![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 17 to 41 of 41. Go back in thread:
Posted by Enigma on April 18, 2009, at 11:13:27
In reply to Re: Remeron for treatment resistant depression..., posted by Zana on April 17, 2009, at 21:38:09
> I know how you feel having been on the med not so merry-go-round for 20 years. I bombed out on every AD known to man but have been getting some relief from Pristiq. Effexor was terrible, Pristiq seems to be helping so far.
> I am also on Remeron for sleep. Did nothing for my depression but is a great sleep aid. My pdoc wants me off it since she thinks it is causing anxiety. I want off the seroquel since I think it is the culprit. We'll see. I haven't gained weight on the seroquel yet but I stuff myself full of vegetables to avoid stuffing myself full of real food.
> Don't give up hope. There's a new combination of something that will help. Get a psychopharm consult, new eyes... Do you have a therapist, someone you can really talk to? I really understand feeling like a depressed life is not worth living. Keep fighting, when you can, to get help.
> And let us know how it goes.
>
> ZanaPristiq eh, I looked that one up after seeing it on a pen at the doc's office and man, talk a about a swooping list of side-effects. It's almost as bad as an MAOI. It doesn't to be mixed with a large with of rx and otc meds either. That one reminds me of Cymbalta, that sent me flying off to the E.R. (suicide watch). Must be really expensive to0 and I'm right near my Medicare coverage gap, so even if I wasn't terrified to take it, I couldn't afford it anyway.
I guess my doc could sample me for a while since it's so new. I don't know. I'm done with the whole lab rate thing.No therapist right now. They don't help me much. I feel like they talk to me like I'm a 5 year old. No thanks.
>I really understand feeling like a depressed life is not worth living.
Nothing is worth this. If I wouldn't leave my family in poverty, I would have nuked myself long ago. I have no blood-family in this country that I care about, nothing binds me here. Already lost the job and friends years ago. I'm a timebomb ticking away. Each day I get closer to flipping a same-sided coin and just calling it out for amusement sake. Game over man.
Posted by Enigma on April 18, 2009, at 11:18:34
In reply to Re: Remeron for treatment resistant depression... » Enigma, posted by Sigismund on April 17, 2009, at 21:49:33
> Why would you give up Nardil because of the side effects to take up Remeron?
>
> At least Nardil works.
>
> Agomelatine would, I imagine, do everything Remeron does?? (when it comes to a place near you)Because I couldn't stand the side-effects of Nardil anymore.. like not being able to sleep... that was a big one. AND, the doc said Remeron (I asked) would be just as good as an AD as Nardil.
Nardil only worked as a 5/10 as an AD anyway. NO AD every got be back to normal or even close.
Posted by johnj1 on April 18, 2009, at 21:26:01
In reply to Re: Remeron for treatment resistant depression..., posted by sowhysosad on April 17, 2009, at 22:47:46
Probably because it knocks them out and makes them easier to deal with. Remeron also made me angry a lot. I remember blowing up so many times over nothing.
Posted by sowhysosad on April 19, 2009, at 10:22:53
In reply to Re: Remeron for treatment resistant depression..., posted by johnj1 on April 18, 2009, at 21:26:01
> Remeron also made me angry a lot. I remember blowing up so many times over nothing.
That's a really common experience too. Elevated adenaline could be to blame, but it could be that people just get grumpy and frustrated from being in a constant mental haze!
Posted by johnj1 on April 19, 2009, at 18:01:12
In reply to Re: Remeron for treatment resistant depression..., posted by sowhysosad on April 19, 2009, at 10:22:53
Yeah, could be. I have a short fuse but remeron made it much worse in a way I can't describe. I broke the visor mirror in the car punching the ceiling. I don't do stuff like that. My wife almost left me. That experience has made me gun shy of meds.
Posted by theo on April 19, 2009, at 22:24:28
In reply to Remeron for treatment resistant depression..., posted by Enigma on April 17, 2009, at 17:15:42
Just curious, I might start Remeron, do you take name brand or generic?
Posted by Enigma on April 19, 2009, at 22:48:05
In reply to Re: Remeron for treatment resistant depression... » Enigma, posted by theo on April 19, 2009, at 22:24:28
> Just curious, I might start Remeron, do you take name brand or generic?
I was taking the generic. I lasted all of one day and ran back to Nardil.
I'm not suicidal anymore.
I may not be able to sleep anymore either, but being suicidal is MUCH worse
Posted by sowhysosad on April 21, 2009, at 19:49:33
In reply to Re: Remeron for treatment resistant depression..., posted by Enigma on April 19, 2009, at 22:48:05
Disappointingly, my friend who was on Remeron has decided not to try any more meds after her negative experience with it, and may never achieve full remission as a result.
I'm really angry with her pdoc. Some years ago she tried fluoxetine and imipramine, had no success and lots of side effects so gave up. So I was pleased to hear she'd decided, reluctantly, to give meds another shot.
