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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by SLS on March 27, 2008, at 4:52:52
I know two people who experienced a dramatic improvement upon the addition of Deplin to Nardil after Nardil poop-out. One of these people is me.
I don't offer any conjectures as to why it works. It really doesn't matter, anyway. Since Deplin has very few side effects (dreaming, flatulence), and its being presumed safe, I think it is worth a 2-3 month trial. It can take that long to work. It took about 6 weeks for me. Interestingly, I experienced a brief (1 day) improvement during the first week. Perhaps this observation extends to others. It might prognosticate that a good response will occur later.
- Scott
Posted by Phillipa on March 27, 2008, at 9:50:34
In reply to MAOI + Deplin - A special combination ?, posted by SLS on March 27, 2008, at 4:52:52
Scott but does it only work with MAOI's Not luvox? Phillipa
Posted by Maxime on March 27, 2008, at 18:46:38
In reply to Re: MAOI + Deplin - A special combination ? » SLS, posted by Phillipa on March 27, 2008, at 9:50:34
> Scott but does it only work with MAOI's Not luvox? Phillipa
He stayed on it for 6 weeks! How long did you stay on it?
maxime
Posted by Phillipa on March 27, 2008, at 21:09:29
In reply to Re: MAOI + Deplin - A special combination ? » Phillipa, posted by Maxime on March 27, 2008, at 18:46:38
As long as my pdoc said to take it. I would like to know if it only works with an MAOI. Especially luvox. As I'm on that med. Thanks for asking Phillipa
Posted by brooke484 on March 27, 2008, at 21:45:58
In reply to MAOI + Deplin - A special combination ?, posted by SLS on March 27, 2008, at 4:52:52
I tried it for 4 weeks with Marplan and nothing happened except for vivid dreams. I told my doctor I wasn't taking it anymore because of the price, so on Tues he gave me 6 weeks worth of samples. I guess I'm trying it again (with 30 mgs of Marplan and 600 mgs of Lithium). Hope something happens this time.
Glad it worked for you.
brooke
Posted by SLS on March 28, 2008, at 5:21:39
In reply to Re: MAOI + Deplin - A special combination ? » SLS, posted by Phillipa on March 27, 2008, at 9:50:34
> Scott but does it only work with MAOI's Not luvox? Phillipa
Dear Phillipa,
I doubt anything will work for you in combination with Luvox.
There are investigators who believe Deplin works for SSRI augmentation as well as antidepressants from other groups. The truth is, there is not enough clinical experience with Deplin to be able to infer its therapeutic value.
- Scott
Posted by Glydin on March 28, 2008, at 7:27:46
In reply to Re: MAOI + Deplin - A special combination ?, posted by SLS on March 28, 2008, at 5:21:39
> > The truth is, there is not enough clinical experience with Deplin to be able to infer its therapeutic value.
>~~~ That said, the Scott-empirical findings are a delight to hear and very very well deserved. I am so very happy for you. I'm sending you a standing ovation to your "never stop trying..." spirit.
My hope is all will just get better and better for you.
Posted by Phillipa on March 28, 2008, at 11:34:09
In reply to Re: MAOI + Deplin - A special combination ?, posted by SLS on March 28, 2008, at 5:21:39
Scott I wonder why my pdoc prescribed it for me. Oh course she said she really didn't know what it did as the drug rep had just given her samples and she gave me the first one and a script for four weeks.
Glad to hear it works for you and may it continue to. Phillipa
Posted by kezia on March 28, 2008, at 12:56:18
In reply to Re: MAOI + Deplin - A special combination ? » SLS, posted by Phillipa on March 28, 2008, at 11:34:09
I thought you asked your doctor for it after reading about it here ???? Regardless, eventually, you have to bite the bullet, try a new med and give it an adequate trial at a therapeutic dose (and 2 weeks is not an adequate trial, frankly). Yes, the initial side effects can be scary, demoralizing and, at times, incapacitating during the start up phase, but if you don't endeavour and endure during the uncomfortable start up phase, you will never be in a position to find relief and start down the path of full recovery and putting your life back in order. It's as simple as that. There comes a point when you have to stop researching a med ad nauseum and try it. Everyone on this board could spend months and months and months reading and re-reading, questioning and re-questioning the adverse effects and benefits of a particular med, but, what it comes down it is individual experience. Harry may react badly to a particular med and reap no benefit from it, while Sally will achieve remission. There is an expression, crude as it may be - Sh*t or get off the pot!
> Scott I wonder why my pdoc prescribed it for me. Oh course she said she really didn't know what it did as the drug rep had just given her samples and she gave me the first one and a script for four weeks.
