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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 76. Go back in thread:
Posted by Ron Hill on July 29, 2010, at 6:34:14
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
Enigma,
I'm very sorry for your suffering.
Have you ever added some lithium to minimize or eliminate your suicidal thoughts? Research shows that lithium is one of best meds to tx suicidal thoughts. Here is a paper. Search the document for the word "lithium" and read those sections:
http://ajp.psychiatryonline.org/cgi/content/full/157/12/1925
Start at 300 mg/day of an extended release lithium formulation. The med called Lithobid is a good med.
I would only go as high as is needed to stop the suicidal thoughts. My experience is that at about 900 mg/day I begin to have some bloating. If 300 or 600 mg/day stops the suicidal thoughts, then it would be well worth the addition of the Lithobid.
I take 90 mg/day of Nardil as part of my med combo. My med combo list is provided at the close of this post.
I have gained 70 pounds due to Nardil. I need the med but, like you, I hate the appearance of my pot belly body.
Prior to p-meds, I always weighed 172 during training and by race day (triathlon) I'd always be right at 155 pounds. I'm 5'11". Today I weight 251 pounds, and I do not know how in the h*ll to cut the weight. I eat 1000 calories per day.
You and I never guessed we would ever look like this, did we? Never in a million years!! I always trained hard and my friends used to say I looked buff. The mirror used to be my friend. Now, I avoid mirrors at all costs.
I often want to hang a sign around my neck that says:
"This Massive Weight Gain is Medication Induced. I'm not a Gluttoness Slob."
So you are not alone my friend. Here are a couple of thoughts:
Have you ever tried Parnate? A while back I discontinued my beloved Nardil for a trial of Parnate. I gave 80 mg/day of Parnate four months to kick-in, but it never did provide an antidepressant action for me. But, it might work for you.
During my four months off of Nardil, my potbelly melted away, erectile dysfunction ceased, and my orgasms returned. The side effects of Nardil are dosage dependent. In other words, as the Nardil dosage is increased, the intensity of the side effects typically increases.
Second, as Jan mentioned, some patients consider taking Metformin. But, it has risks and issues:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000974
Find a way to be well my friend.
Problems are solutions waiting to be found. However, having said that, I am well aware of the debilitating h*ll of bipolar depression.
Don't give up, Enigma. There are many things to try.
Please tell me all of the meds that you currently take.
-- Ron
dx: Bipolar II with ultra rapid cycling, and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
3.75 mg/day Deplin (taken with 2500 mcg/day of sublingual methyl B-12, and 12.5mg/day of sublingual P-5-P)35 ml of Calsons Bottled Fish Oil
100 mg/day phosphatidylserene
Centrum Chewable Multi-vitamins; Only 100% of all the usual vitamins
2000 IU Vitamin E
850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate).
Dark therapy via LowBlueLight glasses (When I remember)
The following are my up and coming add-on trials:25 mg/day agomelatine (Valdoxan)
300 mg/day of lithum carbonate
CoQ10
NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid, + Vitamin C
GTF Chromium
Cromium Picolinate
Cinnamon
Posted by Phillipa on July 29, 2010, at 19:43:08
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by Ron Hill on July 29, 2010, at 6:34:14
Ron what's this about the thyroid as quite frequently type II diabetes and hypothyroidism go hand and hand. My neice is on metformin for above. And she drinks. Jan
Posted by Ron Hill on July 30, 2010, at 4:34:43
In reply to Re: Nardil is killing me - must find alternative! Help » Ron Hill, posted by Phillipa on July 29, 2010, at 19:43:08
> Ron what's this about the thyroid as quite frequently type II diabetes and hypothyroidism go hand and hand. My neice is on metformin for above. And she drinks. Jan
--------------------------------------
Hi Jan,
Sorry, I do not know the answer to your question.
Be well my friend.
-- Ron
Posted by Enigma on August 1, 2010, at 20:22:04
In reply to Re: Nardil is killing me - must find alternative! Help » Phillipa, posted by Ron Hill on July 30, 2010, at 4:34:43
Well, last 2 days (including today), bedridden, suicidal (almost cut myself again), and just endured pure mental and even physical pain. I have some odd illness in my gut where it's too hard to even explain the symptoms for, but gonna call my gastro guy tomorrow if I can or if I'm up to it. Just a couple beautiful days to remind myself how little hope I have, how I have no friends, and my wife just went on a date.