Under the UK guidelines, docs are meant to try one of the tried-and-tested SSRI's first - fluoxetine, citalopram or sertraline. Then they can try mirtazapine (Remeron) or Effexor, then a TCA, reboxetine, moclobemide, dosulepin, AD combos, lithium augmentation or phenelzine for more stubborn cases.
With SSRI's all being very different, there was a good chance that citalopram or sertraline would have worked where fluoxetine failed. But for some reason he decided to start her off on Cymbalta.
Now I know a lot of people have a good response to it, but in the UK the national guidelines discourage docs from using it. Pooled data suggests it's less reliable than the older SSRI's and has a higher incidence of side effects. So the decision to start her on Cymbalta was unconventional to say the least. Lily must have bought him a really nice dinner. And gave him a free pen.
I think it was really unprofessional - given that my friend was VERY anti-meds to start off with - to start her off on a drug that guidelines say is less likely to work and may be more unpleasant to take! How did he expect to achieve compliance?
Then the Remeron was the final nail in the coffin - the heavy sedation, mental fog and binge eating were too much to bear. I just don't think its extreme side effects make it a good candidate for someone who's not comfortable with taking meds in the first place.
Docs are also meant to take into account Remeron's propensity for weight gain before prescribing it, so why give it to someone who already had a weight problem?
So there's another soul completely lost to psychiatry who'll probably never get well, all thanks to this idiot's irresponsible behaviour.
Posted by Enigma on April 22, 2009, at 9:17:22
In reply to Remeron's now put my friend off meds for life..., posted by sowhysosad on April 21, 2009, at 19:49:33
Wow, that's really sad. You can't explain to her that other meds have either very few side effects in comparison, and some may have none (for her). ?
I myself, suffer from every side-effect a drug has. I'm pretty much cursed that way.I'm actually extremely upset with my doc for jumping both feet first towards the Remeron approach and SO QUICK to take me off Nardil.
As soon I was a week off of Nardil I became suicidal. I told my wife to leave me and find another man to take care of her and kids both romantically and financially as I was just a step away from the grave (drama, I know, but true). I think there were 3 days where I didn't speak to anyone, just cried, and thought of ways to fund my family so I could be 'free', legal and not so legal.
Currently, I'm on social security disability (U.S.). It's not much, but it pays the bills (mostly). My wife can't work because she takes care of EVERYTHING else (she's Superwife!), including our youngest child, which I couldn't do if I wanted to.
Even when suicidal, I still wouldn't leave my family in poverty, so my rule is to make sure they are covered financially in case I bite the bullet (literally). But, after a couple of days of being in the worst pain of my life, I went right back on the Nardil, slowly, and I'm human again. Nardil never gets me to 10/10 perfection, more like 5/10, but it drives away the suicide and super intense depression. I literally cannot live without it and it's the only drug that's ever really worked for me (Had some success with selegiline too) as an AD.Now all my sleep problems are back, but they're better than being suicidal, so I'll take door #1. I have insomnia really bad (again), and usually get up many times at night and usually have problems getting back to sleep. Just for laughs, checked my med chest and found this Valarian root bottle ("Promotes restful sleep"), so the last 2 nights I took a pill. Now, I can't say in just 2 nights whether or not it was this pill or not, but once I finally did make it to sleep, I slept through the entire night, both nights, which is extremely rare for me. So, I'm going to be taking this stuff every night from now on, hoping that's what's really keeping me asleep. Now if I could just tackle the insomnia.
Again, sorry about your friend. In the past 15+ years, I've been let down my meds and doctors more times than I can count, but you have to get past it in order to feel better. That's what your friend has to focus on. If I don't like a med, I research a new one. If I don't like a doctor, I research a new one. Simple as that. Sometimes you win, sometimes you fail. I seem to fail a lot more than I win. And finally, whatever doesn't kill you, just weakens your organs and damages your body overall. :(
> Disappointingly, my friend who was on Remeron has decided not to try any more meds after her negative experience with it, and may never achieve full remission as a result.
>
> I'm really angry with her pdoc. Some years ago she tried fluoxetine and imipramine, had no success and lots of side effects so gave up. So I was pleased to hear she'd decided, reluctantly, to give meds another shot.
>
> Under the UK guidelines, docs are meant to try one of the tried-and-tested SSRI's first - fluoxetine, citalopram or sertraline. Then they can try mirtazapine (Remeron) or Effexor, then a TCA, reboxetine, moclobemide, dosulepin, AD combos, lithium augmentation or phenelzine for more stubborn cases.
>
> With SSRI's all being very different, there was a good chance that citalopram or sertraline would have worked where fluoxetine failed. But for some reason he decided to start her off on Cymbalta.
>
> Now I know a lot of people have a good response to it, but in the UK the national guidelines discourage docs from using it. Pooled data suggests it's less reliable than the older SSRI's and has a higher incidence of side effects. So the decision to start her on Cymbalta was unconventional to say the least. Lily must have bought him a really nice dinner. And gave him a free pen.
>
> I think it was really unprofessional - given that my friend was VERY anti-meds to start off with - to start her off on a drug that guidelines say is less likely to work and may be more unpleasant to take! How did he expect to achieve compliance?
