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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 50. Go back in thread:
Posted by Sarah T. on April 8, 2005, at 1:56:36
In reply to Re: Tabitha, ChrisO, KaraS and anyone else - question » Sarah T., posted by KaraS on April 6, 2005, at 3:07:19
Hi Kara,
Do you happen to know whether Melatonin suppresses progesterone? I thought I read that it can suppress estrogen, which may or may not be desirable. About 8 years ago, a friend of mine, who was trying to get pregnant, was taking melatonin every night. She was unable to get pregnant, and it wasn't until several years later that she figured out that the melatonin was making her infertile. These hormones are so powerful, and they affect so many systems, directly and indirectly.
I'm glad to hear the doxepin is helping you so much. How many mg are you taking now? If you are still on that low dose, do you find that you are able to keep the anticholinergic side effects to a minimum? Did those palpitations stop?
Have you ever taken nortriptyline? If so, how was it? I took it many years ago for a brief time. Nortriptyline has a so-called "therapeutic window" or narrow dosage range within which it is effective. I never seemed to be able to find the correct window. I might try it again some day.
Posted by Larry Hoover on April 10, 2005, at 11:00:23
In reply to Tabitha, ChrisO, KaraS and anyone else - question, posted by Sarah T. on April 2, 2005, at 15:15:37
> Have any of you ever had a sleep study to find out exactly what's going on (for example, sleep apnea, restless legs, etc.)? If you have had a sleep study, can you tell me a little bit about it?
I just had one. There is no way, no possible way, to duplicate a clinical sleep study with home recording units. I had a ponytail of wires off of my head. Four sensors on my face (glued right into my beard, too). One of those oxygen sensors on the finger. A special device around my chest to measure respiration. EKG leads on my chest. I think there were about thirty recordings of my sleep.
They said I didn't meet the threshold for treatment, despite years of non-restorative sleep. At least I know I don't have sleep apnea, or PLMD, or RLS....but I awakened 27 times in the night. I remember two. I get too much REM sleep, and I usually wake from a dream, when I do awake.
I have no idea if any of this can be controlled with melatonin, or how melatonin affects the five stages of sleep. I took some the night of the test, but I don't use it any more.
I'm on a trial of zopiclone right now (instead of temazepam). It usually works well, but some nights I'm awake for hours (like last night). I don't know what's up with that.
I think my sleep quality has improved a little bit with the zopiclone.
Lar
Posted by KaraS on April 10, 2005, at 17:06:57
In reply to Kara S, posted by Sarah T. on April 8, 2005, at 1:56:36
> Hi Kara,
>
> Do you happen to know whether Melatonin suppresses progesterone? I thought I read that it can suppress estrogen, which may or may not be desirable. About 8 years ago, a friend of mine, who was trying to get pregnant, was taking melatonin every night. She was unable to get pregnant, and it wasn't until several years later that she figured out that the melatonin was making her infertile. These hormones are so powerful, and they affect so many systems, directly and indirectly.
>
> I'm glad to hear the doxepin is helping you so much. How many mg are you taking now? If you are still on that low dose, do you find that you are able to keep the anticholinergic side effects to a minimum? Did those palpitations stop?
>
> Have you ever taken nortriptyline? If so, how was it? I took it many years ago for a brief time. Nortriptyline has a so-called "therapeutic window" or narrow dosage range within which it is effective. I never seemed to be able to find the correct window. I might try it again some day.
Hi Sarah,
I don't know whether melatonin suppresses progesterone. I haven't studied it that thoroughly. I only use it once in a while so haven't bother to do extensive reserach. I think you're wise to be concerned though. Since it is a hormone it could affect a lot of other things.Yes, the doxepin at 25 mg. does keep the side effects to a minimum. I still am aware of the anticholinergic dumbing down effect unfortunately. But right now if I went off of it without a good back-up plan, I'd be in serious trouble. So for now I'll stick with it. I have an increased appetite which I hate but I don't have orthostatic hypotension and rarely have a problem with dry mouth. The palpitations have stopped (thanks for asking) and the EKG was normal so I'm no longer worried about taking it with regard to cario effects. (I really believe now that the excessive use of the light box had something to do with causing the palpitations.) My sleep is incredible on doxepin - sound, restorative, great dreams. The problem is that it makes it even harder to get up in the morning. How is your sleep currently? The last time you posted to me you were going through a bad time. I hope that you're doing better now.
