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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by jujube on December 12, 2004, at 14:15:08
It's been about a month since my pdoc switched my AD to Anafranil, with Anafranil being the 5th AD I have trialed since January. I am currently at 50 mg, and had planned to go up to 75 mg, but am finding some side effects at 50 mg not pleasant (increasing dizziness/lightheadedness, constipation and weight gain - just weighed myself and have gained 6 pounds with no change in my eating habits). I have also noticed that at 50 mg, there is not much therapeutic difference between the Anfranil and Celexa (but certainly less side effects).
So, what I am thinking about doing is just staying on a small dose of Celexa and adding:
Enada NADH (2.5 - 5 mg - up to four times a week)
DMAE (250 mg - daily)
Sam-e (200 - 400 mg) - trial for two weeks to see if response obtained
Rosavin (100 - 200 mg) - trial for two weeks (if Sam-e fails) to see if response obtained
5-HTP and L-Tyrosine - trial if neither Sam-e or Rosavin workI am currently also taking B-Complex, extra B-6 and B-12, fish oil capsules, zinc and magnesium, vitamin C. I take niacinmide when I am experiencing excessive anxiety. I will be adding Flax seed oil soon.
If the natural route fails me, I will try yet another AD (probably nortriptyline).
Any and all comments/views/advice would be greatly appreciated.
Thanks so much.
Tamara
Posted by Tabitha on December 12, 2004, at 14:28:51
In reply to Anybody have any views on this plan - please, posted by jujube on December 12, 2004, at 14:15:08
did you try St John's Wort? Seems like it has a better track record for depression than SAMe.
Posted by KaraS on December 12, 2004, at 15:44:18
In reply to Anybody have any views on this plan - please, posted by jujube on December 12, 2004, at 14:15:08
> It's been about a month since my pdoc switched my AD to Anafranil, with Anafranil being the 5th AD I have trialed since January. I am currently at 50 mg, and had planned to go up to 75 mg, but am finding some side effects at 50 mg not pleasant (increasing dizziness/lightheadedness, constipation and weight gain - just weighed myself and have gained 6 pounds with no change in my eating habits). I have also noticed that at 50 mg, there is not much therapeutic difference between the Anfranil and Celexa (but certainly less side effects).
>
> So, what I am thinking about doing is just staying on a small dose of Celexa and adding:
>
> Enada NADH (2.5 - 5 mg - up to four times a week)
> DMAE (250 mg - daily)
> Sam-e (200 - 400 mg) - trial for two weeks to see if response obtained
> Rosavin (100 - 200 mg) - trial for two weeks (if Sam-e fails) to see if response obtained
> 5-HTP and L-Tyrosine - trial if neither Sam-e or Rosavin work
>
> I am currently also taking B-Complex, extra B-6 and B-12, fish oil capsules, zinc and magnesium, vitamin C. I take niacinmide when I am experiencing excessive anxiety. I will be adding Flax seed oil soon.
>
> If the natural route fails me, I will try yet another AD (probably nortriptyline).
>
> Any and all comments/views/advice would be greatly appreciated.
>
> Thanks so much.
>
> Tamara
>
>
My first reaction is that you have a high dose of DMAE and a very low dose of SAM-e. I'm also wondering if you're giving the trials enough time.You remind me a lot of myself. When I first joined the board I would post plans like that - only mine weren't as sensible as yours. They would be so long and involved and then I would badger poor Larry over them.
Kara
Posted by jujube on December 12, 2004, at 16:27:34
In reply to Re: Anybody have any views on this plan - please » jujube, posted by KaraS on December 12, 2004, at 15:44:18
> My first reaction is that you have a high dose of DMAE and a very low dose of SAM-e. I'm also wondering if you're giving the trials enough time.
