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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by bleauberry on February 10, 2010, at 17:29:29
Hi Scott.
I was kind of missing your presence here and just thought I would check in to see how things are?
bleauberry
Posted by bulldog2 on February 10, 2010, at 17:49:35
In reply to SLS - Miss Ya, posted by bleauberry on February 10, 2010, at 17:29:29
> Hi Scott.
>
> I was kind of missing your presence here and just thought I would check in to see how things are?
>
> bleauberryYes we all miss you and hope you are okay.
Posted by Phillipa on February 10, 2010, at 21:58:32
In reply to Re: SLS - Miss Ya, posted by bulldog2 on February 10, 2010, at 17:49:35
Ditto Phillipa
Posted by Maxime on February 10, 2010, at 23:51:24
In reply to SLS - Miss Ya, posted by bleauberry on February 10, 2010, at 17:29:29
Yes, same here. I hope you are alright. What meds are you on?
Posted by floatingbridge on February 11, 2010, at 1:29:00
In reply to Re: SLS - Miss Ya » bleauberry, posted by Maxime on February 10, 2010, at 23:51:24
Yes, I've been thinking of you, your possible adderall trial, and, well, how you are doing. I miss you, too.
Posted by SLS on February 11, 2010, at 6:54:30
In reply to SLS - Miss Ya, posted by bleauberry on February 10, 2010, at 17:29:29
I'm okay.
Effexor helped for a few days, then pooped-out. Adderall might as well have been a sugar pill. My doctor raised the dosage of Effexor to 450mg. I am not expecting any positive results. I mentioned Savella (milnacipran). He was familiar with the drug and said that it was an option. He also said that Savella was better than Cymbalta. I have a feeling that I will end up on Nardil by summer. I guess that's as good as it gets for me.
- Scott
Posted by janejane on February 11, 2010, at 8:41:50
In reply to Re: SLS - Miss Ya, posted by SLS on February 11, 2010, at 6:54:30
Thanks for the update. I miss your posts too. Why does your doc think Savella is better than Cymbalta? Efficacy, SE profile? What are your current symptoms?
Posted by Maxime on February 11, 2010, at 9:06:46
In reply to Re: SLS - Miss Ya, posted by SLS on February 11, 2010, at 6:54:30
Thanks Scott. Is Nardil better for you than Parnate? I wish you were having more luck from the other meds. Hang in there.
Posted by uncouth on February 11, 2010, at 10:14:13
In reply to Re: SLS - Miss Ya, posted by SLS on February 11, 2010, at 6:54:30
scott i know i've mentione dthis before but i'll say it again....why not try zyprexa 5mg? it worked very well for me, and worked quickly...if its not working you'll know quickly also. i've been on it about 3 months and just went down to 2.5mg/day, with the intention of now replacing it with abilify if i can. though i've found zyprexa to be much more effecacious than abilify in general for the deepest depression. now that i am out of that i am trying to optimize for tolerability.
Posted by Meltingpot on February 11, 2010, at 15:53:39
In reply to Re: SLS - Miss Ya, posted by SLS on February 11, 2010, at 6:54:30
Scott,
Sorry to hear that the Effexor is not helping. Maybe you should give rTMS a try at some point.
Denise
Posted by floatingbridge on February 11, 2010, at 16:44:18
In reply to Re: SLS - Miss Ya, posted by Meltingpot on February 11, 2010, at 15:53:39
Hey Scott,
I've been poking around John Hopkins BP site w/ my BP friends in mind. Have you looked?
Thanks for the update; I wish the news was better....
fondly,
fb
Posted by SLS on February 11, 2010, at 19:48:58
In reply to Re: SLS - Miss Ya » SLS, posted by janejane on February 11, 2010, at 8:41:50
> Thanks for the update. I miss your posts too. Why does your doc think Savella is better than Cymbalta? Efficacy, SE profile? What are your current symptoms?
He had read a study indicating that Savella was more effective than Cymbalta. The symptoms that affect me the most are anergia, anhedonia, and cognitive impairments.
- Scott
Posted by floatingbridge on February 11, 2010, at 19:53:38
In reply to Re: SLS - Miss Ya » janejane, posted by SLS on February 11, 2010, at 19:48:58
> He had read a study indicating that Savella was more effective than Cymbalta. The symptoms that affect me the most are anergia, anhedonia, and cognitive impairments.
>
>
> - ScottMirapex / requip out of the short list?
Posted by SLS on February 11, 2010, at 19:59:32
In reply to Re: SLS - Miss Ya » SLS, posted by Maxime on February 11, 2010, at 9:06:46
> Thanks Scott. Is Nardil better for you than Parnate? I wish you were having more luck from the other meds. Hang in there.
It seems that both drugs bring diminishing returns after awhile. When it helps, I think Nardil is better for me than Parnate.
- Scott
Posted by SLS on February 11, 2010, at 20:04:39
In reply to Re: SLS - Miss Ya, posted by floatingbridge on February 11, 2010, at 19:53:38
>
> > He had read a study indicating that Savella was more effective than Cymbalta. The symptoms that affect me the most are anergia, anhedonia, and cognitive impairments.
> >
> >
> > - Scott
>
> Mirapex / requip out of the short list?I once tried bromocriptine, a D2 agonist. It helped for the first three days before giving out on me. I am not big on dopamine agonists. I haven't seen anyone experience a robust long term response to any of them. Even so, I wouldn't rule out Mirapex or Requip because, unlike bromocriptine, they stimulate D3 receptors along with D2.
- Scott
Posted by SLS on February 11, 2010, at 20:13:02
In reply to Re: SLS - Miss Ya, posted by uncouth on February 11, 2010, at 10:14:13
> scott i know i've mentione dthis before but i'll say it again....why not try zyprexa 5mg?
