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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 bulldog2 on September 22, 2009, at 16:19:44
I suffer from atypical depression, social phobias, and adhd.
Currently on vyvanse 30 mg which I like. Very smooth stimulant.'
Neurontin 1200 mg twice a day. It's used for anxiety and has an ad effect.
10 mg of oxycodone 4 times a day for pain. This also has an ad effect.
Now after surgery I will be weaned off of this.So if I keep neurontin and vyvanse I need something else to boost the ad effect of this combo.I've used these two meds alone but I still feel somewhat depressed. Something is lacking. I was thinking a small dose of an ssri as maybe serotonin is lacking. Any input would be appreciated.
Thanks
bulldog2
Posted by SLS on September 22, 2009, at 16:35:38
In reply to Please Help Me Complete My Combo, posted by bulldog2 on September 22, 2009, at 16:19:44
> I suffer from atypical depression, social phobias, and adhd.
>
> Currently on vyvanse 30 mg which I like. Very smooth stimulant.'
>
> Neurontin 1200 mg twice a day. It's used for anxiety and has an ad effect.
>
> 10 mg of oxycodone 4 times a day for pain. This also has an ad effect.
> Now after surgery I will be weaned off of this.
>
> So if I keep neurontin and vyvanse I need something else to boost the ad effect of this combo.I've used these two meds alone but I still feel somewhat depressed. Something is lacking. I was thinking a small dose of an ssri as maybe serotonin is lacking. Any input would be appreciated.
>
> Thanks
> bulldog2
Maybe try Wellbutrin first?Add Effexor or Lexapro if necessary.
I'm going to keep in mind that Neurontin gives you an antidepressant effect. We'll see if there isn't some soft bipolarity in there somewhere.
- Scott
Posted by bulldog2 on September 22, 2009, at 17:19:18
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by SLS on September 22, 2009, at 16:35:38
> > I suffer from atypical depression, social phobias, and adhd.
> >
> > Currently on vyvanse 30 mg which I like. Very smooth stimulant.'
> >
> > Neurontin 1200 mg twice a day. It's used for anxiety and has an ad effect.
> >
> > 10 mg of oxycodone 4 times a day for pain. This also has an ad effect.
> > Now after surgery I will be weaned off of this.
> >
> > So if I keep neurontin and vyvanse I need something else to boost the ad effect of this combo.I've used these two meds alone but I still feel somewhat depressed. Something is lacking. I was thinking a small dose of an ssri as maybe serotonin is lacking. Any input would be appreciated.
> >
> > Thanks
> > bulldog2
>
>
> Maybe try Wellbutrin first?
>
> Add Effexor or Lexapro if necessary.
>
> I'm going to keep in mind that Neurontin gives you an antidepressant effect. We'll see if there isn't some soft bipolarity in there somewhere.
>
> - Scott
>Yes I have also been diagnosed with bipolar 2. P-doc says I have so many issues he doesn't know which to address to. thanks.
Posted by willyeee on September 22, 2009, at 20:24:14
In reply to Re: Please Help Me Complete My Combo, posted by bulldog2 on September 22, 2009, at 17:19:18
Small dose of klonopin
Posted by yxibow on September 22, 2009, at 20:32:19
In reply to Please Help Me Complete My Combo, posted by bulldog2 on September 22, 2009, at 16:19:44
> I suffer from atypical depression, social phobias, and adhd.
>
> Currently on vyvanse 30 mg which I like. Very smooth stimulant.'
>
> Neurontin 1200 mg twice a day. It's used for anxiety and has an ad effect.
>
> 10 mg of oxycodone 4 times a day for pain. This also has an ad effect.
> Now after surgery I will be weaned off of this.
>
> So if I keep neurontin and vyvanse I need something else to boost the ad effect of this combo.I've used these two meds alone but I still feel somewhat depressed. Something is lacking. I was thinking a small dose of an ssri as maybe serotonin is lacking. Any input would be appreciated.
How long have you been on the combination (besides the narcotic which I assume is very recent) ? If it hasn't been long, might want to wait a bit before piling more medications on...