Check this out. We got non-legally separated 10 months ago or such, and I spent that entire time trying to find a women on as many dating sites as I could. She goes on a 3 day free weekend (dating site), and finds a guy she likes in 2 days. If that's not depressing, I don't know what is.
I haven't kissed a girl in years? (an adult woman)
I haven't hugged a woman in years?
Forget about the other thing that starts with S.Look up Vythic on M.C - That's me! Of course, I always go for beauty *1st) and women are too vain to hook up with a lesser guy in looks, even though my personality is generally better (via profiles) (sorry women, I've researched this for 25 years, and I've been dead on, *every time*)
Oh well, I wish I could hypnotize my kids into thinking I never existed, then then saying goodbye to this world would be SO much easier. Those 3 are the ONLY ones keeping me here. Dad's already gone. Karma caught up with him, but not my evil mom and brother yet. I'd love to die just to hurt them. Man, it's all in my book, except I don't know how to publish it. If anyone can help me out there, I'd really appreciate it.
Posted by Phillipa on August 1, 2010, at 20:38:17
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Enigma on August 1, 2010, at 20:22:04
Enigma what the heck is MC? And stop this talk now!!!! You can do it I know you can. Think the stomach is the cause of your mental health problems. It's possible you know? Do you have a gastro diagnosis? Love Phillipa
Posted by Enigma on August 4, 2010, at 17:47:53
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by Phillipa on August 1, 2010, at 20:38:17
> Enigma what the heck is MC? And stop this talk now!!!! You can do it I know you can. Think the stomach is the cause of your mental health problems. It's possible you know? Do you have a gastro diagnosis? Love Phillipa
MC = match dot com, or as I like to call it MenGetRejectedTimesInfinity dot com
Philipa, I've been fighting the "severe" depression for 10 years now, the mania and minor depression for about 7.
I'm getting worse, progressively, each and every month. Willpower doesn't cut it when the chemicals in your brain are as f-ed up as mine are. I tried, gave it a good shot too, and probably outlasted most people I know.
But being realistic, I have about 2 drugs left, one of which I've already tried (Selegeline) and that's failed me already, then there Marplan which I forget if I've tried.
There's VNS (Vagus Nerve Stimulation) and DBS (Deep Brain Stimulation). Same thing?? Both of which I cannot even come close to affording. If my mother thankfully would stop running from her negative Karma, death would take her too, like it took my Dad (and no, I want them both dead - they caused this disorder by living in that "hell-house" with their own disorders they never treated - emotional and physical abuse, and so much more (it's all in my unpublished book - "Imprisoned by a Broken Mind", paying for my surgery, which is STILL no guarantee of a cure. The surgery, after throwing all that money away STILL could be a complete waste. Hell, I could die during surgery.
So, if I can't afford the operation, I'd say the meds will poop out in about 3 months for Selegeline, and who knows about Marplan (do they still make it?). I could have only 6-12 months left to live.
Right now, with no love in my life, I'm burning out even faster. I count the days I don't cry now, and there hasn't been one in a while.Chemistry sucks, Genetics Sucks, Biology sucks. I Still, just like when I was 20, am still picky when it comes to women, and nothing I've tried has been able to alter that. I have no friends, since they all abandoned me, literally, and wouldn't even give me the 1 night out a month which is all I asked of them. These are highschool and childhood friends!!! Not the fake co-worker "friends". I still can't believe they just left me here to rot away and die. So, I haven't been to a night club (any type) because when you go alone, *everyone* there (especially where I live) automatically assumes you are a loser. So, been trying all the dating sites, and those have been purely demoralizing rejection. Fun to get rejected by women that you look better than, face, and body, and are 10x as smart as. Now THAT'S a slap in the face.
I'd be so bold as to link my profile so you can see what I look like, but I don't think this forum allows that.So, every corner I turn leads to a dead end. I'm really NOT being melodramatic either. I wind up doing a 360. Fail, Fail, Fail, Fail. 8 months on one dating site and not one date. My wife did it and got a date in 2 days. We're separated, still living together. She's so solace for my pain either, which is a big reason we're separated. It would help if I loved her too, which I don't, and haven't in 20 years of marriage (all of it).
To Sarah, my sole-mate whom I met 5.5 years ago. I still think of you like we met yesterday. I wish I could find her again, even just to see her face...
