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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 77. This is the beginning of the thread.
Posted by J Kelly on March 7, 2016, at 17:13:07
What med or med combo made you "drop to your knees and thank God for pharmaceuticals"?
Even for a short time?
I see pdoc on Wednesday. I'm currently taking:
10mg Zyprexa (weight gain)
.5 mg Klonopin
60mg RitalinConsidering adding:
Nardil
Metformin
LamictalThanks,
Jade
Posted by J Kelly on March 7, 2016, at 17:28:11
In reply to Magic Pill, posted by J Kelly on March 7, 2016, at 17:13:07
> What med or med combo made you "drop to your knees and thank God for pharmaceuticals"?
>
> Even for a short time?For me:
Ritalin
Ritalin plus Klonopin
Emsam plus Klonopin
Parnate plus Klonopin
Parnate, Ritalin, Klonopin
Parnate, Dexedrine, Klonopin
(remission then psychosis)Zyprexa, Ritalin, Klonopin
All of these combos worked for me for a time.
Jade
Posted by Hello321 on March 7, 2016, at 18:38:23
In reply to Re: Magic Pill, posted by J Kelly on March 7, 2016, at 17:28:11
For me, Cyproheptadine. It's not technically a psychiatric med like zyprexa, Prozac, etc.... But the way it works is similar to the effects atypical antipsychotic have on certain serotonin receptors. I think it's inverse agonism of the 5ht2c receptor was the key part of how it helped me from being basically catatonic to feeling pretty normal over a couple of months. I had taken a few atypical antipsychotic before trying Cyproheptadine and got no benefit and I think it is because they tend to just be antagonists at the 5ht2c receptor.
I could see Cyproheptadine possibly boosting the effectiveness of Ritalin through its 5ht2c inverse agonism. This receptor by itself inhibits dopamine in the brain. So the inverse agonist effect decreases it's functions on, allowing dopamine to flow more freely.... I do believe.
Posted by atypical on March 7, 2016, at 23:35:52
In reply to Magic Pill, posted by J Kelly on March 7, 2016, at 17:13:07
Zoloft was the first blessing for many years, then Nardil.
Posted by SLS on March 8, 2016, at 7:41:22
In reply to Re: Magic Pill, posted by Hello321 on March 7, 2016, at 18:38:23
How did you come to try cyproheptadine?
- Scott
Posted by Hello321 on March 8, 2016, at 9:35:56
In reply to Re: Magic Pill » Hello321, posted by SLS on March 8, 2016, at 7:41:22
> How did you come to try cyproheptadine?
>
>
> - ScottI had read about it helping with libido side effects from psych meds and since I was having this side effect that seemed to be lingering after I stopped Effexor, I asked my psychiatrist if I could try Cyproheptadine. I tried it after taking a good amount of antidepressants and a few atypical AP's with no bebefit, and not long after starting it, my Mental Health had improved drastically, along with my libido.
Posted by J Kelly on March 8, 2016, at 10:38:43
In reply to Re: Magic Pill, posted by Hello321 on March 7, 2016, at 18:38:23
Hey there :)
Thanks for posting this, I've never even heard of Cyproheptadine.
How long were you able to benefit from its effects? Or do you still take it? I think you are a lot more knowledgeable about these meds that I am.
> For me, Cyproheptadine. It's not technically a psychiatric med like zyprexa, Prozac, etc.... But the way it works is similar to the effects atypical antipsychotic have on certain serotonin receptors. I think it's inverse agonism of the 5ht2c receptor was the key part of how it helped me from being basically catatonic to feeling pretty normal over a couple of months. I had taken a few atypical antipsychotic before trying Cyproheptadine and got no benefit and I think it is because they tend to just be antagonists at the 5ht2c receptor.
>
> I could see Cyproheptadine possibly boosting the effectiveness of Ritalin through its 5ht2c inverse agonism. This receptor by itself inhibits dopamine in the brain. So the inverse agonist effect decreases it's functions on, allowing dopamine to flow more freely.... I do believe.Any thing that will boost the effectiveness of my current meds would be welcome.