Otherwise, perhaps what Scott was saying might be an idea.-- tidings
Posted by Phillipa on September 22, 2009, at 21:58:36
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by yxibow on September 22, 2009, at 20:32:19
Seriously l0mg of paxil was the only one that did work for me. Love Phillipa
Posted by bulldog2 on September 23, 2009, at 15:16:14
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by yxibow on September 22, 2009, at 20:32:19
> > I suffer from atypical depression, social phobias, and adhd.
> >
> > Currently on vyvanse 30 mg which I like. Very smooth stimulant.'
> >
> > Neurontin 1200 mg twice a day. It's used for anxiety and has an ad effect.
> >
> > 10 mg of oxycodone 4 times a day for pain. This also has an ad effect.
> > Now after surgery I will be weaned off of this.
> >
> > So if I keep neurontin and vyvanse I need something else to boost the ad effect of this combo.I've used these two meds alone but I still feel somewhat depressed. Something is lacking. I was thinking a small dose of an ssri as maybe serotonin is lacking. Any input would be appreciated.
>
>
> How long have you been on the combination (besides the narcotic which I assume is very recent) ? If it hasn't been long, might want to wait a bit before piling more medications on...
>
>
> Otherwise, perhaps what Scott was saying might be an idea.
>
> -- tidingsThe neurontin I have been on for a couple of years. The vyvanse just a couple of weeks. I was started at 30 mg by the p-doc to be conservative.I was thinking of 40 or 50 mg next time I see him.
Now I can see some serotonin in this mix. Linkadge seems to be doing well with amitriptyline and ritalin. Amitriptyline would give me a bit of serotonin and I read in the med insert that tcas potentiate the effect of d-amphetamine and vice versa.Now the percocet I have been on a couple of months so I am a bit used to it. When I take my dose it does add a bit of an ad dose to the mix.
Posted by bulldog2 on September 23, 2009, at 15:16:59
In reply to Re: Please Help Me Complete My Combo, posted by Phillipa on September 22, 2009, at 21:58:36
> Seriously l0mg of paxil was the only one that did work for me. Love Phillipa
Why aren't you using the paxil?
Posted by merry-dove on September 26, 2009, at 9:38:15
In reply to Please Help Me Complete My Combo, posted by bulldog2 on September 22, 2009, at 16:19:44
I have the same maladies. I not familiar with vyvanse. Here are my current meds and I'm finally feeling good again.
Pristiq - 100mg 1 x day - AM
Concerta - 72mg 1 X day - AM
Klonopin - .25 mg. 3 x day and .5mg at bedtime
Vicodin - 1/2 pill 3-4 X day (5mg/500mg tabs)
Abilify (the miracle drug) 2mg 1 x day - AM
I started Pristiq a couple months ago because Cymbalta "pooped out" Klonopin helped me TREMONDOUSLY with anxiety and social phobia. At the time, it literally changed my life. In the last year, however, the depression has become severe and I was suffering extreme fatigue. I started Abilify 1 1/2 weeks ago and it has given me the energy I need to LIVE. The extreme fatigue I had is gone and I am enjoying things. It has been a HUGE transformation
Good luck and God Bless,
Terry
Posted by bulldog2 on September 26, 2009, at 11:21:19
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by merry-dove on September 26, 2009, at 9:38:15
> I have the same maladies. I not familiar with vyvanse. Here are my current meds and I'm finally feeling good again.
> Pristiq - 100mg 1 x day - AM
> Concerta - 72mg 1 X day - AM
> Klonopin - .25 mg. 3 x day and .5mg at bedtime
> Vicodin - 1/2 pill 3-4 X day (5mg/500mg tabs)
> Abilify (the miracle drug) 2mg 1 x day - AM
> I started Pristiq a couple months ago because Cymbalta "pooped out" Klonopin helped me TREMONDOUSLY with anxiety and social phobia. At the time, it literally changed my life. In the last year, however, the depression has become severe and I was suffering extreme fatigue. I started Abilify 1 1/2 weeks ago and it has given me the energy I need to LIVE. The extreme fatigue I had is gone and I am enjoying things. It has been a HUGE transformation
> Good luck and God Bless,
> TerryThank you very much for your post. Looks like a very nice combo. Vyvanse to simplify it is in essense a time released amphetamine drug. That seems to help a lot. My dose is percocet is 10 mg 4-6 times a day for pain. Once my hip is replaced and healed the pain meds will be withdrawn.