I took nort. many years ago. I couldn't tolerate it. It gave me tachycardia on even a small dosage. My resting heart rate was about 100 bpm and I wasn't even at a therapeutic level yet. I was really disappointed because I think it's a good drug. Someday I might try it with a beta blocker if I'm out of other options and I can get a physician to prescribe them both. Several people on this board have had good results with nort. (as you're probably aware of). Might be worth trying it again. The therapeutic window can be a nuisance but at least you don't have to keep upping the dose a million times before giving up on it.Take care,
Kara
Posted by Sarah T. on April 14, 2005, at 19:12:46
In reply to Re: sleep study question » Sarah T., posted by Larry Hoover on April 10, 2005, at 11:00:23
Hi Larry. Thanks for your reply. Wow! You woke up 27 times during the study??!! I wonder whether that happens regularly or whether the many awakenings might have been due to the discomfort of sleeping in an unfamiliar place with all those electrodes and wires getting in the way.
Am I correct in understanding that you did take melatonin on the night of the sleep study? Why? If you don't take it regularly, why did you take it the night of the study? How much did you take? Did you take regular or sustained release?
You said that you are now trying Zoplicone. Is that also known as "Sonata" or is it "Ambien"?
Posted by Sarah T. on April 14, 2005, at 19:43:59
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 10, 2005, at 17:06:57
Hi Kara,
Thanks for your reply. I've been wondering whether you have noticed an improvement in your depressive symptoms while on doxepin? I understand that your improved sleep could, in and of itself, ameliorate your depression, but if it's possible to separate out the effects of that, do you think that low dose of doxepin is helping in other ways, besides sleep?
I was interested to hear about your response to nortriptyline. Did you ever take imipramine? If so, how did that compare with nortriptyline, for you? For me, the TCA's, which I haven't taken in years, were significantly better for mood improvement than anything that's come out in the past 10-15 years (ssri's, Wellbutrin, Strattera, etc., etc), but I had severe cardiovascular effects on the TCA's. I would wake up with resting heart rates of >100 bpm. Before I even got out of bed, my heart rate was often around 105-106. That is absolutely unacceptable. I also had some other side effects that I couldn't live with, such as speech blockage, memory impairment and urinary retention (I was able to cope with the urinary retention with Bethanechol). Those symptoms weren't too bad on desipramine, but on anything like imipramine or amitriptyline, they were severe. I also had some other physical symptoms that weren't as serious, but I was bothered by them. These included edema (especially facial edema), constipation, and excessive sweating and thirst. Oddly enough, the WORST side effects I ever experienced were from maprotiline, which, like so many "newer generation" drugs, turned out to be worse than those from the previous "generation."
Thanks for asking about my sleep. Well, lately, once I finally go to sleep, my sleep has been ok. It's that darn phase shift that I struggle with. I do think that when I'm able to exercise earlier in the day, I tend to go to bed a tiny bit earier that night. I remember reading that vigorous exercise can suppress melatonin for about 12-13 hours, so perhaps that's what's happening with me.
By the way, I did end up trying melatonin. On the first night, I took 1 mg, which was much too much. A couple of nights later, I tried 0.3 mg. That was a bit better, but even that small amount caused some worsening of my depression. It felt more like an exacerbation of the physical symptoms of my depression, but those physical symptoms can, in turn, color (or discolor) everything else for the rest of day, so I've abadoned that project for now.
I always enjoy reading your posts.
Posted by Larry Hoover on April 14, 2005, at 21:34:18
In reply to Re: sleep study question » Larry Hoover, posted by Sarah T. on April 14, 2005, at 19:12:46
> Hi Larry. Thanks for your reply. Wow! You woke up 27 times during the study??!! I wonder whether that happens regularly or whether the many awakenings might have been due to the discomfort of sleeping in an unfamiliar place with all those electrodes and wires getting in the way.