SSRI's have never worked for me. In fact they make me feel worse. Especially Prozac. Does that mean anything to you? Anyone?
My brain is not working. Its a catch 22.
Jade
Posted by J Kelly on March 8, 2016, at 10:41:34
In reply to Re: Magic Pill, posted by atypical on March 7, 2016, at 23:35:52
Hello,
> Zoloft was the first blessing for many years, then Nardil.
How long was Nardil effective for you? I'm thinking of giving it a go. Any advise re: dose etc?
Jade
Posted by Tabitha on March 8, 2016, at 12:31:44
In reply to Magic Pill, posted by J Kelly on March 7, 2016, at 17:13:07
None of these pills are magic, but these are the ones that made a dramatic difference
1) Prozac. The first SSRI that worked for me. It lifted a very heavy and long-standing depression. Ultimately it was too activating and I discontinued it.
2) Cytomel. A thyroid hormone that I started as an augment to anti-depressant (off-label). My thinking was a lot clearer on it and it didn't have the usual AD side-effects. It was working so well I fell prey to an "alternative" doctor who diagnosed me with a bogus thyroid disorder and I became convinced that was my problem all along (rather than bipolar). Wishful thinking on my part. I went off it because it's probably not safe for long-term, my pdoc quit using it, and my GP was very opposed to it since it made my blood levels of thyroid hormone very abnormal.
3) Seroquel. Very helpful for obsessive thoughts, although too sedating to use regularly.
4) Lamotrigine. Helped depression with no noticeable side effects. Depression returned in a couple years.
5) Cymbalta. Worked well as an anti-depressant and really helped chronic joint pain. Depression returned in a year though. Also had bad sexual side effects that did not go away.
6) Fetzima. Replaced the cymbalta, worked well as an anti-depressant without sexual side effects. Depression returned though.
7) Lithium. Probably the last med I ever wanted to try, but it lifted my mood dramatically in about four days. I'm hoping this one will stick. Side effects are noticeable but manageable (tremor and water retention).
Posted by Lamdage22 on March 8, 2016, at 13:44:32
In reply to Magic Pill, posted by J Kelly on March 7, 2016, at 17:13:07
Nardil.
But it didnt go very well in the end and i have damned psychemeds.
Posted by SLS on March 8, 2016, at 14:15:16
In reply to Re: Magic Pill, posted by Tabitha on March 8, 2016, at 12:31:44
> 7) Lithium. Probably the last med I ever wanted to try, but it lifted my mood dramatically in about four days. I'm hoping this one will stick. Side effects are noticeable but manageable (tremor and water retention).
What dosage of lithium works best for you?
Are you taking any other medications?
- Scott
Posted by Zyprexa on March 8, 2016, at 15:29:18
In reply to Magic Pill, posted by J Kelly on March 7, 2016, at 17:13:07
Zyprexa did! 18 years now. Can't live with out it.
Also found perphenazine, zoloft, bupropion sr and CBD oil, work great with it.
Posted by J Kelly on March 8, 2016, at 17:27:21
In reply to Re: Magic Pill, posted by Lamdage22 on March 8, 2016, at 13:44:32
> Nardil.
>
> But it didnt go very well in the end and i have damned psychemeds.How long on Nardil? At what dose did it cause problems for you?
Jade
Posted by J Kelly on March 8, 2016, at 17:32:57
In reply to Re: Magic Pill, posted by Zyprexa on March 8, 2016, at 15:29:18
> Zyprexa did! 18 years now. Can't live with out it.
>
> Also found perphenazine, zoloft, bupropion sr and CBD oil, work great with it.Hey that's great you have a med you can rely on!
I, too, take Zyprexa. I have a love/hate relationship with it.
I will be considering the other meds you listed.
Thanks,
Jade
Posted by Hello321 on March 8, 2016, at 17:43:46
In reply to Re: Magic Pill » Hello321, posted by J Kelly on March 8, 2016, at 10:38:43
The benefits of Cyproheptadine only lasted a couple of months. But it was an awesome couple of months.
