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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by SLS on November 11, 2009, at 14:21:40
How have you been responding to treatment?
I'm feeling better overall, but progress is frustratingly slow.
- Scott
Posted by linkadge on November 11, 2009, at 15:02:16
In reply to Linkadge - How are you doing?, posted by SLS on November 11, 2009, at 14:21:40
Hey, thanks so much for the inquiry. I was just about to come on and say how I am doing.
I seem to have hit a snag with the amitriptyline.
It kind of works to reduce some of the worst feelings but I feel pretty out of it on the drug.
I havn't been taking it like I should and so I am not doing all that great.The other drug I am taking is methlyphenidate which I tolerate a lot better and is probably keeping me floating.
I have crippling sadness which permates everything I do. Almost every moment of my life is a reminder of death. I want to keep working and I want to feel well. Most of the antidepressants just put me in zombie land.
Amitritpyline is less harsh than the nortriptyline was, but the amitriptyline just leaves me feeling too drugged.I have been trying some alterantive augmentation strategies which are not working too well.
I feel so disconnected from my doctor at the moment. Its the same old story. I take a drug, it either stops working or I stop taking it and I don't want to tell my doctor about it.
Linkadge
Posted by SLS on November 11, 2009, at 15:35:06
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 11, 2009, at 15:02:16
Hi Linkadge.
I am saddened and frustrated for you. I can certainly empathize with your having mixed results or transient responses to treatment.
> I seem to have hit a snag with the amitriptyline.
>
> It kind of works to reduce some of the worst feelings but I feel pretty out of it on the drug.I did not tolerate amitriptyline well because I felt so drugged on it. It was quite disgusting.
> I havn't been taking it like I should
That's understandable. I am not always compliant when I feel like I am swallowing poison pills that are going to make me feel like crap.
> The other drug I am taking is methlyphenidate which I tolerate a lot better and is probably keeping me floating.
Long shot: Is it possible that the methylphenidate was acting with the nortriptyline in such a way as to produce the harshness you experienced?
> I have crippling sadness which permates everything I do. Almost every moment of my life is a reminder of death.
I am really sorry to hear this. I cannot empathize fully with your suffering because I generally don't experience such melancholy.
> I want to keep working and I want to feel well.
It's impressive that you are working at all.
> Most of the antidepressants just put me in zombie land.
I am somewhat afraid to suggest this, but it might be worth adding Zyprexa to one of these antidepressants to see if it clears-up the "brain-fog".
> I have been trying some alterantive augmentation strategies which are not working too well.
Do you think that it might be worth taking N-acetylcysteine for long-term neuroprotection?
I wish I could help more.
- Scott
Posted by linkadge on November 11, 2009, at 17:18:34
In reply to Re: Linkadge - How are you doing?, posted by SLS on November 11, 2009, at 15:35:06
I stopped taking the methylphenidate for most of the nortriptyline trial. The nortriptyline was helping somewhat but just wasn't getting to the core. The amitriptyline feels a bit more uplifting, but again produces the drugged feeling.
Linkadge
Posted by bulldog2 on November 11, 2009, at 17:32:15
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 11, 2009, at 17:18:34
> I stopped taking the methylphenidate for most of the nortriptyline trial. The nortriptyline was helping somewhat but just wasn't getting to the core. The amitriptyline feels a bit more uplifting, but again produces the drugged feeling.
>
> Linkadge
>
>Possibly a low dose of an ssri with the ritalin. Seems like you need a bit of serotonin but the tcas are all sedating for the most part.
Posted by FredPotter on November 11, 2009, at 18:13:38
In reply to Re: Linkadge - How are you doing? » linkadge, posted by bulldog2 on November 11, 2009, at 17:32:15
In a week's time I'll add zoloft to my nortriptyline. It's a pity I stopped the Nardil. I feel like drug changes cause perturbations that can take a while to settle. But Nardil had side effects
Posted by Phillipa on November 11, 2009, at 23:45:57
In reply to Re: Linkadge - How are you doing?, posted by FredPotter on November 11, 2009, at 18:13:38
Sad to me is an emotion which a drug can't cure. Did something happen to cause the sadness in your life? Have you been excercising. Lean and trim as you maybe try running? Not antimed just feeling for triggers. Hey you guys know meds I just know how I feel. Phillipa
Posted by SLS on November 12, 2009, at 7:42:27
In reply to Re: Linkadge - How are you doing?, posted by Phillipa on November 11, 2009, at 23:45:57
> Sad to me is an emotion which a drug can't cure.
