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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by LizinManhattan on May 21, 2006, at 1:49:16
Hi,
I am a very frequent lurker (I would post but as of now I don't have anything to contribute!).
I was on anti-depressants for 12 years and just went off them in March (with pdoc's assistance). I am trying to go the so called alternative route. This is what I am currently taking:Fish oil
E (to counteract any oxidation from the fish oil)
Evening Primrose oil (also because of fish oil)
Multivitamin
B12
B6
Iron
Claritin (for allergies)
Birth control pillsI also exercise every day and try to avoid sugar. I am OK, but very sleepy, lethargic, easily frustrated, and sometimes have feelings of hopelessness, guilt, sadness (you know, those great things that all add up to depression;) ).
What do I do next? I have been reading these boards and am wondering about Taurine, SAM-e and magnesium as well as some other supplements. I know zinc and potassium and a bunch of other things can be factors as well... It's just so hard to know where to start!I know there are some real experts on this board; if you have time, please help me.
Thank you so much!
Liz
Posted by Declan on May 21, 2006, at 3:48:29
In reply to Depression treatment-where to go from here?, posted by LizinManhattan on May 21, 2006, at 1:49:16
Were the ADs all of one sort? It might help to know which ones you took most, and which ones you responded to best.
And feel welcome here, please.
Declan
Posted by LizinManhattan on May 21, 2006, at 16:32:57
In reply to Re: Depression treatment-where to go from here? » LizinManhattan, posted by Declan on May 21, 2006, at 3:48:29
Hi,
Declan, thanks for your kind welcome and your great suggestion about detailing my medication history.
I tried all the anti-depressants available at the time. So I was on tricyclics, SSRIs, SNRIs and Wellbutrin. My pdocs also tried augmenting the anti-depressants with Lithium, Ritalin, and Depakote (not all at the same time of course!). The SSRIs and SNRIs sort of worked for a while but then all pooped out on me. MAOIs are what ultimately worked and saved my life (Parnate specifically).
Thank you for your help!
Liz
Posted by Declan on May 21, 2006, at 17:30:46
In reply to Depression treatment-where to go from here?, posted by LizinManhattan on May 21, 2006, at 1:49:16
Lost my bloody post.
I was saying: But I remember you, I think. You've posted here before, right? Some clever person will have something to say. Linkadge might have made it to Toronto (he might live there for all I know). Things might be quiet. But why did you stop Parnate? And did you sleep OK on Parnate? Have you tried deprenyl or selegiline? What do you think of the Emsam patch? And so on.
Declan
Posted by verne on May 21, 2006, at 23:34:25
In reply to Depression treatment-where to go from here?, posted by LizinManhattan on May 21, 2006, at 1:49:16
I'm in the same boat. I've tried many different supplements with varying success but I'm too depressed and foggy to even begin to list them. But if you have a question about any one supplement in particular I've probably tried it and could give an opinion.
One thing in your list did jump out at me though: iron. Unless you are anemic or have a special reason to take it, supplemental iron may be trouble. Too much iron can cause lethargy and a host of symptoms.
Check out: http://www.icakusa.com/healthcaps/personal/ironheart.html
I've always had a high hemoglobin count (too much iron in the blood) and felt better when I donated blood and made an effort to avoid iron-supplements or iron-supplemented food (like cereal). One doctor predicted I would feel *lighter* and have more energy once I got rid of the excess iron and he was right.
Sunshine or full spectrum light also helps.
Verne
Posted by LizinManhattan on May 22, 2006, at 9:38:08
In reply to Re: Depression treatment-where to go from here?, posted by Declan on May 21, 2006, at 17:30:46
Hi Declan,
Yes, I have posted here before. I asked about fish oil and something else as well I think. Over on the babble board (is that what it's claled?) I posted about my MAOI experience and asked about my brother's treatment.
I didn't sleep any worse on Parnate than I do without it (which is horribly non-refreshing sleep but that's another issue). I stopped Parnate because of blood pressure issues. Also, in hindsight I can see that it was losing its efficacy. It gave me a good run of a few years though.
I have not tried deprenyl/seligiline. When I was going off Parnate I was all for going on Emsam, but it wasn't out yet. Now I just want to see if I can go the non-medicinal route.
Oops, have to run for the train!
Liz
> Lost my bloody post.
> I was saying: But I remember you, I think. You've posted here before, right? Some clever person will have something to say. Linkadge might have made it to Toronto (he might live there for all I know). Things might be quiet. But why did you stop Parnate? And did you sleep OK on Parnate? Have you tried deprenyl or selegiline? What do you think of the Emsam patch? And so on.