- Thanks Kara. You're right about the DMAE. I just looked back at my research, and it appears that 130 mg is the recommended starting dose. I was only able to get a product that contains 125 mg of pure elemental DMAE, so I will start with that (one cap a day). Good point about the Sam-e. It is a low dose. I am kind of hoping that with the Celexa, I won't have to go too high. However, you are right, if I don't get at least a minimal response at 400 mg with the Celexa, then perhaps I will go up to 600 mg or 800 mg. >
> You remind me a lot of myself. When I first joined the board I would post plans like that - only mine weren't as sensible as yours.- I remember when I started reading the board. I have to say that your posts, with your well-thought out plans and options, always impressed me. I hadn't realized that lay people could know so much about this stuff. And, unlike me who has the attention span of a tse tse fly, you do really thorough research. My short attention span gets in the way of my reading the lengthier and more detailed studies and reports. Hey, maybe the DMAE will help with the ADHD! That would be nice. Being able to stay focussed and interested in something for an adequate length of time would be so nice. However, my ADHD symptoms have served me well in my current job which requires me to work on four or five urgent priorties almost at the same time. It's a catch 22, I guess.
They would be so long and involved and then I would badger poor Larry over them.
- It's so nice to have someone as knowledgeable and so willing to share their expertise with people as Larry is. He's a gem that's for sure. I have to say that I also appreciate and value the insights of Raybakes and Tealady as well.
Anyways, I saw your thread above about the niacinimide. So glad to hear that you are experiencing some relief from your asthma and panic symptoms. I remember in my early 30s ending up at emergency a few times with breathing problems. Once it was a lung infection, but a couple of other times it ended up being panic. It's so scary when our breathing is affected by either panic or asthma.
Take care.
Tamara
>
Posted by jujube on December 12, 2004, at 16:53:58
In reply to Re: Anybody have any views on this plan - please, posted by Tabitha on December 12, 2004, at 14:28:51
Thanks for the suggestion. I had tried St. John's Wort in the past, a number of years ago. It didn't seem to do anything for me then. Perhaps I didn't have a good brand or was not taking an adequate dose. I'll add it to my list of things to try (again).
Thanks again.
Tamara
> did you try St John's Wort? Seems like it has a better track record for depression than SAMe.
Posted by KaraS on December 12, 2004, at 18:52:39
In reply to Re: Anybody have any views on this plan - please » KaraS, posted by jujube on December 12, 2004, at 16:27:34
> > My first reaction is that you have a high dose of DMAE and a very low dose of SAM-e. I'm also wondering if you're giving the trials enough time.
>
> - Thanks Kara. You're right about the DMAE. I just looked back at my research, and it appears that 130 mg is the recommended starting dose. I was only able to get a product that contains 125 mg of pure elemental DMAE, so I will start with that (one cap a day). Good point about the Sam-e. It is a low dose. I am kind of hoping that with the Celexa, I won't have to go too high. However, you are right, if I don't get at least a minimal response at 400 mg with the Celexa, then perhaps I will go up to 600 mg or 800 mg. >Some people get anxious and stiff neck problems from DMAE in large doses. You may be able to tolerate the 250 but definitely a good idea to start at the 125 mg. In terms of the SAM-e, I wasn't thinking about the Celexa. Best to be cautious there and gradually build up too I guess. I took 1200 mg. but I wasn't taking much else at the time other than a small amount of Effexor. I had recently read a post by someone who said that they didn't have a response to SAM-e until they hit 1600 mg. That's so expensive not to mention that you're supposed to take it in 400 mg. doses at a time. When you factor that in with the fact that you have to take it two hours after a meal and 45 minutes before eating, then your entire day will be revolving around taking the SAM-e.
> > You remind me a lot of myself. When I first joined the board I would post plans like that - only mine weren't as sensible as yours.
>
> - I remember when I started reading the board. I have to say that your posts, with your well-thought out plans and options, always impressed me. I hadn't realized that lay people could know so much about this stuff. And, unlike me who has the attention span of a tse tse fly, you do really thorough research. My short attention span gets in the way of my reading the lengthier and more detailed studies and reports. Hey, maybe the DMAE will help with the ADHD! That would be nice. Being able to stay focussed and interested in something for an adequate length of time would be so nice. However, my ADHD symptoms have served me well in my current job which requires me to work on four or five urgent priorties almost at the same time. It's a catch 22, I guess.
>Thank you for the compliment. I can't believe that you said that though. I don't feel that I know very much at all - at least compared to many of the people here. I also feel that YOU do much more good research than I do. I think I pontificate a lot but I don't always back things up with good studies or abstracts. Fortunately others here do.
