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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Justherself54 on August 11, 2009, at 20:28:50
Just saw my GP before my pdoc appointment. Apparently I have Coccydynia and he's also arranging for me to be tested for sleep apnea.
Then I saw my pdoc. As I'm not getting a whole lot of benefit from Paxil, he wants me to drop my dose to 20 mg. from 30 and is adding Alertec as I am not getting any response from Ritalin.
I'm retrying old meds that worked, hence the Paxil and I think he doesn't want to try an increase as that's what I was on when I had my first prolonged mania.
Right now I'm not too badly depressed but very, very tired. It's not that I don't have interest in doing things..I'm so unfocused it takes me forever to get a task done. Add to that all the issues that come from fibromyalgia and now the Coccydynia, I'm avoiding anything that's going to raise my pain level.
Any thoughts about the drop in Paxil and adding the Alertec.
Sorry to ramble!
Posted by Phillipa on August 12, 2009, at 0:23:46
In reply to Alertec added, posted by Justherself54 on August 11, 2009, at 20:28:50
That's a new one to me will google. Love Phillipa
Posted by Phillipa on August 12, 2009, at 0:37:45
In reply to Alertec added, posted by Justherself54 on August 11, 2009, at 20:28:50
Seriously how long has this been going on it could be what has caused your depression and fibro. Love Phillipa found this
Posted by Justherself54 on August 14, 2009, at 18:10:18
In reply to Alertec added, posted by Justherself54 on August 11, 2009, at 20:28:50
Posted by Phillipa on August 14, 2009, at 21:19:09
In reply to Re: Alertec added--PLEASE? (nm), posted by Justherself54 on August 14, 2009, at 18:10:18
Oh googled it and it's providgil might want to start new thread maybe some not familiar with this name. I copied this for you. I know you can google probably have it sounds good. Love Phillipa
Posted by SLS on August 15, 2009, at 5:40:59
In reply to Alertec added, posted by Justherself54 on August 11, 2009, at 20:28:50
> Just saw my GP before my pdoc appointment. Apparently I have Coccydynia and he's also arranging for me to be tested for sleep apnea.
>
> Then I saw my pdoc. As I'm not getting a whole lot of benefit from Paxil, he wants me to drop my dose to 20 mg. from 30 and is adding Alertec as I am not getting any response from Ritalin.
>
> I'm retrying old meds that worked, hence the Paxil and I think he doesn't want to try an increase as that's what I was on when I had my first prolonged mania.
>
> Right now I'm not too badly depressed but very, very tired. It's not that I don't have interest in doing things..I'm so unfocused it takes me forever to get a task done. Add to that all the issues that come from fibromyalgia and now the Coccydynia, I'm avoiding anything that's going to raise my pain level.
>
> Any thoughts about the drop in Paxil and adding the Alertec.
>
> Sorry to ramble!So, at 30mg, Paxil is acting as an effective antidepressant? The only reason for lowering the dosage is to avoid fatigue and tiredness? It might help. I can't be certain enough about that to be able to enthusiastically recommend it. Since everyone is different in the way they react to psychotropics, I think lowering the dosage is a reasonable experiment to conduct.
Adding Alertec 200-400mg can help some people with drug-induced or fibromyalgia-related fatigue. For some lucky few, it acts as an antidepressant when added as an adjunct. I think this is another experiment worth conducting.
My doctors would love for me to get manic. For me, it is easily controlled using Depakote or Zyprexa. If you became manic at 40mg of Paxil, did you experience fatigue? Fatigue can be a symptom of fibromyalgia. It can also be a symptom of subsyndromal depression.
It occurs to me that taking Cymbalta instead of Paxil might relieve you of your pain conditions. The other thing you can do is to add nortriptyline to Paxil for the same purposes. The addition of nortriptyline might also resolve any residual depression that may exist.
I think the addition of Alertec makes sense. I am less convinced that reducing the Paxil will be productive. Again, it is reasonable to experiment with this in order to find out.
- Scott
Posted by Ron Hill on August 15, 2009, at 22:55:04
In reply to Alertec added, posted by Justherself54 on August 11, 2009, at 20:28:50
> I'm retrying old meds that worked, hence the Paxil and I think he doesn't want to try an increase as that's what I was on when I had my first prolonged mania.
Are you bipolar? Were you "med-induced" bipolar?
What is your dx and what meds are you taking?
-- Ron
dx: Bipolar II and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
Posted by Justherself54 on August 16, 2009, at 0:38:43
In reply to Re: Alertec added » Justherself54, posted by SLS on August 15, 2009, at 5:40:59
I aksed my pdoc about raising the Paxil. His response was no, not when you're not really getting a good partial response to it. One thing, today I took my first Alertec. I've been trying to get the second coat of paint on my bathroom for a month! For some reason I was able to tackle it and get the majority of it done. I seemed to "move" faster and kept on task better than I have for weeks. Will see how the next few days go.
I tried Cymbalta, but for some reason it caused me to have a "rage" episode. I'm usually a pretty logical person and this episode made no sense. I think I would have harmed my brother (my bone of contention) if he had come to my place after we had an argument. It was very bad and very frightening.
I quickly read up on subsyndromal depression. Doesn't it relate more to the elderly? Ekkk. I don't think of myself as elderly :). Thanks for your response. It's a pretty sad life I lead when I get all excited because I painted my bathroom. Thanks for listening.