Posted by Phillipa on August 4, 2010, at 21:31:50
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Enigma on August 4, 2010, at 17:47:53
Enigma that's quite a story of your life. Well as you said you do still have options. And which do you feel you will start with? I can't imagine online dating. Phillipa
Posted by ed_uk2010 on August 5, 2010, at 16:21:41
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Enigma on August 4, 2010, at 17:47:53
Enigma,
Have you considered the possibility of joining a clinical trial? You might have the opportunity to try something that you wouldn't otherwise be able to.
I believe that there are also clinical trials of deep brain stimulation in progress.
http://clinicaltrials.gov/ct2/show/NCT00555698?term=deep+brain+stimulation&rank=20
Posted by Enigma on August 6, 2010, at 19:16:34
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by Phillipa on August 4, 2010, at 21:31:50
> Enigma that's quite a story of your life. Well as you said you do still have options. And which do you feel you will start with? I can't imagine online dating. Phillipa
---
(wicked short version - yeah, we say "wicked" up here in New England, since
we're a British colony, it's a use of slang, even the brit's still use)
Get rid of Nardil ASAP
Get Selegeline or better (unknown drug) ASAPIf I had the money, get more serious about VNS
Read more about DBS
---Well, in the short term, I'm still trying to get into see a new doctor, many miles from the one that quite literally ran out of options for me. He said he had no idea where to go with my treatment because we were out of meds he was familiar with. His only option was to go to a doctor 2 hours away from where I live, opposite Boston, in the boondocks of New Hampshire and get admitted to their general psych ward. Then, after an unknown period of time (in days), the doc on staff there would magically become my new shrink, and then treat me from there - with NO word on when I would get out of the ward. So, seriously, he would not take me as an office patient because he isn't accepting new patients, but WOULD if I stayed in the ward first. (WTF???) I was like, uhm, yeah, that sound REALLY promising with about 100 unknowns. NO THANKS.
Ever stay in a general ward? In other words, one that doesn't segregate by types of illness, level of severity, and age? I'm been in both. I almost ripped my head off to get out of the first ward, which was a "general" psych ward. I found the 2nd to actually feel like a prison, like the first, but at least there were suicidal depressives like me there, and bipolars, non of which talked to themselves, drooled, wore 10 pounds of makeup at 89 years of age, etc. They were all near my age, to a degree and we actually had some good conversations, but still, being without freedom to simply surf the web, watch tv, etc, I was dying to get out of there (and dying to get in there HA HA HA HA).
Man, I gotta post of the right board here to see if someone can help me publish my book. Sure there were people with worse lives out there, but not that many, I'll guarantee you that. It's educational too!!
I unfortunately read today, about VNS, that the patients (the most treatment resistance freaks like me) were the least successful with the procedure. I think it said after 6-12 months after the procedure, in this certain study, the people that failed with 6-12 meds (I failed with a LOT more), had no response to the operation. That, uhm, sucks.
My wife was reading about DBS and they were saying things about it such as it only lasting a YEAR. One year? 30k++ for a YEAR of possible, no-guarantee of success treatment of brain surgery. Read that sentence again. At least VNS said it was meant for a lifetime, -minus changing the batteries in the pulse generator. Sadly with VNS, some people don't notice a positive change for up to 2+ years!!! What am I going to do until them?
(Ren and Stimpy: Ren: Show's over man, let's go home. Stimpy: But what are we going to do till then?!?!?!...)
Posted by Phillipa on August 6, 2010, at 20:26:20
In reply to Re: Nardil is killing me - must find alternative! Help » Phillipa, posted by Enigma on August 6, 2010, at 19:16:34
Also originally from CT so a Yankee. Anyway I don't know what to say. Such a lot of money. There has to be something? I just don't know what? Phillipa
Posted by Leo33 on August 8, 2010, at 17:30:18
In reply to Re: Nardil is killing me - must find alternative! Help » Phillipa, posted by Enigma on August 6, 2010, at 19:16:34
Enigma, your life isn't as bad as you think! Seems like you have your own house, got married and had 3 kids, and have tons of energy to write on this site. Motivation to write a book.
Not to try and out do ya here, In my forties, never been married, no kids, on welfare which I have now hit my lifetime limit and 4 applications and denials from SSDI, live at home with my elderly and ailing parents, not kissed a woman in 11 years or anything else, have to go to clinic for psych nurse to prescribe meds, had to go to state hospital for inpatient after last psych nurse clinic failure in 2008.
