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Dr. Bob is Robert Hsiung, MD,
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Posted by zonked on May 19, 2010, at 11:05:31
In reply to Re: Marplan update thread..., posted by SLS on May 12, 2010, at 17:14:17
Scott,
How are you doing, how many weeks into treatment are you, and where are you at dose-wise?
Tuesday I increased to 40mg/day (20 b.I.d.) and it's barely taken the edge off my depression/anxiety...
Also I am a bit worried, my blood pressure and pulse since starting Marplan are higher (159/95 and 110bpm), but consistent--almost the exact numbers a week apart.
Normal for me is like, 130-140something over 80-90something, pulse in the 90s.
The ONLY "forbidden" thing I've been doing is one cup of coffee in the morning (which is allowed according to the Marplan website's diet card.). Strangely enough, I was able to eat and drink things like coffee, salami, etc without any increase in BP on parnate and nardil, respectively.
Afraid to tell pdoc cuz this med is having *some* effect, and don't want to stop it.
Feedback welcome--perhaps there's an antihypertensive I can take daily to bring BP down a bit?
Hanging in there, it's hard.. And hope you (SLS) are doing well.
Thinking of asking for a bump up to 50 or 60 if there's no improvement by next Tuesday...
-z
-z
Posted by SLS on May 19, 2010, at 12:22:19
In reply to Re: Marplan update thread 5/19 » SLS, posted by zonked on May 19, 2010, at 11:05:31
Hi Zonked.
I am still taking 30mg of Marplan, but I have been taking it for only 10 days total. I experienced a mild blip improvement 4 days ago, but it lasted for only a fraction of the day. MAOIs do that to me sometimes when I first start taking them. It is a bad sign, I think. Never has such an early response prognosticated a robust and long-lasting improvement.
I hope you have better luck.
- Scott
Posted by zonked on May 19, 2010, at 17:26:59
In reply to Re: Marplan update thread 5/19 » zonked, posted by SLS on May 19, 2010, at 12:22:19
Scott,
Hang in there man. It'll be interesting to see where we are at in another 3 weeks or so. I, too, have had flashes where I've felt better.. Today I've felt a lot more like myself than I have been. I am learning not to expect remission to be waking up one day and feeling completely better, it may take a few weeks and perhaps more dose adjustments for the effect to be consistent...
Interestingly, I tested my BP at the store today and it was my usual--not elevated at all (although, my pulse was still about 110bpm).
-z
> Hi Zonked.
>
> I am still taking 30mg of Marplan, but I have been taking it for only 10 days total. I experienced a mild blip improvement 4 days ago, but it lasted for only a fraction of the day. MAOIs do that to me sometimes when I first start taking them. It is a bad sign, I think. Never has such an early response prognosticated a robust and long-lasting improvement.
>
> I hope you have better luck.
>
>
> - Scott
Posted by JayBTV2 on May 20, 2010, at 20:12:16
In reply to Re: Marplan update thread 5/19 » SLS, posted by zonked on May 19, 2010, at 17:26:59
I wish you both luck and please keep updating. I've been doing well on Marplan for a little over two months. Kinda like Zonked said just feeling more like myself....
Also I mentioned it in the other thread but it's really effected my appetite. I just don't have any interest in food. Honestly it's been great I've dropped from 190 to 180 since I've been on it but every now and again I kinda wish I could enjoy something to eat.
Have you guys noticed any effect on your appetite?
Posted by SLS on May 21, 2010, at 5:15:50
In reply to Re: Marplan update thread 5/19, posted by JayBTV2 on May 20, 2010, at 20:12:16
> Have you guys noticed any effect on your appetite?
I have noticed that there isn't as much craving for carbohydrates as with Nardil. I have not had a reduction in appetite, but that it hasn't increased so far is great. I am taking 30mg and will stay at that dosage until next week. Unfortunately, I have not improved.
- Scott
Posted by zonked on May 22, 2010, at 14:11:57
In reply to Re: Marplan update thread 5/19, posted by JayBTV2 on May 20, 2010, at 20:12:16
I haven't noticed much change in appetite one way or the other.
