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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 46. This is the beginning of the thread.
Posted by Lamdage22 on July 18, 2013, at 13:21:09
Hey Folks,
im still in the hospital.. and i have come to find this was a really good decision to come here. Its a really good place.
The docs are determined to get me back on track, they are caring, they listen, they take side effects i get seriously.. there are Professors involved in the treatment... One of Psychopharmacology. This blows my mind.. i never felt so understood and cared for. I had high expectations coming here and they exceed them day after day.
This hospital does not schmooze with pharma-industry. They care for patients interests only.After treatment i will be doing a Psychosocially supervised job without payroll.. Its okay though.. i do have this illness i have to deal with, but at least im ok financially. I look forward to have something to do again when im out of the hospital and who knows, maybe they can support me on the way back to the "real" job market.
So im still on 300mgs of Seroquel which is serving me well. Tomorrow i will take my last dose of Effexor and will switch to Parnate "Jatrosom". I do NOT have to wait for two weeks, instead they draw blood to see if they can start the Parnate already. They expect a week until i can start.
I am taking Acetylcystein regularly.. and i wonder when i should take this? Twice a day or all at once? Dosage?
Also i am coming off of Lithium which made me eat like crazy. I do not want to take it in any considerable dosage. Maybe i will take a very low dose if i can convince the doctors.
Im also interested in Glutamate antagonism so i consider a low dose of Lamictal in addition to Acetylcystein and super low dose Lithium perhaps.
I did feel stupid at 200mgs of Lamictal and i did loose hair due to Lamictal i believe.
Any thoughts or suggestions are welcome.
I am happy to not have to put any more "crisis" threads on here and hope to continue on recovery road.
Greetings from Germany
Posted by SLS on July 18, 2013, at 13:39:55
In reply to Doing a fair bit better!, posted by Lamdage22 on July 18, 2013, at 13:21:09
Hi Lamdage.
Your story is an example of how things should be done. Everything that you and your doctors are doing is perfect. I hope the tranylcypromine (Parnate; Jatrosom) works for you.
I admire you for you perseverance and drive to get well. Keep working.
- Scott
> Hey Folks,
>
> im still in the hospital.. and i have come to find this was a really good decision to come here. Its a really good place.
>
> The docs are determined to get me back on track, they are caring, they listen, they take side effects i get seriously.. there are Professors involved in the treatment... One of Psychopharmacology. This blows my mind.. i never felt so understood and cared for. I had high expectations coming here and they exceed them day after day.
> This hospital does not schmooze with pharma-industry. They care for patients interests only.
>
> After treatment i will be doing a Psychosocially supervised job without payroll.. Its okay though.. i do have this illness i have to deal with, but at least im ok financially. I look forward to have something to do again when im out of the hospital and who knows, maybe they can support me on the way back to the "real" job market.
>
> So im still on 300mgs of Seroquel which is serving me well. Tomorrow i will take my last dose of Effexor and will switch to Parnate "Jatrosom". I do NOT have to wait for two weeks, instead they draw blood to see if they can start the Parnate already. They expect a week until i can start.
>
> I am taking Acetylcystein regularly.. and i wonder when i should take this? Twice a day or all at once? Dosage?
>
> Also i am coming off of Lithium which made me eat like crazy. I do not want to take it in any considerable dosage. Maybe i will take a very low dose if i can convince the doctors.
>
> Im also interested in Glutamate antagonism so i consider a low dose of Lamictal in addition to Acetylcystein and super low dose Lithium perhaps.
>
> I did feel stupid at 200mgs of Lamictal and i did loose hair due to Lamictal i believe.
>
> Any thoughts or suggestions are welcome.
>
>
> I am happy to not have to put any more "crisis" threads on here and hope to continue on recovery road.
>
>
> Greetings from Germany
>
Posted by SLS on July 18, 2013, at 13:45:12
In reply to Re: Doing a fair bit better! » Lamdage22, posted by SLS on July 18, 2013, at 13:39:55
I forgot to mention that NAC is usually given as 2000 mg/day for mood disorders.
Minocycline is another drug that modulates glutamate activity. It is usually given as 200 mg/day.