So you are not alone, also I am not a bad looking guy either, and have college degree and a lot of travel. Women want the confident personality types, If you suffer from depression then you are not going to be that, you need that mania.
Anyway, hang in there, you are in a tough spot, but looks like you have enough inside you to fight a bit longer.
Maybe the psych's can put you on heavy anti psychotics to sedate you beyond the point that you care, seems to be the going trend. God forbid no benzo's if they actually work.
Posted by softheprairie on August 9, 2010, at 4:47:04
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by ed_uk2010 on July 24, 2010, at 17:41:34
> >Selegiline worked (for a while) and I want to switch back to it (but poops out rather fast). Emsam worked for my depression but I was allergic to the dermal transfer technology and got awful poison ivy (well worse) rashes.......
>
> Have you tried selegiline orally disintegrating tablets (Zelapar)?
>
> Zelapar is only approved for use in Parkinson's disease but it may have other applications. With Zelapar, the selegiline is absorbed across the lining of the mouth. The idea is to reduce MAO inhibition in the gut and to reduce the formation of selegiline metabolites (which may cause adverse effects).
>
> I have no idea what dose of Zelapar would be needed to exert an antidepressant effect. It would be useful to hear from someone who has tried it.
>
I took Zelapar in 2007-2008. I found some benefit from Emsam, but did not like the patch form, and asked my pdoc if other forms of selegiline were available. I took the dose of Zelapar where each orally disintegrating tablet was 1.25 mg, and I slowly worked up to 15 mg., or something like that. Although, I guess that doesn't divide evenly. Maybe it was 16 mg. I am pretty sure I got up to 10 or more tablets a day. It gave me a little relief, but I came to think it wasn't enough, and I wanted to move on to try something else. (Also, the hassle of following the MAOI diet when on that high of a dose. Plus, I knew I was costing the insurance a lot, for not much benefit.)Just as a warning, I am kind of surprised my insurance covered it. I think this high of a dose was costing them something like a thousand dollars a month.
Luckily, desipramine has been much better for me, and I don't have to follow those diet and other med restristions of MAOIs any more.
Posted by donald Klein on August 9, 2010, at 8:11:01
In reply to Re: the Zelapar form of selegiline, posted by softheprairie on August 9, 2010, at 4:47:04
I believe the difficulty is the concurrent use of hi doses of bzd
with maoi which renders them sedative to the point of toxicity.
of course very difficult to withdraw from hi dose bzd as outpatient
so detox as inpatient may be necessary. Have seen "refractory"
depressives on this combination relieved by bzd discontinuation
Posted by Enigma on August 9, 2010, at 18:50:14
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Leo33 on August 8, 2010, at 17:30:18
> Enigma, your life isn't as bad as you think! Seems like you have your own house, got married and had 3 kids, and have tons of energy to write on this site. Motivation to write a book.
>Well, I wrote the book now, 1-2 years ago. I couldn't do it now. The kids were easy on my part :). First try, all 3. Must have some serious swimmers.
Energy? No. Anger, hatred, maybe. Depression sucked out all the energy I used to have. I did get a hypo-manic day on Saturday so I went out for the first time in 6 months, all alone. I told myself not to do it, but I did anyway. Had a horrible, depressing time. No one would even come near me. After the first club's bad sucked, I went to another place, that I had, since their all "kiddies" there. I intentionally separated myself from the crowd and went to the balcony so I didn't have to face anyone, or hurt anyone. I carry a knife nowadays, *everywhere* I go. My psychotic side/which is really my defense mechanism to pain and suffering, took on a life of it's own now, even though I still try and suppress it. I got up to leave 15 mins early when some f-ing idiots, thank god I didn't see them, decided to throw lemon wedges at me from below. I thought something was falling out of my pocket and looked down at the ground and saw what they were, normally I'd yell down to *everyone* below me and demand whomever was doing this to make their cowardly face known, but there were cops there, bouncers everywhere, and I would look like the crazy one. I was so depressed, I didn't care, and I just shook my head and left, saying, again, it happened again. Someone had to be mean to me, just cause I was alone (and listening to my headphones at a live band, lol, they sucked).