> Declan
Posted by LizinManhattan on May 22, 2006, at 9:44:23
In reply to Re: Depression treatment-where to go from here? » LizinManhattan, posted by verne on May 21, 2006, at 23:34:25
Hi Verne,
Thank you for your reply. I'm sorry you haven't been having much luck with the supplements. When I get to the stage of actually trying different ones out I will be sure to look you up!Thanks for your concern about the iron. I was actually dagnosed with anemia so I am hoping that my levels are OK. I actually had my physical last week and they drew blood to test for that among other things so I should find out soon if my iron levels are all right.
In the darker months I use a light box but I have actually thought about using it a bit year round as well...
Thanks, Verne!
Liz
> I'm in the same boat. I've tried many different supplements with varying success but I'm too depressed and foggy to even begin to list them. But if you have a question about any one supplement in particular I've probably tried it and could give an opinion.
>
> One thing in your list did jump out at me though: iron. Unless you are anemic or have a special reason to take it, supplemental iron may be trouble. Too much iron can cause lethargy and a host of symptoms.
>
> Check out: http://www.icakusa.com/healthcaps/personal/ironheart.html
>
> I've always had a high hemoglobin count (too much iron in the blood) and felt better when I donated blood and made an effort to avoid iron-supplements or iron-supplemented food (like cereal). One doctor predicted I would feel *lighter* and have more energy once I got rid of the excess iron and he was right.
>
> Sunshine or full spectrum light also helps.
>
> Verne
>
>
Posted by Meri-Tuuli on May 23, 2006, at 3:59:55
In reply to Depression treatment-where to go from here?, posted by LizinManhattan on May 21, 2006, at 1:49:16
Hey there!
Have you tried St John's Wort? Its pretty good, and would probably be good for you, as I get the impression that you responded best to the MAOIs? Its acts abit like a MAOI (ie noradrenaline, sertonin and dopamine action and some GABA too) but it doesn't have any side effects. Well, maybe some very very mild ones which go away in the first couple of weeks anyway. I can't even remember what mine were! Oh it seemed to make me feel more cold (but that could have been because it was winter!) And at first my bladder felt like the size of a pea, but that soon went away.
You need a reputable brand like Kira or pernika.
Also, I wouldn't take the birth control pills. They can induce depression in some women.
I have no experience/knowledge about claritin, but maybe that might be contributing?
Kind regards,
Meri
Posted by LizinManhattan on May 25, 2006, at 0:43:05
In reply to Re: Depression treatment-where to go from here?, posted by Meri-Tuuli on May 23, 2006, at 3:59:55
Hi Meri,
Thanks for your reply! St. John's Wort is definitely on my list. However, I recently found out that birth control pills can become less effective if you take St. John's Wort at the same time, so I need to do some more research on that. As for the birth control pills, I sort of have to take them for medical reasons (the contraceptive effect is just an added "benefit").
Thanks for your reply, Meri!
Liz
> Hey there!
>
> Have you tried St John's Wort? Its pretty good, and would probably be good for you, as I get the impression that you responded best to the MAOIs? Its acts abit like a MAOI (ie noradrenaline, sertonin and dopamine action and some GABA too) but it doesn't have any side effects. Well, maybe some very very mild ones which go away in the first couple of weeks anyway. I can't even remember what mine were! Oh it seemed to make me feel more cold (but that could have been because it was winter!) And at first my bladder felt like the size of a pea, but that soon went away.
>
> You need a reputable brand like Kira or pernika.
>
> Also, I wouldn't take the birth control pills. They can induce depression in some women.
>
> I have no experience/knowledge about claritin, but maybe that might be contributing?
>
> Kind regards,
>
> Meri
Posted by Declan on May 26, 2006, at 6:23:49
In reply to Re: Depression treatment-where to go from here? » verne, posted by LizinManhattan on May 22, 2006, at 9:44:23
Hi Liz
You responded to Parnate. What about mucana pruriens?
Declan
Posted by Declan on May 26, 2006, at 7:01:53
In reply to Re: Depression treatment-where to go from here? » LizinManhattan, posted by Declan on May 26, 2006, at 6:23:49
And rhodiola.
Posted by LizinManhattan on May 29, 2006, at 13:05:23
In reply to Re: Depression treatment-where to go from here? » LizinManhattan, posted by Declan on May 26, 2006, at 6:23:49
Hi Declan,
I will definitely look into mucana pruriens. (For some reason I keep on reading it as mucous prunes!)
I am doing fairly well on the mixture I described in my first post with the recent addition of magnesium. However, I find myself needing more energy, motivation, and sex drive and less "word finding problems" if that makes sense.
Thanks, Declan!
Liz
> Hi Liz
> You responded to Parnate. What about mucana pruriens?