No, I'm sure it was happening regularly, and was the explanation for my feeling non-restored every morning. It amazed me that this was not some sort of critical finding. The sleep doctor said that I had nothing to treat! He was also an *sshole. He said, three times, three different ways "Sorry, we don't do magic here. Nope. No magic." Right. Like I drove three hours to spend three hours getting hooked up and briefed and interviewed, and got all this paste glued in my hair ("don't worry, it'll wash out"....but meanwhile I have to drive home with globs of goo like horns coming out of my scalp), in the misguided notion that I might find some magic. Harrumppfff.
> Am I correct in understanding that you did take melatonin on the night of the sleep study? Why?
I was taking it regularly, then. I didn't want to change anything I normally did.
> If you don't take it regularly, why did you take it the night of the study?
Sorry if I was confusing. I was taking it regularly then. I stopped when I went on the zopiclone (after the sleep study, he did at least suggest an alternative med).
> How much did you take? Did you take regular or sustained release?
Regular form, dose approx. 1.5 mg.
> You said that you are now trying Zoplicone. Is that also known as "Sonata" or is it "Ambien"?
It's called Imovane. Not available in US, I think. Canada, Britain, Europe have it. Not US.
That new sleep med that was just announced in US (Lunesta, eszopiclone) is one enantiomer of zopiclone. It wasn't worth getting the racemic zopiclone past the FDA, so they did the same thing as they did with Celexa to create Lexapro. Only the s-enantiomer, rather than a mixture of r- and s-.
Lar
Posted by Sarah T. on April 14, 2005, at 23:30:35
In reply to Re: sleep study question » Sarah T., posted by Larry Hoover on April 14, 2005, at 21:34:18
> > > The sleep doctor said that I had nothing to treat! He was also an *sshole.
>>> Lar
>Ah, yes. Quite a few of my doctors have been of the *sshole persuasion. I think that's one reason I haven't dragged myself in for a sleep study yet. I'm just so sick and tired of expending lots of energy, time and money on these medical workups, only to walk away, hundreds or thousands of dollars poorer, and none the wiser. Most of what I've learned about what ails me and the purported treatments, I've learned from this board and from my own reading. Was the doctor who ran your sleep study the chairman of a department? I've had the worst experiences with physicians who are also administrators.
Posted by Sarah T. on April 14, 2005, at 23:33:41
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 10, 2005, at 17:06:57
Kara, before you tried doxepin, did you ever try Surmontil/trimipramine? In looking through the archives, I see that a few doxepin-takers also tried Surmontil, and vice-versa.
Posted by KaraS on April 15, 2005, at 13:46:00
In reply to Re: Melatonin etc. » KaraS, posted by Sarah T. on April 14, 2005, at 19:43:59
> Hi Kara,
>
> Thanks for your reply. I've been wondering whether you have noticed an improvement in your depressive symptoms while on doxepin? I understand that your improved sleep could, in and of itself, ameliorate your depression, but if it's possible to separate out the effects of that, do you think that low dose of doxepin is helping in other ways, besides sleep?
I'm only taking 25 mg. but it has definitely had an antidepressant effect - even at that low dosage. I am not completely anhedonic anymore. I can enjoy a tv show, a movie and even music again.
> I was interested to hear about your response to nortriptyline. Did you ever take imipramine? If so, how did that compare with nortriptyline, for you? For me, the TCA's, which I haven't taken in years, were significantly better for mood improvement than anything that's come out in the past 10-15 years (ssri's, Wellbutrin, Strattera, etc., etc), but I had severe cardiovascular effects on the TCA's. I would wake up with resting heart rates of >100 bpm. Before I even got out of bed, my heart rate was often around 105-106. That is absolutely unacceptable. I also had some other side effects that I couldn't live with, such as speech blockage, memory impairment and urinary retention (I was able to cope with the urinary retention with Bethanechol). Those symptoms weren't too bad on desipramine, but on anything like imipramine or amitriptyline, they were severe. I also had some other physical symptoms that weren't as serious, but I was bothered by them. These included edema (especially facial edema), constipation, and excessive sweating and thirst. Oddly enough, the WORST side effects I ever experienced were from maprotiline, which, like so many "newer generation" drugs, turned out to be worse than those from the previous "generation."I've never taken imipramine but I've taken desipramine and it gave me tachycardia. Since imipramine metabolizes to desipramine I'm pretty certain I wouldn't be able to tolerate it. The only reason I haven't increased the doxepin (which is obviously helping) is because of the side effects. I no longer worry about the cardio effects however, since I'm no longer getting palpitations and my EKG (ECG?) was fine.