I disagree.
Sadness can be a symptom of MDD such that the right biological treatment causes it to evaporate. Of course, there are life situations or persistent depressive thought styles that can remain separate from MDD, in which case psychotherapy can help.
- Scott
Posted by bulldog2 on November 12, 2009, at 8:33:01
In reply to Re: Linkadge - How are you doing?, posted by Phillipa on November 11, 2009, at 23:45:57
> Sad to me is an emotion which a drug can't cure. Did something happen to cause the sadness in your life? Have you been excercising. Lean and trim as you maybe try running? Not antimed just feeling for triggers. Hey you guys know meds I just know how I feel. Phillipa
Please stop with the exercising. I doubt that exercise cures sadness. Many depressed people exercise. Why is there always an assumption that depressed people exercise.
What bothers me about this exercise mantra is the assumption someone is depressed because they don't exercise.
Posted by bulldog2 on November 12, 2009, at 11:02:28
In reply to Re: Linkadge - How are you doing?, posted by Phillipa on November 11, 2009, at 23:45:57
> Sad to me is an emotion which a drug can't cure. Did something happen to cause the sadness in your life? Have you been excercising. Lean and trim as you maybe try running? Not antimed just feeling for triggers. Hey you guys know meds I just know how I feel. Phillipa
I doubt that something so deep as persistant sadness has anything to do with lack of exercise. I agree with Scott but also here's something for you to think about.
Is it important to have a spiritual life in this turbulent world to feel happiness. To believe in a creator and feel this world and its happenings have some meaning?
You ride your bike every night and I think you indicate that helps a bit with your anxiety. But does your bike riding bring you any closer to what ails and torments you?
Posted by Maxime on November 12, 2009, at 14:45:45
In reply to Linkadge - How are you doing?, posted by SLS on November 11, 2009, at 14:21:40
I am sorry that things aren't moving faster for you. I hope you feel much better soon.
Posted by linkadge on November 12, 2009, at 16:43:57
In reply to Re: Linkadge - How are you doing?, posted by bulldog2 on November 12, 2009, at 8:33:01
I have been exerciseing plenty - perhaps too much. I don't know what is causeing the sadness. I just graduated and got a good job that I enjoy - it is what I've always wanted to do.
I just can't stop thinking about death. I feel as if I am 85 years old and dying. I feel worthless. I want to connect but I don't know how.
The feelings are neverending and I often want to end it all (don't worry not a suicide note).
My diet is impecable and I run more than 5k a day.
Linkadge
Posted by linkadge on November 12, 2009, at 16:46:54
In reply to Re: Linkadge - How are you doing?, posted by Maxime on November 12, 2009, at 14:45:45
I'm really not here to complain about this or that. Sympathy doesn't do much for me. I am just stating how I feel and that I know its not normal cause I feel its not normal and I have felt much better.
Linkadge
Posted by linkadge on November 12, 2009, at 16:52:44
In reply to Re: Linkadge - How are you doing?, posted by Maxime on November 12, 2009, at 14:45:45
I read an article in the newspaper today about a soccer player who commit suicide. I've never heard of him but there was a lot I identified with.
He was a healthy, good looking guy with a promising career. The article suggested that he had not been honest with his doctor about the progress he was making with treatment.
I would have a hard time telling my doctor that I am not doing well as he thinks I am. Part of me doesn't want to dissapoint him and part of me wants to live the lie that I am doing well.
Linkadge
Posted by Phillipa on November 12, 2009, at 19:19:36
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 12, 2009, at 16:52:44
Link your're not responsible for the pdoc. Tell him how you feel and something isn't right. Love Phillipa
Posted by Netch on November 13, 2009, at 9:47:26
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 12, 2009, at 16:43:57
> I have been exerciseing plenty - perhaps too much. I don't know what is causeing the sadness. I just graduated and got a good job that I enjoy - it is what I've always wanted to do.
>
> I just can't stop thinking about death. I feel as if I am 85 years old and dying. I feel worthless. I want to connect but I don't know how.