So I will need a replacement for the percocet as that adds to helping me feel better.
So will be on neurontin and vyvanse. Klonopin low dose at night for sleeping.So I'm thinking of a good ad that might blend in with the neurontin and vyvanse. I guess low dose ssri or something like pristique might be good. After the addition of an ad something like abilify might be good. I tend to add one thing at a time.How did you feel after the addition of the pristique? Did you need abilify for the whole combo to kick in?
Thanks
bulldog2
Posted by merry-dove on September 26, 2009, at 13:21:31
In reply to Re: Please Help Me Complete My Combo » merry-dove, posted by bulldog2 on September 26, 2009, at 11:21:19
> > I have the same maladies. I not familiar with vyvanse. Here are my current meds and I'm finally feeling good again.
> > Pristiq - 100mg 1 x day - AM
> > Concerta - 72mg 1 X day - AM
> > Klonopin - .25 mg. 3 x day and .5mg at bedtime
> > Vicodin - 1/2 pill 3-4 X day (5mg/500mg tabs)
> > Abilify (the miracle drug) 2mg 1 x day - AM
> > I started Pristiq a couple months ago because Cymbalta "pooped out" Klonopin helped me TREMONDOUSLY with anxiety and social phobia. At the time, it literally changed my life. In the last year, however, the depression has become severe and I was suffering extreme fatigue. I started Abilify 1 1/2 weeks ago and it has given me the energy I need to LIVE. The extreme fatigue I had is gone and I am enjoying things. It has been a HUGE transformation
> > Good luck and God Bless,
> > Terry
>
> Thank you very much for your post. Looks like a very nice combo. Vyvanse to simplify it is in essense a time released amphetamine drug. That seems to help a lot. My dose is percocet is 10 mg 4-6 times a day for pain. Once my hip is replaced and healed the pain meds will be withdrawn.
> So I will need a replacement for the percocet as that adds to helping me feel better.
> So will be on neurontin and vyvanse. Klonopin low dose at night for sleeping.So I'm thinking of a good ad that might blend in with the neurontin and vyvanse. I guess low dose ssri or something like pristique might be good. After the addition of an ad something like abilify might be good. I tend to add one thing at a time.
>
> How did you feel after the addition of the pristique? Did you need abilify for the whole combo to kick in?
>
> Thanks
> bulldog2
>When Cymbalta stopped working I started Pristiq. Both are SNRI's which affect noripinephrine as well as seratonin. Pristiq helped some for my depression but I was still barely functioning. I decided to add Abilify as a last resort. I was out of ideas except for switching to an MAOI. Abilify turned out to be my lifesaver.
As far as klonopin, I started taking it about 3 years ago. I was taking Cymbalta at that time which was keeping depression somewhat under control. But I had such severe social phobia I very seldom went out in public, except to work. The klonopin completely changed my life. I started talking to neighbors I hadn't talked to in the 12 years we lived there! I could go to stores, parties, etc. I enjoyed life for a couple years. Then the Cymbalta pooped out, I had some stressful situatiions come up and I was on the verge of suicide. That's when I switched to Pristiq but it didn't quite do the job.
The Abilify has lifted the depression, given me energy and motivation. I'm fine in social situations which I still attribute to the klonopin. I take one 5 mg at bedtime (it makes me drowsy at that dose) But I also take 1/2 pill each morning, again about 11:30AM and again about 3:30PM. That dose doesn't make me drowsy. This regime keeps my anxiety at bay.
Hope this helps you. Feel free to ask me anything you would like to know.
Good luck and God Bless.
Terry
Posted by bulldog2 on September 26, 2009, at 15:14:32
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by merry-dove on September 26, 2009, at 13:21:31
> > > I have the same maladies. I not familiar with vyvanse. Here are my current meds and I'm finally feeling good again.