> Declan
Posted by LizinManhattan on May 29, 2006, at 13:08:28
In reply to Re: Depression treatment-where to go from here?, posted by Declan on May 26, 2006, at 7:01:53
Hi again,
Does it matter what kind of rhodiola? This might be just what I need as it seems to help with energy levels.
Thanks, Declan.
Liz
> And rhodiola.
Posted by Declan on May 29, 2006, at 17:26:36
In reply to Re: Depression treatment-where to go from here? » Declan, posted by LizinManhattan on May 29, 2006, at 13:05:23
Hi Liz
Psychopharmacology 101 again.
I had fewer word finding problems on moclobemide. NE? Definately sharper but not more comfortable. The only thing with rhodiola is sleep, but if you could handle Parnate you'll have no trouble. I took 'Rosavin' rhodiola.
Declan
Posted by LizinManhattan on May 31, 2006, at 1:00:04
In reply to Re: Depression treatment-where to go from here?, posted by Declan on May 29, 2006, at 17:26:36
Hi Declan,
Not sure what you mean by "NE," perhaps "no energy" or some babble-speak I am not familiar with. That, or I am just tired!
I started taking Taurine today as I have been reading about that a little bit. I also bought some protein powder which I figure can't hurt as I don't get a lot of protein from my food anyway.
Do you know if anyone has done any research on word-finding problems?
Liz> Hi Liz
>
> Psychopharmacology 101 again.
>
> I had fewer word finding problems on moclobemide. NE? Definately sharper but not more comfortable. The only thing with rhodiola is sleep, but if you could handle Parnate you'll have no trouble. I took 'Rosavin' rhodiola.
>
> Declan
Posted by Larry Hoover on June 6, 2006, at 7:42:14
In reply to Re: Depression treatment-where to go from here? » Meri-Tuuli, posted by LizinManhattan on May 25, 2006, at 0:43:05
> Hi Meri,
>
> Thanks for your reply! St. John's Wort is definitely on my list. However, I recently found out that birth control pills can become less effective if you take St. John's Wort at the same time, so I need to do some more research on that. As for the birth control pills, I sort of have to take them for medical reasons (the contraceptive effect is just an added "benefit").
> Thanks for your reply, Meri!
> LizBirth control pills rely on a synthetic or modified steroid structure. Natural estrogen, for example, has a half-life measured in minutes, if not seconds. That would hardly be practical, to take billionths of a gram of a hormone, every two minutes, so they settled on long-lasting hormone analogs.
SJW speeds the clearance of those analogs from your body, via enhanced enzyme activity in your liver. Birth control dose would need to be adjusted, but would not necessarily be excluded. It would mean having back-up protection, and spending some energy balancing out the dose. I can't be sure, but I bet that SJW gradually increases the liver function, so to match that, you'd have to gradually increase the dose of the birth control meds.
Lar
Posted by Larry Hoover on June 6, 2006, at 7:47:22
In reply to Re: Depression treatment-where to go from here? » Declan, posted by LizinManhattan on May 29, 2006, at 13:05:23
> Hi Declan,
> I will definitely look into mucana pruriens. (For some reason I keep on reading it as mucous prunes!)
> I am doing fairly well on the mixture I described in my first post with the recent addition of magnesium. However, I find myself needing more energy, motivation, and sex drive and less "word finding problems" if that makes sense.
> Thanks, Declan!
> LizIt could be oxidative stress. You need alphalipoic acid (100-200 mg/day), vitamin C slow-release (2000 mg/day), selenium (200 mcg/day), and you'd probably respond to N-acetyl-cysteine and Enada NADH. Vitamin D might provide a significant boost, too. Up to 4000 IU/day.
You may really need some zinc and chromium. Check out the info here, and see if the shoe fits. http://lpi.oregonstate.edu/infocenter/minerals.html
The cysteine and Enada require some experimentation. If you wanna go there, I'll help you sort it out.
Lar
Posted by dessbee on June 8, 2006, at 12:24:15
In reply to Re: Depression treatment-where to go from here? » Meri-Tuuli, posted by LizinManhattan on May 25, 2006, at 0:43:05
I have similar symptoms and have tried all your supplements except Birth control pills (I am a man). The only supplement of yours I can recommend is fish oil (no more than 4 gram).
You could be histadelic (high histamine) considering your allergy.
Histadelics should avoid b12 and folic acid. These supplements will only make your symptoms worse.Evening Primrose oil has a short term energizing effect but it wears off and will worsen your depression. The body uses GLA for producing both inflammatory and anti-inflammatory prostaglandins. Your fatigue could be a sign of inflammatory prostaglandins. It is really gambling with your health taking GLA.