> Thanks for asking about my sleep. Well, lately, once I finally go to sleep, my sleep has been ok. It's that darn phase shift that I struggle with. I do think that when I'm able to exercise earlier in the day, I tend to go to bed a tiny bit earier that night. I remember reading that vigorous exercise can suppress melatonin for about 12-13 hours, so perhaps that's what's happening with me.Sorry to hear you're still struggling with insomnia. I'm still trying to deal with the delayed sleep phase as well. The doxepin helps me sleep but I still don't want to go to bed at night until later and later each day. Vigorous exercise is good for so many things if you have the time and can make yourself do it.
> By the way, I did end up trying melatonin. On the first night, I took 1 mg, which was much too much. A couple of nights later, I tried 0.3 mg. That was a bit better, but even that small amount caused some worsening of my depression. It felt more like an exacerbation of the physical symptoms of my depression, but those physical symptoms can, in turn, color (or discolor) everything else for the rest of day, so I've abadoned that project for now.Definitely sounds like melatonin isn't for you. It was worth the try though.
> I always enjoy reading your posts.
Thanks. Same here.
Kara
Posted by KaraS on April 15, 2005, at 13:48:54
In reply to KaraS, another question for you, posted by Sarah T. on April 14, 2005, at 23:33:41
> Kara, before you tried doxepin, did you ever try Surmontil/trimipramine? In looking through the archives, I see that a few doxepin-takers also tried Surmontil, and vice-versa.
No, I haven't but I'm curious about it and have it on my list of things to try for 2 reasons. It has some slight dopaminergic activity and it mixes the best with MAOIs so it would probably be the safest TCA to mix with selegiline. Have you ever tried it? Are you thinking of it in terms of being your main AD or to take a small dose for sleep and/or anxiety purposes?
K
Posted by Sarah T. on April 15, 2005, at 18:54:09
In reply to Re: KaraS, another question for you » Sarah T., posted by KaraS on April 15, 2005, at 13:48:54
> > Kara, before you tried doxepin, did you ever try Surmontil/trimipramine?
> Have you ever tried it? Are you thinking of it in terms of being your main AD or to take a small dose for sleep and/or anxiety purposes? > K
I was thinking of taking a small dose for sleep and/anxiety, in the same way you're taking doxepin. I'm not currently taking anything else except for trying lots of different alternative remedies; however, I am thinking of either doxepin or surmontil for the near future, and I wonder which would be better for combining with other medicines. I'm almost 100% certain that I wouldn't be able to go above 25mg on the Doxepin/surmontil because of side effects, so I expect that I'd want to try to combine it with something else. Are you waiting for the selegiline patch? I'm interested to try it, when -- or should I say "if" -- it's ever released, but I'm concerned that I'll react to it the same way I reacted to Adderall. Those levorotatory isomers of the amphetamines do not agree with me, but maybe the transdermal route will be better for us.
Posted by Sarah T. on April 15, 2005, at 19:01:10
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 15, 2005, at 13:46:00
> >> I'm only taking 25 mg. but it has definitely had an antidepressant effect - even at that low dosage. I am not completely anhedonic anymore. I can enjoy a tv show, a movie and even music again.> > >
It's so good to hear that even 25 mg is helping your depression. I guess I should just bite the bullet and try doxepin or Surmontil. I'm afraid I won't be able to get out of bed, though. I have enough difficulty getting up even without a sedating medicine.
Posted by KaraS on April 15, 2005, at 19:38:24
In reply to Re: KaraS, another question for you » KaraS, posted by Sarah T. on April 15, 2005, at 18:54:09
> > > Kara, before you tried doxepin, did you ever try Surmontil/trimipramine?