So that marks every time I've gone out alone, I was either insulted in some way, mistreated, and so on. Sad, cause I'm 190 pounds, and it's mostly muscle except for the gut from f-ing Nardil, and I have a very mean looking face. You would have to be pretty stupid to mess with me, but just add alcohol, and there were probably a few of them doing it, so, there ya go. I fear nothing. Even multiple attackers, as long my trusty blade is with me. Assholes. Immature assholes.Going out at night was one of the few activities I still enjoyed, even with the depression, but I always needed one friend to go with me. They're all gone now. Abandoned me for a million different reasons. Sad thing is, I'm STILL the life of the party when I'm out and don't act depressed (unless alone), but just about everyone I know thinks that part of their life is over, so guess who suffers. Me. Never got lucky and found any younger people to hang with.
> Not to try and out do ya here, In my forties, never been married, no kids, on welfare which I have now hit my lifetime limit and 4 applications and denials from SSDI, live at home with my elderly and ailing parents, not kissed a woman in 11 years or anything else, have to go to clinic for psych nurse to prescribe meds, had to go to state hospital for inpatient after last psych nurse clinic failure in 2008.
41 here. My life, women, and social outings-wise, went to hell at 40. I have NO idea why. It's like everyone knew I was single and 40 and stayed far away from me or was just offended that I would even speak to them, like I would make them look uncool or something.
Well, I wish I never got married, don't regret the kids though, but the marriage killed 20 years of my life and I should have got out at 30 and still had a chance to meet a pretty girl. You must be lonely as hell. I know I am. Wow, I got lucky and when I went on long term disability and failed to come back, I got accepted to disability right away. I feel so bad for you. 4 denials??? You know, they wrote this letter about me at work than ended my career and I thought it was WAY over the top and hurt my feeling like you wouldn't believe, because they basically made me sound like I couldn't do ANY part of my job in ANY way. I HATED my boss (ex-friend!!) and always wondered why he went so god damn far with it. Maybe he was trying to help me get disability? I NEVER thought of that until just now (it's been 10 years I think, or is it 6?).. maybe that's why they made me sound so useless... I should ask him someday..inpatient is hell, IMHO. Are you there now or out? I couldn't use a computer or cell phone or almost anything like that at the place I was at for a few days. Good thing I checked myself in and was able to check myself out. It's a jail. They even monitored what we talked about at the dinner table, I actually had a few girls into me.. it was strange! Too bad none were lookers or I would have married them.
Kissing, hugging, intimacy.. haven't had any of that, though I'm technically married, but separated now. Sadly, I got very lonely at 19, my gf/wife, was an idiot leech and wouldn't let me go no matter how mean I was to her. We became friends with benefits which is something, if she had a backbone or confidence would/should have NEVER allowed, and she should have NEVER accepted when I asked her out. All she had to do was ask me one question. "Are you in love with me". I would have said "no", and ya know, I bet she wouldn't have even cared. My depression was always chemical, and still is, but now I'm depressed "situationally" too. I met my soul-mate 6 years ago - we got split up without getting contact info, and I lost her, just like that. Someone that took me 14 years to find, love at first sight, and I was so happy, and confident we'd meet later (we tried, long story) that we didn't exchange #'s first. I will NEVER forgive myself for that night. I fell in love with her 2-3 days later and have been in love "with her ghost", ever since. I remember ever second of our short, patheticly fun time together.
She helped kill my marriage, just because (I) compared her to my wife. When I did that, I started to have real disgust for my wife.. when that happened, I knew there was no going back. I don't even know what "sex" is anymore, and I'd actually pay an escort (if I had the money) just to let me be affectionate with her, no sex!!! Intimacy is what I missed, through the entire marriage. It degraded over time after the first 5-10 years of our 20 year relationship.
I tried match.joke and it was an epic failure, and oh, I went out with a bang, today actually. I changed my profile and trashed all the users there (targeted pretty women) and listed my DISMAL experience with the site in my profile. I'll leave that up for 2 months. Funny thing, they can't even flame me because all I stated was facts. Some lady emailed me and said non-attractive women have the exact same problem there and told me that pretty women on there get 200 emails a week. So, these chicks do the most selfish and vain thing possible and pick (ONE) of the best looking of all the respondents, and literally blow off the rest without even a response. They act like they are ordering from a dinner menu or picking the nicest looking car out of the lot.