>
> Then the Remeron was the final nail in the coffin - the heavy sedation, mental fog and binge eating were too much to bear. I just don't think its extreme side effects make it a good candidate for someone who's not comfortable with taking meds in the first place.
>
> Docs are also meant to take into account Remeron's propensity for weight gain before prescribing it, so why give it to someone who already had a weight problem?
>
> So there's another soul completely lost to psychiatry who'll probably never get well, all thanks to this idiot's irresponsible behaviour.
Posted by Sigismund on April 22, 2009, at 14:56:15
In reply to Re: Remeron's now put my friend off meds for life..., posted by Enigma on April 22, 2009, at 9:17:22
>And finally, whatever doesn't kill you, just weakens your organs and damages your body overall. :(
yeah, I was never impressed by the other version.
Posted by sowhysosad on April 22, 2009, at 16:47:13
In reply to Re: Remeron's now put my friend off meds for life..., posted by Enigma on April 22, 2009, at 9:17:22
Sorry to hear about your situation Enigma. I'm in a really similar situation to you, albeit in a med-free period at the moment. Been depressed for over 6 months, unable to work, losing the will to go on, and my wife regularly running out of patience. It sucks. Glad to hear you've improved back on the Nardil.
As for my friend, I've tried reassuring her that there are plenty of other meds out there and that Remeron's side effects are extreme but to no avail. She's one of these virulently anti-meds people that are all too common in the UK, and her bad experience with psychiatry has just confirmed her preconceptions.
It annoys me that so many docs worldwide put their faith in a drug that is, for many of us, a glorified antihistamine with no antidepressant effect.
With regard to finding another doc, the way mental health works in the UK is that each area has a mental health team assigned to it and they treat ALL cases referred by family doctors in their patch.
For example, my area is designated South Leeds and everyone in that area is treated by a particular pdoc and her "team" at one particular suburban health centre. They're responsible for all referred mental health cases amongst a quarter of the population of a city of around 700,000 people.
If you're not happy with that, tough ****. In fact, I only get to see one of her juniors who seems to know way less about psychopharmacology than I do, and I'm just a layman who reads a lot. I guess the only way you could change docs is to move house or get yourself hospitalised. At least the treatment is free, but few people have private health insurance or can afford a private pdoc, so you don't get to shop around.
> Wow, that's really sad. You can't explain to her that other meds have either very few side effects in comparison, and some may have none (for her). ?
> I myself, suffer from every side-effect a drug has. I'm pretty much cursed that way.
>
> I'm actually extremely upset with my doc for jumping both feet first towards the Remeron approach and SO QUICK to take me off Nardil.
> As soon I was a week off of Nardil I became suicidal. I told my wife to leave me and find another man to take care of her and kids both romantically and financially as I was just a step away from the grave (drama, I know, but true). I think there were 3 days where I didn't speak to anyone, just cried, and thought of ways to fund my family so I could be 'free', legal and not so legal.
> Currently, I'm on social security disability (U.S.). It's not much, but it pays the bills (mostly). My wife can't work because she takes care of EVERYTHING else (she's Superwife!), including our youngest child, which I couldn't do if I wanted to.
> Even when suicidal, I still wouldn't leave my family in poverty, so my rule is to make sure they are covered financially in case I bite the bullet (literally). But, after a couple of days of being in the worst pain of my life, I went right back on the Nardil, slowly, and I'm human again. Nardil never gets me to 10/10 perfection, more like 5/10, but it drives away the suicide and super intense depression. I literally cannot live without it and it's the only drug that's ever really worked for me (Had some success with selegiline too) as an AD.
>
> Now all my sleep problems are back, but they're better than being suicidal, so I'll take door #1. I have insomnia really bad (again), and usually get up many times at night and usually have problems getting back to sleep. Just for laughs, checked my med chest and found this Valarian root bottle ("Promotes restful sleep"), so the last 2 nights I took a pill. Now, I can't say in just 2 nights whether or not it was this pill or not, but once I finally did make it to sleep, I slept through the entire night, both nights, which is extremely rare for me. So, I'm going to be taking this stuff every night from now on, hoping that's what's really keeping me asleep. Now if I could just tackle the insomnia.
>
> Again, sorry about your friend. In the past 15+ years, I've been let down my meds and doctors more times than I can count, but you have to get past it in order to feel better. That's what your friend has to focus on. If I don't like a med, I research a new one. If I don't like a doctor, I research a new one. Simple as that. Sometimes you win, sometimes you fail. I seem to fail a lot more than I win. And finally, whatever doesn't kill you, just weakens your organs and damages your body overall. :(
Posted by Enigma on April 22, 2009, at 18:03:59
In reply to Re: Remeron's now put my friend off meds for life., posted by sowhysosad on April 22, 2009, at 16:47:13
> Sorry to hear about your situation Enigma. I'm in a really similar situation to you, albeit in a med-free period at the moment. Been depressed for over 6 months, unable to work, losing the will to go on, and my wife regularly running out of patience. It sucks. Glad to hear you've improved back on the Nardil.
