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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 105. Go back in thread:
Posted by SLS on August 6, 2006, at 8:13:03
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » SLS, posted by Maximus on August 5, 2006, at 18:10:10
Hi.
> Wow, another drug! I think this will be the one you have been looking for a while, i hope so. I think being on Meridia feels like being on a huge dose of Effexor. Give it a good trial.
Thanks for the well-wishes.
> On what do you attribute your "ultra-resistance" to treatment, if you don't mind?
Some very efficient negative feedback loop that serves to maintain an errant homeostasis. I just don't know where the mechanism lies that facilitates this process. I used to think that it was a presynaptic thing, but it happens so fast. My system will adapt within three days of responding to medication. I'm not sure what to think. Got any ideas?
- Scott
Posted by Maximus on August 6, 2006, at 13:13:49
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » Maximus, posted by SLS on August 6, 2006, at 8:13:03
> Some very efficient negative feedback loop that serves to maintain an errant homeostasis. I just don't know where the mechanism lies that facilitates this process. I used to think that it was a presynaptic thing, but it happens so fast. My system will adapt within three days of responding to medication. I'm not sure what to think. Got any ideas?
Do you have a good environment without too much stress?
For the medication, i'm not sure. The thing is you have already taken some extra powerful and very clever combination of meds. Personally i would ask for some Lithium, on top of all your current meds.
I'm "fascinating" by your perseverance. Don't stop buddy! Bye.
Posted by ed_uk on August 7, 2006, at 13:37:57
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow., posted by SLS on August 4, 2006, at 22:03:09
Hi Scott
Why did you decide that you will increase your sibutramine dose from 10mg to 20mg, when 15mg is the usual maximum dose?
Hope the sibutramine helps :) It seems like quite a 'stimulating' drug.
Ed
Posted by SLS on August 7, 2006, at 19:47:41
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » SLS, posted by ed_uk on August 7, 2006, at 13:37:57
> Hi Scott
>
> Why did you decide that you will increase your sibutramine dose from 10mg to 20mg, when 15mg is the usual maximum dose?
>
> Hope the sibutramine helps :) It seems like quite a 'stimulating' drug.If I can tolerate it, why not? There really is no guideline for depression. I don't want to waste time being a guinea pig on some dosage finding mission. If it works, I can try reducing it later. Peter Mueller, MD has used 20mg for his patients with fibromyalgia and various CNS disorders. They seem to do well with it. We'll see how I tolerate the 10mg first.
- Scott
Posted by Phillipa on August 7, 2006, at 20:41:54
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » ed_uk, posted by SLS on August 7, 2006, at 19:47:41
Scott you sound so determined and strong. I know it will work. You deserve it with all you've been through. Love Jan
Posted by theo on August 8, 2006, at 9:54:55
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow., posted by SLS on August 4, 2006, at 22:03:09
> I have the type of bipolar disorder where you are depressed all of the time except for the rare occasion when a drug provokes a manic reaction. At one point, this was to be named Bipolar III. Now, I don't know what it is to be named in the new classification scheme.
>
>
> - ScottWow, sounds like me. By the way, I noticed in your cocktail, no more Keppra? Did you find it not doing much?
How's the Meridia?
Posted by SLS on August 8, 2006, at 10:03:15
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » SLS, posted by theo on August 8, 2006, at 9:54:55
> > I have the type of bipolar disorder where you are depressed all of the time except for the rare occasion when a drug provokes a manic reaction. At one point, this was to be named Bipolar III. Now, I don't know what it is to be named in the new classification scheme.
> >
> >
> > - Scott
>
> Wow, sounds like me. By the way, I noticed in your cocktail, no more Keppra? Did you find it not doing much?Keppra is a funny drug. I found that it actually made my depression noticeably worse at higher dosages. At lower dosages, I was experiencing diminishing returns, so I decided it wasn't worth taking anymore.
> How's the Meridia?Nothing yet. Today is day 4. I can't feel anything at all. No side effects. I'll probably stay at 10mg for a few more days.
- Scott
Posted by ed_uk on August 8, 2006, at 15:16:50
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » ed_uk, posted by SLS on August 7, 2006, at 19:47:41
Hi Scott
Let us know how it helps :)
Ed
Posted by SLS on August 9, 2006, at 20:23:23
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » SLS, posted by ed_uk on August 8, 2006, at 15:16:50
5 days @ 10mg
So far, so good. That means I don't feel any worse, and I'm not experiencing any significant side effects.