Jay, can you describe in a bit more detail how far into Marplan treatment you noticed a significant change in mood and what dosage you were at, at the time?
Also, how were you doing when you started treatment? Moderately depressed, severely depressed? Any significant anxiety features? And are you on any other psych meds?
Thx
-z
Posted by ed_uk2010 on May 22, 2010, at 14:43:57
In reply to Re: Marplan update thread 5/19, posted by SLS on May 21, 2010, at 5:15:50
Scott,
This probably isn't an appropriate time to ask this but...
Have you ever wondered whether a complete break from psych meds for a few months might allow your brain to adjust in some way which could make it possible for you to respond to them again in future? I've just got this idea that for some people, a break from meds might allow them to become sensitive to them again. I think this could be useful if prolonged treatment had lead to a form of tolerance.
I know it might be difficult to reduce your meds but from what you've said, the improvement you currently experience from them is quite small.
What do you think? This probably doesn't sound appealing but it's just a thought. You seem to have become very resistant to medication after many years of treatment.
Posted by SLS on May 22, 2010, at 14:57:56
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 22, 2010, at 14:43:57
> Scott,
>
> This probably isn't an appropriate time to ask this but...
>
> Have you ever wondered whether a complete break from psych meds for a few months might allow your brain to adjust in some way which could make it possible for you to respond to them again in future? I've just got this idea that for some people, a break from meds might allow them to become sensitive to them again. I think this could be useful if prolonged treatment had lead to a form of tolerance.
>
> I know it might be difficult to reduce your meds but from what you've said, the improvement you currently experience from them is quite small.
>
> What do you think? This probably doesn't sound appealing but it's just a thought. You seem to have become very resistant to medication after many years of treatment.
What you say makes sense. Of course, it would be a gamble to discontinue all medication based upon an intuitive guess. I am getting about a 15-20% improvement. That is just enough to allow me to live independently. I am afraid to strip that improvement away.I will remain open to your suggestion.
Thanks, Ed.
- Scott
Posted by ed_uk2010 on May 22, 2010, at 17:42:25
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 22, 2010, at 14:43:57
For some reason I can't read Scott's reply. The screen just goes blank. Not sure why.
Posted by ed_uk2010 on May 22, 2010, at 17:47:02
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 22, 2010, at 14:57:56
Hi Scott,
I can read your message now. Perhaps I was having a problem with my computer.
>What you say makes sense. Of course, it would be a gamble to discontinue all medication based upon an intuitive guess.
I know, and I agree. It was just a thought really because you have tried so many ADs recently with only small benefits. If there was a way of making the meds work again it would be fantastic.
>I am getting about a 15-20% improvement. That is just enough to allow me to live independently.
Do you think that there's a chance that certain of your symptoms are aggravated by meds? I tend to find that ADs help some of my symptoms (eg. anxiety) and worsen others (eg. fatigue).
Posted by Phillipa on May 22, 2010, at 20:13:42
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 22, 2010, at 17:47:02
Ed no anxiety relief for me from ad's. But low dose of benzos allows sleep and a bit of recovery. Then it's push push push. Love PJxxx
Posted by SLS on May 26, 2010, at 13:15:09
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 22, 2010, at 17:47:02
> Do you think that there's a chance that certain of your symptoms are aggravated by meds?
Lamictal might be adding to the memory and cognitive impairments that my depression produces. Other than that, I can't think of anything.
For the past three days, I have noticed an improvement. Although subtle, it is unmistakable. This may not be terribly meaningful, though. With a new drug, I often experience this sort of response that lasts 1-3 days and then disappears. It usually occurs 10-13 days after beginning treatment. That is where I am right now. I am trying not to get my hopes up at this point, but it is difficult. I tend to be an optimist.
- Scott
Posted by bulldog2 on May 26, 2010, at 15:49:11
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 26, 2010, at 13:15:09
> > Do you think that there's a chance that certain of your symptoms are aggravated by meds?
