![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Frustratedmama on March 13, 2010, at 18:05:47
Hi everyone,
Well, I am back....not really a good thing cause when I was gone, I was doing well! Ok, so here goes...First my current list of meds:Pristiq 100 mg (AM)
Librium 5 mg (AM)
Adderall XR 15 mg (AM)
Xyxal (like Zyrtec for allergies) 5 mg (PM)
Halcion .25 mg (PM)Symptoms that are returning include lack of motivation, social isolation, feeling worthless, not getting work or anything productive done, not showering, fatigue, and irritable.
Looking for advice? Ok experts....what do you all recommend? My pdoc is very open to suggestions and we have been through lots of trials....I am willing to try anything (even things that have failed before if there is a chance I could salvage this before I spiral down again!).
I look forward to reading your responses!
FM
Posted by Phillipa on March 13, 2010, at 19:33:26
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
I'm sorry this is happening to you. Do you have a gut feeling about which med you might want to change first? Phillipa
Posted by Frustratedmama on March 13, 2010, at 21:15:54
In reply to Re: Need advice- Meds FAILING again! » Frustratedmama, posted by Phillipa on March 13, 2010, at 19:33:26
Unfortunately, I dont have any idea where to start....but I know something needs to change and FAST....I spiral down so quickly :(....It started about a month ago and is already getting pretty bad....I can't take much more of this - I am so darn sick of this happening....just want to be stable....I take my meds like they are prescribed and was doing great for a long time too. It's just so darn frustrating!
Posted by Phillipa on March 13, 2010, at 23:46:00
In reply to Re: Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 21:15:54
With the time change tonight I guess a lot in bed hopefully tomorrow someone will have an idea for you. Love Phillipa
Posted by Lou Pilder on March 14, 2010, at 7:35:30
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
> Hi everyone,
> Well, I am back....not really a good thing cause when I was gone, I was doing well! Ok, so here goes...First my current list of meds:
>
> Pristiq 100 mg (AM)
> Librium 5 mg (AM)
> Adderall XR 15 mg (AM)
> Xyxal (like Zyrtec for allergies) 5 mg (PM)
> Halcion .25 mg (PM)
>
> Symptoms that are returning include lack of motivation, social isolation, feeling worthless, not getting work or anything productive done, not showering, fatigue, and irritable.
>
> Looking for advice? Ok experts....what do you all recommend? My pdoc is very open to suggestions and we have been through lots of trials....I am willing to try anything (even things that have failed before if there is a chance I could salvage this before I spiral down again!).
>
> I look forward to reading your responses!
>
> FM
>
FM,
You wrote,[...my..list...feeling worthless...what do you recommend...am willing to try anything...there is a chance...].
Let us reason together.
If you could post answers here to the following, then I could have the opportunity to respond accordingly.
A. Did you feel worthless before you took the chemicals in your list?
B. What is in your thinking that causes you to feel worthless, if you know?
C. Do you have a hope that a different chemical could cause you to not feel worthless?
D. Do you know if the psychiatrist that has prescribed the chemicals to you has or has not taken those chemicals him/her self?
E. Are you aquainted with the chemical nature of nerve agents?
F. Other questions not stated
Lou
Posted by Frustratedmama on March 14, 2010, at 10:30:08
In reply to Lou's response-chanzezar » Frustratedmama, posted by Lou Pilder on March 14, 2010, at 7:35:30
Lou,
I will answer your questions here:A. Did you feel worthless before you took the chemicals in your list? YES - EVEN MORE SO
B. What is in your thinking that causes you to feel worthless, if you know? Scientific research leads me to beleive that it is DEPRESSION
C. Do you have a hope that a different chemical could cause you to not feel worthless? YES OR A CHANGE IN CHEMICALS - WITHOUT ANY CHEMICALS I AM NOT ABLE TO MAKE ACCURATE DECISIONS AND HAVE BEEN SUICIDAL SO FOR ME CHEMICALS HAVE LITERALLY SAVED MY LIFE
D. Do you know if the psychiatrist that has prescribed the chemicals to you has or has not taken those chemicals him/her self?