Me, if I miraculously for 5 emails of interest, I would be fair and DATE all 5.Dating is officially death BTW. At least where I live. The women on the site think they can pick a sole-mate, from a god-damned menu!!!! You don't know ANYONE unless you've spent real time dating them several times. But these women are so lazy, it's unreal. They even write in their profiles that they don't want to date a lot of men, just want one "winner". The lucky man who's a a 9 or a 10. I said from the first month of there, that's it's just one huge beauty contest. I'm about 6-8, in most women's eyes, and even 5's were blowing me off. How depressing.
>
> So you are not alone, also I am not a bad looking guy either, and have college degree and a lot of travel. Women want the confident personality types, If you suffer from depression then you are not going to be that, you need that mania.
>
> Anyway, hang in there, you are in a tough spot, but looks like you have enough inside you to fight a bit longer.
>
> Maybe the psych's can put you on heavy anti psychotics to sedate you beyond the point that you care, seems to be the going trend. God forbid no benzo's if they actually work.I think my age nips it in the bud. I'm just too old to get the pretty girl I want. I don't like girls my own age.. they really look it.. (no offense), but somehow, I aged very well, and don't look old, wrinkled, bald, etc.
See, I don't want to be on heavy drugs so I don't care. That's not me anymore. I'd rather die with my personality the same as it's always been. I'm not going to die drooling and comatose, or end up that way. I'm taking my life into my own hands. I tried all the atyp. Antip., and suffered from way too many side effects. No thanks. Pretty sure I've tried benzo's too. Nothing works on me.
Looking into DBS studies now. I want my selegeline and this Nardil crap OUT of my system. Selly won't last me long, but it's better than failing Nardil with 3-4 MAJOR side effects I've had for 3 years. I can't even go outside if it's humid. I'm covered head to toe with sweat in about 3 mins.
Enough complaining.. done so much the last few days.. ack..
Nice talking to ya, and it's "nice", but horrible to hear you're in the same boat, at least with women. God I hate them. If I didn't find them so damn attractive.. I thought about going to Europe for a while. No cash though.
I hear dating EXISTS there, so does casual dating/sex/loving/sharing/intimacy.Women here.. I wish I knew what happened to them. I wish I was alive during "free love". So many women in the world and people are so selective. What happened to casual dating/one night-ers, flings, short relationships. There is safety with condoms!!! I'm not a hedonist but I think it's ridiculous that more people don't enjoy each other mentally and physically without SO MANY SUPID RULES, BS RESTRICTIONS, SUPERFICIAL TRIVIAL GARBAGE, ETC!!!!!!! Just imagine.. dating a different pretty girl every 4-6 weeks. Heaven on Earth for me. So many experiences to be had with the opposite sex, but so many rules so no one is "getting any". So, you grow old and die, missing out on a giant CHUNK of living. I'll die by those words.
Posted by Dr. Bob on August 10, 2010, at 14:47:58
In reply to Re: the Zelapar form of selegiline, posted by donald Klein on August 9, 2010, at 8:11:01
> I believe the difficulty is the concurrent use of hi doses of bzd
> with maoi which renders them sedative to the point of toxicity.
> of course very difficult to withdraw from hi dose bzd as outpatient
> so detox as inpatient may be necessary. Have seen "refractory"
> depressives on this combination relieved by bzd discontinuationDon,
Welcome! It's always great to see one of The Best Psychiatrists in the U.S.A. and Canada Specializing in the Treatment of People with Mood Disorders here. :-)
http://www.psycom.net/depression.central.psychiatrists.html
Bob
Posted by violette on August 10, 2010, at 19:10:30
In reply to Re: welcome! » donald Klein, posted by Dr. Bob on August 10, 2010, at 14:47:58
http://www.psycom.net/depression.central.psychiatrists.html
Bob
Just a note about the list of 'best psychiatrists" posted here: the ones listed in my area run the worst mental hospital in my city. It's well-regarded and well-known for its research, but the patient care is very poor. That can be verified by the view of just about any experienced psychiatrist, social worker, therapist, family practitioner, or mental patient in my city. It's well know for being the 'worst'.
Just a word of caution to anyone looking at that list - best does not necessarily = best in practice.