>
> Glad to hear it works for you and may it continue to. Phillipa
Posted by SLS on March 28, 2008, at 14:27:15
In reply to Re: MAOI + Deplin - A special combination ? » SLS, posted by Glydin on March 28, 2008, at 7:27:46
Gosh. Thanks for the warm and fuzzy affirmations. It has been a very, very long and painful road for me. It is a scary feeling that I am first awakening at age 48. I will experience a grieving process for the 3 decades of my life that were stolen from me. No matter. Getting well at all is a miracle. I could have gone the rest of my life never having known such a wonderful existence.
I am mostly guarded in my enthusiasm for the persistence of my treatment response. I'm still looking over my shoulder to see if the beast is still chasing me. Adding Deplin has certainly made a difference in augmenting my inadequate response to the other 4 drugs I'm taking, but I am scared it might not keep working. I suppose that is a fear that many of us will deal with.
Thanks again.
- Scott
-------------------------------------------------> > > The truth is, there is not enough clinical experience with Deplin to be able to infer its therapeutic value.
> >
>
> ~~~ That said, the Scott-empirical findings are a delight to hear and very very well deserved. I am so very happy for you. I'm sending you a standing ovation to your "never stop trying..." spirit.
>
> My hope is all will just get better and better for you.
Posted by SLS on March 28, 2008, at 14:49:08
In reply to Re: MAOI + Deplin - A special combination ? » Phillipa, posted by kezia on March 28, 2008, at 12:56:18
> I thought you asked your doctor for it after reading about it here ???? Regardless, eventually, you have to bite the bullet, try a new med and give it an adequate trial at a therapeutic dose (and 2 weeks is not an adequate trial, frankly).
An adequate trial for Deplin is at least 2 months.
> There comes a point when you have to stop researching a med ad nauseum and try it. Everyone on this board could spend months and months and months reading and re-reading, questioning and re-questioning the adverse effects and benefits of a particular med, but, what it comes down it is individual experience.
Great point.
I would like to reiterate that we here at Psycho-Babble do not know nor understand more than the neuroscientists and clinical investigators. For the most part, it is folly to assume enough of an understanding of the workings of the brain and the drugs that act on it, so as to presume to predict the clinical benefits any one person will glean from a particular drug.
The inability to predict with meaningful consistency the therapeutic efficacy and adverse effects of drugs on the individual is seen on a regular basis on Psycho-Babble.
We at PB are only marginally better than one being blind-folded, spun around, and asked to hit
the piñata with one swing using a toothpick.Doctors with the best track records are those whom are smart enough to pay attention to the subtleties of each case and draw associations from what is observed. They also pay attention to the medical literature to glean a clinical advantage by reading the work of others.
I guess the bottom line is that most of us posting on Psycho-Babble are less qualified to deduce the behaviors of people and the drugs used to treat them than what the frontiers of medicine have yet to establish.
- Scott
Posted by Maxime on March 28, 2008, at 15:27:32
In reply to Re: MAOI + Deplin - A special combination ? » Phillipa, posted by kezia on March 28, 2008, at 12:56:18
You are right on! And people can write about their experiences, but yours may not be the same. Also, I would never stop or try a med based on what people write here. You just have to try it and for longer than a couple of weeks. You have to put up with side effects because meds have side effects.
So tired of seeing the same questions all the time here.
Maxime
Posted by Phillipa on March 28, 2008, at 19:58:15
In reply to Re: MAOI + Deplin - A special combination ? » Phillipa, posted by kezia on March 28, 2008, at 12:56:18
No fear at all from Deplin and no side effects when on it. I'm a health food nut so it intrigues me. Phillipa No MAOI"S though. I know we react different and I'm wishing Scott well. If my pdoc decides she wants me on something else will try it but she is a fan of luvox in low doses. Phillipa
Posted by bulldog2 on March 30, 2008, at 17:20:06
In reply to Re: MAOI + Deplin - A special combination ?, posted by SLS on March 28, 2008, at 5:21:39
> > Scott but does it only work with MAOI's Not luvox? Phillipa
>
> Dear Phillipa,
>
> I doubt anything will work for you in combination with Luvox.
>
> There are investigators who believe Deplin works for SSRI augmentation as well as antidepressants from other groups. The truth is, there is not enough clinical experience with Deplin to be able to infer its therapeutic value.
>
>
> - ScottAny reason you believe Deplin would not work with Luvox?
Posted by SLS on March 30, 2008, at 18:12:44
In reply to to Scott about deplin and luvox, posted by bulldog2 on March 30, 2008, at 17:20:06
> > > Scott but does it only work with MAOI's Not luvox? Phillipa
> >
> > Dear Phillipa,
> >
> > I doubt anything will work for you in combination with Luvox.
> >
> > There are investigators who believe Deplin works for SSRI augmentation as well as antidepressants from other groups. The truth is, there is not enough clinical experience with Deplin to be able to infer its therapeutic value.
> >
> >
> > - Scott
>
> Any reason you believe Deplin would not work with Luvox?Nope.