> > > Pristiq - 100mg 1 x day - AM
> > > Concerta - 72mg 1 X day - AM
> > > Klonopin - .25 mg. 3 x day and .5mg at bedtime
> > > Vicodin - 1/2 pill 3-4 X day (5mg/500mg tabs)
> > > Abilify (the miracle drug) 2mg 1 x day - AM
> > > I started Pristiq a couple months ago because Cymbalta "pooped out" Klonopin helped me TREMONDOUSLY with anxiety and social phobia. At the time, it literally changed my life. In the last year, however, the depression has become severe and I was suffering extreme fatigue. I started Abilify 1 1/2 weeks ago and it has given me the energy I need to LIVE. The extreme fatigue I had is gone and I am enjoying things. It has been a HUGE transformation
> > > Good luck and God Bless,
> > > Terry
> >
> > Thank you very much for your post. Looks like a very nice combo. Vyvanse to simplify it is in essense a time released amphetamine drug. That seems to help a lot. My dose is percocet is 10 mg 4-6 times a day for pain. Once my hip is replaced and healed the pain meds will be withdrawn.
> > So I will need a replacement for the percocet as that adds to helping me feel better.
> > So will be on neurontin and vyvanse. Klonopin low dose at night for sleeping.So I'm thinking of a good ad that might blend in with the neurontin and vyvanse. I guess low dose ssri or something like pristique might be good. After the addition of an ad something like abilify might be good. I tend to add one thing at a time.
> >
> > How did you feel after the addition of the pristique? Did you need abilify for the whole combo to kick in?
> >
> > Thanks
> > bulldog2
> >
>
> When Cymbalta stopped working I started Pristiq. Both are SNRI's which affect noripinephrine as well as seratonin. Pristiq helped some for my depression but I was still barely functioning. I decided to add Abilify as a last resort. I was out of ideas except for switching to an MAOI. Abilify turned out to be my lifesaver.
>
> As far as klonopin, I started taking it about 3 years ago. I was taking Cymbalta at that time which was keeping depression somewhat under control. But I had such severe social phobia I very seldom went out in public, except to work. The klonopin completely changed my life. I started talking to neighbors I hadn't talked to in the 12 years we lived there! I could go to stores, parties, etc. I enjoyed life for a couple years. Then the Cymbalta pooped out, I had some stressful situatiions come up and I was on the verge of suicide. That's when I switched to Pristiq but it didn't quite do the job.
>
> The Abilify has lifted the depression, given me energy and motivation. I'm fine in social situations which I still attribute to the klonopin. I take one 5 mg at bedtime (it makes me drowsy at that dose) But I also take 1/2 pill each morning, again about 11:30AM and again about 3:30PM. That dose doesn't make me drowsy. This regime keeps my anxiety at bay.
>
> Hope this helps you. Feel free to ask me anything you would like to know.
>
> Good luck and God Bless.
> TerryYes the vyvanse and neurontin lift my mood and make me more sociable. Generally I am reclusive by nature and avoid social situations. By the way vyvanse is d-amphetamine and I feel is very smooth. Might ask my p-doc for a higher dose and it lasts for about 12 hours.
However my emotions are very raw and I am very sensitive to rejection and at times if I let insults pile up I can explode.
Need something to blunt and protect me from abrasive and toxic people who are very abundant in my family.
I guess serotonin has a reputation for being good for that. Any suggestions would be welcome.
Maybe abilify would make a good drug to augment mine.
I guess as I get ready for surgery certain People who I thought were close and have not wished me well really bothers me. I need something to give me tougher armour in this jungle of a society. Guess that is how I see it.
Posted by Phillipa on September 26, 2009, at 20:48:06
In reply to Re: Please Help Me Complete My Combo, posted by bulldog2 on September 26, 2009, at 15:14:32
Bulldog the real world can be nasty as we've discussed l truly wish you well with the surgery and I'm sure you're also getting anxious. Isn't it this week? Love Phillipa
Posted by yxibow on September 27, 2009, at 4:50:16
In reply to Re: Please Help Me Complete My Combo, posted by bulldog2 on September 23, 2009, at 15:16:14
> The neurontin I have been on for a couple of years. The vyvanse just a couple of weeks. I was started at 30 mg by the p-doc to be conservative.I was thinking of 40 or 50 mg next time I see him.Give the Vyvanase time. There's no reason to start adding TCAs to the mixture.
The timeline of psychoactive drugs isn't overnight. Another couple of weeks won't hurt and it might help to see just how well you tolerate what you already have and not make a bigger mixture than necessary.
I can tell you from personal experience that though I don't have infinite time to regain more functionality, regret can happen from inserting drugs more quickly than necessary.
