re: Remeron blocks SSRI side effects, posted by linkadge on August 20, 2005, at 17:01:21
Hi Link,
Have you ever tried Dexedrine Spansules?
~ed
Posted by ed_uk on August 21, 2005, at 6:11:28
In reply to Re: Remeron blocks SSRI side effects » ed_uk, posted by 4WD on August 20, 2005, at 22:16:53
Hi Marsha,
Here's some more info on pilocarpine.
http://emc.medicines.org.uk/emc/industry/default.asp?page=displaydoc.asp&documentid=5786
Read.......
Contra-indications
Special warnings and special precautions for use
Interaction with other medicinal products and other forms of Interaction
.......to check that pilocarpine would be safe for you.
Although there's a possibility that pilocarpine might cause psych side effects, I doubt that these would occur unless the dose was excessive. The aim of taking pilocarpine would be to find the minimum dose which would control the anticholinergic side effects of imipramine.
Kind regards
~Ed
Posted by 4WD on August 21, 2005, at 14:19:24
In reply to Pilocarpine » 4WD, posted by ed_uk on August 21, 2005, at 6:11:28
> Hi Marsha,
>
> Here's some more info on pilocarpine.
>
> http://emc.medicines.org.uk/emc/industry/default.asp?page=displaydoc.asp&documentid=5786
>
> Read.......
>
> Contra-indications
>
> Special warnings and special precautions for use
>
> Interaction with other medicinal products and other forms of Interaction
>
> .......to check that pilocarpine would be safe for you.
>
> Although there's a possibility that pilocarpine might cause psych side effects, I doubt that these would occur unless the dose was excessive. The aim of taking pilocarpine would be to find the minimum dose which would control the anticholinergic side effects of imipramine.
>
> Kind regards
>
> ~Ed
>
>
Thanks, Ed.I know you take a big dose of Celexa. Don't you get all kinds of unpleasant side effects from it? I thought Luvox was the drug of choice for OCD. Did it not work well?
Is OCD your only diagnosis? Or is there depression as well? I have some mild OCD tendencies and it seems like they kind of go hand in hand.
Marsha
Posted by ed_uk on August 21, 2005, at 14:42:45
In reply to Re: Pilocarpine, posted by 4WD on August 21, 2005, at 14:19:24
Hi Marsha,
>Don't you get all kinds of unpleasant side effects from it?
I'm supposed to be taking 60mg at the moment. I've been taking 80mg recently. Lack of motivation is my main side effect. It also reduces my libido and makes me sweat more than usual. No other side effects.
>I thought Luvox was the drug of choice for OCD. Did it not work well?
I don't think it's any more effective for OCD than the other SSRIs. It has a reputation for causing more drowsiness than the other SSRIs so I don't really want to try it. I was drowsy enough on Paxil. Luvox is almost never prescribed in the UK, it's the forgotten SSRI.
>Is OCD your only diagnosis?
Hmmm, not sure how to answer that. I've had different diagnoses at different times in my life. Most of my anxiety could be thought of as being on the OCD spectrum.
Kind regards
~Ed
Posted by linkadge on August 21, 2005, at 17:11:48
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by ed_uk on August 21, 2005, at 5:52:52
Briefly.
Linkadge
Posted by 4WD on August 21, 2005, at 18:01:32
In reply to Re: Pilocarpine » 4WD, posted by ed_uk on August 21, 2005, at 14:42:45
> Hi Marsha,
>
> >Don't you get all kinds of unpleasant side effects from it?
>
> I'm supposed to be taking 60mg at the moment. I've been taking 80mg recently. Lack of motivation is my main side effect. It also reduces my libido and makes me sweat more than usual. No other side effects.
>
> >I thought Luvox was the drug of choice for OCD. Did it not work well?
>
> I don't think it's any more effective for OCD than the other SSRIs. It has a reputation for causing more drowsiness than the other SSRIs so I don't really want to try it. I was drowsy enough on Paxil. Luvox is almost never prescribed in the UK, it's the forgotten SSRI.
>
> >Is OCD your only diagnosis?
>
> Hmmm, not sure how to answer that. I've had different diagnoses at different times in my life. Most of my anxiety could be thought of as being on the OCD spectrum.
>
> Kind regards
>
> ~EdI just can't imagine that you don't get dry mouth at that dose. I get the apathy, too. But that's on most ssri's . The Lexapro is weird. I wake up in the morning feeling like someone has sneaked into my bedroom and hooked me up to an adrenaline drip about an hour and a half before my normal wakeup time. I wake up, manage to doze off and on for a little longer. Get up and am filled with this huge nervous energy. It lasts about three hours and then I just feel tired for a few hours. Pretty much the same deal with Celexa. But I do think I have more energy with Lex than Celexa. Have you tried Lexapro?
Marsha
Posted by flipsactown on August 22, 2005, at 12:24:12
In reply to Re: Remeron blocks SSRI side effects » linkadge, posted by SLS on August 20, 2005, at 7:45:17
> > I'd try it, but I really just don't care anymore.
> >
> >
> > Linkadge
>
>
> I hope this is just a passing phase, Linkadge. I have been through it before. To be honest, I have grown weary of investigating psych stuff and don't much care about detail anymore. I just want to know enough to put me on the right track or in front of the right doctor. Just give me the right drugs and let me begin living a life enriched with things other than knowledge of biological psychiatry. I'd be very happy not to know anything about the differential roles that the various 5-HT receptors play in favor of watching Jethro Tull in concert.