I appreciate your mentioning it again. I have tried Zyprexa at 10-20mg. It was helpful for about a week. I experienced similar transient responses to Risperdal and Geodon, but not Seroquel. Maybe I'll try some Zyprexa along with the Abilify.
> i've found zyprexa to be much more effecacious than abilify in general for the deepest depression. now that i am out of that i am trying to optimize for tolerability.
That sounds reasonable. I have been as high as 20mg with Abilify, but find the higher dosages to produce some reductions in motivation and activity level.
Have you ever tried Mirapex or Requip?
Thanks.
- Scott
Posted by gman22 on February 11, 2010, at 20:13:14
In reply to Re: SLS - Miss Ya » floatingbridge, posted by SLS on February 11, 2010, at 20:04:39
I was missing you, too. I agree with you on the dopamine agonists. I tried mirapex for about 2 weeks and it was throwing me into ultra rapid cycling. I would be fine from 7am -2pm, then have horrible "spells" until about 8pm, then feel good again. Weird.
Posted by Phillipa on February 11, 2010, at 20:16:53
In reply to Re: SLS - Miss Ya » uncouth, posted by SLS on February 11, 2010, at 20:13:02
Scott an old babbler is doing very well on requip, vyvanase, and low dose antipsychotic. This person had been on seemingly every combo and ECT but this has given him his life back. Seriously. Phillipa
Posted by SLS on February 11, 2010, at 21:07:36
In reply to Re: SLS - Miss Ya, posted by Phillipa on February 11, 2010, at 20:16:53
> Scott an old babbler is doing very well on requip, vyvanase, and low dose antipsychotic. This person had been on seemingly every combo and ECT but this has given him his life back. Seriously. Phillipa
Thanks, Phillipa. That sounds encouraging.
- Scott
Posted by Phillipa on February 11, 2010, at 22:12:22
In reply to Re: SLS - Miss Ya » Phillipa, posted by SLS on February 11, 2010, at 21:07:36
I'm dead serious. Love Phillipa
Posted by Phillipa on February 11, 2010, at 22:21:54
In reply to Re: SLS - Miss Ya » Phillipa, posted by SLS on February 11, 2010, at 21:07:36
Scott sent the link to his googleable website also on facebook. Phillipa
Posted by bleauberry on February 12, 2010, at 17:16:04
In reply to SLS - Miss Ya, posted by bleauberry on February 10, 2010, at 17:29:29
That is encouraging the doctor is considering Savella. I thought I was the only fan of that drug.
For the symptoms you described, Scott, Savella did really well for me.
As big of a fan as I am, I still am not completely sold on Savella monotherapy. The more astounding case reports or small studies I've seen involved combinations with Risperdal, or Pindolol, or other SSRIs/SNRIs.
To me Savella feels like it works in regions of the brain that other meds don't.
Are you still taking Abilify and Nortriptyline? If you are, I can't help but wonder...always suspicious, ya know...if one or both are actually preventing other things from doing what they do? I mean, yeah, I know Abilify is "supposed" to help ADs work better, but it doesn't mean it will for sure, it doesn't mean it won't actually become a roadblock months later, and it doesn't mean it if it does good for several months that it will still be doing that 2 years later. Ya know? My gut instinct and logic just tells me that any antipsychotic, Abilify or not, at your dose, is going to be blocking too much stuff. I don't think its partial agonism overcomes that kind of blockage. If those dopamine receptors are blocked too much for too long, symptoms like the ones you described would be easily predicted. I think maybe that's why low doses of APs are used for AD augmentation. Ya know, 2.5mg-10mg abilify, (personally I think 1mg-5mg is the range), 5mg Zyprexa, .5mg-1mg Risperdal, etc.
Anyway, hopefully Effexor will kick in one of these days real soon. In the meantime, I like the idea of considering Savella as a backup plan. Based on what I know of this drug, I would not swap Effexor for Savella. Instead, I would lower the Effexor dose and ad Savella to it. And if still taking Abilify and/or Nortriptyline, I would have to put them in front of the jury to make a judgement as to whether they were pulling their weight or not.
Wishing you a smooth day! You're one tough guy.
Posted by elanor roosevelt on February 15, 2010, at 20:10:37
In reply to Re: SLS - Miss Ya, posted by SLS on February 11, 2010, at 6:54:30
Scott
My pdoc put me on cymbalta and i was ready to give up
he then added a low dose of abilfy and i felt better immediatelyif effexor isn't working yet it may be time to give up. the best thing i got out of my last try with effexor was the withdrawal--really--the nightmares were so fantastic
write yours downgood luck
Posted by Lou Pilder on February 16, 2010, at 9:35:53
In reply to Re: SLS - Miss Ya, posted by SLS on February 11, 2010, at 6:54:30
> I'm okay.
>
> Effexor helped for a few days, then pooped-out. Adderall might as well have been a sugar pill. My doctor raised the dosage of Effexor to 450mg. I am not expecting any positive results. I mentioned Savella (milnacipran). He was familiar with the drug and said that it was an option. He also said that Savella was better than Cymbalta. I have a feeling that I will end up on Nardil by summer. I guess that's as good as it gets for me.
>
>
> - ScottScott,
You wrote,[...that's as good as it gets for me...].
I got the news today as reading this thread about you. And then I had a vision of you standing at the edge of the Great Gulf. And I saw the Rider on the White Horse afar off speaking to you saying, "Scott, Scott, take heed that no man deceive you."
Lou
Posted by SLS on February 16, 2010, at 14:36:11
In reply to Lou's response- » SLS, posted by Lou Pilder on February 16, 2010, at 9:35:53
Thanks, Lou. I appreciate your concern and input.
- Scott
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Dr. Bob is Robert Hsiung, MD,
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