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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 44. This is the beginning of the thread.
Posted by Phillipa on March 1, 2006, at 21:53:09
Please post here what med you like, what you take it for, what it does for your condition please stated it and what doseages. Thanks Phillipa
Posted by bipolarspectrum on March 1, 2006, at 21:55:53
In reply to I Like and Believe In This Med For Whatever Condit, posted by Phillipa on March 1, 2006, at 21:53:09
I vote for lithium,
lithium keeps me from crazy, non-stop tears (bipolar depression)... 1200mg/day with a blood level around 0.8... side effects are polydyspia and polyuria and cognitive cloud...
bps
Posted by RobertDavid on March 1, 2006, at 22:55:57
In reply to LITHIUM, posted by bipolarspectrum on March 1, 2006, at 21:55:53
I have to say klonopin. It's the only thing I've tried that has helped my social anxiety, though not perfect.
Posted by Meri-Tuuli on March 2, 2006, at 4:35:14
In reply to I Like and Believe In This Med For Whatever Condit, posted by Phillipa on March 1, 2006, at 21:53:09
.... all work good for me!
And maybe chronium too, although I'm always too scared to go above 200mcg/day.
Posted by john berk on March 2, 2006, at 7:59:33
In reply to Klonopin, posted by RobertDavid on March 1, 2006, at 22:55:57
I agree, Klonopin/Clonazepam is the only drug that has been totally reliable for me, even with some of my ocd symptoms. i wouldn't leave home without it...john
Posted by DanielJ on March 2, 2006, at 9:36:49
In reply to Re: Klonopin » RobertDavid, posted by john berk on March 2, 2006, at 7:59:33
I am putting this question in because my son was
given Klonopin 2 years ago and it made him sleep
and seemed addicting. The Zoloft he is taking now
is effective but has ugly side effect for him. Is
it possible he didn't take Klonopin long enough to
realize the benefits of this medication? I think he was on it for a month.
Posted by DanielJ on March 2, 2006, at 10:02:33
In reply to Re: Klonopin » RobertDavid, posted by john berk on March 2, 2006, at 7:59:33
I am putting this question in because my son was
given Klonopin 2 years ago and it made him sleep
and seemed addicting. The Zoloft he is taking now
is effective but has ugly side effect for him. Is
it possible he didn't take Klonopin long enough to
realize the benefits of this medication? I think he was on it for a month.
Posted by john berk on March 2, 2006, at 11:25:07
In reply to Re: Klonopin How Long before it works right?, posted by DanielJ on March 2, 2006, at 10:02:33
Hi, it didn't work at all for me for the first 2 weeks, was ready to go back to valium, but when it "kicked in" it really worked well, with my ocd it even made obsessive thoughts less intrusive.
I started at 1.5 mgs., 4 years later i am only on 2-2.5 a day, it does have addiction potential, but people like my cousin with epilepsy go as high as 20 mgs. sometimes.i have also read that it is nuero-protective, one doctor said of all his older patients on klonopin, none ever developed alzheimers or parkinsons disease. i dont know about that, but i highly recommend klonopin, although 2 mgs. would make you drowsy if taken all at once, best maybe at bedtime, that is when i take most of mine, only 0.5 during the day, with prozac...john
Posted by RobertDavid on March 2, 2006, at 16:45:08
In reply to Re: Klonopin How Long before it works right?, posted by DanielJ on March 2, 2006, at 9:36:49
> I am putting this question in because my son was
> given Klonopin 2 years ago and it made him sleep
> and seemed addicting. The Zoloft he is taking now
> is effective but has ugly side effect for him. Is
> it possible he didn't take Klonopin long enough to
> realize the benefits of this medication? I think he was on it for a month.Dosing is critical with benzo's like klonopin. If you don't take enough, it won't be effective. If you take to much, you'll have increased side effects such as sedation.
As I recall it took me a few weeks to feel it realling kicking in/working. I think most would agree that you need to start low and slowly increase to lessen the sedative side effects (which do diminish somewhat in time).
I take 2mgs of klonopin at night for generalized social anxiety. It seems the normal range I see in treating anxiety disorters is 1 to 4 mgs a day. Some take it all at night, particlarly when you take higher doses, some take most 75% at night and some split doses. I think it's just something that's trial and error to see what works.
As far as it's addictive properties (which I don't think is an accurate term), you just don't stop taking it cold turkey, you wean off it slowly.
Anyway, I hope that's of some help to you.