>
> Lamictal might be adding to the memory and cognitive impairments that my depression produces. Other than that, I can't think of anything.
>
> For the past three days, I have noticed an improvement. Although subtle, it is unmistakable. This may not be terribly meaningful, though. With a new drug, I often experience this sort of response that lasts 1-3 days and then disappears. It usually occurs 10-13 days after beginning treatment. That is where I am right now. I am trying not to get my hopes up at this point, but it is difficult. I tend to be an optimist.
>
>
> - ScottPossibly you could convince your p-doc to let you go to 90 mg? I once read a article where an opinion was rendered that part of the problem with marplan is the 60 mg limit is to low and leads to the impression that the drug is weak.
Posted by SLS on May 26, 2010, at 17:16:34
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 26, 2010, at 13:15:09
> For the past three days, I have noticed an improvement. Although subtle, it is unmistakable. This may not be terribly meaningful, though. With a new drug, I often experience this sort of response that lasts 1-3 days and then disappears. It usually occurs 10-13 days after beginning treatment. That is where I am right now. I am trying not to get my hopes up at this point, but it is difficult. I tend to be an optimist.
I paid my doctor a visit today. He consented to allow me to increase my dosage of Marplan gradually to 60mg.
I'm still fighting optimism. I get tired of riding the rollercoaster, but I always get excited when I begin to respond favorably to anything. It's hard not to feel good when you feel good.
- Scott
Posted by Phillipa on May 26, 2010, at 21:14:07
In reply to Re: Marplan update thread 5/19, posted by SLS on May 26, 2010, at 17:16:34
Scott are you saying if you feel good you don't allow yourself to? Could that be part of the problem. Thinking as I write. Phillipa
Posted by SLS on May 27, 2010, at 6:24:43
In reply to Re: Marplan update thread 5/19 » SLS, posted by Phillipa on May 26, 2010, at 21:14:07
> Scott are you saying if you feel good you don't allow yourself to?
No. I am saying that when I start to feel good, I tend to assume that it is the beginning of a new life which I begin to plan for. It is an emotional let-down to then relapse and have to give up so many wonderful things. I am just trying to prevent a big disappointment by tempering my reaction to what might be a fleeting response to treatment. When a treatment works, there is nothing I could do to prevent myself from undergoing the positive changes in conscious experience, even if I tried "not to allow it".
- Scott
Posted by ed_uk2010 on May 27, 2010, at 14:02:38
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 26, 2010, at 13:15:09
>Lamictal might be adding to the memory and cognitive impairments that my depression produces.
Perhaps you could try a lower dose?
>For the past three days, I have noticed an improvement.
I hope it continues for you Scott. I think it's a good sign that you're feeling optimistic.
Posted by Phillipa on May 27, 2010, at 19:56:45
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 27, 2010, at 14:02:38
Me also and thanks for clarifying Scott. Phillipa
Posted by SLS on May 28, 2010, at 0:46:40
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 27, 2010, at 14:02:38
> > Lamictal might be adding to the memory and cognitive impairments that my depression produces.
> Perhaps you could try a lower dose?I have tried to reduce the dosage of Lamictal on several occasions. It seems that 200mg is the minimum effective dosage for me.
> > For the past three days, I have noticed an improvement.
> I hope it continues for you Scott. I think it's a good sign that you're feeling optimistic.I am sorry to have to report that my antidepressant response to Marplan has disappeared. I don't expect it to return. The response follows a temporal pattern consistent with my previous treatment failures. I will continue increasing the dosage of Marplan to 60mg. I haven't decided how much time I will invest (waste) in Marplan if there is no hint of further response.
- Scott
Posted by Phillipa on May 28, 2010, at 19:58:10
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 28, 2010, at 0:46:40
Scott I'm so sorry for this happening. I bet a higher dose will work. Keep on plugging and we'll definitely be here to support you. Love Phillipa
Posted by ed_uk2010 on May 29, 2010, at 12:59:28
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 28, 2010, at 0:46:40
>I am sorry to have to report that my antidepressant response to Marplan has disappeared. I don't expect it to return.