> They would be so long and involved and then I would badger poor Larry over them.
>
> - It's so nice to have someone as knowledgeable and so willing to share their expertise with people as Larry is. He's a gem that's for sure. I have to say that I also appreciate and value the insights of Raybakes and Tealady as well.Yes, definitely, and several others too numerous to mention (including JLx and Simus) who aren't necessarily around as often but make great contributions. This forum has been such a wonderful source of information and support for me. Previous to finding this site, I literally had no one at all to talk to about medications or supplements or even depression (other than my doctor of course) for so many years.
> Anyways, I saw your thread above about the niacinimide. So glad to hear that you are experiencing some relief from your asthma and panic symptoms. I remember in my early 30s ending up at emergency a few times with breathing problems. Once it was a lung infection, but a couple of other times it ended up being panic. It's so scary when our breathing is affected by either panic or asthma.Thanks. I think it was 75% panic but something is definitely causing my nasal membranes to swell up so that I can't breathe out of my nose very often. I'd like to get my mother on niacinamide as well. Right now she's starting on an Ativan habit. I'll keep pushing for the B3 though. But she's of the opinion that if her pdoc doesn't tell her to take it then she shouldn't. How did you get yours to listen to you? Maybe tonight when I talk to her and tell her about my success with it, she'll listen.
I will be very curious to see how you fare on various aspects of your new program. Definitely keep us posted!
Kara
Posted by Larry Hoover on December 12, 2004, at 22:38:57
In reply to Anybody have any views on this plan - please, posted by jujube on December 12, 2004, at 14:15:08
> It's been about a month since my pdoc switched my AD to Anafranil, with Anafranil being the 5th AD I have trialed since January. I am currently at 50 mg, and had planned to go up to 75 mg, but am finding some side effects at 50 mg not pleasant (increasing dizziness/lightheadedness, constipation and weight gain - just weighed myself and have gained 6 pounds with no change in my eating habits). I have also noticed that at 50 mg, there is not much therapeutic difference between the Anfranil and Celexa (but certainly less side effects).
>
> So, what I am thinking about doing is just staying on a small dose of Celexa and adding:
>
> Enada NADH (2.5 - 5 mg - up to four times a week)Ron Hill (geez, I miss Ron here) and I both found that TMG made NADH more comfortable. NADH can give a bit of a raw edginess along with the energy boost.
> DMAE (250 mg - daily)
I honestly don't know anything about it. I eat enough fish to get lots that way.
> Sam-e (200 - 400 mg) - trial for two weeks to see if response obtained
No reason to limit dose, if you're cautious. I see no reason to be too concerned about taking it with low-dose Celexa. Or, for that matter, I see no concern adding SJW to Celexa. They would be complimentary, and you'd just watch that your doses weren't too high. I see Celexa + SJW something like adding Remeron to Effexor. They're different enough to not be strictly additive in effect.
> Rosavin (100 - 200 mg) - trial for two weeks (if Sam-e fails) to see if response obtained
Worth a shot. So is Ashwagandha.
> 5-HTP and L-Tyrosine - trial if neither Sam-e or Rosavin work
You might do better with DLPA that tyrosine.
> I am currently also taking B-Complex, extra B-6 and B-12, fish oil capsules, zinc and magnesium, vitamin C. I take niacinmide when I am experiencing excessive anxiety. I will be adding Flax seed oil soon.Just be aware that with all that omega-3 intake, you might conceivably block some omega-6 transformations. Every now and again, just take a GLA supplement (borage or EPO) for three days. Then back to the omega-3s.
> If the natural route fails me, I will try yet another AD (probably nortriptyline).Ever tried desipramine?
> Any and all comments/views/advice would be greatly appreciated.
>
> Thanks so much.
>
> TamaraThe unfortunate thing is how long it takes to adequately do all these experiments. Good luck.
Lar
Posted by jujube on December 13, 2004, at 9:15:18
In reply to Re: Anybody have any views on this plan - please » jujube, posted by Larry Hoover on December 12, 2004, at 22:38:57
> > Enada NADH (2.5 - 5 mg - up to four times a week)
>
> Ron Hill (geez, I miss Ron here) and I both found that TMG made NADH more comfortable. NADH can give a bit of a raw edginess along with the energy boost.-- Thanks for the tip Larry. I don't have any TMG on hand, but have DMG in 100 mg capsules. Would DMG (100 mg or more) be worth trying with the NADH to take away some of the edginess?