Posted by DanielJ on March 2, 2006, at 17:42:55
In reply to Re: Klonopin How Long before it works right? » DanielJ, posted by RobertDavid on March 2, 2006, at 16:45:08
I started looking through my sons med boxes from
2 yrs ago when he was taking Klonopin. It looks like
he was taking .25 mg wafers and I think this was
for panic attack (which turned out to be a difficulty in swallowing caused by Zypexa).
Pretty small amount but it might br the wafers are
for as needed application. Does that mean I can't compare the effects of the wafers to
Klonopin in tablet form?
Posted by RobertDavid on March 2, 2006, at 17:55:09
In reply to Re: Klonopin How Long before it works right?, posted by DanielJ on March 2, 2006, at 17:42:55
Are you sure klonopin came in wafers? I know that xanax has a wafer that you have to swallow as it's an extended release, but I don't think klonopin has one. Anyway, I either swallow it or let it disolve under my tounge. Sometimes I just chew them.
Posted by Chairman_MAO on March 2, 2006, at 20:11:18
In reply to I Like and Believe In This Med For Whatever Condit, posted by Phillipa on March 1, 2006, at 21:53:09
Not on it right at this moment but:
Nardil 1mg/kg: Dysthymia/atypical depression, social phobia: Among drugs marketed as such in the US, this is without a doubt the most robust antidepressant. Actually effective for anxiety!
buprenorphine sublingual 4mg qd-qid: Far and away the best pharmacological aid for addictive/compulsive beahvior. There is virtually no reason to ever subject someone to nalrexone because this exists. Can be calming and energizing at the same time. A good antidepressant (especially for those with mild-moderate chronic pain). I have a feeling this would also be good in panic disorder and perhaps even as a mood stabilizer.
d-amphetamine 20mg bid-tid: If you have problems concentrating, this can help. I don't get much of a mood lift from it, and I hate the appetite suppression. If I could take it with Nardil I would actually be fully functional. Probably going to end up forgoing it and getting back on phenelzine. Great for sexual function IN LOW DOSES.
Posted by yxibow on March 5, 2006, at 5:03:21
In reply to I Like and Believe In This Med For Whatever Condit, posted by Phillipa on March 1, 2006, at 21:53:09
> Please post here what med you like, what you take it for, what it does for your condition please stated it and what doseages. Thanks Phillipa
Let's see.. polypharmacy for a rare visual somatiform disorder. Looking at the medical card that I made to put in my wallet. Everyone should make one of these. You never know when a EMT tech or a surgeon will need it. Seriously.
Ambien -- probably used to it now, but keeps me from waking early I think. 20mg.
Aprazolam (Xanax) -- PRN for a "panic button" day. Helps with an extra stressful day even on top of the Valium. More immediate gratification.
Biperiden (Akineton) -- preferred anticholinergic for those rare days of necessity. More than about 1.5-2mg a day and can cause subclinical atropine toxicity. At this very moment also helps dry the mouth for a salivary awareness that is part of the entire somatiform spectrum that I had wished was gone long ago.
Cymbalta -- secondary depression. 90mg. Not enamoured of the electric shocks but it works for what it is worth.
Diazepam (Valium) -- high dose to fight my somatiform disorder which seems to encompass GABA and D2. 170mg for now. Used to take Klonopin -- Valium provides possibly greater anxiolytic relief. Trileptal makes it necessary to dose even higher because of P450
Gapapentin (Neurontin) - augments but does not work in itself, with the Diazepam. 3600mg.
Methocarbamol (Robaxin) - provides mild relief for a drug induced spasmotic condition I have. Its cousin Soma would be better but doc does not want to combine with high dose Diazepam. 3375mg. Higher and it creates a P450 serotonin syndrome situation.
Propranolol (Inderal) -- PRN. Provides relief for subclinical random serotonin syndrome and extreme drug induced hand shaking. Don't use it much these days. But it works -- at least 80mg at a time is required.
Seroquel -- do I love it, no, do I think about the possibility in the range of 1/4% per year or who knows of TD, no I dont like that, do I not like the intense morning sedation, no -- but I need it for its D2 action. Zyprexa would be better but it causes potential permanent pseudoparkinsonism in me. 950mg. Trileptal makes it necessary to dose even higher because of P450.
Trileptal -- still at a hovering position until possible liver tests for an extremely remote reason it could harm it. I dont think I'm at a clinical enough dose. So neutral. 300mg.
I think that covers the exaustive list. I'm sure I probably forgot yet another one.
Better living through chemistry?
Posted by SLS on March 5, 2006, at 14:27:34
In reply to Re: I Like and Believe In This Med For Whatever Co » Phillipa, posted by yxibow on March 5, 2006, at 5:03:21
That's quite a list.