I'm sorry to hear that Scott. If 60mg doesn't help, what do you plan to try next?
Posted by zonked on May 29, 2010, at 13:13:29
In reply to Re: Marplan update thread 5/19 » SLS, posted by ed_uk2010 on May 29, 2010, at 12:59:28
Well, I am still at 40mg/day and my symptoms are still parked at 20-30% symptom improvement.
Long story short, I am still having to be seen in the crisis clinic because I won't be able to see my new shrink until 6/10.
I went there today, hoping for a dose increase but was told it was too soon, even though I presented the prescribing info which says dosage increases can be made up to 10mg/week, and let them know I needed high doses of Nardil and Parnate (respectively) for those drugs to work well.
I hate the brick walls with this disorder and some clinicians--it seems that as long as I am sub-acute it doesn't matter how much I'm still suffering...
Does anyone know if leaving oneself "parked" at a sub-remissive dose for too long decreases the chance of a higher dose working later? It looks like I have no choice but to stay at 40 until 6/10.
Scott, I am so sorry to hear you haven't responded well--you probably know they went up to 80 in some of the studies.
-z
Posted by Hombre on May 29, 2010, at 20:58:56
In reply to Re: Marplan update thread 5/19 » ed_uk2010, posted by SLS on May 28, 2010, at 0:46:40
Scott, that really sucks about the positive effects of Marplan petering out.
I'm going out on a limb and I hope I'm not derailing the thread:
Do you think feel that there are any nutritional factors that have influenced the success of any of the medications you've taken? I'm starting to form a theory that there are plenty of reasons why someone a) might not be able to get optimum nutrition to support the myriad chemical processes induced by meds b) they might not even be absorbing enough of said nutrients/cofactors/coenzymes/etc.
This isn't an either/or thing in my mind. It's just that I've noticed that a lack of certain things (e.g. magnesium, zinc) can lead to temporary poop-out symptoms which resolve after said nutrients are reintroduced in sufficient quantity for a sufficient amount of time. If my meds change or my supplements are not consistent (what a drag popping all those huge tablets), I don't get the optimum effect and I might not even make the connection between the to. If Vitamin X does not do anything on no meds or on Med A + B, I might not take it with Med A + B + C, or Med D. You get the idea.
I'm just throwing it out there. Your mileage will most certainly vary.
Posted by SLS on May 30, 2010, at 7:14:50
In reply to Re: Marplan update thread 5/19 » SLS, posted by Hombre on May 29, 2010, at 20:58:56
Hola Hombre.
> Scott, that really sucks about the positive effects of Marplan petering out.
It has not left me in a very hopeful state of mind. I have all but given up on the idea that I will ever enjoy the feeling of being alive.
> I'm going out on a limb and I hope I'm not derailing the thread:
Not at all.
> Do you think feel that there are any nutritional factors that have influenced the success of any of the medications you've taken?
My first reaction is to say no. I have tried taking megadoses of vitamins for years at a time. However, my mind remains open to the possibility that I just wasn't taking the right ones. I am currently interested in taking fish oil and NAC (N-acetylcysteine)
> I've noticed that a lack of certain things (e.g. magnesium, zinc) can lead to temporary poop-out symptoms which resolve after said nutrients are reintroduced in sufficient quantity for a sufficient amount of time.Where have you observed this to happen?
It is just as daunting a project to consider the myriad combinations of supplements as it is of drugs. At this point, I am only taking a multivitamin.
Thank you *very* much for your input.
- Scott
Posted by Hombre on May 31, 2010, at 18:42:18
In reply to Re: Marplan update thread 5/19 » Hombre, posted by SLS on May 30, 2010, at 7:14:50
Scott,
I'm going to go over my notes and start a new thread in Alternative when I know how I want to put the ideas together. I'll link to it when I do.
Hombre
This is the end of the thread.
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