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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by LazyorAnxious on August 11, 2015, at 17:15:42
Hi all.
I've been lurking on this site for a while, but now I need to ask a question.
I've worked with several psychiatrists in the past, some of which were good, some bad. I've taken many different kinds of medications for varying problems, but have never found a great combination. The list below is basically in order.
Ritalin
Adderall
Vyvanse
Buproprion - Had no effect
Sertraline - SLEEEEEPY
Citalapram - so very sleepy
Risperidol - Zombie like and forgetful
Buproprion again Felt worsening depression and anxiety
Buspirone - Had no effect
Desimipramine - Couldn't stop crying for 3 days.
Vilazadone - meh
Tried Effexor, didn't really seem to do anything, but was only on for about 2 weeks before I was "diagnosed" bipolar. (Which I don't agree with)
Depakote - made me very tired
Lamictal - 200 mg - lessened symptoms of depression but only to about a 3 or 4/10 from a 1 or 2.
Abilify - 2.5 mg-5 mg - only seemed to make me not want to do anything. Sad around doing nothing a lot on 5 mg.
Tried Wellbutrin again while on Lamictal, suicidal thoughts returned en masse.Then, I found Parnate. Was considering ECT at the time but wanted to this first, so I did. It's worked. I'd say I went from a 1/10 (wanted to die badly) to about a 7, which I'd consider "normal".
I've had some weird effects from it, though. I've got a massive increase in appetite which has caused me to skyrocket in weight (245, heaviest I've ever been). I've got dry mouth (doesn't bother me really) and diarrhea, but oh well. I can get tired sometimes, especially in the afternoon. Some insomnia sometimes, especially at first, but it's been better and can be helped a lot with the safe antihistamines.
Overall, very happy with it. But I still have other issues that I don't know how to address.
1: I still find it very hard to get myself to do things that aren't "fun". It took me several weeks to start applying for jobs. Some of this was because of anxiety and I think some of it was apathy/laziness. Anyone have any ideas on how to tell the difference? Is this something that would be better to use therapy for?
2: I still have problems with self-control. Adderall helped a lot with this when I took it last a few years ago. I ended up stopping the Adderall because I was no longer in school (because I was depressed) but it helped me lose a lot of weight and helped me control what I said around others better. It made the decision to go running+go the gym a no brainer because the motivation was just... there. I didn't have to struggle and try to convince myself only to fail more than half the time. I'm almost positive my ability to lose weight wasn't solely from the appetite loss, but also from increased self-control. I still wanted to eat during the day, but I was able to say "no, I'd rather wait until later tonight when my self-control is at 0 again". Basically I was eating solely in the late afternoon-night, which is not abnormal nor unhealthy. (Intermittent fasting is what it's called). I'd eat this way without Adderall if I could, but I have no self-control. Is this something I should go to therapy for?
3: I still have problems with self-esteem. I still have very little faith in myself, I still don't feel like I deserve anything. I still feel like a loser for not being able to control what I eat/say. I degrade myself in front of friends all the time because I feel I need to show that I hate myself... blah blah. Therapy?
So, I've asked "therapy?" to all 3 points above, but what I'm here on this particular sub-board for is to ask if there's medication that can help. I'm open to trying therapy again, despite my failure with it in the past. But, if there's a medication that can help also, I'd love to try it.
"Why don't you just ask your psychiatrist?"
I tried to. As soon as I brought up a bunch of different medications that I've seen people on this site/other sites use with Parnate, she rejected every single one saying "it's contraindicated" or whatever. So, I'm gonig to find a new psych. Before I do that, I'd love to hear some options I can bring forth that would be good for my problems. Should I try for Adderall again? I've heard mixed things about it with Parnate.
Nortriptyline?
Mirapex?
Requip?Any ideas that you guys have for my issues that I can ask a new psych about when I call would be great. I'd like to have a list so that I know before I go whether they'll even CONSIDER any of them.
Thanks a bunch guys, for any information.
