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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by blueberry on November 15, 2006, at 18:15:21
I would like to know what your best short-term fast fixes are for depression. I keep a daily diary to keep track of what I took, what doses, what side effects, how good, etc. I searched my notes.
While stuck without a doctor and in deep depression with current meds not working, I have researched my daily med notes back through 2005 to see what worked and what didn't. I need to buy a little time.
Tyrosine...seemed to give pretty good antidepressant effects real fast, like in hours, but was super hard to get the dosing and scheduling right. I doubt it would work
longterm. Any supplements just seem to poop out a lot faster than anything else, at least in my experience.Taurine...was good for anxiety and seemed to supercharge the tyrosine. Doubtful of longterm results.
Xanax...gave me good antidepressant effects just about anytime I tried it, with low doses of .25mg at a time working the best. Getting off it was hard, but wasn't too bad, but then, I was never on it longer than 2 weeks.
Amisulpride...excellent, but fierce sexual side effects.
Adrafinil...good, but sexual side effects and explosive diarrhea.
And I came across several places in my notes where it said, "always remember 20mg prozac is better than 10mg". I've been on 10mg for months.
And generally speaking when I looked at monthly trends, 20mg prozac+5mg zyprexa was fair...I had comments like "I am not suffering from classical depression, but rather depression without sadness, no zeal, no joy, and there is some anxiety, but basically ok".
So I have some thinking to do. Just trying to buy some time for a new doc and hopefully stay out of the hospital.
Posted by Phillipa on November 15, 2006, at 18:32:28
In reply to Best Short Term Depression Fixes?, posted by blueberry on November 15, 2006, at 18:15:21
So you're saying you're thinking 20 of prozax with zyprexa maybe an option? I hope so for your sake. Love Phillipa
Posted by blueberry on November 15, 2006, at 20:47:35
In reply to Re: Best Short Term Depression Fixes? » blueberry, posted by Phillipa on November 15, 2006, at 18:32:28
> So you're saying you're thinking 20 of prozax with zyprexa maybe an option? I hope so for your sake. Love Phillipa
Hi Phillipa,
Yeah, I have been at 10mg prozac + 2.5mg zyprexa for months. My common sense says to get back to 20prozac+5zyprexa where I was in 2005. I was researching and actually the most common starting dose for zyprexa is 10mg. I've never even been as high as a common starting dose. The combo of the two meds, symbyax comes in 6zyprexa/25prozac or 12zyprexa/25prozac for starting doses.
Posted by Phillipa on November 15, 2006, at 21:04:05
In reply to Re: Best Short Term Depression Fixes? » Phillipa, posted by blueberry on November 15, 2006, at 20:47:35
I hate to put it like this but we've always seemed so similar in our inability to take the full dose of a med. Maybe I'll try to do it and just suffer through the start up effects. It's shorter than ll years. Love Phillipa
Posted by Lindenblüte on November 15, 2006, at 21:59:15
In reply to Re: Best Short Term Depression Fixes? » blueberry, posted by Phillipa on November 15, 2006, at 21:04:05
What's short-term to you, blueberry?
I have found ethanol to be an effective AD, acts very fast, but unfortunately poops out within an hour or so.
Last time I started getting a lot of breakthrough depression, I bumped up my cymbalta dose. I got a decent response at 60, a great response at 90, and then ... well, then I noticed more and more depressed days, so I increased cymbalta to 120. I noticed a striking difference within 48 hours. Really.
The good think about increasing the dosage of a med that you are already on is that the side effects are not so intense- AND you don't have to wait for an old drug to clear your system before you start this one.
I think I also had a good response to seroquel, 300mg. It stabilized everything, but the baseline to which it stabilized everything was mild-moderate depression. Seroquel has now been empirically demonstrated to be an effective AD for bipolar depression, acts fast. Search for BOLDER II study, I've posted about it before. I believe it, and I encourage you to give it a shot, particularly since you were considering whether you had bipolar depression recently?
best of luck to you blueberry- how's life? sometimes life can be a very good short-term depression fix. playing with a kitten. reading an inspirational story. calling an old friend. watching stupid movies.
laughing?
lol I wish
-Li
Posted by FredPotter on November 15, 2006, at 22:25:15
In reply to Re: Best Short Term Depression Fixes? » blueberry, posted by Phillipa on November 15, 2006, at 21:04:05
yes I found 5mg Zyprexa pretty heavy. It worked after a few days but only FOR a few days. Then my weight and blood sugar went up and I had to stop it anyway. Beware of Z if you have diabetic tendencies Fred
Posted by stargazer on November 15, 2006, at 23:12:00
In reply to Re: Best Short Term Depression Fixes?, posted by FredPotter on November 15, 2006, at 22:25:15
Blueberry
It sound like you have alot of options already. That one called amulpiside, or something like that, You say excellent but with sexual side effects. I wouldn't care about that if my depression went away. If you were just having ECT, you obviously were in dire straits so why omit that med at all? You can get the sexual stuff right later but for now you should focus on getting your depression under control.
Can that be obtained in the U.S. or only in Europe. I would love to get my hands on it. I have never had an excellent response to a med so I am so amazed that you wouldn't go with that again.
I was going to suggest seroquel if you are in a really bad way to just get you out of it. Not sure of the antidepressant effects though,I haven't been on it that long.