Posted by donald Klein on August 10, 2010, at 19:26:04
In reply to 'Best Psychiatrist' list, posted by violette on August 10, 2010, at 19:10:30
> http://www.psycom.net/depression.central.psychiatrists.html
>
> Bob
>
> Just a note about the list of 'best psychiatrists" posted here: the ones listed in my area run the worst mental hospital in my city. It's well-regarded and well-known for its research, but the patient care is very poor. That can be verified by the view of just about any experienced psychiatrist, social worker, therapist, family practitioner, or mental patient in my city. It's well know for being the 'worst'.
>
> Just a word of caution to anyone looking at that list - best does not necessarily = best in practice.It is very difficult to evaluate just how good any doctor is at a distance. Obviously such lists provide only moderate guidance and reasoned skepticism is always advisable.
Just as the professional's difficult job is to objectively evaluate and monitor treatment , the patient has the same task. Both are not easy.
Posted by violette on August 10, 2010, at 19:47:42
In reply to Re: 'Best Psychiatrist' list, posted by donald Klein on August 10, 2010, at 19:26:04
I don't disagree with you. I came across that list before; checked up on the psychiatrists listed in my area-one had a curriculum vitae over 25 pages long...the other I don't even want to mention.
The best psychiatrist I found in my city? Not one published article. (Maybe he did some research in the 60s or 70s but nothing online).
I found the psychiatric community in my city seem to know of one another's competency, reputation, assets through word of mouth...through both colleagues and patients, and that referrals are the Best way to find the Best of the Best...as opposed to lists, which may (or may not) have political connotations involved. There may be less subjectiveness involved when referrals represent a consensus of reputation within the local community.
Posted by former poster on August 10, 2010, at 22:46:01
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Leo33 on August 8, 2010, at 17:30:18
I was on Nardil for 15 years. I switched to Cymbalta 60mg a day and a low dose of Dextroamphetamine- about 10mg a day. I think this combo is close to being effective as Nardil without a lot of the side effects and dietary restrictions. It's been 3 years now and I'm looking for an alternative to Cymbalta because of the sexual side effects. So I think there are other options to consider. Hope you feel better soon.
Posted by g_g_g_unit on August 11, 2010, at 4:39:04
In reply to Re: Nardil is killing me - must find alternative! Help, posted by former poster on August 10, 2010, at 22:46:01
> I was on Nardil for 15 years. I switched to Cymbalta 60mg a day and a low dose of Dextroamphetamine- about 10mg a day. I think this combo is close to being effective as Nardil without a lot of the side effects and dietary restrictions. It's been 3 years now and I'm looking for an alternative to Cymbalta because of the sexual side effects. So I think there are other options to consider. Hope you feel better soon.
Wow - really? "As effective as Nardil" for what? Depression? Or do you also experience benefits w/r/t social anxiety?
Posted by Enigma on August 11, 2010, at 9:53:27
In reply to Re: Nardil is killing me - must find alternative! Help, posted by former poster on August 10, 2010, at 22:46:01
Glad you post, talk about my thread being hijacked..
Cymbalta caused my first stay a psych ward. I felt strange right after taking in, then went completely suicidal, sobbing, ideation, etc. It was horrible. 2 days after it was out of my system, I felt like myself again.
15 years of Nardil.. I can't imagine that. I've had headaches now for a week that last most of the day and 2 doctors are blaming Nardil, neither are p-docs. I want off it mainly for the weigh gain - 15 pounds on a short guy like me - 5'9" looks HORRIBLE. I'm embarrased to take my shirt of in front people, at my pool, the beach, etc. Looks like I'm pregnant since I gained only a tiny amount of fat everywhere besides the gut. It's all gut and love handles, for a guy that's with 160-170pnd from 16-30+
41 now and I HATE it.
The sweating, I won't even mention that again. Changing my clothes 3 times a night is so much fun, even with fans and a cool room temp.I'll have to look at Dextroamphetamine, thanks. Can't touch Cymbalta though, until I want to commit suicide early. Been thinking of doing that anyway.
My clocks ticking and I failed at getting a single date (and I'm rougly a 7-8) in looks... can't get a girl now because I'm on disability. Who's gonna take me in? Life is pointless for me.I was going to apply for a couple dbs trials, but I'm almost lost all the will to keep fighting. I don't care anymore. I feel I have nothing to live for past 40. Life's been going downhil since then.