Posted by phidippus on August 11, 2015, at 20:07:51
In reply to Parnate Adjuncts for Anxiety/Discipline/SelfEsteem, posted by LazyorAnxious on August 11, 2015, at 17:15:42
'safe antihistamines' are not all that safe.
>Some of this was because of anxiety and I think some of it was apathy/laziness. Anyone have any ideas on how to tell the difference? Is this something that would be better to use therapy for?
the difference is apathy is a lack of feeling, whereas laziness is a lack of motivation. there are issues here that should be addressed by the Parnate, namely the apathy and anxiety but most of these issues can be addressed in therapy as well.
>I still have problems with self-control. Adderall helped a lot with this when I took it last a few years ago. I ended up stopping the Adderall because I was no longer in school
If your response is indicative of ADHD, I would highly recommend you go back on the Adderall.
>I have no self-control. Is this something I should go to therapy for?
We have decades worth of research demonstrating the effectiveness of a wide range of psychotherapies for the treatment of ADHD in both children and adults. Some people turn to psychotherapy instead of medication, as it is an approach that does not rely on taking stimulant medications. Others use psychotherapy as an adjunct to medication treatment. Both approaches are clinically accepted.
>I still have problems with self-esteem. Therapy?
Yes.
>Should I try for Adderall again? I've heard mixed things about it with Parnate.
It works fine with Parnate. I think you should do it.
>Nortriptyline?
Is a fine adjunct to Parnate for depression.
>Mirapex?
Do you have restless legs syndrome? May help with depression, but also has some serious side effects, including compulsive behavior.
>Requip?
See above.
Eric
ps. lazy or anxious? Do you dread doing things?
Posted by Lazyoranxious on August 12, 2015, at 10:37:42
In reply to Re: Parnate Adjuncts for Anxiety/Discipline/SelfEsteem » LazyorAnxious, posted by phidippus on August 11, 2015, at 20:07:51
Very true, but I don't take them every night and when I do it's Doxylamine, which isn't Seratonogic AFAIK.
I think it's probably laziness, but I know I do have problems with "mental" anxiety. As in, I don't actually feel it physically, I just have anxious thoughts.
I'm not really sure on the ADHD. I was tested for it and the test showed (and I think it was a good test) that I don't have it. It seems that when I actually try, I can focus and pay attention just fine. Perhaps my self-control problem comes from something else.
Regardless, thanks for posting about the Adderall. Perhaps I'll ask to try it again despite my lack of true symptoms. I really recall it making it so much easier to get up and start things as well as to resist doing/saying stupid things. And it helped immensely in me losing weight.
Thinking about this more, I don't think it's anything depression related anymore. I think it's either anxiety or complacency with mediocrity.
I often dread doing things that I know are going to cost a lot of $, like getting my car fixed. So I put it off. I'm positive this isn't an uncommon problem though.
Thanks for your post!
Posted by Zyprexa on August 14, 2015, at 23:50:10
In reply to Re: Parnate Adjuncts for Anxiety/Discipline/SelfEsteem, posted by Lazyoranxious on August 12, 2015, at 10:37:42
I think you should go with the aderall. Add it to the parnate. The 2 will probably work better.
Posted by SLS on August 15, 2015, at 7:04:02
In reply to Parnate Adjuncts for Anxiety/Discipline/SelfEsteem, posted by LazyorAnxious on August 11, 2015, at 17:15:42
I found that Nardil works better than Parnate for apathy, amotivation, and anxiety. It is definitely pro-social. I also think that Nardil is more of a "mood brightener". Weight-gain, dizziness, and initial anorgasmia prevent some people from staying with Nardil long enough to respond to it. It has been reported that anorgasmia lasts 3 months for some people, but can return. This was my experience as well. Adding nortriptyline enhanced the antidepressant effects of Nardil for me. It may be that your adding amphetamine to Nardil would address ADHD and possibly weight-gain. For depression, I respond better to Focalin than to Adderall or Ritalin. I also find that Lamictal adds still more antidepressant effects to Nardil.
