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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Rdragon on August 15, 2009, at 18:10:51
Hey guys, I have a meeting with my pdoc the August 17th, and I was wondering what you guys think would be a good direction to take with my medications.
I've tried, Lexapro, Zoloft, Paxil, and Prozac. Should I just keep trying SSRI's/SNRI's or should I try something like Remeron? (I made a thread about Remeron and somebody said that it was useless except as a sleep aid) Any thoughts would be appreciated. =)
Posted by Maxime on August 15, 2009, at 18:22:03
In reply to What Medication Direction Should I Take?, posted by Rdragon on August 15, 2009, at 18:10:51
> Hey guys, I have a meeting with my pdoc the August 17th, and I was wondering what you guys think would be a good direction to take with my medications.
>
> I've tried, Lexapro, Zoloft, Paxil, and Prozac. Should I just keep trying SSRI's/SNRI's or should I try something like Remeron? (I made a thread about Remeron and somebody said that it was useless except as a sleep aid) Any thoughts would be appreciated. =)I would first go back and try the SSRIs/SNRIs in COMBINATION with a mood stabiliser or an augmenter. Something like lamictal, lithium, or depakote, abililfy could make a big difference. If that doesn't work you should try an MAOI or a tricyclic.
Posted by Maxime on August 15, 2009, at 18:24:30
In reply to What Medication Direction Should I Take?, posted by Rdragon on August 15, 2009, at 18:10:51
I forgot to add that you should try the Remeron. Just because a couple of posters here didn't have any luck with it doesn't mean that you won't.
Posted by morganator on August 15, 2009, at 18:58:53
In reply to Re: What Medication Direction Should I Take? » Rdragon, posted by Maxime on August 15, 2009, at 18:24:30
Hey man,
What are you on right now? I can't remember what you said you were on before. Sorry, my memory is bad right now.
Would your parents agree to pay for a course of rTMS?
Oh Geeze, I don't know why my computer does that when I send a link. As you will see, there is a practitioner of rTMS in Richmond.
So I guess your current regimen is not working. Why not try Parnate? or Nardil? Or, try Cymbalta or Pristiq. \
You are still on and going to stay on Geodon I assume.
Did you ever get your hands on some lithium? What has your doc said about lithium?
If you try Remeron, you need to take a higher dose for the antidepressant effect. I'm guessing you may have to go as high as 45 mgs.
Seriously though, I would try the rTMS if your parents and insurance will pay for it. Also, it would not hurt to just try something like Parnate for a few months.
Posted by Rdragon on August 15, 2009, at 19:10:09
In reply to Re: What Medication Direction Should I Take?, posted by morganator on August 15, 2009, at 18:58:53
> Hey man,
>
> What are you on right now? I can't remember what you said you were on before. Sorry, my memory is bad right now.
>
> Would your parents agree to pay for a course of rTMS?
>
> http://www.google.com/aclk?sa=l&ai=C0PSnz0iHSrWeBc-Itgfuq9jOCeWui54B77uqvRDd4_iAMQgAEAEgtlQoA1CWk7XfB2DJppuN7KSAEKABta-w7wPIAQGqBCFP0Otp7WK9dX5j9wiG644fMMqf855AOlFJDMg6VGA_UP8&sig=AGiWqtyueNsawofBBRjFmPdb0xVrCJwv4g&q=http://www.neurostartms.com/Patient/Find-Provider.aspx%3Futm_source%3DGoogle%26utm_medium%3DCPC%26utm_term%3DFind%252Ba%2520Provider%26utm_campaign%3DPaid%252BSearch
>
> Oh Geeze, I don't know why my computer does that when I send a link. As you will see, there is a practitioner of rTMS in Richmond.
>
> So I guess your current regimen is not working. Why not try Parnate? or Nardil? Or, try Cymbalta or Pristiq. \
>
> You are still on and going to stay on Geodon I assume.
>
> Did you ever get your hands on some lithium? What has your doc said about lithium?
>
> If you try Remeron, you need to take a higher dose for the antidepressant effect. I'm guessing you may have to go as high as 45 mgs.
>
> Seriously though, I would try the rTMS if your parents and insurance will pay for it. Also, it would not hurt to just try something like Parnate for a few months.
>I'm on Prozac and Geodon at the moment. And I actually sent you a pm over at imminst a while ago asking you about the rTMS. (Guess you never got it) It definitely sounds like something that is worth considering and it's a VERY safe alternative to ECT. I'll report back here with what my pdoc says about it.
I'm not sure what my pdocs opinion on MAOI's is; I do know he hasn't prescribed one in years. I think I'll try a couple more standard antidepressants before trying an MAOI.
Posted by morganator on August 15, 2009, at 19:21:47
In reply to Re: What Medication Direction Should I Take? » morganator, posted by Rdragon on August 15, 2009, at 19:10:09
Yeah maybe I did get it I just forgot.
Did you ever go up on the Prozac? You can go as high as 60 or 80 I believe.
Really though, it appears that taking an MAOI is not a big deal. There are only a few things you need to watch out for as far as diet goes. I'm kinda pissed at myself for not starting Parnate instead of Zoloft all over again. I feel like I need a bigger kick.
I think I told you this before, and this comes from the opinion of a 3 different p docs I have spoken to recently, the more antidepressant trials you go through, the harder and harder it gets to treat your illness. This may not be the case with everyone, but I am pretty sure it is with me. So, you may want to take a few weeks to seriously consider your next move.
After what you have been through, it just makes sense to me to go for the treatment option that is MOST LIKELY to work i.g. Parnate JMHO
Morgan
Posted by Rdragon on August 15, 2009, at 20:03:04
In reply to Re: What Medication Direction Should I Take? » Rdragon, posted by morganator on August 15, 2009, at 19:21:47
> Yeah maybe I did get it I just forgot.