With SSRI's not working for you, well, I think our knowledge of everyone's uniques brain and how they react to each different med comes up a bit too short to really get an idea of what that means. I'd just say it means focusing on meds that target other neurotransmitters might be best. But still, i wouldnt count out some of the new SSRI's, like Brintellix or Viibrud that include direct agonist effects on certain serotonin receptors in their mechanism of action.
I really get interested in how medications affect the brain. And lately I've started getting interested in how ones diet affects their brain, too.
Posted by J Kelly on March 8, 2016, at 18:06:30
In reply to Re: Magic Pill » J Kelly, posted by Hello321 on March 8, 2016, at 17:43:46
> The benefits of Cyproheptadine only lasted a couple of months. But it was an awesome couple of months.
Hey, I'll take a couple of months :)
>
> With SSRI's not working for you, well, I think our knowledge of everyone's uniques brain and how they react to each different med comes up a bit too short to really get an idea of what that means. I'd just say it means focusing on meds that target other neurotransmitters might be best. But still, i wouldnt count out some of the new SSRI's, like Brintellix or Viibrud that include direct agonist effects on certain serotonin receptors in their mechanism of action.I'm bad at keeping track of which meds I've tried. Which I know isn't helpful in my trek towards wellness. I tried Viibryd with no luck. Brintellex not sure.
>
> I really get interested in how medications affect the brain. And lately I've started getting interested in how ones diet affects their brain, too.Well...the more you know, the more we benefit. So keep at it!
Jade
Posted by Tabitha on March 8, 2016, at 18:29:33
In reply to Re: Magic Pill » Tabitha, posted by SLS on March 8, 2016, at 14:15:16
>
> What dosage of lithium works best for you?
>
> Are you taking any other medications?
>
>
I'm at 600mg now, still considered low dose I think. Also taking lamotrigine and fetzima (a newer SNRI) but the plan is to taper off the fetzima after stabilizing on lithium. Would be nice if I can just take lamictal+lithium for mood. Also taking a sleep med.
Posted by J Kelly on March 8, 2016, at 19:11:09
In reply to Re: Magic Pill, posted by Tabitha on March 8, 2016, at 12:31:44
> None of these pills are magic, but these are the ones that made a dramatic difference
>
> 1) Prozac. The first SSRI that worked for me. It lifted a very heavy and long-standing depression. Ultimately it was too activating and I discontinued it.
>
> 2) Cytomel. A thyroid hormone that I started as an augment to anti-depressant (off-label). My thinking was a lot clearer on it and it didn't have the usual AD side-effects. It was working so well I fell prey to an "alternative" doctor who diagnosed me with a bogus thyroid disorder and I became convinced that was my problem all along (rather than bipolar). Wishful thinking on my part. I went off it because it's probably not safe for long-term, my pdoc quit using it, and my GP was very opposed to it since it made my blood levels of thyroid hormone very abnormal.
>
> 3) Seroquel. Very helpful for obsessive thoughts, although too sedating to use regularly.
>
> 4) Lamotrigine. Helped depression with no noticeable side effects. Depression returned in a couple years.
>
> 5) Cymbalta. Worked well as an anti-depressant and really helped chronic joint pain. Depression returned in a year though. Also had bad sexual side effects that did not go away.
>
> 6) Fetzima. Replaced the cymbalta, worked well as an anti-depressant without sexual side effects. Depression returned though.
>
> 7) Lithium. Probably the last med I ever wanted to try, but it lifted my mood dramatically in about four days. I'm hoping this one will stick. Side effects are noticeable but manageable (tremor and water retention).Hi Tabitha,
Thanks so much for this list. Certainly gives me (and I'm sure others) some meds to consider. Glad the Lithium is working for you, I may give it a try.
Jade
Posted by Horse on March 8, 2016, at 22:42:24
In reply to Re: Magic Pill » Tabitha, posted by J Kelly on March 8, 2016, at 19:11:09
Hi Jade,
I'm a little late here. I'm wondering what symptoms you want to treat. I apologize if you've gone over this already.