>
> That being said, have you tried any of the neuroleptics that act as agonists at postsynaptic 5-HT1a receptors like ziprasidone or aripiprazole? Do you think gepirone might produce a therapeutic action as a partial agonist at these sites, or will it be as impotent as buspirone as an antidepressant? I wish flexinoxan were around. It is more potent than gepirone and lacks the NE alpha-2 receptor antagonist metabolite.
>
> * Give yourself permission to be sick and tired of anything, but try to isolate which things are causing you feelings of helplessness or mental fatigue and put them away for awhile. You might find that you will find a renewal of energy and a more positive outlook. This might mean avoiding PB and psychiatric research for awhile. In the meantime, you will be able to deal with your true immediate priorities and perhaps gain a better insight into what things are acting as obstacles to your happiness.
>
>
> - ScottHello Scott and Linkage,
I have not posted in awhile. Scott, I am happy to see you are doing better. So what meds are you taking if you don't mind me asking?
Anyway, I have had good results with Lexapro 30mg, Wellbutrin 400mg and Trazodone 100mg for at least 18 months, but I can feel my unipolar depression returning. Also, with Trazodone, although it allows me to sleep more than a couple of hours at a time, it has become nearly impossible to have an orgasm, even when I take Viagra. I was thinking of asking my pdoc to switch me back to Remeron instead of Trazodone. The only reason I had asked to switch to Trazodone was because of weight gain. Now that I have recently lost 22 pounds over a 2 month period, and counting, with the help of the high protein, low carb diet I discovered when I bought the Showtime Rotisserie, I want to switch back to Remeron which allowed me to have an orgasm. What do you wise men think?
FST, a very frustrated man.
Posted by ed_uk on August 22, 2005, at 15:56:05
In reply to Re: Pilocarpine, posted by 4WD on August 21, 2005, at 18:01:32
Hi M,
I've never had a dry mouth on SSRIs, even on Paxil 60mg. I didn't get a dry mouth on lofepramine either - a TCA. Amitriptyline causes me a dry mouth at doses >40mg.
I haven't tried Lexapro. The problem is, the max dose is 20mg and I think I might need more than that. UK docs rarely exceed maximum doses. A lot of Americans seem to take 40mg Lexapro.
Kind regards
~Ed
Posted by 4WD on August 22, 2005, at 21:13:19
In reply to Re: Pilocarpine » 4WD, posted by ed_uk on August 22, 2005, at 15:56:05
> Hi M,
>
> I've never had a dry mouth on SSRIs, even on Paxil 60mg. I didn't get a dry mouth on lofepramine either - a TCA. Amitriptyline causes me a dry mouth at doses >40mg.
>
> I haven't tried Lexapro. The problem is, the max dose is 20mg and I think I might need more than that. UK docs rarely exceed maximum doses. A lot of Americans seem to take 40mg Lexapro.
>
> Kind regards
>
> ~Ed
>
>
I'd have thought 80mg was more than the max dose for Celexa?You could go ahead, get the Lex script, keep on with the Celexa for a month, get the Lex refill and then for a month try it at 20 and if needed, go up to 40. You'd have plenty since you'd have two months worth to work with. Then if that worked, tell the pdoc.
Or wouldn't they go for that? I guess it depends on the doctor. Some don't mind being second guessed. Others get offended. But who could argue with success?
You are fortunate in that you don't get those side effects. I'm thinking of taking my Lex at night. That way, my mouth would be dry while I'm asleep (it's worse a few hours after taking it) and I wear a breath-rite strip to bed anyway. Maybe I could experience the worst of the side effects when I won't know about it.
It's a shame there's not some kind of med-exchange program. I just know there are thousands of us out here with shoeboxes of unused meds (trials that didn't work out) and thousand smore of us who could sure use the unused meds.
I AM NOT suggesting such a thing.
Marsha
Posted by Iansf on August 22, 2005, at 23:57:33
In reply to Re: Pilocarpine » 4WD, posted by ed_uk on August 21, 2005, at 14:42:45
Ed, Luvox may make many people sleepy but not all. It gave me insomnia. I had to take 25mg trazadone every night to be able to sleep. Actually I found it extremely effective as an antidepressant and anti-social phobia medication. Unfortunately, it effectively eradicated my sex life. I was totally impotent, genitally numb and lacking libido. I even found sex somewhat antipathetic. It finally made it possible to meet potential partners, but destroyed the possibility of physical intimacy. Really a bummer in that regard.
Ian
Posted by linkadge on August 23, 2005, at 15:20:40
In reply to Re: Luvox » ed_uk, posted by Iansf on August 22, 2005, at 23:57:33
Seinfeld was right, relationships work great when there's no possability of sex.
Linkadge
Posted by ed_uk on August 23, 2005, at 15:27:39
In reply to Re: Pilocarpine, posted by 4WD on August 22, 2005, at 21:13:19
Hi M,
>I'd have thought 80mg was more than the max dose for Celexa?
The official max is 60mg, some people take more. There's a case report of someone taking 160mg for OCD.
>But who could argue with success?
I think they would :-((((
>I AM NOT suggesting such a thing.
;-)
Kind regards
~Ed
Posted by ed_uk on August 23, 2005, at 15:31:42
In reply to Re: Luvox » ed_uk, posted by Iansf on August 22, 2005, at 23:57:33
Hi Ian,
>Ed, Luvox may make many people sleepy but not all.
Definately. It does seem more likely to cause drowsiness that the other SSRIs though.
>I was totally impotent, genitally numb and lacking libido.
I'm not impotent on Celexa 60-80mg. I can only have an erection for a short time though. I also have a low libido, although I do find it quite easy to orgasm.
Kind regards
Ed
This is the end of the thread.
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