Posted by former poster on August 11, 2010, at 11:09:46
In reply to Re: Nardil is killing me - must find alternative! Help, posted by g_g_g_unit on August 11, 2010, at 4:39:04
For me, the Cymbalta / Dex combo was about 95% as effective for social anxiety. It seems the 2 meds potentiate each other, responding to a much lesser dose of both meds. The Cymbalta gave me a remarkable relief from depression immediately. Then after about a year on it an even more astonishingly robust response. Better than any other non MAOI med. Only trade-off is that sex is nearly impossible while on Cymbalta unless Viagra is used.
I can relate to the "Nardil gut" I gained about 50lbs on Nardil!!
Posted by angels78 on August 11, 2010, at 11:37:13
In reply to Re: Nardil is killing me - must find alternative! Help » former poster, posted by Enigma on August 11, 2010, at 9:53:27
When you were on Nardil, what was your diet like?
Posted by angels78 on August 11, 2010, at 11:42:15
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
> I'm concerned about the weight gain. I look HORRIBLE. If ANYONE knows how to lose the weight while on 75 mg of Nardil and (10mg? of Ambien/4 mg Klonpin night
Yeah, the insomnia sucked huh, i would only get 4 hrs of sleep and wake up. then have to take another ambien for second period of sleep. which wasnt good because it left me droggy the next day.
Posted by pedr on August 11, 2010, at 14:43:03
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
Hi Enigma,
sorry you're feeling so horrible. My Dx is not dissimilar. I have atypical "treatment resistant" depression and OCD. On top of that I have chronic IBS-C which leaves me in varying degrees of pain and discomfort every day. I also have tried the standard groups of meds and cannot tolerate many (e.g. a tiny Paxil dose gave me daytime nightmares, like being in a Tim Burton film). I'm on 90mg Nardil and it has helped more than anything I've tried by miles. Still I go through periods of depression which typically last 5-6 days. I don't know why. I just sit tight and wait for them to pass.I was 150 lb when my IBS-C was bad (you become afraid of all food and so you stop eating it) but my "normal" weight has always been ~ 170lb. Now I am 200lb. Like you, nothing I seem to do touches it - exercise, diet and so on. I also look and feel pregnant with that weird big belly but lean limbs look. Makes my SA really difficult on the subway, I'm convinced that people are staring at me.
Here's your list of SE's (I get or have had all of them and more) with any advice I have:
Nardil causes
- fatigue,
--- have you considered adding Provigil? Some people report excellent results. Didn't do squat for me.
- insomnia (need 2-3 meds to sleep at night),
--- apparently melatonin can be taken with Nardil. The bottle says not, as do some websites. But my shrink thinks it's OK, and lots of people have tried it. Perhaps give it a go.
- constant overheating/sweating/uncontrollable body temp (too high/can't cool down - drinking coffee makes me sweat!), unbearable in humidity (I could ALWAYS tolerate it before Nardil),
- now crying spells (new, never had them until 1 year ago or 6 months ago - some severe crying spells - suicidal - uncontrollable crying - loud, severe. (not a side effect, I think it's pooping out. Nardil never caused this before - been on nardil for 2-3 years) - 75 mg.
--- have you considered 90mg or higher? or augmentation with Provigil?
- Max dose causes (blood pressure problems, dizzy spells when bending over, raising head back up, fairly bad. Hyptotension? I forget the term.
--- I used to get this but it has passed. Not sure why yours is persisting. Try 2 things: 1/ drink loads of water. This increases blood pressure. 2/ increase your salt intake (as long as your doc approves). This also increases blood pressure. I was able to play soccer as long as I did these steps beforehand.
- Anorgasmia
- Inability to regulate body temperature/overheating
- Severe fatigue
- Unable to lose weight, weight gain from eating little to no calories - very low carb diet
>> If anyone knows of anything that will help, please toss on your comments. Just looking in the mirror after a shower causes depression. Now I wear a beach/surfer shirt to hide my body at the pool/beach. :(Looking in the mirror can't cause depression directly. I know that you probably know that but it's true. It sounds as though body image is incredibly (excessively?) important to you. Don't get me wrong, I don't like looking pregnant either (and it's cost me a fortune in clothing) and I get anxious&down about it often, but since there's f-all you can do about it, the only thing left to do is change your attitude towards your body image. Accept that this is the way it's going to be whilst on Nardil. If you can make peace with the weight gain, the less it will get you down and the better you will feel.
Apologies if that came across as preachy-sounding, it wasn't intended to be, it's just my suggestion.
Pete
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