Wow, I hate to hear that. Unfortunately the reality for me is I simply cannot go med-free for any length of time. I turn into a completely different person, a danger to myself and others, as they say. I wouldn't last long "out there" without my meds. I hate the dependence on them, but, what else can I do?
> As for my friend, I've tried reassuring her that there are plenty of other meds out there and that Remeron's side effects are extreme but to no avail. She's one of these virulently anti-meds people that are all too common in the UK, and her bad experience with psychiatry has just confirmed her preconceptions.
Ahh, that's a shame. My mother is kinda hit or miss like that. She'll take meds for certain physical ailments, but if I tell her she's depressed (she lost her husband 2 years ago, my dad) and still cries over it a good deal of the time, she refuses outright to take a mild AD. But, she's got issues with accepting the fact that she might have any form of mental illness, even a temporary situation-based one. ...and, she's actually got her share of them. :)
> It annoys me that so many docs worldwide put their faith in a drug that is, for many of us, a glorified antihistamine with no antidepressant effect.I hear that. I don't know what my doc's attraction to Remeron is. I'll have to ask him next visit. All I know is, he's not going to be pleased when I tell him I took all of 1 dose and jumped back to Nardil. Heh.. shows how much he knows about what my real needs are though.
> With regard to finding another doc, the way mental health works in the UK is that each area has a mental health team assigned to it and they treat ALL cases referred by family doctors in their patch.
>
> For example, my area is designated South Leeds and everyone in that area is treated by a particular pdoc and her "team" at one particular suburban health centre. They're responsible for all referred mental health cases amongst a quarter of the population of a city of around 700,000 people.OMG, that's horrible. It's great here in the states. I've changed docs a dozen times till I landed on the one I'm at now, and I'm generally pretty happy with him. He does rush each appt though and has to do "his thing" each appt first which ends up leaving you 5-10 mins at the end of the appt to really talk. It's really starting to get on my nerves. I miss my last doc, but he changed jobs from private practice to working with *really* sick patients. He was a GREAT doctor.
> If you're not happy with that, tough ****. In fact, I only get to see one of her juniors who seems to know way less about psychopharmacology than I do, and I'm just a layman who reads a lot. I guess the only way you could change docs is to move house or get yourself hospitalised. At least the treatment is free, but few people have private health insurance or can afford a private pdoc, so you don't get to shop around.
Wow, horrible. I have seen my share of docs that I knew about 10x more than about my disorder. I couldn't believe it. I would think to myself, wow, can I get paid $180 per visit each time I come here instead? As for a few docs, I was TELLING THEM what drugs and what dosages to give me, and they were writing the scripts, no lie. Luckily insurance was paying for the visits as there's no way I would pay these jokers that kind of money for signing a piece of paper.
All I know is, Depression, Bipolar Disorder and so on, etc, has destroyed my life. I'm a shadow of my former self. I lost interest in so many things I used to enjoy. Just recently I decided to write a book about my life, my psychotic upbringing, my career and the end of it, and my disorder and how it permanently ruined my life. It really sucked to life 1/2 a life as I do now. I want to be the person I used to be. But, medical tech is just not there yet. I've already tried every drug and drug combo in the book and believe I'm on the best combo I'm ever gonna find. Now I still have to lose the 45 pounds from Seroquel I can't seem to shed to safe my life, deal with not being able to drink anymore (Geodon just won't allow it) - and it was one thing that I still enjoyed about life, stolen from a pill!... bah... And there are still millions walking the street thinking I'm just "weak"...
Posted by sowhysosad on April 22, 2009, at 18:51:37
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 22, 2009, at 18:03:59
> Wow, I hate to hear that. Unfortunately the reality for me is I simply cannot go med-free for any length of time. I turn into a completely different person, a danger to myself and others, as they say. I wouldn't last long "out there" without my meds. I hate the dependence on them, but, what else can I do?
This drug-free period was the pdoc's idea. I was informed of the plan by telephone after my last appointment. At the appointment itself I was told to increase my imipramine but I adamantly refused to continue with it, so he had to go back to the pdoc for another consult after I left.
Not sure whether it was actually to reassess me drug-free as they claimed, or more down to the fact that it was 7 weeks 'til my follow-up appointment because of the junior's annual leave, but only takes 4 weeks to withdraw.
Another thing I forgot to mention: the qualified consultant's time is massively over-subscribed. Last time I was there a woman turned up who was having what looked like an acute dystonic reaction to an AP and asked to see her. She was in a terrible state, but was sent away to see her family doc with the vague excuse that it might be due to a physical condition which was under investigation so they couldn't prescribe anything (they had this conversation within earshot in the waiting room).
> As for a few docs, I was TELLING THEM what drugs and what dosages to give me, and they were writing the scripts, no lie. Luckily insurance was paying for the visits as there's no way I would pay these jokers that kind of money for signing a piece of paper.
I have that kind of relationship with my GP. Unfortunately it was my bright idea to try Remeron and then imipramine, neither of which helped me at all!