SG
Posted by med_empowered on November 16, 2006, at 4:34:46
In reply to Re: Best Short Term Depression Fixes?, posted by stargazer on November 15, 2006, at 23:12:00
maybe something more stimulating...wellbutrin, provigil, that sort of thing. Or up the prozac. You could try lamictal. You could switch out the zyprexa for abilify, which would mean less sedation and possibly more dopamine action, which would probably be a good thing...at lower-end doses it really is calming, but not very neuroleptic-ish; at higher doses, its pretty much just a very tolerable neuroleptic..nothing particularly special about it.
Buspar might help...it can calm you down a bit, and it also boosts the action of ssri drugs, so it might rev up the prozac.
adding a tricyclic might help..they're sedating and can be pretty bad in terms of side effects, but a low dose tca sometimes helps minimally responsive ssri treatments.
have you considered dopamine agonists? there's a slew of them now...they have definite side effects, but some of them also seem to help people with depression, and they can help with add-type symptoms in some people,too.
have you tried opiates? there's increasing interest in opiates for mood disorders and schizophrenia. The big one I think is Temgesic, but I've read articles where Ultram was used for some people.
if you opt to stay on zyprexa...maybe you could switch to the dissolving kind? or add in metformin? the dissolving kind usually causes fewer side effects and you'll need a lower dose; adding in metformin can help rectify the metabolic changes zyprexa tends to cause.
Good luck!
Posted by stargazer on November 16, 2006, at 7:17:34
In reply to Re: Best Short Term Depression Fixes?, posted by med_empowered on November 16, 2006, at 4:34:46
An amazing phlethora of drugs....where to start....is all of this info located someowhere on a spreadsheet to know for what symptoms, what to try? My doctor doesn't have anything like that or reference unless it's in his head, and I don't think it is.
Med E- are you a doctor, scientist or something else and who oversees your treatment? Is your depression under control now and are you like the rest of us always experimenting, getting relief for short periods, then experimenting again? At least it sounds like you know what you are doing? Can you prescribe for me? Only kidding, but you would probably make some progress in my 25+ years to get an answer that works for longer than a few months.
It seems alot of your suggestions are custom
preparations unlike what the pdocs, mine anyway would order...that is why I am trying to find a psychopharmacologist around here (CT in US)without any luck. SIGH......................
Posted by pseudoname on November 16, 2006, at 16:45:41
In reply to Best Short Term Depression Fixes?, posted by blueberry on November 15, 2006, at 18:15:21
> I would like to know what your best short-term fast fixes are for depression.
Like lindenblute says, it depends on what you mean by short-term, but FAST, I can advise a little on. Ritalin and Adderall both have provided immediate relief from my worst depressive states. They don't last more than several hours -- but sometimes that's all you need to get going again. Tolerance develops pretty quickly, though.
I agree with med_empowered about opioids. I've only really tried buprenorphine (Subutex®), but it works in about 90 minutes and usually provides relief from the worst troughs. It takes getting used to (there are serious opioid side effects at first). I have not yet noticed any tolerance to the benefit, which lasts me about 6 hours.
Blueberry, I'm really sorry you're not getting better sustained relief from the ECT, which was a mixed bag for you to say the least. I may go in for ECT next week. As I'm mentioning in another thread, it was your reports & suggestions that lead me to demand that they spread out the treatments, which they've so far agreed to do.
Posted by blueberry on November 16, 2006, at 20:24:47
In reply to Re: Best Short Term Depression Fixes?, posted by stargazer on November 15, 2006, at 23:12:00
Amisulpride is fairly easy to get. There are overseas pharmacies on the web that sell it without a prescription. Years ago it was harder to get, but these days it is easier. Just type in a google search something like "amisulpride no prescription" or change the word amisulpride to deniban or solian. Overseas it is more commonly called deniban or solian.
I am willing to make lots of trades in life to get a little better, but sex isn't one of them.
Posted by stargazer on November 17, 2006, at 10:21:17
In reply to Re: Best Short Term Depression Fixes? » stargazer, posted by blueberry on November 16, 2006, at 20:24:47
Everone's priorities are different and I can understand that. Good luck with your situation...SG
Posted by Jost on November 17, 2006, at 23:34:33
In reply to Re: Best Short Term Depression Fixes? » Phillipa, posted by blueberry on November 15, 2006, at 20:47:35
Have you tried provigil (modafinil)?
It's not the most powerful drug, but it's pretty effective and few downsides.
It helps energy, mood, concentration. It helped me when I was in a pretty deep depression--didn't make me not depressed, but really helped me keep going, even if it was tough-- I'd recommend that.
Jost
Posted by Jost on November 17, 2006, at 23:37:09
In reply to Re: Best Short Term Depression Fixes?, posted by Jost on November 17, 2006, at 23:34:33
I noticed you had some problems with adrafinil. Don't know if modafinil would affect you in the same way, since it's a metabolite of adrafinil--
but adrafinil didn't affect me at all- and modafinil helped, so they are at least somewhat significantly different.
Jost
Posted by Caedmon on November 19, 2006, at 7:49:11
In reply to Best Short Term Depression Fixes?, posted by blueberry on November 15, 2006, at 18:15:21
For me, partial sleep deprivation combined with light therapy works wonders. Within hours, my depression is 40-80% reduced. (If I were to estimate a percent reduction.)
Not a good idea for everyone, but it does work for me.
I've worked around the rebound issue by gradually advancing the time to wake by 1 hour or less each morning (i.e. if I had to wake at 3:00 that first morning, I wake up at 4, 5, and then 6 on subsequent mornings). Hope that makes sense.
- Chris
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