I hope it affords you the relief you deserve.
- Scott
Posted by TylerJ on March 5, 2006, at 22:53:41
In reply to Re: I Like and Believe In This Med For Whatever Co » Phillipa, posted by Chairman_MAO on March 2, 2006, at 20:11:18
> Not on it right at this moment but:
>
> Nardil 1mg/kg: Dysthymia/atypical depression, social phobia: Among drugs marketed as such in the US, this is without a doubt the most robust antidepressant. Actually effective for anxiety!
>
> buprenorphine sublingual 4mg qd-qid: Far and away the best pharmacological aid for addictive/compulsive beahvior. There is virtually no reason to ever subject someone to nalrexone because this exists. Can be calming and energizing at the same time. A good antidepressant (especially for those with mild-moderate chronic pain). I have a feeling this would also be good in panic disorder and perhaps even as a mood stabilizer.
>
> d-amphetamine 20mg bid-tid: If you have problems concentrating, this can help. I don't get much of a mood lift from it, and I hate the appetite suppression. If I could take it with Nardil I would actually be fully functional. Probably going to end up forgoing it and getting back on phenelzine. Great for sexual function IN LOW DOSES.Do you like it as well as "The Old Nardil"? Chairman, what are the differences between the old and the new anyway? Most people here say the "New" is not nearly as good, and I know you are very well educated in meds/drugs..in other words I trust and value your opinion. I'm doing very well on Parnate myself, however I want to be maoi educated for possible future needs. Thank you.
Tyler
Posted by yxibow on March 6, 2006, at 3:29:19
In reply to Re: I Like and Believe In This Med For Whatever Co » yxibow, posted by SLS on March 5, 2006, at 14:27:34
> That's quite a list.
>
> I hope it affords you the relief you deserve.
>
>
> - ScottThank you -- I do too. Only through polypharmacy has my disorder gone way down in the past 4 years. Its still a hideous unexplainable thing like a piano falling on your head but that's life. I know I have genetic disposition to neurochemical imbalances.
Posted by deniseuk on March 6, 2006, at 11:30:56
In reply to I Like and Believe In This Med For Whatever Condit, posted by Phillipa on March 1, 2006, at 21:53:09
Zyprexa 10mg now and again.
Used to love prothiaden 75mg
then loved Seroxat 20mg.
Foolishly came off Seroxat, was fine for 3 years then another bout of depression this time no medication apart from Zyprexa at 10mg helped.
Regret coming off Seroxat as I believe it not only helped me but also protected me. Those ten years were the best years of my life. Hopefully they'll be more to come.
I feel as though I'm owed five years of some happiness as I have very few good memories now from the age of 35 to 40. Did I break a mirror?
Denise
Posted by Chairman_MAO on March 7, 2006, at 11:48:35
In reply to Re: I Like and Believe In This Med For Whatever Co » Chairman_MAO, posted by TylerJ on March 5, 2006, at 22:53:41
I have never used the original formulation, so I cannot offer an opinion. :(
My "gut feeling" as well as logical reasoning point to the same conclusion: that the "New Nardil" is probably slightly less potent than the "Old Nardil".
This is, however, NOT due to the tablet excipients or whatever else most of the conspiracy-theory proponents argue, but simply because the "New" version is a "branded generic" (a more prototypical example of an oxymoron is difficult to imagine). The "old" version was manufactured to "A" standards which call for no more than a 10% variation from the stated amount of active drug per tablet. The "new" version is manufactured to "AB" standards, which allow up to a 20% variation in dosage. Thus, someone who was taking 90mg +/- 9mg of the old is now taking 90mg +/- 18mg of the new. As the margin of error is now in excess of one tablet, the new formulation may be weaker for some individuals, especially those taking high dosages.The old version was NOT enterically coated, nor did it contain a different active ingredient. I am not a pharmacist, but I do not see how any of the excipients in either of the formulations could have enhanced bioavailability or changed the pharmacokinetics all that much. The reason the sulfate salt is used instead of phenelzine base is because the stomach is a polar environment, and the salt is non-polar. That way, most of the dose will make it beyond the stomach--whether it is in the old formulation, new formulation, a capsule, liquid, peanut butter sandwich, jello mold, etc.
I have yet to hear any arguments in favor of the "new" Nardil being radically different that make anything resembling a modicum of sense to me. If someone could offer me what they claim is a sound rationale for a radical difference in efficacy, I would hear it with an open mind and ears.
The maintainer of www.socialfear.com agrees with me, FWIW. The "new" Nardil for me has worked so well that I cannot imagine what a dramatically better effect would be.