>
> > Have you ever tried it? Are you thinking of it in terms of being your main AD or to take a small dose for sleep and/or anxiety purposes? > K
>
>
> I was thinking of taking a small dose for sleep and/anxiety, in the same way you're taking doxepin. I'm not currently taking anything else except for trying lots of different alternative remedies; however, I am thinking of either doxepin or surmontil for the near future, and I wonder which would be better for combining with other medicines. I'm almost 100% certain that I wouldn't be able to go above 25mg on the Doxepin/surmontil because of side effects, so I expect that I'd want to try to combine it with something else. Are you waiting for the selegiline patch? I'm interested to try it, when -- or should I say "if" -- it's ever released, but I'm concerned that I'll react to it the same way I reacted to Adderall. Those levorotatory isomers of the amphetamines do not agree with me, but maybe the transdermal route will be better for us.
I think you're right that Surmontil is fairly easily mixed with other meds. I don't think you have anything to lose by trying either of these two drugs at low doses. The one advantage that doxepin has over Surmontil is that it is less anticholinergic. I'm very afraid of anything that's going to dumb me down at all. (I'm not feeling terribly sharp these days to begin with!)
I was thinking in terms of mixing Surmontil (or doxepin?) with selegiline + DLPA. I had been waiting for the Ensam patch but since I had the anxiety meltdown a couple of months ago, I'm afraid I wouldn't be able to tolerate the patch unless I'm able to combine it with something very anxiolytic. (Initially when I tried selegiline it made me sleepy but after the third or fourth day, it still made me feel tired initially but started producing more of a stimulant type effect about 8-9 hours after I took it.) But maybe you're right, maybe the transdermal delivery system will reduce the side effects and make it easier to tolerate for both of us. Then maybe they'll make a lot of psych meds in patch form and life will get much easier for many of us. (I'm trying to think positively, can you tell?)Kara
Posted by KaraS on April 15, 2005, at 19:41:37
In reply to Re: Melatonin etc. » KaraS, posted by Sarah T. on April 15, 2005, at 19:01:10
> > >> I'm only taking 25 mg. but it has definitely had an antidepressant effect - even at that low dosage. I am not completely anhedonic anymore. I can enjoy a tv show, a movie and even music again.> > >
>
> It's so good to hear that even 25 mg is helping your depression. I guess I should just bite the bullet and try doxepin or Surmontil. I'm afraid I won't be able to get out of bed, though. I have enough difficulty getting up even without a sedating medicine.
You can always stop it if you find that it's making things worse. Wait until your body has adjusted to the medication before judging it though. I still struggle to get out of bed but at least I've had restorative sleep before I face the struggle!
Posted by Sarah T. on April 16, 2005, at 23:16:18
In reply to Re: KaraS, another question for you » Sarah T., posted by KaraS on April 15, 2005, at 19:38:24
KS: > > > > > I think you're right that Surmontil is fairly easily mixed with other meds. I don't think you have anything to lose by trying either of these two drugs at low doses. The one advantage that doxepin has over Surmontil is that it is less anticholinergic. I'm very afraid of anything that's going to dumb me down at all. (I'm not feeling terribly sharp these days to begin with!) >
ST: Thanks for letting me know that Doxepin is less anticholinergic than Surmontil. I do remember seeing one of those charts rating various meds according to their adverse effects, but I haven't seen the chart in a while. I'll have to do a search on it.
KS:>> I was thinking in terms of mixing Surmontil (or doxepin?) with selegiline + DLPA. I had been waiting for the Ensam patch but since I had the anxiety meltdown a couple of months ago, I'm afraid I wouldn't be able to tolerate the patch unless I'm able to combine it with something very anxiolytic. (Initially when I tried selegiline it made me sleepy but after the third or fourth day, it still made me feel tired initially but started producing more of a stimulant type effect about 8-9 hours after I took it.) But maybe you're right, maybe the transdermal delivery system will reduce the side effects and make it easier to tolerate for both of us. Then maybe they'll make a lot of psych meds in patch form and life will get much easier for many of us. (I'm trying to think positively, can you tell?) > Kara >
ST: I wonder why you got tired from the Selegiline at first. How many milligrams did you take? When you felt the stimulant effect 8-9 hours later, perhaps it was one or more of those metabolites kicking in. I am curious about your initial fatigue on what is supposedly a stimulating medicine. One reason for my interest is that, when I developed tolerance to Dexedrine, that tolerance manifested primarily as fatigue (sometimes extreme) and, at times, a zombie-like affect. I assumed that my presynaptic receptors had become overly efficient at dopamine reuptake. Initially, my doctor told me to take more, but that was the worst thing to do! I became completely immobilized when I increased the daily dose, or if I took too many milligrams at once, or if I took one dose too close to the next one.