>
> The feelings are neverending and I often want to end it all (don't worry not a suicide note).
>
> My diet is impecable and I run more than 5k a day.
>
> LinkadgeI know the feeling, it sucks big time.
Posted by bulldog2 on November 13, 2009, at 11:43:31
In reply to Re: Linkadge - How are you doing?, posted by Netch on November 13, 2009, at 9:47:26
> > I have been exerciseing plenty - perhaps too much. I don't know what is causeing the sadness. I just graduated and got a good job that I enjoy - it is what I've always wanted to do.
> >
> > I just can't stop thinking about death. I feel as if I am 85 years old and dying. I feel worthless. I want to connect but I don't know how.
> >
> > The feelings are neverending and I often want to end it all (don't worry not a suicide note).
> >
> > My diet is impecable and I run more than 5k a day.
> >
> > Linkadge
>
> I know the feeling, it sucks big time.
>I recently had a hip replacement. Really taxes the body and mind. Not good for my depression. Currenty using neurontin,percocet and vyvanse and that does left. However running out of percocet.
Posted by floatingbridge on November 13, 2009, at 22:12:16
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 12, 2009, at 16:52:44
Linkadge, you can file this under mind your own beeswax, but here I go.
> I don't know what is causing the sadness. I just graduated and got a good job that I enjoy - it is what I've always wanted to do.
I suffered my first major (Major) depression right after graduating graduate school. I'm not saying it's the same. I'm pointing out a major life change--sometimes 'happy' events can stir up 'stuff'.
> I would have a hard time telling my doctor that I am not doing well as he thinks I am. Part of me doesn't want to disappoint him and part of me wants to live the lie that I am doing well.
I so want to be a 'good' patient--that means for me getting better, etc. But you yourself acknowledge the lie. The rub here, that I see, is you don't have the 'key' to why life says, "wow, good!" and you still feel sad. It seems nonsensical, I know, but we are all so mysterious and complex.
More than two cents worth--
I really wish you well, whatever it takes--the right meds, good therapy, or....
wishing you the best Linkadge and a swift remission,
fb
>
> Linkadge
>
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Posted by mogger on November 13, 2009, at 23:51:12
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 12, 2009, at 16:52:44
Linkadge,
I really hope that you begin to improve. Something is definitely out there and will click. Have you tried massive amounts of fish oil? Like 8-10 grams of EPA (never mind the DHA) a day? I have found this to really create a feeling of wellbeing and has helped my depression. Also, 18 grams of inositol a day is great for me. And finally, I have added 6 grams a day of taurine divided into 3 doses that seems to really help. These are all supplements of course (you are the one of the most knowledgable people on here) that could augment your medication? Hang in there and one final thing, if the 5k run a day takes you to 45 minutes of workout that is fine but my doctor has me at a minimum of 45 minutes of consistent cardio (I run like hell) as he says that there is conclusive evidence that 45 to 1 hour of exercise is where real benefits occur for the mind. Take care and babblemail me if you have any questions,
Joseph
Posted by floatingbridge on November 14, 2009, at 9:46:04
In reply to Re: Linkadge - How are you doing?, posted by mogger on November 13, 2009, at 23:51:12
Ditto on the fish oil.
Posted by bulldog2 on November 14, 2009, at 11:38:38
In reply to Re: Linkadge - How are you doing? » mogger, posted by floatingbridge on November 14, 2009, at 9:46:04
> Ditto on the fish oil.
I find a good way to get fish oil is consumption of sardines. Mash them into a salad and add olive oil. Make into a good sandwich.
Posted by Phillipa on November 14, 2009, at 19:26:49
In reply to Re: Linkadge - How are you doing?, posted by bulldog2 on November 14, 2009, at 11:38:38
Bulldog sorry yuck!!! Rather take the supplements. Phillipa
Posted by SLS on November 19, 2009, at 12:53:05
In reply to Re: Linkadge - How are you doing?, posted by linkadge on November 12, 2009, at 16:43:57
I'm a real dummy.
Why don't you try adding some lithium to the amitriptyline to enhance your response to it. Given your family history, it makes a great deal of sense. Probands and their first degree relatives often respond to the same drugs.
- Scott
This is the end of the thread.
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