>
> Did you ever go up on the Prozac? You can go as high as 60 or 80 I believe.
>
> Really though, it appears that taking an MAOI is not a big deal. There are only a few things you need to watch out for as far as diet goes. I'm kinda pissed at myself for not starting Parnate instead of Zoloft all over again. I feel like I need a bigger kick.
>
> I think I told you this before, and this comes from the opinion of a 3 different p docs I have spoken to recently, the more antidepressant trials you go through, the harder and harder it gets to treat your illness. This may not be the case with everyone, but I am pretty sure it is with me. So, you may want to take a few weeks to seriously consider your next move.
>
> After what you have been through, it just makes sense to me to go for the treatment option that is MOST LIKELY to work i.g. Parnate JMHO
>
> MorganI went up to 40mg but then went back down to 20. And yeah I guess you're right about the Parnate, I'll ask about it and see what he says. If he refuses to prescribe it (which he might because he hasn't prescribed one in years), then I guess Remeron is the next med.
For me it doesn't seem like I've gotten HARDER to treat, I've remained at the same hardness level throughout my whole treatment phase. I do understand what you mean though, and I'll try not to go through too many trials.
Posted by floatingbridge on August 15, 2009, at 20:17:29
In reply to Re: What Medication Direction Should I Take? » morganator, posted by Rdragon on August 15, 2009, at 20:03:04
Hi Rdragon,
I'm sorry, but I don't remember your Dx--in response to remeron, I have a friend in remission (!) on lexapro and remeron--something about them working together for her unipolar depression. I haven't heard about monotherapy w/ remeron. Would you add-on?
best, and feel better soon,
fb
Posted by johnj1 on August 15, 2009, at 21:32:14
In reply to What Medication Direction Should I Take?, posted by Rdragon on August 15, 2009, at 18:10:51
Why not try a TCA? Nortryptline has been very good for lots of people. I took it for about 11 years.
Posted by Phillipa on August 15, 2009, at 22:05:10
In reply to Re: What Medication Direction Should I Take? » Rdragon, posted by johnj1 on August 15, 2009, at 21:32:14
Also quite a few seem to be doing well on pristiq. That's another option. Phillipa
Posted by manic666 on August 16, 2009, at 2:38:18
In reply to What Medication Direction Should I Take?, posted by Rdragon on August 15, 2009, at 18:10:51
remeron, can i just say ,i tried it a baby does it make you fat . an i mean soon as you take it . i went up a waist size in 2 weeks, i am vain to say that was enough an time to stop , i dont no if it would have helped my illness but no way was i blobing out that fast.
Posted by SLS on August 16, 2009, at 5:42:15
In reply to Re: What Medication Direction Should I Take? » Rdragon, posted by Maxime on August 15, 2009, at 18:24:30
> I forgot to add that you should try the Remeron. Just because a couple of posters here didn't have any luck with it doesn't mean that you won't.
Some have praised Remeron as being their magic pill. Unfortunately, NE alpha-2 antagonists like Remeron make my depression worse.
- Scott
Posted by SLS on August 16, 2009, at 5:44:35
In reply to Re: What Medication Direction Should I Take?, posted by manic666 on August 16, 2009, at 2:38:18
> remeron, can i just say ,i tried it a baby does it make you fat . an i mean soon as you take it . i went up a waist size in 2 weeks, i am vain to say that was enough an time to stop , i dont no if it would have helped my illness but no way was i blobing out that fast.
What dosage of Remeron did you try?
Thanks.
- Scott
Posted by maxime on August 16, 2009, at 19:52:50
In reply to Re: What Medication Direction Should I Take?, posted by manic666 on August 16, 2009, at 2:38:18
> remeron, can i just say ,i tried it a baby does it make you fat . an i mean soon as you take it . i went up a waist size in 2 weeks, i am vain to say that was enough an time to stop , i dont no if it would have helped my illness but no way was i blobing out that fast.
It did the same thing to me and I stopped taking it after a few weeks. It was making me eat everything in sight. I couldn't keep going on that way.
Posted by SLS on August 16, 2009, at 20:08:05
In reply to Re: What Medication Direction Should I Take? » manic666, posted by maxime on August 16, 2009, at 19:52:50
> > remeron, can i just say ,i tried it a baby does it make you fat . an i mean soon as you take it . i went up a waist size in 2 weeks, i am vain to say that was enough an time to stop , i dont no if it would have helped my illness but no way was i blobing out that fast.
>
> It did the same thing to me and I stopped taking it after a few weeks. It was making me eat everything in sight. I couldn't keep going on that way.I'm curious as to what dosage you were taking. Do dosages of 45mg and higher produce less hunger?
- Scott
Posted by floatingbridge on August 16, 2009, at 20:25:09
In reply to Re: What Medication Direction Should I Take? » manic666, posted by maxime on August 16, 2009, at 19:52:50
Maxime, my friend in remission on lexapro and remeron says the same thing. But her weight evened out, she's happy at nursing school and being mom to an 8 year old boy, so she doesn't mind the extra weight. (She did not become obese--just hippy.) And seeing her happy is just lovely!
fb
(I don't know her doses.)
Posted by Maxime on August 16, 2009, at 22:00:48
In reply to Re: What Medication Direction Should I Take? » maxime, posted by SLS on August 16, 2009, at 20:08:05
> I'm curious as to what dosage you were taking. Do dosages of 45mg and higher produce less hunger?
>
>
> - ScottScott, I only got to 30 mg and then stopped. Apparently there is less hunger at the higher dosages. I was actually put on it to gain weight while in an eating disorder program. I can't believe they did that to me ... it was very disturbing for me to say the least.
This is the end of the thread.
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