First med that comes to mind is lamotigine (lamictal). Helps soooo much with rapid cycling. I'm almost normal :P
Posted by J Kelly on March 9, 2016, at 7:34:02
In reply to Re: Magic Pill » J Kelly, posted by Horse on March 8, 2016, at 22:42:24
> Hi Jade,
>
> I'm a little late here. I'm wondering what symptoms you want to treat. I apologize if you've gone over this already.I took these off the net (yes I'm that lazy) but they accurately describe my symptoms:
Feelings of helplessness and hopelessness. A bleak outlooknothing will ever get better and theres nothing I can do to improve my situation (most of the time, not always).Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. Ive lost my ability to feel joy and pleasure.
Loss of energy. Feeling fatigued, sluggish, and physically drained. My whole body feels heavy, and even small tasks are exhausting or take longer to complete.
Self-loathing. Strong feelings of worthlessness or guilt. I harshly criticize myself for perceived faults and mistakes.
Concentration problems. Trouble focusing, making decisions, or remembering things.
I also suffer from anxiety that gets bad at times. Almost panic. I'm developing a fear of leaving my house, don't like to be around others, and sometimes I feel sketchy when driving.>
> First med that comes to mind is lamotigine (lamictal). Helps soooo much with rapid cycling.
This med keeps popping up for me. I'm going to mention it to my pdoc later today.
>I'm almost normal :PWhat a wonderful state. Normal. I'd even settle for almost :)
Jade
Posted by Lamdage22 on March 11, 2016, at 7:20:45
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 8, 2016, at 17:27:21
> > Nardil.
> >
> > But it didnt go very well in the end and i have damned psychemeds.
>
> How long on Nardil? At what dose did it cause problems for you?
>
> Jade
>I was on Nardil for a total of 3 times. Those 3 times maybe 14 months total?
All doses made problems.
Posted by J Kelly on March 13, 2016, at 14:41:49
In reply to Re: Magic Pill, posted by Lamdage22 on March 11, 2016, at 7:20:45
> > > Nardil.
> > >
> > > But it didnt go very well in the end and i have damned psychemeds.
> >
> > How long on Nardil? At what dose did it cause problems for you?
> >
> > Jade
> >
>
> I was on Nardil for a total of 3 times. Those 3 times maybe 14 months total?
>
> All doses made problems.
>
>Even on AP's and Lithium?
Jade
Posted by J Kelly on March 13, 2016, at 14:43:16
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 13, 2016, at 14:41:49
> > > > Nardil.
> > > >
> > > > But it didnt go very well in the end and i have damned psychemeds.
> > >
> > > How long on Nardil? At what dose did it cause problems for you?
> > >
> > > Jade
> > >
> >
> > I was on Nardil for a total of 3 times. Those 3 times maybe 14 months total?
> >
> > All doses made problems.
> >
> >
>
> Even on AP's and Lithium?
>
> Jade
>I'm feeling a little desperate :(
Posted by Lamdage22 on March 14, 2016, at 16:18:55
In reply to Re: Magic Pill » Lamdage22, posted by J Kelly on March 13, 2016, at 14:41:49
Yes even on APs. I needed much more APs when Parnate kicked in. Lithium made me gain weight SO fast that i decided not to pursue it.
There is such a thing as post psychotic depression and post manic depression!
The feeling you have now (post manic/post psychotic) may go away. And MAOI may be contraindicated for you now.
Posted by Lamdage22 on March 14, 2016, at 16:24:30
In reply to Re: Magic Pill, posted by Lamdage22 on March 14, 2016, at 16:18:55
Jeez i really dont know what to tell you... I wish i had psychic abilities to tell yo what is best for you, but i dont.
Hmmm.
You tried other options? Maybe you can try to remember what you tried and more importantly what you didnt try.
You are not boring anyone.
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Dr. Bob is Robert Hsiung, MD,
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