* Nardil caused me to feel "foggy" in the beginning. However, this soon gave way to improvement and clarity of thought.
I tried switching from the Parnate I had been taking to Nardil about a year ago. I didn't respond as well to it as I had in the past, so I returned to Parnate. I aborted the trial prematurely, though. I was impatient. I didn't give it a full 12 weeks, which is sometimes required of Nardil to work.
I should have tried Marplan at high dosages. I only reached 40 mg/day. I saw recently that someone needed 90 mg/day to respond to it. Still, it felt much "cleaner" than either Parnate or Nardil. There was no trend for weight-gain for me.
Good luck with whatever you decide to do.
- Scott
Posted by SLS on August 15, 2015, at 7:20:35
In reply to Re: Parnate Adjuncts for Anxiety/Discipline/SelfEsteem » LazyorAnxious, posted by phidippus on August 11, 2015, at 20:07:51
Does psychotherapy address attention deficits? Given the history of stimulant use to successfully treat attentional symptoms exclusive of psychotherapy, I would be surprised if psychotherspy were as effective as pharmacotherapy. Perhaps psychotherapy hadn't been adequately studied in the past.
How long does psychotherapy take to work in the treatment of attentional symptoms in pediatric ADHD? The early years of childhood are critical for learning and success in school. It is imperative that any therapy work quickly.
It has been reported recently that adult ADD is not necessarily a continuation of childhood ADHD. Perhaps psychotherapy is more effective in the adult population.
Any comments?
- Scott
Posted by phidippus on August 16, 2015, at 15:01:11
In reply to Re: Parnate Adjuncts for Anxiety/Discipline/SelfEsteem » phidippus, posted by SLS on August 15, 2015, at 7:20:35
>Does psychotherapy address attention deficits?
According to a recent report (http://www.sciencedirect.com/science/article/pii/S1388245713012285) in Clinical Neurophysiology, adults with A.D.D. were shown to benefit from mindfulness training combined with cognitive therapy; their improvements in mental performance were comparable to those achieved by subjects taking medications.
>how long does psychotherapy take to work in the treatment of attentional symptoms in pediatric ADHD?
Most behavior modification strategies take 8 to 12 weeks to implement.
>It has been reported recently that adult ADD is not necessarily a continuation of childhood ADHD.
if you have adhd as an adult you had it as a child. ADHD is not something that develops later in life. Adult ADHD is an extension of childhood ADHD but the symptoms in adults may manifest differently and are often more subtle.
Eric
Posted by SLS on August 16, 2015, at 18:58:00
In reply to Re: Parnate Adjuncts for Anxiety/Discipline/SelfEsteem » SLS, posted by phidippus on August 16, 2015, at 15:01:11
> if you have adhd as an adult you had it as a child. ADHD is not something that develops later in life.
I came across this a few days ago:
http://bipolarnews.org/?p=3319
12 weeks is pretty quick for psychotherapy to improve childhood ADHD. That's very encouraging. It would seem worth trying this before taking medication.
- Scott
Posted by Lamdage22 on August 25, 2015, at 12:43:38
In reply to Re: Parnate Adjuncts for Anxiety/Discipline/SelfEsteem » phidippus, posted by SLS on August 16, 2015, at 18:58:00
If you find a treatment for lack of discipline, please shoot me an email :)
Posted by yuliy davidov on August 29, 2015, at 6:37:42
In reply to Parnate Adjuncts for Anxiety/Discipline/SelfEsteem, posted by LazyorAnxious on August 11, 2015, at 17:15:42
LazyorAnxious hi
you tried l-methylfolate? many know it as deplin prescription drug and a lot of money, but there are generics without a prescription and little price
on the internet a lot of information about this drug, and many admiring comments of those whom it helped to radically
Find the subjective impressions and discussion on forums : reddit ,longecity and customer Reviews on amazon.I do not advertise it
This is the end of the thread.
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