I would love to see Deplin work as an effective augmenter to all standard antidepressants. However, so far, there haven't been enough success stories to be able to draw many inferences. The manufacturer of Deplin claims that it will increase the synthesis of NE, DA, and 5-HT by providing folate to participate in the enzymatic cycles. I think it accelerates the rate limiting steps by activating tyrosine hydroxylase and tryptophan hydroxylase. One could hypothesize that an MAOI would work additively to Deplin to increase the pool of available neurotransmitter for release.
For Phillipa, however, it doesn't seem that there is enough of an antidepressant response to Luvox to augment with Deplin. I guess I am just frustrated that she still be ill after all this time. If I were her, I would continue with Deplin for 2 - 3 months and swap out Luvox for Nardil should the former treatment prove inadequate.
- Scott
Posted by Phillipa on March 30, 2008, at 19:59:08
In reply to Re: to Scott about deplin and luvox » bulldog2, posted by SLS on March 30, 2008, at 18:12:44
Scott for some reason my body won't let go of luvox and the pdoc says to stick with it and laughs at MAOI's. And she works with them. According to the Deplin site it increases all three neurotransmitters and in my case maybe that's enough? As I did have the good results on day three. Phillipa. let's just say she still has one paatient on an Maoi. So not starting anyone new.
Posted by Phillipa on March 30, 2008, at 21:09:28
In reply to Re: to Scott about deplin and luvox » SLS, posted by Phillipa on March 30, 2008, at 19:59:08
Scott another comment about luvox. Seems saw another pdoc here last summer that wanted a baseline and took me off luvox and put me on very high doses of benzos 6mg first of xanax long acting then when I didn't sleep at all he changed to 8mg of ativan. I only took 6mg as the dose was so high. Didn't sleep another week. Ended up in ER. ER doc called the head psch doc at the uptown hospital branch and came back and said their consultation both had decided there was something in luvox that my brain needed and was advised to go back on the luvox and low dose of valium. And low and behold sleeping again. And Deplin is a med I feel holds promise for me. According to the ER the autoimmune thyroid flutuating nature of my thyroid and chronic lymes could have some impact on that will never know. Even years ago a pdoc in another place had me on 2.5mg of paxil and 7.5mg of luvox with low dose xanax. Many drug trials undisclosed on this site. Including addition of T3. So my whole life of meds is not on this board. Nor will it ever be. So in a way I find it negative to say that luvox and deplin will not work for me . As you said psychiatry and the workings of the brain are in it's infancy. So after about l0 pdocs and many moves will stick with present meds and probably depending on what the pdoc says either add back Deplin or can it. Thanks for hearing me. Phillipa
Posted by SLS on March 30, 2008, at 21:35:38
In reply to Re: to Scott about deplin and luvox » SLS, posted by Phillipa on March 30, 2008, at 19:59:08
> As I did have the good results on day three.
Now THAT is encouraging. I felt a brief improvement on day 3 also. Bear in mind that the drug representatives counseled my doctor and indicated a waiting period of 2-3 months is necessary with Deplin treatment. Your improvement on day 3 is what I like to call a positive "blip" and might be a prognosticator of a robust response later. I do hope it works for you.
How long have you been taking Deplin for?
- Scott
Posted by Phillipa on March 31, 2008, at 10:38:58
In reply to Re: to Scott about deplin and luvox » Phillipa, posted by SLS on March 30, 2008, at 21:35:38
Scott after two weeks and surgery was coming up and the possible masking of B12 deficiency I stopped and still have the two weeks left as haven't seen the pdoc since. And seems no matter how many number we call no pdocs taking medicaire. I also think I need a good one and they are full after calls. And some only take cash low on this end. A therapist said it's always been like that here. I could start it again and see what happens. After reading their web-site again I saw that it riased all neurotramsmitters. And unfortunately my pdoc had only seen the drug rep the day before and really knew nothing at all. She gave me one pill as the rep only gave her one box and only one brochure on the med which she kept to read herself. Thanks for your understanding. Phillipa
Posted by Racer on April 11, 2008, at 10:07:37
In reply to MAOI + Deplin - A special combination ?, posted by SLS on March 27, 2008, at 4:52:52
Another option to consider is Metan-X. It's another methylfolate "medical food," but it contains a lower dose of methylfolate, with the addition of pyridoxal 5'-phosphate and methylcobalamin. It's being marketed for diabetes management and vascular health, but my pdoc prescribed it when he suggested (ie: prescribed an OTC substance) I start SAMe, to normalize homocysteine levels. I've taken it for some time now, and can't say whether it helps or not, but it certainly hasn't hurt.
The other benefit is that it is much less expensive than Deplin, and may be a more accessible choice for those without prescription drug coverage.
Hope that helps someone out there.
This is the end of the thread.
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