I have noticed a bit of spaciness and more difficulty concentrating when reading.
My appetite has actually increased rather than decreased.
I noticed that I am urinating more without having increased my fluid intake. I believe this is an indicator of fat mobilization (lipolysis). I hope so. I could afford to lose a bit of weight.
So that's about it.
Currently:
nortripyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 10mg
- Scott
Posted by Phillipa on August 9, 2006, at 20:26:32
In reply to Re: Sibutramine (Meridia) - Day 5, posted by SLS on August 9, 2006, at 20:23:23
Scott I'm exited for you!!!!!Love Phillipa
Posted by SLS on August 9, 2006, at 20:53:18
In reply to Re: Sibutramine (Meridia) - Day 5 » SLS, posted by Phillipa on August 9, 2006, at 20:26:32
> Scott I'm exited for you!!!!!Love Phillipa
Thanks.
:-)
- Scott
Posted by SLS on August 11, 2006, at 6:27:52
In reply to Re: Sibutramine (Meridia) - Day 5, posted by SLS on August 9, 2006, at 20:23:23
6 days @ 10mg
I am experiencing some dysphoria that I attribute to the sibutramine. It is not a normal feature of my depression. There is also a sort of "muddiness" to the way I am feeling. I don't like it. Hopefully, it will pass. I will probably increase the dosage to 20mg tomorrow.
Currently:
nortripyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 10mg
- Scott
Posted by ed_uk on August 11, 2006, at 13:29:34
In reply to Re: Sibutramine (Meridia) - Day 6, posted by SLS on August 11, 2006, at 6:27:52
Hi Scott
>I will probably increase the dosage to 20mg tomorrow.
Why Scott? If you think you're having side effects it might be best not to increase the dose.
Regards
Ed
Posted by SLS on August 11, 2006, at 14:13:54
In reply to Re: Sibutramine (Meridia) - Day 6 » SLS, posted by ed_uk on August 11, 2006, at 13:29:34
> > I will probably increase the dosage to 20mg tomorrow.
> Why Scott? If you think you're having side effects it might be best not to increase the dose.
I guess I'm just being impatient. I was hoping to be at 20mg for two weeks before my next doctor's visit. I am doing better today. I'm not sure what I'll do yet.
Thanks for your concern.
What's up with you? Things still going OK? How's work?
- Scott
Posted by SLS on August 11, 2006, at 23:44:00
In reply to Re: Sibutramine (Meridia) - Day 6, posted by SLS on August 11, 2006, at 6:27:52
7 days @ 10mg
I continue to experience some dysphoria. However, it is not as acute today as it was yesterday. I will wait until tomorrow to increase the dosage to 20mg.
Currently:
nortripyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 10mg
- Scott
Posted by SLS on August 13, 2006, at 7:57:01
In reply to Re: Sibutramine (Meridia) - Day 7, posted by SLS on August 11, 2006, at 23:44:00
7 days @ 10mg
1 days @ 20mgI took the second daily dose of sibutramine last night for a total of 20mg for the day. I am experiencing an increase in dysphoria and anergia this morning. I'm not too happy about this. I am quickly losing hope that this drug will prove effective for me. I'm not giving up just yet, though.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg
- Scott
Posted by Racer on August 13, 2006, at 12:31:47
In reply to Re: Sibutramine (Meridia) - Day 8, posted by SLS on August 13, 2006, at 7:57:01
Scott, I know you have a history of responding for a couple of days, only to lose the response. Have you ever had it the other way around? That you feel worse for a few days as you titrate up, but get a better response later in treatment? Do you think there's a chance of such a thing happening this time around?
You know I'm really pulling for you on this one, and you know why, so I admit freely that I'm biassed in favor of giving it a good chance...
Still, I'm sorry you're not having a great ride. I hope it gets better.
Remind me again: have you ever had a good response that lasted for any length of time?
xoxo
Posted by SLS on August 13, 2006, at 13:10:29
In reply to Re: Sibutramine (Meridia) - Day 8 » SLS, posted by Racer on August 13, 2006, at 12:31:47
> Scott, I know you have a history of responding for a couple of days, only to lose the response. Have you ever had it the other way around? That you feel worse for a few days as you titrate up, but get a better response later in treatment?