-- tidings
Posted by bulldog2 on September 27, 2009, at 16:04:26
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by Phillipa on September 26, 2009, at 20:48:06
> Bulldog the real world can be nasty as we've discussed l truly wish you well with the surgery and I'm sure you're also getting anxious. Isn't it this week? Love Phillipa
Thank you for your well wishes as all people who just have enough times to wish me good luck are truly appreciated. Surgery is on 9/29 and yes I am getting a bit anxious.
Really working on building tougher emotional armour as this is a jungle so to speak. If cbt will do it fine but if I need meds to help so be it.
I'm sure many here have been injured by people who prey on those who are preceived as being weak.Much of my life has has been spent in avoidance of situations I perceived as having some danger as others may also do.But this stratagy also leads to loss of many life opportunites.
So now is the time for a new life style for dealing with predators. I have discussed a new approach. I guess we all have people in our lives that are toxic. I mean people who do not like you or may even hate you. They always look for opportunities to do psychological damage. Actually I look on it as warfare.We (me and the p-doc) is to begin getting these people out of my life. That means to put down your guns and walk away. That means the war is over.
This can be very difficult but something I have to do. I will no longer attend any social functions where these people attend. I will no longer have these people to my house for family functions.For to many years I felt obligated to attend these family functions.I informed certain people about my decision.
I feel that it is my right to push these toxic people out of my life.For to many years I felt pressure to be civil to people who were rude and obnoxious to me. I finally exploded. I had it.I will no longer wage war with people who feel compelled to wage psychological against me. One of these people actually wrote in an email he was angry about things that occurred in the past and felt compelled to attack me. I wrote an email to him that the war was over and I will no longer be in his company.He was outraged. How could I not attend these family events but he would not modify his behavior to be civil. Wow...I must attend family events and he will continue to be rude and obnoxious.
I said "GOOD BYE" this is over. You are out of my life.
I realize this is a long story but I guess there is a theme. I have control of my life and can make decisions about people who are toxic to me.
When one feels trapped in a bad situation or situations one gets depressed. Once you see you have options and one is get as many toxic people out of your life you will feel better.
Posted by Phillipa on September 27, 2009, at 19:47:29
In reply to Re: Please Help Me Complete My Combo, posted by bulldog2 on September 27, 2009, at 16:04:26
Bulldog haven't spoken to my sister in years. I understand. Phillipa ps that's Tuesday right will be thinking of you seriously. How long in hospital?
Posted by bulldog2 on September 28, 2009, at 10:06:02
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by Phillipa on September 27, 2009, at 19:47:29
> Bulldog haven't spoken to my sister in years. I understand. Phillipa ps that's Tuesday right will be thinking of you seriously. How long in hospital?
2 to 4 days. Trying to formulate a new outlook and it has nothing to do with drugs.Just don't give a bleep what people think of me. I wanted everyone to love me. Bad philosophy. Be nice to those who care for me and cut loose the toxic people who only try to hurt me.
Posted by Phillipa on September 28, 2009, at 19:26:52
In reply to Re: Please Help Me Complete My Combo, posted by bulldog2 on September 28, 2009, at 10:06:02
In all seriousness please watch the health care workers to make sure they througly wash their hands before touching you or anything in your room. Love Phillipa
Posted by SLS on September 29, 2009, at 6:01:35
In reply to Re: Please Help Me Complete My Combo, posted by bulldog2 on September 28, 2009, at 10:06:02
> > Bulldog haven't spoken to my sister in years. I understand. Phillipa ps that's Tuesday right will be thinking of you seriously. How long in hospital?
>
> 2 to 4 days. Trying to formulate a new outlook and it has nothing to do with drugs.Just don't give a bleep what people think of me. I wanted everyone to love me. Bad philosophy. Be nice to those who care for me and cut loose the toxic people who only try to hurt me.Welcome to the world of acquired wisdom.
I'm glad that you have taken away that pressure to seek universal approval. It can only help your physical and mental health. Look for balance. It should lead to a better quality of life.
- Scott
Posted by Phillipa on September 29, 2009, at 20:11:20
In reply to Re: Please Help Me Complete My Combo » bulldog2, posted by SLS on September 29, 2009, at 6:01:35
Hope he's doing well at least the surgery is over. Love Phillipa
This is the end of the thread.
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