> > Just saw my GP before my pdoc appointment. Apparently I have Coccydynia and he's also arranging for me to be tested for sleep apnea.
> >
> > Then I saw my pdoc. As I'm not getting a whole lot of benefit from Paxil, he wants me to drop my dose to 20 mg. from 30 and is adding Alertec as I am not getting any response from Ritalin.
> >
> > I'm retrying old meds that worked, hence the Paxil and I think he doesn't want to try an increase as that's what I was on when I had my first prolonged mania.
> >
> > Right now I'm not too badly depressed but very, very tired. It's not that I don't have interest in doing things..I'm so unfocused it takes me forever to get a task done. Add to that all the issues that come from fibromyalgia and now the Coccydynia, I'm avoiding anything that's going to raise my pain level.
> >
> > Any thoughts about the drop in Paxil and adding the Alertec.
> >
> > Sorry to ramble!
>
> So, at 30mg, Paxil is acting as an effective antidepressant? The only reason for lowering the dosage is to avoid fatigue and tiredness? It might help. I can't be certain enough about that to be able to enthusiastically recommend it. Since everyone is different in the way they react to psychotropics, I think lowering the dosage is a reasonable experiment to conduct.
>
> Adding Alertec 200-400mg can help some people with drug-induced or fibromyalgia-related fatigue. For some lucky few, it acts as an antidepressant when added as an adjunct. I think this is another experiment worth conducting.
>
> My doctors would love for me to get manic. For me, it is easily controlled using Depakote or Zyprexa. If you became manic at 40mg of Paxil, did you experience fatigue? Fatigue can be a symptom of fibromyalgia. It can also be a symptom of subsyndromal depression.
>
> It occurs to me that taking Cymbalta instead of Paxil might relieve you of your pain conditions. The other thing you can do is to add nortriptyline to Paxil for the same purposes. The addition of nortriptyline might also resolve any residual depression that may exist.
>
> I think the addition of Alertec makes sense. I am less convinced that reducing the Paxil will be productive. Again, it is reasonable to experiment with this in order to find out.
>
>
> - Scott
Posted by Justherself54 on August 16, 2009, at 0:46:17
In reply to Re: Alertec added » Justherself54, posted by Ron Hill on August 15, 2009, at 22:55:04
Thanks for responding. I was diagnosed as BP2, although there has been evidence of some mixed episodes. Looking back, I can see a lot of manias, fortunately, they were very productive ones, with my finances getting the most beating from them.
I'm taking 20 mg. paxil, 100 mg Eltroxin, Alertic, 7.5 mg zopiclone and .05 mg clonazapam, although I'm having a sleep study done soon for sleep apnea, as my sleep is terrible. I've taken mostly all mood stabilizers, but can't hack them.
Any comments welcomed.
Posted by SLS on August 16, 2009, at 5:31:31
In reply to Re: Alertec added » SLS, posted by Justherself54 on August 16, 2009, at 0:38:43
"Subsyndromal" means that the symptoms are very mild or barely perceptible such that they don't rise to the level of a fully developed illness. It has nothing to do with being elderly.
I'm glad that you are able to function better with the Alertec. I consider it quite an accomplishment to paint a bathroom.
For some reason, a lot of people here are opting to add nortriptyline to their ongoing drug treatment. Relatively speaking, I have had a great deal of luck with it. Besides using it in conjunction with MAOIs, I have also combined it with Effexor. Some doctors are using it more and more to supplement SSRI / SNRI drugs, as it produces a more even distribution of serotonin and norepinephrine reuptake inhibition. If you are getting only partial relief with your current medications after a sufficiently long trial, nortriptyline might be worth looking into. For what it is worth, although being bipolar, I never had a manic reaction to nortriptyline. It still remains a possibility, though.
I hope Alertec works some magic for you.
- Scott
Posted by Ron Hill on August 16, 2009, at 12:32:05
In reply to Re: Alertec added » Ron Hill, posted by Justherself54 on August 16, 2009, at 0:46:17
> Thanks for responding. I was diagnosed as BP2, although there has been evidence of some mixed episodes. Looking back, I can see a lot of manias, fortunately, they were very productive ones, with my finances getting the most beating from them.
> I'm taking 20 mg. paxil, 100 mg Eltroxin, Alertic, 7.5 mg zopiclone and .05 mg clonazapam, although I'm having a sleep study done soon for sleep apnea, as my sleep is terrible. I've taken mostly all mood stabilizers, but can't hack them.> Any comments welcomed.
Just Herself,
Are you sure it's okay for me to give my comments? I ask because I have serious disagreement with the med tx your pdoc has you on. But, I will hold my tongue until I have more information.
What was the purpose of Ritalin which has now been replaced with Alertic?
Please list the moodstablizers that you have taken and the reason you could not tolerate each.
Have you ever taken an antipsychotic medication? If so, which one(s) and what was your response?
-- Ron
dx: Bipolar II and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
Posted by Phillipa on August 16, 2009, at 19:46:17
In reply to Re: Alertec added » SLS, posted by Justherself54 on August 16, 2009, at 0:38:43
Sounds like an improvement? Any updates today? Love Phillipa
This is the end of the thread.
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