Actually, my most recent trial of Wellbutrin followed that sort of pattern. It produced some mild dysphoria for about a week before I responded well to it.
> Do you think there's a chance of such a thing happening this time around?
Yes. I have this very silly little piece of brain tissue that always thinks there's a chance of something good happening. After all this time, I don't know why.
> You know I'm really pulling for you on this one, and you know why, so I admit freely that I'm biassed in favor of giving it a good chance...
Much of the dysphoria that I experienced this morning seems to have passed. There is still a little there, but that I am not feeling worse is a good thing.
> Still, I'm sorry you're not having a great ride. I hope it gets better.
Thanks.
> Remind me again: have you ever had a good response that lasted for any length of time?Yes. In 1987, at age 27, a combination of Parnate 60mg and desipramine 150mg produced a complete remission that lasted six months until the drugs were discontinued due to the appearance of mania. After being without medication for two months, I relapsed into depression. Without getting into the particulars of what transpired subsequently, I no longer respond to the same combination.
- Scott
Posted by ed_uk on August 14, 2006, at 15:34:33
In reply to Re: Sibutramine (Meridia) - Day 8 » Racer, posted by SLS on August 13, 2006, at 13:10:29
Hi Scott
Do you feel worse on 20mg than you did on 10mg?
Ed
Posted by SLS on August 14, 2006, at 20:02:49
In reply to Re: Sibutramine (Meridia) - Day 8, posted by SLS on August 13, 2006, at 7:57:01
7 days @ 10mg
2 days @ 20mg
I am experiencing less dysphoria today. There is a certain "muddiness" to the way I feel, but I believe this will pass. I thought I felt a little brighter first thing in the morning. It was encouraging.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg
- Scott
Posted by Phillipa on August 14, 2006, at 20:15:53
In reply to Re: Sibutramine (Meridia) - Day 9, posted by SLS on August 14, 2006, at 20:02:49
Go Scott!!!!!! Prove the meds can work . I'm routing for you. Go Go you can do it!!!!!Love Phillipa
Posted by TJO on August 15, 2006, at 6:04:08
In reply to Re: Sibutramine (Meridia) - Day 9 » SLS, posted by Phillipa on August 14, 2006, at 20:15:53
Hi Scott,
I'll keep my fingers crossed that this is the right drug for you, and the brightness in the am continues. You really deserve to get well! :-).Love, Tam
Posted by ed_uk on August 15, 2006, at 14:23:28
In reply to Re: Sibutramine (Meridia) - Day 9, posted by SLS on August 14, 2006, at 20:02:49
Hi Scott
Do you think there is any reason to continue the Topamax? I got the impression that it wasn't really helping. I wonder whether you could reduce your nortriptyline dose......with sibutramine being an SNRI.
Ed
Posted by SLS on August 15, 2006, at 15:28:40
In reply to Re: Sibutramine (Meridia) - Day 9 » SLS, posted by ed_uk on August 15, 2006, at 14:23:28
> Hi Scott
>
> Do you think there is any reason to continue the Topamax? I got the impression that it wasn't really helping.It seems that Topamax provides me with a bit more mental energy. I can get a few more things done while taking it. Right now, it is difficult to say whether or not it is still helping, but I think it is worth continuing with until I complete the trial of sibutramine.
> I wonder whether you could reduce your nortriptyline dose......with sibutramine being an SNRI.
I'm pretty sure that thought had entered my doctor's mind. However, without really knowing for sure how nortriptyline performs its role, I think we were both reluctant to reduce its dosage. What adverse effects might you expect from this combination?
Thanks, Ed.
- Scott
Posted by SLS on August 15, 2006, at 18:19:19
In reply to Re: Sibutramine (Meridia) - Day 9, posted by SLS on August 14, 2006, at 20:02:49
7 days @ 10mg
3 days @ 20mg
I am experiencing little, if any, drug-induced dysphoria today.It is difficult for me to evaluate how the sibutramine is affecting me otherwise. I had a very stressful day dealing with emotional issues, so there has been some sadness and anxiety to deal with. I think there is still a muddy feeling, but it seems to be disappearing.
Overall, I cannot report any improvement in depression.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg
- Scott
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