Posted by Sarah T. on April 17, 2005, at 1:20:52
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 15, 2005, at 19:41:37
Hi Kara,
One other question -- how soon before you go to bed do you take your doxepin? And, I also wanted to mention that I think I made a mistake in taking that melatonin. I took it on only two nights, in very low doses, but I've been feeling quite depressed physically since that time. I think I'm just too sensitive to be tampering with hormones.
Posted by KaraS on April 17, 2005, at 2:45:02
In reply to Re: KaraS, another question for you » KaraS, posted by Sarah T. on April 16, 2005, at 23:16:18
> KS:>> I was thinking in terms of mixing Surmontil (or doxepin?) with selegiline + DLPA. I had been waiting for the Ensam patch but since I had the anxiety meltdown a couple of months ago, I'm afraid I wouldn't be able to tolerate the patch unless I'm able to combine it with something very anxiolytic. (Initially when I tried selegiline it made me sleepy but after the third or fourth day, it still made me feel tired initially but started producing more of a stimulant type effect about 8-9 hours after I took it.) But maybe you're right, maybe the transdermal delivery system will reduce the side effects and make it easier to tolerate for both of us. Then maybe they'll make a lot of psych meds in patch form and life will get much easier for many of us. (I'm trying to think positively, can you tell?) > Kara >
>
> ST: I wonder why you got tired from the Selegiline at first. How many milligrams did you take? When you felt the stimulant effect 8-9 hours later, perhaps it was one or more of those metabolites kicking in. I am curious about your initial fatigue on what is supposedly a stimulating medicine. One reason for my interest is that, when I developed tolerance to Dexedrine, that tolerance manifested primarily as fatigue (sometimes extreme) and, at times, a zombie-like affect. I assumed that my presynaptic receptors had become overly efficient at dopamine reuptake. Initially, my doctor told me to take more, but that was the worst thing to do! I became completely immobilized when I increased the daily dose, or if I took too many milligrams at once, or if I took one dose too close to the next one.I think I may have hypersensitive dopamine autoreceptors (not caused by stimulants in my case). I have reacted paradoxically to other stimulating meds and supplements. Things that are supposed to make me quite stimulated usually put me to sleep instead. The fact that after a few days I was getting stimulation 8-9 hours later was actually quite a good sign for me. Your experience with Dexedrine sounds terrible. It sounds like you've had some really bad experiences with a lot of medications. I hope that doxepin or Surmontil will help you without providing any new problems.
K
Posted by KaraS on April 17, 2005, at 2:57:27
In reply to Re: Melatonin etc. » KaraS, posted by Sarah T. on April 17, 2005, at 1:20:52
> Hi Kara,
>
> One other question -- how soon before you go to bed do you take your doxepin? And, I also wanted to mention that I think I made a mistake in taking that melatonin. I took it on only two nights, in very low doses, but I've been feeling quite depressed physically since that time. I think I'm just too sensitive to be tampering with hormones.
>That's too bad about the melatonin. It's amazing that it had such a strong effect on you after only two nights. I was worried about it causing me more depression but it didn't seem to.
I take the doxepin about an hour or two before I intend to go to sleep. I also try to keep it within 2 hours of the time I took it the previous night. I have my fingers crossed that it will work for you.
K
Posted by Sarah T. on April 17, 2005, at 22:46:05
In reply to Re: KaraS, another question for you » Sarah T., posted by KaraS on April 17, 2005, at 2:45:02
Hi Kara,
I'm interested in your theory about your hypersensitive dopamine receptors. I'd like to read up on that. I react paradoxically to a lot of medicines. It's so difficult. I'm jealous of people who can take medication cocktails. I can barely tolerate one medicine at a time, let alone several. My biggest disappointment was developing the tolerance to Dexedrine because it was the only medicine that has really helped me over many, many years and numerous drug trials. I hope that I can benefit from it again some day. In spite of its bad reputation, I really do think it's a good drug, and it's been around for at least 50 years or so. So much research has been done on it, so it's not like taking something that's just gone through a few 6 or 8-week clinical trials and is then FDA-approved and marketed.