My recommendation for depression is st john wort (600 mg) and/or seroctin (700 mg), zinc 20 mg, fish oil (2-4 gram)
Posted by dessbee on June 8, 2006, at 12:53:22
In reply to Depression treatment-where to go from here?, posted by LizinManhattan on May 21, 2006, at 1:49:16
B6 will elevate your histamine levels and worsen your symptoms if you are histadelic; especially if you are taking high doses of B6.
Posted by Larry Hoover on June 8, 2006, at 15:16:42
In reply to Re: You could be histadelic » LizinManhattan, posted by dessbee on June 8, 2006, at 12:24:15
> Evening Primrose oil has a short term energizing effect but it wears off and will worsen your depression. The body uses GLA for producing both inflammatory and anti-inflammatory prostaglandins. Your fatigue could be a sign of inflammatory prostaglandins. It is really gambling with your health taking GLA.
I'm going to ask you to explain that mechanism, okay? How does GLA go to inflammatory processes? Which prostaglandins?
Lar
Posted by dessbee on June 9, 2006, at 9:37:15
In reply to Re: You could be histadelic » dessbee, posted by Larry Hoover on June 8, 2006, at 15:16:42
I am pretty sure you already know this.
GLA can be transformed into PGE1 and PGE2.
PGE1 is anti-inflammatory, PGE2 is inflammatory.
The best way to block PGE2 formation is through competitive inhibition with EPA (fish oil fatty acid) since GLA and EPA uses the same enzyme.
EPA uses this enzyme for PGE3 formation, another anti-inflammatory prostaglandin.It is essential to focus on what can heal depressive symptoms, like SJW or Seroctin. When one starts taking to many different supplements it becomes very difficult to conclude which supplements that are working and which are not.
Posted by Larry Hoover on June 9, 2006, at 12:00:55
In reply to Re: You could be histadelic » Larry Hoover, posted by dessbee on June 9, 2006, at 9:37:15
> I am pretty sure you already know this.
> GLA can be transformed into PGE1 and PGE2.
> PGE1 is anti-inflammatory, PGE2 is inflammatory.
> The best way to block PGE2 formation is through competitive inhibition with EPA (fish oil fatty acid) since GLA and EPA uses the same enzyme.
> EPA uses this enzyme for PGE3 formation, another anti-inflammatory prostaglandin.The thing I was trying to get out is that the answer you gave was correct or incorrect, depending on these other things.
In an omega-3 deficient state, particularly one deficient in EPA, the massive intake of omega-6 PUFAs we get with all the vegetable oil that is flooding the food chain (industrial food supply) goes on to become inflammatory prostaglandins, via arichidonic acid.
To make GLA a good choice though, you have to block the fatty acid from the enzyme that would take it to arichadonic acid. You just lose the benefit altogether, that way. In fact, you promote the formation of free arichadonate. You want the GLA to go dihomogammalinolenic acid, instead. The anti-inflammatory precursor.
I thought your post was incomplete because you didn't give the factors that govern the trend towards one outcome versus the other.
GLA is *not* contraindicated in North Americans, virtually for certain. It should be the assumed case. The general diet is shifted far far towards an inflammatory state already. GLA is definitely necessary, but you shouldn't begin taking it until you get your EPA stores replenished. Once you've been on fish oil for 2 or 3 months, GLA is going to get shunted into the optimal biochemical pathway. Before that enzyme gets blocked, though, GLA is inflammatory.
Lar
Posted by dessbee on June 9, 2006, at 13:33:00
In reply to Re: You could be histadelic » dessbee, posted by Larry Hoover on June 9, 2006, at 12:00:55
I disagree. Accumulation of DihommoGLA will increase arichadonic acid and result in more PGE2. GLA should be carefully supplemented.
Posted by Larry Hoover on June 13, 2006, at 7:47:55
In reply to Re: You could be histadelic, posted by dessbee on June 9, 2006, at 13:33:00
> I disagree. Accumulation of DihommoGLA will increase arichadonic acid and result in more PGE2. GLA should be carefully supplemented.
I still need to explain more, then. You said "will increase arichadonic acid". I say can.
The increase in DGLA under GLA supplementation is spectacular, especially when in the presence of substantial EPA. The increase in AA is trivial, against the background increase already present.
The increase in DGLA concentration, compared to baseline, is by factors of orders of magnitude.
The increase in AA is a tiny percentage, when compared to baseline.
Huge increase in DGLA, but tiny risk compared to the background "normal" fatty acid flux.
Lar
Posted by dessbee on June 14, 2006, at 5:09:37
In reply to Re: You could be histadelic » dessbee, posted by Larry Hoover on June 13, 2006, at 7:47:55
I disagree. DGLA is an inflammatory precursor as well. An increase in AA is NOT trivial since it will lead to more PGE2.
Supplements of GLA increases side effects of omega-6 since we already get too much af these fatty acids in our food.
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