NO THAT IS NOT ANY OF MY BUSINESSE. Are you aquainted with the chemical nature of nerve agents? YES
F. Other questions not stated
HARD TO ANSWER QUESTIONS NOT STATED
Posted by Lou Pilder on March 14, 2010, at 10:43:01
In reply to Re: Lou's response-chanzezar » Lou Pilder, posted by Frustratedmama on March 14, 2010, at 10:30:08
> Lou,
> I will answer your questions here:
>
> A. Did you feel worthless before you took the chemicals in your list? YES - EVEN MORE SO
>
> B. What is in your thinking that causes you to feel worthless, if you know? Scientific research leads me to beleive that it is DEPRESSION
>
> C. Do you have a hope that a different chemical could cause you to not feel worthless? YES OR A CHANGE IN CHEMICALS - WITHOUT ANY CHEMICALS I AM NOT ABLE TO MAKE ACCURATE DECISIONS AND HAVE BEEN SUICIDAL SO FOR ME CHEMICALS HAVE LITERALLY SAVED MY LIFE
>
> D. Do you know if the psychiatrist that has prescribed the chemicals to you has or has not taken those chemicals him/her self?
> NO THAT IS NOT ANY OF MY BUSINESS
>
> E. Are you aquainted with the chemical nature of nerve agents? YES
>
> F. Other questions not stated
> HARD TO ANSWER QUESTIONS NOT STATEDFM,
You wrote,[...leads me to believe that it is depression...](part B)(causes you to feel worthless)
I am unsure as to what you are wanting to mean. If you could clarify the following, then I could have the opportunity to respond accordingly.
A. Do you mean that there is a state of being called depression that induces you to feel worthless, or that feeling worthless is a description of the state of depression or something else?
Lou
Posted by Frustratedmama on March 14, 2010, at 12:20:10
In reply to Lou's reply-chknoreighg? » Frustratedmama, posted by Lou Pilder on March 14, 2010, at 10:43:01
Lou,
I mean no disrespect - but, I am looking for advice on medication here and going back and forth with semantics is not helpful for me. If you have medication advice I would surely appreciate it; if not, I am done corresponding with you. Answering my questions with more questions is not helping me right now. I hope you understand.
FM
Posted by polarbear206 on March 14, 2010, at 14:19:27
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
How long were you stable before your downward spiral? How long have you been on this cocktail? I question the use of Halcion and Librium, which are not usually 1st line choice. Why not just use klonopin instead of both? Do you have ADHD also? You may need a mood stabilzer to augment your AD. Have you ever tried any of the mood stablizers?
Posted by manic666 on March 14, 2010, at 15:17:52
In reply to Re: Lou's posts » Lou Pilder, posted by Frustratedmama on March 14, 2010, at 12:20:10
i carnt answer your questions,///but i loved your firery reply,s
Posted by bleauberry on March 14, 2010, at 18:20:14
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
I feel for you. It is hard to know what to do when things go weird.
For sure I would not add another medication. The losers, whichever ones they are, have to go. Bring on board something new. I see people pile new meds on top of failing meds all the time, and then end up with a laundry list of a cocktail and they are no better than they were on just 2 or 3 meds. So, maybe some weeding is in order?
I don't want to bore you with my long explanations of why I feel the way I do. Just know that I have good reason to say these things:
Savella (true SNRI) added to current combo, with lower doses of pristiq and adderall.
Savella without the others.
Zoloft + Nortriptyline (true SNRI, not the wannabe fake called effexor).
If you are into your own med choices, amisulpride.
Clean up the food choices if not squeaky clean healthy stuff.
I hope you are feeling better soon.
Posted by Phillipa on March 14, 2010, at 19:45:07
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
Turn your babblemail light on go to registration to do this. Phillipa
Posted by topcatclr on March 14, 2010, at 21:42:24
In reply to Re: Lou's posts, posted by manic666 on March 14, 2010, at 15:17:52
Who made Lou the expert? No offense, just asking.
Posted by Frustratedmama on March 14, 2010, at 21:43:52
In reply to Re: Need advice- Meds FAILING again!, posted by polarbear206 on March 14, 2010, at 14:19:27
> How long were you stable before your downward spiral?