Posted by Sarah T. on April 17, 2005, at 22:54:49
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 17, 2005, at 2:57:27
> > > That's too bad about the melatonin. It's amazing that it had such a strong effect on you after only two nights. I was worried about it causing me more depression but it didn't seem to.
I think that the problem might have been the melatonin-induced depression combined with possible hormonal things going on. I'm not sure. In the past, I've discovered that it's not good for me to try a new medicine during the second half of my cycle. If it's a medicine that's NOT activating for me (like an ssri), then I tend to get more depressed. I've had strikingly different responses to trying the same drug at different points in my cycle.
> > I take the doxepin about an hour or two before I intend to go to sleep. I also try to keep it within 2 hours of the time I took it the previous night. I have my fingers crossed that it will work for you. > KThanks again, Kara. I really appreciate your help. I am going to discuss both doxepin and surmontil with my doctor the week after next. I am wondering whether you feel that the doxepin has helped you with being organized when that is called for? You said that you feel the medicine affects your cognition a bit adversely, but it's not noticeable in the way you write and express yourself.
Posted by KaraS on April 17, 2005, at 23:46:29
In reply to Re: KaraS, another question for you » KaraS, posted by Sarah T. on April 17, 2005, at 22:46:05
> Hi Kara,
>
> I'm interested in your theory about your hypersensitive dopamine receptors. I'd like to read up on that. I react paradoxically to a lot of medicines. It's so difficult. I'm jealous of people who can take medication cocktails. I can barely tolerate one medicine at a time, let alone several. My biggest disappointment was developing the tolerance to Dexedrine because it was the only medicine that has really helped me over many, many years and numerous drug trials. I hope that I can benefit from it again some day. In spite of its bad reputation, I really do think it's a good drug, and it's been around for at least 50 years or so. So much research has been done on it, so it's not like taking something that's just gone through a few 6 or 8-week clinical trials and is then FDA-approved and marketed.
Sarah,That's too bad that you're not able to take the one medication that has worked for you. It's so tough when you're medication sensitive. Maybe, as you say, in the future you'll be able to take the Dexedrine again. I certainly hope so. I also hope that you'll be able to find something else that will help you a lot in the interim.
K
Posted by KaraS on April 18, 2005, at 0:15:29
In reply to Re: Melatonin etc. » KaraS, posted by Sarah T. on April 17, 2005, at 22:54:49
> > > > That's too bad about the melatonin. It's amazing that it had such a strong effect on you after only two nights. I was worried about it causing me more depression but it didn't seem to.
>
> I think that the problem might have been the melatonin-induced depression combined with possible hormonal things going on. I'm not sure. In the past, I've discovered that it's not good for me to try a new medicine during the second half of my cycle. If it's a medicine that's NOT activating for me (like an ssri), then I tend to get more depressed. I've had strikingly different responses to trying the same drug at different points in my cycle.
>
>
> > > I take the doxepin about an hour or two before I intend to go to sleep. I also try to keep it within 2 hours of the time I took it the previous night. I have my fingers crossed that it will work for you. > K
>
> Thanks again, Kara. I really appreciate your help. I am going to discuss both doxepin and surmontil with my doctor the week after next. I am wondering whether you feel that the doxepin has helped you with being organized when that is called for? You said that you feel the medicine affects your cognition a bit adversely, but it's not noticeable in the way you write and express yourself.
>
That's amazing that you're able to tell the difference in effects from medication depending on the stage of your menstrual cycle. I've never been that in tune to be able to determine that. The doxepin doesn't really make me any more organized - though it controls the anxiety ansd so allows me to function and then get some things done. The anticholinergic effects are minor at the 25 mg. dosage but I would love to be able to find something else that would help with concentration etc. I will probably try DMAE and the selegiline for that as well.K
Posted by Sarah T. on April 19, 2005, at 0:13:58
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 18, 2005, at 0:15:29
KS: > > > > > > > > > > > > That's amazing that you're able to tell the difference in effects from medication depending on the stage of your menstrual cycle. I've never been that in tune to be able to determine that.