- Scott
Posted by Lamdage22 on July 18, 2013, at 14:30:26
In reply to Re: Doing a fair bit better!, posted by SLS on July 18, 2013, at 13:45:12
Thanks, Scott!
I guess NAC is a long term thing anyway so i dont have to worry much about when i take it or if i miss a dose sometime.
So Glutamate antagonism is a good idea? I want to do this against compulsiveness, against addictive behaviour and agression somewhat. Do you think Glutamate antagonism helps against behavioural addictions, too?
I liked that Lithium helps against bad thoughts against self/others and the "evening out of temper" effect.
Maybe i can convince em to give me just a little bit since that one study was done where areas with more Lithium in the water had less homicide and suicides.. Which sounds like a real good thing if it does that psychologically. I dont think significant doses are in drinking water anywhere.Thanks for the reassuring words.
Posted by SLS on July 18, 2013, at 14:46:10
In reply to Re: Doing a fair bit better!, posted by Lamdage22 on July 18, 2013, at 14:30:26
Is there any concern regarding serotonin syndrome from mixing Parnate with Geodon?
Some researchers are looking at glutamate hyperactivity as contributing to depression. Minocycline, Lamictal, and NAC are supposed to help with this. It can take several months for NAC to begin working. I failed to respond to NAC. Actually, it might have made me feel worse. Interestingly, ketamine promotes an increase in glutamate release at dosages that are observed to be effective in treating depression. The brain is not easily understood.
Prazosin is supposed to be good for PTSD. I like it. It feels like a clean antidepressant for treating my bipolar depression.
- Scott
Posted by Lamdage22 on July 18, 2013, at 15:02:25
In reply to Re: Doing a fair bit better!, posted by Lamdage22 on July 18, 2013, at 14:30:26
And all this anti-psychiatry talk i have polluted the board with, i take it back. You get the help you need and find a doctor that will get you back on track.
I am wary of some Medications including Zyprexa, Haldol and of ECT. But there is good stuff out there. Just be sure its doing more good than harm.. you take the pills to have an easier time in life, not a harder time.
And find a doc that seriously weighs pros and cons and makes you understand your choices. One that is careful not to do any unnecessary harm. Psyche meds CAN harm you, but they shouldnt unless you go completely bananas without the medication and there is no alternative.
I mean, what is wrong with some people? They put a chemical into their body everyday for months and years and they do not know the name of it? Seriously it is YOUR choice to take the pills unless you have a court order. So in order to make that choice you need to know what you are doing and the doctor should support you in knowing what you are doing.
Posted by Lamdage22 on July 18, 2013, at 15:10:46
In reply to Re: Doing a fair bit better!, posted by Lamdage22 on July 18, 2013, at 15:02:25
Oh okay..
Well, since that Psychopharmacology Professor is available to be consulted, i will see if my docs can draw some more info from his brain.
I have also seen that excess Glutamate can play a role in Schizophrenia so i place my bet on Glutamate antagonism since i have Schizo-Affective Disorder.
Posted by SLS on July 18, 2013, at 15:46:58
In reply to Re: Doing a fair bit better!, posted by Lamdage22 on July 18, 2013, at 15:10:46
> Oh okay..
>
> Well, since that Psychopharmacology Professor is available to be consulted, i will see if my docs can draw some more info from his brain.
>
> I have also seen that excess Glutamate can play a role in Schizophrenia so i place my bet on Glutamate antagonism since i have Schizo-Affective Disorder.
Yes. That makes sense.Have your doctors mentioned minocycline?
- Scott
Posted by Tomatheus on July 18, 2013, at 16:22:26
In reply to Doing a fair bit better!, posted by Lamdage22 on July 18, 2013, at 13:21:09
Lamdage,
I just wanted to say that I'm encouraged to hear about the positive direction that you seem to be headed in and about the fact that you're finding your hospitalization to be helpful. I wish you the best in making the transition from being in the hospital to working at your supervised job.
T.
