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Re: Newbie w/treat-res melancholic double depression

Posted by MarkinBoston on October 11, 2000, at 1:46:57

In reply to Newbie w/treat-res melancholic double depression, posted by MarkinBoston on September 19, 2000, at 3:59:56

Thanks for all the info guys. I had some trouble finding my thread here and just stubled upon it now. Thought I'd give an update.

First, I am feeling better. I started titrating up on the serzone. I wanted to see what it did alone since it was new to me. I was up to 100mg AM and 200mg at 9PM, and then switched the morning drug to Effexor XR 150mg in the AM. In the several times I've used Effexor it had made me speedy. Paradoxically, I was zonked. The next morning I tried 37.5mg of the original stuff I had left over and had the same reaction, yet it continued way past the normal half-life. Called it quits with Effexor and the doc suggested dropping back a step on Serzone and re-titrate up again. I've been doing that. I also asked to get back on testosterone, and after nearly a week of 10mg/day Androgel and starting to feel better mentally, and my skin is just a touch oilier now. Even though Androderm is less convenient, I think it took effect sooner. It also has the benefit of releasing to match the normal daily high and low periods. The diuretic blood pressure medicine brought down my systolic by 30 points, but diastolic by 1 or 2. I feel the testosterone is starting to increase my BP now too. I'll get blood done in a week.

The interesting new thing that happened was titrating up on Serzone to 200mg pm and 100 am. I was zonked again during the day. 40mg of Ritalin didn't help a bit. Thinking, mood, and motivation were all good, but bad memory. Today in the AM I only took 50mg Serzone and 20mg Ritalin and my memory improved in the afternoon, I felt more up, and not zonked at all. So, I saw the pdoc today (ran out of Ritalin and caught her up on things). She wanted to write me up for Provigil, which while it sounds very good, I had a very good day today and want to titrate down on Serzone (even though I'm now at a sub-theraputic dose) and not change too many variables at once. I know the Ritalin and testosterone are both helping me and was relieved that my memory improved late day implicating Serzone, yet, I do think it is doing something for me and want to dose it right before switching dopamine agonists.

With 40mg of Ritalin not even denting my Serzone somanance, I was afraid that I had built tolarance. Today, I was also relieved to find out that it wasn't because 20mg on rising boosted me all day - to the point where I want to see if 10mg is enough.

I called Dr. Jensen's office and he is going to print soon with the 2nd Edition. I'll probably not wait and get the first now and that second when available.

Now, all I need is a libido (wasn't that in the Wizard of OZ?) which should be soon once the testosterone kicks in. I'm afraid I'll have to cut back due to blood pressure again though. I also hope I don't get the high estradiol. I feel like if I do, I'm going to have to tough it out for a couple days just to get blood showing it above "normal" in order to try and convince him to manage it. I wasn't impressed with this doc the last time I saw him. He didn't see the need for using Clomid when a guy goes off replacement therapy - "its only a couple weeks and Clomid has side effects", to which I replied "MD's are using anesthesia for surgery these days, arn't they?" He also wasn't open to check for what my gonads could do on their own when stimulated with Clomid or HGRH - "that's only done in research."

As to cushings syndrome. Its a typical trait of melancholics. Half show dex suppression, half don't. The problem with most cortisol antagonists is that they suppress other hormones too, so someone would need sex hormone replacement in combination. I'll look up the ones mentioned.
The doc actually had me get a brain MRI ($2000 my HMO's bill) and no pititary or other brain abnormalities were noticed. Didn't have any adrenal tests, though.

Liver numbers: When the panels were done, I was neg for Hep A,B, and C. Havn't taken risks since my hiv- test a few years ago. My regular doc wanted another reading. I told him it would be a waste of money, because I'd had three and all were about the same readings. The first time I saw him I gave him copies of all the blood labs and the MRI report from when I went for a physical in May. The plan is to get new numbers after losing weight.

JohnL, thanks. We do seem to have similar chemistries going on and I'm watching the updates on your cocktail. I feel fairly good now and not pressured to rush into anything because I can't function. I think I have time to read the book, piece the clues together, do the remaining tests, and work on a better coctail and stay on maintenance.

Thyroid? Well, it (T4) was on the low end of normal one time and OK the second. I think the evidence now suggests dopamine difficientcy reguarding energy. It amazes me how T4 is screened, while T3 is the real active ingredient. Testing is sensitive enough now to measure it. Same goes for testosterone. Total is measured, while its only unbound and weakly bound T that are active.

One quirky thing about the anti-hypertensive I'm on, Triamterene 37.5mg/HCTZ 25mg caps. I don't sweat and get cold on it. Not what I'm used to at all and often have some face flush. The only other thing that had similar effect was when a herbal nutritionist had me take "Devil's Claw" for it many years ago. I kept it up that summer, then stopped taking it. I went EOD for a week on the diuretic so I could poop again and the sweating/warmth returned, so the other drugs weren't responsible. Feeling warm at least gives me some hope that my metabolic rate is high enough to support weight loss. Oh, well, just an anecdote.

Thanks for your support,




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