ST: Hi Kara. This evening I read that melatonin is a substrate of the cytochrome P450 1A2 enzyme and that estradiol inhibits that same enzyme. So, if estradiol levels are high, then melatonin levels would be increased. And then, there is so much interplay between the hormones and neurotransmitters. Ah, it gets so complicated. I just want something that works!
KS: The doxepin doesn't really make me any more organized - though it controls the anxiety ansd so allows me to function and then get some things done. The anticholinergic effects are minor at the 25 mg. dosage but I would love to be able to find something else that would help with concentration etc. I will probably try DMAE and the selegiline for that as well. > K >
ST: That's a really good point about the anxiety affecting the ability to get things done. Perhaps some of my disorganization is caused by anxiety. Can you tell me what DMAE is? I should know that, but I don't. You don't mean DHEA, do you?
Posted by KaraS on April 19, 2005, at 20:39:20
In reply to Re: Melatonin etc. » KaraS, posted by Sarah T. on April 19, 2005, at 0:13:58
> ST: Hi Kara. This evening I read that melatonin is a substrate of the cytochrome P450 1A2 enzyme and that estradiol inhibits that same enzyme. So, if estradiol levels are high, then melatonin levels would be increased. And then, there is so much interplay between the hormones and neurotransmitters. Ah, it gets so complicated. I just want something that works!
>Hi, I hear you about your frustration. I think I've given up on a magic cure. I'd be satisfied these days with a few meds and supplements that when taken together, will treat most of my problems so that I can lead a decent life.
That's amazing about the estrogen and melatonin connection. I hadn't known that. You really can effect a lot of different systems when you introduce somthing new into your body. You were wise to do the research.
> KS: The doxepin doesn't really make me any more organized - though it controls the anxiety ansd so allows me to function and then get some things done. The anticholinergic effects are minor at the 25 mg. dosage but I would love to be able to find something else that would help with concentration etc. I will probably try DMAE and the selegiline for that as well. > K >
>
> ST: That's a really good point about the anxiety affecting the ability to get things done. Perhaps some of my disorganization is caused by anxiety. Can you tell me what DMAE is? I should know that, but I don't. You don't mean DHEA, do you?DMAE is a supplement. The DMAE stands for dimethylaminoethanol. It is very similar to choline - the only difference is one methyl group if I remember correctly. It's a supplement that is in all of the natural treatments for ADD. I don't know if it lives up to all of the hype but it may be worth a try to help with organization issues. Tamara was taking it for a while and she may still be taking it if you want to ask her about it. It can increase anxiety so start out with smaller doses (which I'm sure you would anyway).
Here are a couple of links if you're interested in reading more about it. One of them is from Dr. Sahelian's site. He is extremely conservative in dosage so keep that in mind.
http://www.raysahelian.com/dmae.html
Let me know what you think.Kara
Posted by Sarah T. on April 19, 2005, at 23:27:19
In reply to Re: Melatonin etc. » Sarah T., posted by KaraS on April 19, 2005, at 20:39:20
KS: > >> Hi, I hear you about your frustration. I think I've given up on a magic cure. I'd be satisfied these days with a few meds and supplements that when taken together, will treat most of my problems so that I can lead a decent life.
ST: Hi. I think I've given up on the magic cure most of the time. If I found the magic cure, I'm afraid that it, too, would poop out on me. I think that most of the meds HAVE to poop out because developing tolerance is our body's way of adapting. I think it's a homeostatic mechanism of sorts. In order to prevent "poop out" or tolerance, the human body would have to be designed differently, and that's not likely to happen in the near future.
KS: > DMAE is a supplement. The DMAE stands for dimethylaminoethanol. It is very similar to choline - the only difference is one methyl group if I remember correctly. It's a supplement that is in all of the natural treatments for ADD. >
> Here are a couple of links if you're interested in reading more about it. One of them is from Dr. Sahelian's site. He is extremely conservative in dosage so keep that in mind. >
> http://www.raysahelian.com/dmae.html
> ttp://healthinfo.healthgate.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-33da65dd4&chunkiid=21390 > Let me know what you think. > KaraST: Thank you very much for the information and those links. I like that fact that Sahelian seems fairly conservative. I think I might try that supplement at some point. I didn't have any luck with tyrosine. In fact, I had a stiff neck and anxiety from tyrosine, so I think it would be a good idea to start at a VERY low dose for DMAE.
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