Posted by Phillipa on July 18, 2013, at 16:59:12
In reply to Re: Doing a fair bit better!, posted by Tomatheus on July 18, 2013, at 16:22:26
Just saying hi Lamadge and wishing you well back home in Germany. Seems like their health system is a good one. Phillipa
Posted by Lamdage22 on July 19, 2013, at 4:07:34
In reply to Re: Doing a fair bit better! » Lamdage22, posted by SLS on July 18, 2013, at 14:46:10
Hi Scott,
yes i think so, too. Certainly Ketamine could be problematic for me with Schizo-Affective.
This Prazosin, what side effects can occur? Any weight gain?
I have frequent nightmaires and maybe a bit of PTSD, too. I was diagnosed couple times. So im quite interested in this.Yes the health care systhem is a bit better, especially for less wealthy people. My insurance pays part of the costs and my dad said he is willing to pay the rest. Professor visits etc. cost extra. So this is not standard. The leading prof banned certain practices with pharma-industry from the whole hospital. Im in the station for people with private insurance. Not the mandatory public insurance.
Thats how it works here.. you need health insurance by law and pretty much anyone can get treatment regardless of wealth.I am wary of Antibiotics because i read up on Candida and how harmful Antibiotics can be to the biology of the gut.
Greetings and thx for your posts
Posted by Lamdage22 on July 21, 2013, at 4:12:16
In reply to Re: Doing a fair bit better!, posted by Lamdage22 on July 19, 2013, at 4:07:34
Hi Scott,
yes i think so, too. Certainly Ketamine could be problematic for me with Schizo-Affective.
This Prazosin, what side effects can occur? Any weight gain?
I have frequent nightmaires and maybe a bit of PTSD, too. I was diagnosed couple times. So im quite interested in this.Yes the health care systhem is a bit better, especially for less wealthy people. My insurance pays part of the costs and my dad said he is willing to pay the rest. Professor visits etc. cost extra. So this is not standard. The leading prof banned certain practices with pharma-industry from the whole hospital. Im in the station for people with private insurance. Not the mandatory public insurance.
Thats how it works here.. you need health insurance by law and pretty much anyone can get treatment regardless of wealth.I am wary of Antibiotics because i read up on Candida and how harmful Antibiotics can be to the biology of the gut.
Greetings and thx for your posts
Posted by SLS on July 21, 2013, at 4:56:10
In reply to Anyone!?, posted by Lamdage22 on July 21, 2013, at 4:12:16
> Hi Scott,
>
> yes i think so, too. Certainly Ketamine could be problematic for me with Schizo-Affective.
>
> This Prazosin, what side effects can occur? Any weight gain?I didn't gain any weight on top of what was already there.
> I have frequent nightmaires and maybe a bit of PTSD, too. I was diagnosed couple times. So im quite interested in this.
It is recommended that one begins treatment by taking a single 1 mg dose at bedtime. Dizziness often occur during the first few days, so taking 3 mg/day (1 mg three times a day) for the first week is advised. From there, you can increase the dosage more quickly. I am currently taking 25 mg/day, but you might be okay taking 6 - 12 mg/day in divided doses. I remember feeling some fatigue, tiredness, and malaise during the first week. These things completely disappeared.
- Scott
Posted by Lamdage22 on July 21, 2013, at 14:35:25
In reply to Re: Anyone!? » Lamdage22, posted by SLS on July 21, 2013, at 4:56:10
Scott, any lack of drive, weight gain or sexual side effects?
Any worrysome long time repercussions?
Posted by SLS on July 21, 2013, at 18:27:40
In reply to Scott Prazosin, posted by Lamdage22 on July 21, 2013, at 14:35:25
> Scott, any lack of drive, weight gain or sexual side effects?
> Any worrysome long time repercussions?I experienced a small amount of dizziness, fatigue, muscle weakness, and malaise for the first week.
* No weight gain.
* Reduced sex drive.
* Slight reduction of motivation at dosages that are too high.
- Scott
Posted by Lamdage22 on July 22, 2013, at 12:24:29
In reply to Re: Scott Prazosin » Lamdage22, posted by SLS on July 21, 2013, at 18:27:40
Doing pretty ok.. although a fellow patient pisses me off. That bitch seriously told a doctor i ate her chocolate. It was in the fridge, there was no name on it so WTF!?