> All I know is, Depression, Bipolar Disorder and so on, etc, has destroyed my life. I'm a shadow of my former self. I lost interest in so many things I used to enjoy. Just recently I decided to write a book about my life, my psychotic upbringing, my career and the end of it, and my disorder and how it permanently ruined my life.
Sounds like a great idea - should be really cathartic.
> And there are still millions walking the street thinking I'm just "weak"...
What can you do? **** 'em. You know your suffering is real.
Posted by Enigma on April 23, 2009, at 8:32:10
In reply to Re: Remeron's now put my friend off meds for life. » Enigma, posted by sowhysosad on April 22, 2009, at 18:51:37
> This drug-free period was the pdoc's idea. I was informed of the plan by telephone after my last appointment. At the appointment itself I was told to increase my imipramine but I adamantly refused to continue with it, so he had to go back to the pdoc for another consult after I left.
Interesting.. I gotta look up imipramine.. never heard of that one (at least by that name). I think my docs know better than to take me off drugs. My irritable/rage filled bipolar side will end my marriage and get me or someone else killed (via road rage) if it ever surfaces again. I can't drink on Geodon :( (I know that's trivial to most people, but not to me), but it does a great job at mood stabilization for me. No rage, no irritability. Wife is happy.
I tried a Vivactil (TCA) once and in just a couple days of use, I was so psychotic, I was punching walls and actually threw a chair at my wife (in her direction - I knew it wouldn't hit her) - she almost left me. I quit the drug immediately. Luckily, I wasn't at a mall or someplace full of people. There were other drugs that had me picking fights with people right in front of their kids.. it was awful.
> Not sure whether it was actually to reassess me drug-free as they claimed, or more down to the fact that it was 7 weeks 'til my follow-up appointment because of the junior's annual leave, but only takes 4 weeks to withdraw.Ahh.
>
> Another thing I forgot to mention: the qualified consultant's time is massively over-subscribed. Last time I was there a woman turned up who was having what looked like an acute dystonic reaction to an AP and asked to see her. She was in a terrible state, but was sent away to see her family doc with the vague excuse that it might be due to a physical condition which was under investigation so they couldn't prescribe anything (they had this conversation within earshot in the waiting room).Ack, that's horrible.
> I have that kind of relationship with my GP. Unfortunately it was my bright idea to try Remeron and then imipramine, neither of which helped me at all!Heh, you win some, you lose some. I think I picked Seroquel myself as well, and now have a basketball for a stomach. I still can't figure out why nothing I do drops the weight.
>
> > And there are still millions walking the street thinking I'm just "weak"...
>
> What can you do? **** 'em. You know your suffering is real.
>Exactly. Screw them. It's just really sad is all. I wish I had the power to brush by someone and give them all my disorders for a month or year!, just to see how they handle it. Then give them the innate knowledge that I'm the only one who can really take the disorder away (after they've tried everything else, just like I have). Man, to think of all the side-effects I've suffered.
I'd probably laugh in the face at a psycho-killer aiming to try and kill me. I'd say "HA!, what are you gonna do to me? I've had an ever shifting treatment resistant bipolar II disorder for 15-20 years now, and you still haven't met my mother, BRING IT ON, ****ER!"
Hmm, think I'll put that quote in my book.
Posted by sowhysosad on April 23, 2009, at 9:59:11
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 23, 2009, at 8:32:10
> Interesting.. I gotta look up imipramine.. never heard of that one (at least by that name).
I think it's branded as deprenil or topfranil in the US. It was the first tricyclic discovered way back in the '50s. It has a dual action, slightly favouring norepinephrine over serotonin. Works for some but not me sadly! Notorious for inducing psychosis though, so might trigger mania.
> I'd probably laugh in the face at a psycho-killer aiming to try and kill me. I'd say "HA!, what are you gonna do to me? I've had an ever shifting treatment resistant bipolar II disorder for 15-20 years now, and you still haven't met my mother, BRING IT ON, ****ER!"
>
> Hmm, think I'll put that quote in my book.LOL! Maybe that shoud be the title!
Posted by Enigma on April 23, 2009, at 17:43:59
In reply to Re: Remeron's now put my friend off meds for life. » Enigma, posted by sowhysosad on April 23, 2009, at 9:59:11
> > Interesting.. I gotta look up imipramine.. never heard of that one (at least by that name).
>
> I think it's branded as deprenil or topfranil in the US. It was the first tricyclic discovered way back in the '50s. It has a dual action, slightly favouring norepinephrine over serotonin. Works for some but not me sadly! Notorious for inducing psychosis though, so might trigger mania.Ah, I've heard of those names. After my last trip down TCA lane, I'll never try one again. I don't need a divorce right now.
>
> > I'd probably laugh in the face at a psycho-killer aiming to try and kill me. I'd say "HA!, what are you gonna do to me? I've had an ever shifting treatment resistant bipolar II disorder for 15-20 years now, and you still haven't met my mother, BRING IT ON, ****ER!"