I think it has been almost a year- I would need to check back on my posts actually :) Maybe 9 months-rough estimate....How long have you been on this cocktail? Same as above; changes made include switched from Vyvanse to adderall xr and back a few times due to side effects and changes in sleep meds (Lunesta versus halcion)
I question the use of Halcion and Librium, which are not usually 1st line choice. Why not just use klonopin instead of both? The Librium is so low a dose that it helps without any side effects and the Halcion is the only thing I respond to at night now....
Do you have ADHD also? Yes
You may need a mood stabilzer to augment your AD. Have you ever tried any of the mood stablizers? I have tried most- none have worked real well but I am willing to try again. I might try the savella route next. although that isnt a mood stabilizer....what would you recommend?
Posted by Frustratedmama on March 14, 2010, at 21:44:26
In reply to Re: Lou's posts, posted by manic666 on March 14, 2010, at 15:17:52
Thanks Manic :)
Posted by Frustratedmama on March 14, 2010, at 21:47:09
In reply to Re: Need advice- Meds FAILING again! » Frustratedmama, posted by Phillipa on March 14, 2010, at 19:45:07
Ok :)
Posted by Frustratedmama on March 14, 2010, at 21:51:24
In reply to Re: Lou's posts, posted by topcatclr on March 14, 2010, at 21:42:24
I didn't think he was "the expert", sorry if that was unclear. I meant that everyone on here is an expert. I actually was responding to Lou's post above....
Posted by Frustratedmama on March 14, 2010, at 21:53:46
In reply to Re: Need advice- Meds FAILING again!, posted by bleauberry on March 14, 2010, at 18:20:14
Hi Bleuberry,
Thank you for your response. I will take it with me when I go this week. I am thinking Savella may work but am dreading the titration of the Pristiq. Wish me luck- I may need to change something else too. Will keep you all posted!
FM
Posted by softheprairie on March 15, 2010, at 0:18:41
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
Apparently not all that many people enjoy/respond so well to the meds in my current cocktail like I do, but I will tell you the meds I am taking and am pleased with, so that you can look up more about them or talk to your prescriber about them:
desipramine 300 mg
Cytomel (T3) 50 mcg
perphenazine one and a half 4 mg pills at night, plus can take more prn
Bystolic (aka nebivolol), a beta blocker, slows down the fast heartbeat & anxiety that the desipramine (& Cytomel, to a lesser degree) cause, 2.5 mg nightly, plus can take more prn, but have only do so once
Posted by floatingbridge on March 16, 2010, at 0:54:25
In reply to Need advice- Meds FAILING again!, posted by Frustratedmama on March 13, 2010, at 18:05:47
Hi FM, sorry you're back:(
I'm not the expert you asked for--. But I do have an opinion. Maybe klonopin as PB suggested. It can have depressive qualities, but it pulled me out of a spin and helped stabilze me. Librium didn't cut it. Part of a down spiral is fear, anxiety, and klonopin could get you more comfortable. (I now take Xanax CR.)
Halicon has some odd s/e's? Nothing else gets you to sleep? I wonder if it is
destabilizing somehow....Feel better soon--! Best to you....
Ummm. I was just thinking. Abilify 2mgs helped for awhile. Put a stopper in my episode. I discontinued, though.
Posted by bleauberry on March 16, 2010, at 17:30:09
In reply to Re: Need advice- Meds FAILING again! » bleauberry, posted by Frustratedmama on March 14, 2010, at 21:53:46
Well, if you end up going that route, you know there are no guarantees. But here's a bright spot. You do not need to stop Pristiq before starting Savella. In Japan Savella is commonly prescribed in combination with Paxil or Luvox. Yeah that's right, a SSRI + SNRI combo. So it might not be as rough as you anticipate. You could cross taper or maybe even find a sweet spot with both at some lower dose.
> Hi Bleuberry,
> Thank you for your response. I will take it with me when I go this week. I am thinking Savella may work but am dreading the titration of the Pristiq. Wish me luck- I may need to change something else too. Will keep you all posted!
> FM
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.