Why doesnt she waste the Professors time with this sh*t. I didnt know it was hers, i told her it was me. She makes this a public thing. What a bitch. She can go f*ck off. Sry.. i tend to indulge in stuff like that alot.
Anyway.. i think the NAC is good. I think the Seroquel is good. Im halfway where i want to be.
Adding Parnate soon. I told the doctors i am willing to raise Seroquel, but that i want a high dose of Parnate.
Posted by Lamdage22 on July 23, 2013, at 4:55:00
In reply to Feelin better yet again. I blame NAC, posted by Lamdage22 on July 22, 2013, at 12:24:29
The doctors pissed me off today. I had a reasonably good mood yesterday maybe even a bit euphoria if you want to call it euphoria.
They talk about it like its a huge problem.I offered to take more Seroquel along Jatrosom, but what i meant was more like "id rather take more seroquel than to get a b*llsh*t low dose of Jatrosom".
Now they raised the Seroquel to 400 and give me 10!!! mg of Jatrosom tomorrow. A nurse told me you had to start the oh so important MAOI diet a couple of days in advance before 10 mg of Parnate?? B*LLSH*T!
I do not feel very supported.. it feels almost like they dont want to change anything about my mental state. Im a schizo-depressive with depression far more strong than psychosis. What the f*ck are they thinking? If i dont get a decent dose of my Parnate im going somewhere else.
Then they bitch around with a financial decision i want to make. How is this their business? I will sell a condo with 50k earned in one year. If i need financial advice i talk to my freakin realtor not these fool doctors.
Im really pissed off and i wonder if this is any good here.
Also i want to move back to my home and they bitch around like its a bad thing that i now have some hope (because i get a medication that is superior to placebo: Parnate) and that i have good plans. They want my father to call here and tell them that its a good idea to sell the home. Who do they think they are the police? Im fuckin 24.
Im pissed off and i wonder how to defend myself against this stupidity.
Help Please
Posted by Lamdage22 on July 23, 2013, at 14:51:18
In reply to Doctors pissed me off. HELP, posted by Lamdage22 on July 23, 2013, at 4:55:00
Posted by Tomatheus on July 23, 2013, at 15:26:14
In reply to Cooled down again. I can be pretty on edge i guess (nm), posted by Lamdage22 on July 23, 2013, at 14:51:18
Lamdage,
I'm sorry to hear that you were feeling upset with the doctors who've been treating you at the hospital. I know that it can be upsetting when those who are responsible for your care at a hospital make decisions that you're at odds with. Patients generally have fewer options when hospitalized than they do when they're being seen on an outpatient basis, and that can be frustrating. Sometimes I think it helps to vent our frustrations about our treatments on forums like this when we're upset. I think it can allow us to sort out what we're going through, and it gives us the opportunity to get others' perspectives.
Do you think that there's any chance that your doctors might be planning on eventually increasing your Jatrosom dose? A lot of times doctors like to start off by prescribing low doses of medications to make sure that patients can tolerate the drugs before increasing to the target dose. Could your doctors be planning something like this?
T.
Posted by Lamdage22 on July 24, 2013, at 1:19:45
In reply to Re: Cooled down again. I can be pretty on edge i guess » Lamdage22, posted by Tomatheus on July 23, 2013, at 15:26:14
Yes, they sure are. But given my extensive positive experience with MAOI i think they could have gone with 25 mgs without a problem.
I will ask for such a rase tomorrow. 10mg is really a joke.Im a little worried Parnate will send me on the edge to much. Idk if Seroquel counteracts this much.
Anyway, i think ill be fine. Just have to figure out some stuff now. Lots of decision making these days. But in a way its fun not being that passive anymore.
Posted by Tomatheus on July 24, 2013, at 2:07:58
In reply to Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 1:19:45
Lamdage,
You might be right that starting out at 25 mg of Jatrosom/Parnate wouldn't cause any problems for you. I think that your doctors are probably just trying to be safe by having you slowly work your way up to a therapeutic dose. Sometimes we don't always respond to medications in the same way that we used to respond to them, and I think (from experience) that this is especially true when psychosis is involved. And given the fact that you said that you were worried about Jatrosom/Parnate sending you "on edge too much," I can see why your doctors would want you to start low on Jatrosom/Parnate and to work your way up. Having said this, I don't think that you'd be out of line by asking your doctors if they could increase your Jatrosom dose to 25 mg. I of course would like for your doctors to agree to the dose increase and for you to do well on 25 mg or higher of Jatrosom/Parnate, but if your doctors don't agree to the increase, that doesn't necessarily mean that you won't eventually get to take the dose of the medication that you'd like to take. It could just mean that you might have to wait longer than you'd like to get to where you want to be medication wise.