> >
> > Hmm, think I'll put that quote in my book.
>
> LOL! Maybe that shoud be the title!
>LOL, that would be nice, wouldn't it.
Man, I'm tired. Just went "shopping" with the wife and kids, and as usual, we had to yell at them the entire time. Too bad a babysitter just isn't in our paltry budget...but with the loss of sanity each time we need to pick up a few things, I think we need to tap into the savings for it. It's probably worth keeping the few brain cells I have left.
Posted by sowhysosad on April 23, 2009, at 18:06:08
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 23, 2009, at 17:43:59
> Ah, I've heard of those names. After my last trip down TCA lane, I'll never try one again. I don't need a divorce right now.
Yeah, it seemed to make me worse if anything. I realise now that this depression is leaning very heavily towards atypical, and all the research I've seen points towards tricyclics being pretty useless in that area. Probably because all bar clomipramine favour norepinephrine whilst atypical seems to be more of a serotonin and dopamine issue.
> Man, I'm tired. Just went "shopping" with the wife and kids, and as usual, we had to yell at them the entire time. Too bad a babysitter just isn't in our paltry budget...but with the loss of sanity each time we need to pick up a few things, I think we need to tap into the savings for it. It's probably worth keeping the few brain cells I have left.
I know the feeling! Finding it really hard to deal with my kids' behaviour at the mo, and my parental lameness is just feeding my wife's resentment! Thank **** for online grocery shopping - one less trauma to deal with!
Posted by metric on April 24, 2009, at 21:03:16
In reply to Remeron's now put my friend off meds for life..., posted by sowhysosad on April 21, 2009, at 19:49:33
> Disappointingly, my friend who was on Remeron has decided not to try any more meds after her negative experience with it, and may never achieve full remission as a result.
>
> I'm really angry with her pdoc. Some years ago she tried fluoxetine and imipramine, had no success and lots of side effects so gave up. So I was pleased to hear she'd decided, reluctantly, to give meds another shot.
>
> Under the UK guidelines, docs are meant to try one of the tried-and-tested SSRI's first - fluoxetine, citalopram or sertraline. Then they can try mirtazapine (Remeron) or Effexor, then a TCA, reboxetine, moclobemide, dosulepin, AD combos, lithium augmentation or phenelzine for more stubborn cases.
>Why is phenelzine preferred over tranylcypromine (Parnate in the U.S.)? I think the latter is more effective and with fewer side-effects. It is, however, more prone to dangerous (but still rare) hypertensive events. My guess is that's the reason for the preference of phenelzine.
> With SSRI's all being very different, there was a good chance that citalopram or sertraline would have worked where fluoxetine failed. But for some reason he decided to start her off on Cymbalta.
>I disagree. I've taken them all (including venlafaxine and duloxetine) and none of them work. They all have horrible side-effects.
> Now I know a lot of people have a good response to it, but in the UK the national guidelines discourage docs from using it. Pooled data suggests it's less reliable than the older SSRI's and has a higher incidence of side effects. So the decision to start her on Cymbalta was unconventional to say the least. Lily must have bought him a really nice dinner. And gave him a free pen.
>
> I think it was really unprofessional - given that my friend was VERY anti-meds to start off with - to start her off on a drug that guidelines say is less likely to work and may be more unpleasant to take! How did he expect to achieve compliance?
>
> Then the Remeron was the final nail in the coffin - the heavy sedation, mental fog and binge eating were too much to bear. I just don't think its extreme side effects make it a good candidate for someone who's not comfortable with taking meds in the first place.
>
> Docs are also meant to take into account Remeron's propensity for weight gain before prescribing it, so why give it to someone who already had a weight problem?
>
> So there's another soul completely lost to psychiatry who'll probably never get well, all thanks to this idiot's irresponsible behaviour.Well, in defense of the psychiatrist (words you'll seldom hear from me), it's not like he had any effective alternatives to work with -- at least none that wouldn't jeopardize his license, if the UK is anything like the U.S.
Posted by sowhysosad on April 24, 2009, at 22:06:05
In reply to Re: Remeron's now put my friend off meds for life., posted by metric on April 24, 2009, at 21:03:16
> Why is phenelzine preferred over tranylcypromine (Parnate in the U.S.)? I think the latter is more effective and with fewer side-effects. It is, however, more prone to dangerous (but still rare) hypertensive events. My guess is that's the reason for the preference of phenelzine.
I wondered that myself, given that phenelzine is hepatoxic and more likely to cause weight gain. I came to the same conclusion as you.
> > With SSRI's all being very different, there was a good chance that citalopram or sertraline would have worked where fluoxetine failed. But for some reason he decided to start her off on Cymbalta.
> >
>
> I disagree. I've taken them all (including venlafaxine and duloxetine) and none of them work. They all have horrible side-effects.
