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Re: Developing bad habits on Psycho-Babble?

Posted by SLS on November 28, 2022, at 22:28:16

In reply to Re: Developing bad habits on Psycho-Babble? » SLS, posted by TriedEveryMedication on November 26, 2022, at 16:24:16

> Hi Scott,
> I was the one who posted trying 100mg of pristiq. I spent almost 8 weeks at 100mg before dropping to 75mg for a week then 50mg etc.

What does that indicate to you?

> I think I give meds a fair shake, except when I cannot tolerate the initial side effects. I have a full-time job where I'm expected to be a high performer.

I addressed that situation in my prior posts. I don't know what to suggest. After 1990, I didn't have those kinds of responsibilities. That was a moot point, as I was so impaired that I could not read beyond two sentences word-for-word. I became a skimmer. This allowed me get through more than two sentences. I was so cognitively impaired, that I had to figure out how to operate the same automobile interior door handle every Sunday evening on the way to dinner. The NIH research clinician overseeing my case called my efforts to survive "heroic". The doctor treating me at New York University (NYU), after the end of my initial visit, called my condition "horrendous". I cried instantly because I finally heard the words that I needed to hear. I felt vindicated.

I always found what Mark Schmidt, MD of the NIH said to me regarding the existential nature of depression. He demonstrated extraordinary insight for someone who was spared a depressive illness. He said that there is a "timelessness" to depression. When you are in the middle of it, it never had a beginning nor will it have an end. Over the last 20 years, I haven't kept track of the number of pharmacological treatment regimes I have tried. I think the total number of antidepressants I've tried is close to 60. That includes Wellbutrin while it was still investigational. I tried a series of three investigational pro-serotonergic compound. They were being studied by Pharmuka Pharmaceuticals, Inc. Indalpine exerted both reuptake inhibition and release of serotonin. I found the pure releaser the cleanest of the three with respect to side effects. Indalpine was the first pro-serotonergic drug approved in the world as far as I can tell. The first SSRI to be approved for use anywhere in the world was zimelidine (Zelmid), a French drug. Very soon after its introduction, it was recalled and removed from market due to reports of GuillainBarré, a fatal neurological disorder.

I have taken more than 50 drugs and untold numbers of drug combinations. I used to list them, but the whole thing got old, and I stopped taking notes and filling out mood rating forms.

I was treatment-resistant until I wasn't. Right? I was always treatable. Only one doctor had the poor judgment to say that I would never got well, and that something was f*ck*d up with my receptors. This guy was the protege of Nathan Klein at NYU. Nathan Klein is considered the father of psychopharmacology. Shopsin was one of the earliest investigators and advocates for lithium treatment. He also wrote a book describing a new syndrome that they called "schizo-affective disorder". These are some of the brains I picked. There are many more. My questions were endless.

We all have stories.

Linkadge, what is so different about you that you should separate yourself from me, a person who tried and failed at least 100 treatments before finding one that brought me to remission? Which drug trial left you in a fetal position beside my parents, audibly whimpering for three days (moclobemide)? Have you ever curled up and whimpered due to experiencing intense psychic pain? I don't know. Yeah - You had side effects, too. Could it be that my side effects were worse than yours? Hell is hell. Unfortunately, we both know it intimately.

I think you might be sacrificing remission for palliative measures.

By the way, in 1983, after seeing my first investigative psychiatrist at Columbia-Presbyterian, I was told that they could do nothing more for me. In other words, I was told that I was untreatable. I refused to take them at their word. If no one in the world could cure me, I set out to cure myself. It was simple logic that I had no choice. I'm sure my doctor thought me presumptuous. It really wasn't presumption. It was survival. So, I set out to cure myself. After 2 weeks of passionate, intense research using several book indices of medical journals, and in the absence of the Internet, I returned to my doctor with my theory as to what might be the neurobiological underpinnings of my illness specifically. I suspected that the biology of suffers were probably heterogeneous. My conclusion is that my brain was deficient in dopamine. I found only one author that proposed a dopamine deficit in depression. I don't remember his first name, but I think he operated out of the University of Chicago. There were a couple of drugs I wanted to try based upon my suspicions. Nomifensine, amineptine, brupropion, and bromocriptine were the ones I was most interested. When I proposed bromocriptine, my doctor laughed and replied, "Yeah, sure, if you want to puke all day long."

I asked to try Wellbutrin, an investigational that was close to approval. It was touted as being dopaminergic. I asked my doctor and her boss, Frederick Quitkin, for them to get Wellbutrin on a compassionate usage basis. They said no - not without leaving the program and having six months of psychotherapy. I said that I would be happy to see any psychological in Manhattan for an *evaluation*, but that I would not commit to a therapy for which there is no diagnostic evaluation for first. So, I left the program, but not without some very assertive language on my part regarding their lack of belief in their own descriptions of the origin of affective disorders. This, with Ronald R. Fieve's door right down the hall! I was incredulous. I left her in tears. The word that elicited her emotional reaction was "autonomous". This was the existential character of major depressive disorders. I was an ultra-rapid cycler, a pattern that was well described in the book "Mood Swing" written my - Ronald R. Fieve. It was my reading it and comparing my ultra-cyclicity to the anecdotes about his patients. I would not have sought treatment without it.

I left the program voluntarily. I found a researcher listed as a clinical investigator of Wellbutrin named Donald Sweeney. I told him about my theory and my focus on dopamine. This was what sparked my attention on Wellbutrin, as it was described then as a robust dopamine reuptake inhibitor. Sweeney told me that Wellbutrin was a good drug, but it didn't do what I thought it did. In reality, scientists remain baffled when it comes to explaining the pharmacology / mechanisms of action of Wellbutrin. He told me that Baron Shopsin was working with it. So, I found him and became a patient of Shopsin's (Nathan Klein's protege). After failing to respond to 900 mg/day of Wellbutrin, I asked him for nomifensine. He denied me. He said that it was "a piece of sh*t". I began crying in front of him. He relented. Nomifensine (Merital) was a potent dopamine reuptake inhibitor that was used around the world as the gold standard for dopamine research as a probe to study dopamine pharmacology. It was the only drug that he ever saw me have a robust improvement. He was chased out of New York for the inappropriate use of investigation drugs and failure to account for the absence of the pills he was supposed keep track of. He failed an audit of drug amounts compared to the size of his declared research population. I chased him out into the parking lot. As he was passing me in his Maserati, he opened his window and said one word to me: periactin.

There's more - of course.

I'm really not sure what impelled me to describe some of my experiences.

We all have stories.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.




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