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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by utopizen on December 5, 2005, at 18:24:59
Okay, for over a year now I've had urinary retention (difficulty urinating fully, in one time, etc.)
Now with Aricept, I get to add on a MUCH worsened case of dry mouth, to the point where drinking a liter of water each hour seems to be the only way of not waking up at 3 or 5 A.M. with severe dry mouth.
This is WITH 4x/daily dosing of Evoxac, a dry mouth med, which is actually typically dosed 3x/day, but now doesn't even last into the night after bedtime dosing.
It use to be Evoxac controlled the dry mouth from amphetamines (I've tried 'em all, use to use Adderall, now on Desoxyn, and urinary hesitation began on Adderall, so don't blame one over the other).
I know several on this board have mentioned long-term use of amphetamines tend to lead to this, but my G.P. went through all my meds, one by one, and couldn't find any prostate complications as side effects of any on her medical system database.
I'm not saying that means anything, but it does suggest amphetamine-associated urology complications are bit more obscure in literature than perhaps should be.
I've put off a urology eval, missed my first one, but finally am set to see one in a couple of weeks.
I've heard from one poster here amphetamine use led him to simply take an alpha blocker.
I asked my G.P. about that, and she goes, "uh-uh, I am not even giving you a prostate check-- I can't do all the tests an urologist can do. I'm referring you to a specialist in the hospital's system."
She also dismissed the notion of an alpha blocker, saying that's for "enlarged prostate," but it seems that it's either enlarged with the amphetamine in my system or tiny when I add Klonopin (which I am suppose to take 1mg, 3x/day).
Also, I read on Google "Duvoid" is a drug given for urinary hesitation.
Well, lately it's become a full-blown case of urinary incontinence as well at times.
It's like the amphetamines, which I began after a few months of Ritalin at 18 before moving on to mostly Adderall (a brief stint with Dexedrine) for two years and then later some back-and-forth with Ritalin, Adderall and Desoxyn has somehow left my blood vessels down there so manipulated, it can't properly contract normally.
I'm a male 22 year old. Why the heck is this happening to me with just 4 years of prescribed stimulants, and not apparently more common in kids my age(?)
Maybe it's just my body being more sensitive to it, or my height, being 6'3," or a combination of factors-- but one poster has mentioned "oh, I take an alpha blocker, no problem, it's all good" or something way back when.
Um, this isn't right. There's surgeries for urology. If it is minimal enough, I wonder, if I'm asked about it, if surgery could somehow be more preferable.
It's annoying I'm already on Aricept 5mg/day, Desoxyn 20mg/day, Lexapro 30mg/day, and Evoxac 30mg 4x/day (for dry mouth from Aricept + Desoxyn).
Now yet another drug for a side effect? I've noticed, be it Lexapro or just maturity, my social anxiety just isn't there when I go off Desoxyn for a couple of days, and Klonopin too.
I'm completely calm. So it's like, I'm beginning to see Klonopin as a drug for a side effect, too.
I hate this.
I shouldn't complain-- Aricept, or whatever my mind is doing, has somehow led me to become so poetic my friends are very proud, I wrote a hard-hitting letter to my college newspaper that really seemed to nail some sense into a controversy, and my prose is incredible on my poetry/prose site.
Should I attribute Aricept to it? Somewhat, definitely. The dreaming at first for 2 months was so crystal clear, I knew it was really encoding memories in a completely different dimension I was use to. Words now flow not mechanically, like amphetamines can seem responsible for causing, but with seamlessly integrated, cohesive thoughts when I talk or write.
Oh, don't include this as a writing example =)
I'm just, um, psycho-babbling.
I basically am looking for anecdotes from others, so I feel a bit comforted to know I am not like a novel case study for my urologist to see when I first meet him two weeks from now.
Of course, I'll let you all know if he stops half-way during his eval, with my pants down, and yells out to all 40 of his student interns:
"Students, come quick! There's a 22 year old with urological maladies I've yet to see in my geriatric patients! You, grab that camera of yours, this is going to be presented at the next Conference!!"
Posted by iforgotmypassword on December 6, 2005, at 10:38:44
In reply to Aricept water retention, amphetamine urinary stuff, posted by utopizen on December 5, 2005, at 18:24:59
hi, i meant to message you sooner, because of your account of aricept helping you with expression, as that is a huge deficit of mine. :( but one thing that may be wierd thing that i read about aricept is that it may actually prevent acetylcholine binding to nicotinic receptors. i don't have much documentation of it, i just read it in "Tuning the Brain" by Jay. A. Goldstein, so it may be a piece of puzzling theoretical knowlege that doesn't translate into practice i am not sure, but it may be something worth looking into. i'm not even 100% sure what nicotinic receptors actually do, but i wonder if perhaps maybe the two ACh receptors can compete and make imbalance and alienate the other if one is stimulated too much? (i really have no idea.) but perhaps if maybe your current regimen of a very potent catecholaminergic amphetamine, an AChE inhibitor, and a muscarinc agonist could be leaving your nictonic receptors starved. (again i have no idea.)
i stopped taking aricept. i think it may have been making me feel worse initially (but again i could have been having a few of my bad nights), and after reading in jay a. goldsteins book i started to worry. (but really manily because of the 70 day half life that could screw things up if i wanted to get a brain scan likely needing weeks upon weeks of washout.)
sorry i wish i could think of something more helpful. i had urinary blocking due to desipramine once, and incontinece a few times that may have been tied to drugs (which could have been zoloft, mirapex, or just withdrawl effects from the desipramine, as i sure had other of those, i.e. massive overeating, and somlenence)...
about the prostate issue, if it is enlarged aren't you supposed to be able to feel it? like when you sit down and stuff and when their is pressure around the perineal area? or is that only in obvious cases, or something else entirely?