>
> Well, in defense of the psychiatrist (words you'll seldom hear from me), it's not like he had any effective alternatives to work with -- at least none that wouldn't jeopardize his license, if the UK is anything like the U.S.I still maintain another SSRI might have been worth a try. She wasn't very compliant when taking fluoxetine, and perhaps she might have an issue with 2D6 metabolism that interfered with its action. Plus fluoxetine also boosts dopamine and noradrenaline in some parts of the brain which she may not have tolerated. Why did he not try sertraline or citalopram for example? Or even an MAOI?
Posted by Enigma on April 25, 2009, at 5:36:35
In reply to Re: Remeron's now put my friend off meds for life., posted by metric on April 24, 2009, at 21:03:16
> Why is phenelzine preferred over tranylcypromine (Parnate in the U.S.)? I think the latter is more effective and with fewer side-effects. It is, however, more prone to dangerous (but still rare) hypertensive events. My guess is that's the reason for the preference of phenelzine.
It totally depends who you are, you should know that. Drugs would differently on everybody, including their side-effects. I tried Parnate and hated it. I couldn't tolerate it, and it nothing for my depression - at least I couldn't even get to a dose where it would be effective, due to side-effects. That's why I'm on Nardil. I'm used to most of Nardil's side effects by now, but it took a very long time, and I was off/on it at least 3-4 times because I couldn't deal with the side-effects.
>
> > With SSRI's all being very different, there was a good chance that citalopram or sertraline would have worked where fluoxetine failed. But for some reason he decided to start her off on Cymbalta.
> >
>
> I disagree. I've taken them all (including venlafaxine and duloxetine) and none of them work. They all have horrible side-effects.They all have horrible side-effects, FOR YOU, not everyone.
Posted by sowhysosad on April 25, 2009, at 7:38:23
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 25, 2009, at 5:36:35
> > I disagree. I've taken them all (including venlafaxine and duloxetine) and none of them work. They all have horrible side-effects.
>
> They all have horrible side-effects, FOR YOU, not everyone.That's a good point. I've taken some SSRI's and had very minor, barely discerniible side effects.
Posted by metric on April 25, 2009, at 12:18:27
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 22, 2009, at 18:03:59
> Ahh, that's a shame. My mother is kinda hit or miss like that. She'll take meds for certain physical ailments, but if I tell her she's depressed (she lost her husband 2 years ago, my dad) and still cries over it a good deal of the time, she refuses outright to take a mild AD. But, she's got issues with accepting the fact that she might have any form of mental illness, even a temporary situation-based one. ...and, she's actually got her share of them. :)
Perhaps she doesn't appreciate having her emotions invalidated by your suggestion that she's "mentally ill". There is absolutely nothing medically pathological about emotional distress per se -- even severe distress.
> Wow, horrible. I have seen my share of docs that I knew about 10x more than about my disorder. I couldn't believe it. I would think to myself, wow, can I get paid $180 per visit each time I come here instead? As for a few docs, I was TELLING THEM what drugs and what dosages to give me, and they were writing the scripts, no lie. Luckily insurance was paying for the visits as there's no way I would pay these jokers that kind of money for signing a piece of paper.
>So that's okay as long as someone *else* foots the bill? Why should anyone have to pay for a service they don't want? If people weren't so doped up on mind-numbing "antidepressants", maybe they wouldn't be so complacent. Maybe we'd see some much needed change.
Listening to the bromidic "mental health" propaganda spewed daily is enough to drive any modestly intelligent individual capable of critical thought to contemplate taking an antidepressant so that he might instead smile at the platitudes.
Posted by Enigma on April 25, 2009, at 13:39:12
In reply to Re: Remeron's now put my friend off meds for life., posted by metric on April 25, 2009, at 12:18:27
Oh goody, a debate.
> Perhaps she doesn't appreciate having her emotions invalidated by your suggestion that she's "mentally ill". There is absolutely nothing medically pathological about emotional distress per se -- even severe distress.
Do you think I walk up to her face and say "Mom, did you know you're mentally ill"? Uhm. No. She constantly calls me on the phone crying all the time about Dad. I think 2+ years is an excessive time to be grieving in this way, FOR HER, especially at the rate she is. So, I calmly suggested she go talk to a therapist or psychiatrist and get their opinion and I told her there are a large number of mild AD's that would help her through the tough times.
I'm 40 now, been suffering from depression (and bipolar disorder) since high school, seen leagues of therapists, doctors, and done research all my life, and minored in psych in college, so I'd like to think I know just a teensy weensy bit about the @#@$-ing subject. Also, I'd like to think I know my mother a hell of a lot better than you do.
She's actually got a host of mental illness, not just diagnosed by me, but my therapists and doctors as well. She has Narcissistic Personality Disorder, for starters, and if you know anything about that disorder, you would know that they believe they are superior to others, are unable to make mistakes (cannot say "sorry"), and couldn't possibly have a something "wrong" with them, especially a mental illness (among other symptoms). My current doctor said that they're so difficult to deal with (and I know, she raised me) that he won't even treat them, but refer them to other doctors because it's almost impossible to convince them that they have a "problem".