Posted by TylerJ on March 7, 2006, at 12:10:23
In reply to Re: I Like and Believe In This Med For Whatever Co » TylerJ, posted by Chairman_MAO on March 7, 2006, at 11:48:35
Interesting. Do you use any augmentation agents with Nardil? How long has it been working for you? Thanks for the info. :)
Tyler
Posted by Chairman_MAO on March 7, 2006, at 13:05:52
In reply to Re: I Like and Believe In This Med For Whatever Co » Chairman_MAO, posted by TylerJ on March 7, 2006, at 12:10:23
Well recently I started it again at 60mg/day and am taking 20mg d-amphetamine bid-tid. Working better than I expected after only a week; I hope my doctor will go for it. I am going to try to feel it out to see if he will; if not I will order the NARdil from overseas or find some other way to get it and keep the amphetamine script. I cannot afford to see a specialist who is comfortable with prescribing these drugs together (even though it is far from unheard of), and I have wasted too much time on the med-go-round. My blood pressure is fine, I monitor my diet, and I have an emergency antihypertensive. Frankly I notice less of an effect from the amphetamine than when I am not on Nardil, even though the benefit is greater.
This combination is much better insofar as sexual problems are concerned as well (esp "sensitivity").
Posted by ed_uk on March 7, 2006, at 14:22:27
In reply to Re: I Like and Believe In This Med For Whatever Co » TylerJ, posted by Chairman_MAO on March 7, 2006, at 13:05:52
In my opinion, the hoopla surrounding the 'new' Nardil is having a powerful reverse placebo effect on patients ie. people respond to it less well because they have been told that it doesn't work. The power of suggestion is extremely strong.
Ed
Posted by Chairman_MAO on March 7, 2006, at 15:12:19
In reply to The 'new' Nardil » Chairman_MAO, posted by ed_uk on March 7, 2006, at 14:22:27
I agree. At times I was tempted to go beyond 1mg/kg/day or try bioavailability enhancing strategies in order to ensure that I got as much benefit as the "old" Nardil was supposed to give. However, too much MAO inhibition causes a drastic fall in dopamine synthesis, viz. a very high dose of phenelzine may provide as much benefit as not enough. I found I felt better at 1mg/kg "straight up". One problem I think people may have is not taking it tid-qid. The half-life is only 2-3 hours, and there is definitely an acute anxiolytic effect not related solely to MAO inhibition. Perhaps this has to do with the pharmacokinetics of its GABA-T-inhibiting metabolite or the formation thereof. I don't know.
Posted by forgetful mary on March 7, 2006, at 16:14:36
In reply to The 'new' Nardil » Chairman_MAO, posted by ed_uk on March 7, 2006, at 14:22:27
Really now??? Well if I had known that they changed it appreciably maybe I wouldn't have had MRI's and other brain scans prompted by symptoms caused by the new nardil. Only after discovering the NPAC site, after two years unaware that the drug was so different did I realize that the drug had even changed appreciably so your theory does appear to "go out the window" on that one. Because of that I mulled over life circumstances etc to try and figure out why I was so depressed despite my tried and true Nardil--That was my first mistake which I should have learned years ago have no impact on a biological cause. My symptoms occurred before I knew the changes had been made , (I gave no thought to the look of the pill believing it was inconsequential) Reading posts of other nardil users only recently learning of the drastic change in the medication I see many others have been suffering unknowingly as well and then come upon the site or info through other means, (apparently that placebo effect works even when you are clueless???) Are you possibly a Pfizer executive who would love to disavow any knowledge of their actions??? LOL
> In my opinion, the hoopla surrounding the 'new' Nardil is having a powerful reverse placebo effect on patients ie. people respond to it less well because they have been told that it doesn't work. The power of suggestion is extremely strong.
>
> Ed
Posted by ed_uk on March 7, 2006, at 16:18:38
In reply to Re: The 'new' Nardil » ed_uk, posted by Chairman_MAO on March 7, 2006, at 15:12:19
Hi Chairman
I've never heard of anyone benefitting from more than 90mg phenelzine per day (the recommended maximum dose). In contrast, a lot of people seem to need more than 60mg tranylcypromine (the recommended maximum dose). In the UK, the manufacturer of tranylcypromine cautions against using doses in excess of 30mg per day. This is very sad.
Ed
Posted by ed_uk on March 7, 2006, at 16:21:12
In reply to Re: The 'new' Nardil » ed_uk, posted by Chairman_MAO on March 7, 2006, at 15:12:19
PS. The UK manufacturer of phenelzine suggests that patients can only receive 90mg per day if they are in hospital. How silly.
Ed
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