Posted by utopizen on December 7, 2005, at 10:19:19
In reply to does anyone know of competition between ACh-m n?, posted by iforgotmypassword on December 6, 2005, at 10:38:44
Okay, I take Psychopharmacology, and, have to do a presentation on the novel clinical applications (and by novel I also mean obscure) for the "Cognitive Enhancers" (Aricept, etc.)
All I have to say is...
I think you're over-thinking. And if I am saying that, that's... over-thinking.
So you're probably like me, and have obsessive thoughts. Aricept just makes things worse that way. If I was not on Klonopin 1mg 3/day, I wouldn't touch Aricept.
Aricept makes me more agitated, a bit manic in my thoughts racing and even made me so manic once at 10mg after a couple of weeks of that dose I had paranoia. It subsidied after a few days of wash-out, and I then returned to just 5mg/day.
Keep in mind the agitation is a combination of Aricept and Desoxyn both acting up.
As for Evoxac, there is a study on PubMed claiming it does act as a "neuroprotective." It seems to make sense, theoretically anyhow. Klonopin would certainly be a "neuroprotective," given it inhibits action potentials from over-firing. But don't sweat nonsense like that.
Nicotinic receptors are really not known for what the heck they do.
If we did know what nicotonic receptors do, Straterra might actually work. Biederman once was quoted in the press when he was experimenting with this drug, and claimed "We are finding that AD/HD appears to be affected by the nicotonic receptors."
Well, maybe for some, but I tried nicorette gum and all it did was make me nervous. I've smoked only to impress a hot girl a few times, and don't notice any effect whatsoever. I haven't tried Strattera, but my doctor smirks about it and said, "It's like Buspar for anxiety."
(That's like saying, anyone who thinks it works is getting a placebo effect).
We know that schitzophrenics like cigerettes a lot, but it's likely a combination of the cognitive impairment from the antipsychotics AND their schitzophrenia.
As for enlarged prostate, I have no idea what you mean. All I know is, when I haven't take Desoxyn, for like, 15 hours or so, I will notice my prostate is quite exagerrated, until I take Desoxyn again, which shrinks it quite a bit. Klonopin for some reason seems to help control the incontinence I've begun to experience, but the urinary retention is still there. All I know is, this is a long-term side effect of amphetamines for me. I did not get such drastic enlargement and shrinkage back when I started @ 18, yet I'm only 22 and this started a year ago.
I'll check into the book you're talking about, but keep in mind neuroscientists are wack jobs for the most part when they try to take their empirical findings and apply it to clinical implications.
M.D.'s don't actually listen to them, because they never seem to shut-up about "neurotoxicity" and are convinced one drug = one receptor. Atypical antipsychotics, for instance, affect about 12-15 different receptor sites. So, things aren't that simple. Ignore the stuff they talk about.
As for expression, I believe you need to also concern yourself with anxiety. No one types as pedantically as you or I without a bit of anxiety.
Writing prose and poetry has helped me ground myself, but whenever I type on this board, I find myself so anxious it's terrible. I tried to avoid this board often for that reason.
I advise starting a blog, and just free-writing what comes to mind: poetry, prose, news, whatever. It will get you into the habit of writing, so it kills writer's block.
Also, read books. It helps my writing style immensely, my articulation too.
I'm reading right now Paul Auster: Collected Prose. I think you'd find it fascinating. He's bound to win a Nobel Prize one day, I bet my cat on it.
> hi, i meant to message you sooner, because of your account of aricept helping you with expression, as that is a huge deficit of mine. :( but one thing that may be wierd thing that i read about aricept is that it may actually prevent acetylcholine binding to nicotinic receptors. i don't have much documentation of it, i just read it in "Tuning the Brain" by Jay. A. Goldstein, so it may be a piece of puzzling theoretical knowlege that doesn't translate into practice i am not sure, but it may be something worth looking into. i'm not even 100% sure what nicotinic receptors actually do, but i wonder if perhaps maybe the two ACh receptors can compete and make imbalance and alienate the other if one is stimulated too much? (i really have no idea.) but perhaps if maybe your current regimen of a very potent catecholaminergic amphetamine, an AChE inhibitor, and a muscarinc agonist could be leaving your nictonic receptors starved. (again i have no idea.)
>
> i stopped taking aricept. i think it may have been making me feel worse initially (but again i could have been having a few of my bad nights), and after reading in jay a. goldsteins book i started to worry. (but really manily because of the 70 day half life that could screw things up if i wanted to get a brain scan likely needing weeks upon weeks of washout.)
>
> sorry i wish i could think of something more helpful. i had urinary blocking due to desipramine once, and incontinece a few times that may have been tied to drugs (which could have been zoloft, mirapex, or just withdrawl effects from the desipramine, as i sure had other of those, i.e. massive overeating, and somlenence)...
>
> about the prostate issue, if it is enlarged aren't you supposed to be able to feel it? like when you sit down and stuff and when their is pressure around the perineal area? or is that only in obvious cases, or something else entirely?
This is the end of the thread.
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