>
> > Wow, horrible. I have seen my share of docs that I knew about 10x more than about my disorder. I couldn't believe it. I would think to myself, wow, can I get paid $180 per visit each time I come here instead? As for a few docs, I was TELLING THEM what drugs and what dosages to give me, and they were writing the scripts, no lie. Luckily insurance was paying for the visits as there's no way I would pay these jokers that kind of money for signing a piece of paper.
> >
>
> So that's okay as long as someone *else* foots the bill? Why should anyone have to pay for a service they don't want? If people weren't so doped up on mind-numbing "antidepressants", maybe they wouldn't be so complacent. Maybe we'd see some much needed change.Jeez, and I HAVE to "be civil". What, I should pay for this??? That's like bringing my car to a mechanic, and instructing the mechanic which tool to use, where to use it, and telling them each step involved in fixing my car, then when they go to inspect it, instructing them how this is done as well, and then all they do is sign the appropriate documents and slap a sticker on my car.
The GOVERNMENT requires inspections, and if *I* did all the work, you bet your ### that I would require them to foot the bill. Actually, I would rather demand a check for MY services and 5% of that for the inspector for putting the sticker on my car.Still responding to your last comment above.. A service I don't want? I NEED that service whether she does the work or I do. Doped up on AD's?? You obviously haven't been suicidal and felt that intense pain that could only be quell by ending your life. I can't believe I'm arguing with you. You sound like one of those people I like to hurt, physically, that believe our symptoms, equivalent to cancer, aids, and so forth, are all "in our heads", and we should "snap out of it". What ARE you doing on this board anyway?
>
> Listening to the bromidic "mental health" propaganda spewed daily is enough to drive any modestly intelligent individual capable of critical thought to contemplate taking an antidepressant so that he might instead smile at the platitudes.
>Wow, look at me, I can use big words to get my idiotic message across. Propaganda.. Yep, just like Aids and Cancer. Just propaganda. Do everyone a favor here, troll, and get off this forum. Sorry Bob.
Posted by sowhysosad on April 25, 2009, at 15:00:51
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 25, 2009, at 13:39:12
> Still responding to your last comment above.. A service I don't want? I NEED that service whether she does the work or I do. Doped up on AD's?? You obviously haven't been suicidal and felt that intense pain that could only be quell by ending your life. I can't believe I'm arguing with you. You sound like one of those people I like to hurt, physically, that believe our symptoms, equivalent to cancer, aids, and so forth, are all "in our heads", and we should "snap out of it". What ARE you doing on this board anyway?
> >
> > Listening to the bromidic "mental health" propaganda spewed daily is enough to drive any modestly intelligent individual capable of critical thought to contemplate taking an antidepressant so that he might instead smile at the platitudes.
> >I think Metric has a minor point in that US society is perhaps over-medicalised. with big business the major culprit.
However, I wouldn't suggest for a second you were guilty of that Enigma. You're clearly very knowledgeable and caring. It's clear Metric has an anti-psychiatry agenda.
Posted by metric on April 25, 2009, at 17:58:49
In reply to Re: Remeron's now put my friend off meds for life., posted by Enigma on April 25, 2009, at 13:39:12
> Jeez, and I HAVE to "be civil". What, I should pay for this??? That's like bringing my car to a mechanic, and instructing the mechanic which tool to use, where to use it, and telling them each step involved in fixing my car, then when they go to inspect it, instructing them how this is done as well, and then all they do is sign the appropriate documents and slap a sticker on my car.
>
> The GOVERNMENT requires inspections, and if *I* did all the work, you bet your ### that I would require them to foot the bill. Actually, I would rather demand a check for MY services and 5% of that for the inspector for putting the sticker on my car.
>Calm down. No, of course you shouldn't have to pay shrinks (or any doctor) to obtain your drugs.
Making all drugs legally available OTC would completely eliminate that problem.> Still responding to your last comment above.. A service I don't want? I NEED that service whether she does the work or I do. Doped up on AD's?? You obviously haven't been suicidal and felt that intense pain that could only be quell by ending your life. I can't believe I'm arguing with you.
It might be "obvious", but it's untrue.
> You sound like one of those people I like to hurt, physically, that believe our symptoms, equivalent to cancer, aids, and so forth, are all "in our heads", and we should "snap out of it".
Wait a sec, you like to physically hurt people that disagree with you? Ignoring the fact that I would whoop your *ss if you tried such a thing, I'm curious what makes you so angry? I have no desire to harm people with whom I disagree.
I fully admit that my last post sounded a bit cantankerous upon rereading, but it wasn't my intention to send you flying off the handle. You need to relax a bit. Pop a few Xanax.
> >
> > Listening to the bromidic "mental health" propaganda spewed daily is enough to drive any modestly intelligent individual capable of critical thought to contemplate taking an antidepressant so that he might instead smile at the platitudes.
> >
>
> Wow, look at me, I can use big words to get my idiotic message across. Propaganda.. Yep, just like Aids and Cancer. Just propaganda. Do everyone a favor here, troll, and get off this forum. Sorry Bob.Propaganda is a big word? Sorry. Doesn't Google have an English to dumbed-down-English translator you could use?
This is the end of the thread.
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