> > Sam-e (200 - 400 mg) - trial for two weeks to see if response obtained
>
> No reason to limit dose, if you're cautious. I see no reason to be too concerned about taking it with low-dose Celexa. Or, for that matter, I see no concern adding SJW to Celexa.- Someone else also suggested SJW. I'll add that to my list of trials. I had tried it in the past, and did not get any response. But, I may have not been using a good brand or perhaps I didn't give it enough time. I had heard that it can take up to 8 weeks to get a response.
> You might do better with DLPA that tyrosine.- Good point about the DLPA. I had tried tyrosine and ended up with a bit too much nervous energy. But, at the time, I was using a very high dose from the get go (1,500 mg a day) with 1,000 mg of L-Glutamine. I am not sure which caused the nervous energy. So, if I do try the tyrosine again, I will start slow and work up and not combine it with Glutamine. With respect to the DLPA, I haven't found any in Canada. I'll have to check the Health Canada schedules again to see if it is yet another prohibited substance. If it is not prohibited, then I will order some.
>
>
> Just be aware that with all that omega-3 intake, you might conceivably block some omega-6 transformations. Every now and again, just take a GLA supplement (borage or EPO) for three days. Then back to the omega-3s.
>
- Thanks. So, I would actually stop the
omega-3s for three days, take the GLA, then re-start the omega 3s?
> Ever tried desipramine?- I have never tried desipramine. I have a lot of anxiety, and had heard that desipramine can be quite activating and may aggravate anxiety. That is why I hadn't considered it in the past.
> The unfortunate thing is how long it takes to adequately do all these experiments. Good luck.
>
- But experimenting can be fun, especially when the experiments can lead to better quality of life! I am about to become my my own human guinea pig!Thanks again Larry. Take care.
Tamara
Posted by Ron Hill on December 13, 2004, at 22:35:58
In reply to Re: Anybody have any views on this plan - please » jujube, posted by Larry Hoover on December 12, 2004, at 22:38:57
Posted by Larry Hoover on December 15, 2004, at 16:31:39
In reply to Lar, thank you for your kind words (nm) » Larry Hoover, posted by Ron Hill on December 13, 2004, at 22:35:58
Ron! Dude! Hit and run isn't fair. Just come back.
Lar
Posted by TeeJay on December 15, 2004, at 19:35:08
In reply to Re: Lar, thank you for your kind words » Ron Hill, posted by Larry Hoover on December 15, 2004, at 16:31:39
> Ron! Dude! Hit and run isn't fair. Just come back.
>
> LarI'll second that......thoroughly enjoyed rons posts and would sure like to see em again :-)
Posted by Ron Hill on December 15, 2004, at 21:20:01
In reply to Re: Lar, thank you for your kind words » Ron Hill, posted by Larry Hoover on December 15, 2004, at 16:31:39
Probably back in February. Miss everyone a lot.
Glad to see that you are continuing to provide top-notch info on alt and med boards. Good job! I hope you’re doing well my friend.
U-oh, I hear sirens. PB police in route to redirect.
-- Ron
> Ron! Dude! Hit and run isn't fair. Just come back.
>
> Lar
Posted by Ron Hill on December 15, 2004, at 21:23:44
In reply to Re: Lar, thank you for your kind words, posted by TeeJay on December 15, 2004, at 19:35:08
Posted by TeeJay on December 16, 2004, at 20:02:45
In reply to Thank you TeeJay. Talk to ya in February. (nm) » TeeJay, posted by Ron Hill on December 15, 2004, at 21:23:44
.
Posted by Larry Hoover on December 18, 2004, at 10:32:49
In reply to Thank you TeeJay. Talk to ya in February. (nm) » TeeJay, posted by Ron Hill on December 15, 2004, at 21:23:44
Thanks for 'splainin', Lucy. ;-)
I admire your integrity.
Lar
This is the end of the thread.
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