I think that you're probably right in saying that you'll be fine. I think that you've already made some progress in the treatment of your conditions, and I think that the odds are favorable that you'll make more progress. Sometimes the process of getting to where you want to be can be one of taking two steps forward and one step backward, as the saying goes, but I think it's most likely that if you remain patient and keep trying different treatment options that you'll at least get closer to where you want to be. So, good luck with everything, and if you'd like, please feel free to keep letting us know how things are going.
T.
Posted by Lamdage22 on July 24, 2013, at 3:45:49
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 2:07:58
Thanks Thomatheus.
Im angry like sh*t! Look at the list of my diagnoses.. look at all the things i need to decide and take care of.
I dont even have an psychologist to help me. Now i eventually am treated by an GP !?? Mind you i pay a bit short of 300$ a day.
They keep telling me how i need to be patient. Because they are too f*ck*ng lazy and partially incompetent to help me!
F*CK
Posted by SLS on July 24, 2013, at 6:05:33
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 3:45:49
I like what Tomatheus wrote to you.
It is incredibly difficult to be patient when one is in pain. This is especially true when the mental illness itself creates a state of mind that compromises one's ability to remain patient.
For me, I have made a habit of starting tranylcypromine at 20 mg/day for a few days before moving up to 30 mg/day. As Tomatheus noted, one can react differently to the same drug at different times. This is especially true if the system has been exposed to a different set of drugs. Hopefully, you will begin to feel better soon after reaching 40 mg/day.
- Scott
Posted by Lamdage22 on July 24, 2013, at 13:48:38
In reply to Re: Doing a fair bit better » Lamdage22, posted by Tomatheus on July 24, 2013, at 2:07:58
Thanks folks, for your backup.. i need all the backup i can get right now. I will try to articulate that to the doctors.. But they are soo sensitive. Why do i have to worry all the time about hurting my doctors feelings?
Today they told me to not "indulge in too much activism".. Are their brains wired the wrong way or something? Im freakin 24 years old and i havent really moved for almost a year.
So its not good news to them that i am finally able to kick my own *ss a little bit? Maybe they dont wanna have their *ss*s kicked by me to WORK.
I have so many problems, i cant even tell them all of it because it would overwhelm them. If i approach this in a "not too much activism" manner, a lifetime will not be enough to get to the point of enjoying life to the fullest.
How can i reason with these folks?
Lamdage needs backup in Germany;)
Thx guys.
Posted by Tomatheus on July 24, 2013, at 13:50:12
In reply to Re: Doing a fair bit better, posted by Lamdage22 on July 24, 2013, at 3:45:49
Hello again Lamdage,
You sound frustrated, to say the least. I think that your frustration is understandable. Receiving care that's not up to your expectations can be frustrating. Although psychiatric care has made what I think is significant progress over the past century, I think that there is still more guesswork and trial and error in psychiatry than most patients like us can stand, and I think that that can be one source of the resentment that a lot of patients feel toward the mental health and medical systems. I can't say from my position the degree to which you might be right about your doctors being lazy and incompetent, but I think that even the best doctors might seem incompetent when the treatment options that they have to work with leave a lot to be desired. In much the same way that a master chef is only as good as the ingredients that he or she uses, psychiatrists in a lot of ways are only as good as the treatment options that they have available to them. In their quests to first do no harm, your doctors probably want to be as careful as they can be to avoid prescribing any treatment that might lead to added distress and/or dysfunction. Unfortunately, this can sometimes interfere with getting you the treatment that might serve you best in the shortest time frame possible.
So, how are things going for you at present? If you already asked your doctors about increasing your Jatrosom/Parnate dose, what did they say?
Here's to hoping that you're finding some peace of mind.
T.
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