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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by snapper on April 5, 2004, at 19:41:08
Hi, & thankns to anyone who reads this and responds - in advance --- Has anybody had a positive effect from an MAOI such as Parnate- taken 12 years ago then pooped out, had any success with re-initiating it several years later and had very good response. Secondly Has anyone here that currently frequents PB had A Very successful response To Marplan?
I am getting desperate!! and Do Not like the S/E'
profile that I know to be significant with Nardil-
I have been on every class of AD's out there and do not wish to entertain the thoguht of the TCA's-I have had 27 ECT treatments over a period of 5 to 7- months back in fall of 2001 & spring 2002. I had a pretty robust response to about the 1st 10 to 12 Ect treatments...enought that I was able to go an a trip to Arizona but while out there I REALLY screwded up and started drinking. I was continuing to take my FXR- and Depakote when I was stuipidly Medicating my self for residual social anxieties.. I could feel my self falling slowly but surely and I ended up coming home after 5 weeks.. then continued w/approx. 12-14 more ECT treatments. Then in March of 2002 - One of the Dr.s Administering ECT told me that he did'nt see any reason to continue with any more treatments. I think he probably made the correct choice in no more treatments- (prob also to save my memory)! Then told me to attend a partial 1/2 day outpatient program at hosp. then found out that Medicaid was NOT paying for any of it. So needless to say I continued on FXR and some other meds. But my social anxiety etc kept me from going out and being active to keep the depression at bay. Eventually my Mom & Dad did'nt know what to do with me because all I wanted to do was stay up late at night and sleep till 4 to 6 p.m. the t next day (obviously all in an effort to avoid dealing with things!)My Mom and Dad are Very supportive but just did'nt know what to do with me so they took it upon themselves to put me in a "Group Home" it was NUTS !! The administrators were ignorant and mean and indifferent, the house rules sucked and I knew I did NOT belong there... I told my parents that if they did'nt get me out of there I was going to kill myself... needless to say they responded and immediately found another Residential Care Facility for me to stay in from July of 2002 to Feb of 2003- It was much better and there were more functional people there -but it also Mainly consisted of Sr. Citizens. Some Shcizo-Effective's , some BI-Polar types and even some people around my age (35) at the time!! I liked it a whole lot better but still was not fully functional cuz a lack of response to AD's etc. Jump forward to now, I have been living w/ My semi-retired parents and my sister (41) who moved home from AZ, to also try and get her life back together!! So my living situation is much improved - However I still am very depressed, anxious, phobic about most things in re: to doing outside the home etc. My current pdoc tells me that I need to "Just get out and be with people" and My symptoms will Improve-while that is true to some extent, I still know I feel very hopeless and helpless. I am a partial responder to AD's and mood stabilizers etc. I have intense suicidal Ideation every day my short term memory is absolutely crap I am severely anergic and anhedonic, nothing is fun, I feel like I am about to lose my mind half the time-have an almost constant pressure in my head - I am edgy irritable , nervous, hostile and feel like telling the world to stick it. I do see a T every 2 weeks and she is very supportive etc. When I try to do the things that should and do usually improve depression and anxiety - like exercize etc. I am so fatigued that I feel like an 92 yr old man. MY parents feel better than I do. My pdoc who I currently see, says that he has given me everything and offered me everything that Psychiatry has to offer and I just don't belive him!! HE is not a pill pusher and says I am expecting to much from "these medications". Yes I do realize the psycho-social aspects of trying to recover from Dep. & Anxiety-but I also feel that there must be must be some more effective meds to help me- fwiw he practices out of a County Mental Health Clinic, and I sometimes think that because of this, he sort of has his hands tied in trying to help me find other potential pharamacological remedies> ie: can only do so much but nothing to radical!! Depression and anxiety disorders have literally cost me my business, my car, my credit, my freedom and independence all of my self esteem and then some. I am not asking anybody to feel sorry for me but I would just like to know from some of you out there-if you have been in this type of situation(s) and have figured a way out!!
Current diagnosis:
BP II- Atypical features
Anxiety disorders-OCD, GAD,Social Phobia, panic,etc.
and previous pdoc says Personality Disorder-NOS
Which might be true from just having all these mental symptoms!
I know that there are no easy answers to all or any of this but I just have to have some relief!!!
Thanks for listening and any input or replies are appreciated!!
Thanks
Snapper
Posted by jay on April 5, 2004, at 20:45:28
In reply to MAOI'S /ECT/ ATYPICAL DEP.Please read (kinda long), posted by snapper on April 5, 2004, at 19:41:08
Hi..I am majorly sorry for your nasty experiences. I’ve had pretty much a lifetime of hell dealing with dumb doctors and psychiatrists. But, there *are* good ones out there, and you have every right in the world to go searching for one. What I do is make 1-2 appointments, and ask *everything* to see their response, ask what they can do for me, what they would and wouldn’t treat me with..etc. It’s all of our rights to have this option. Also, be aggressive in learning up about medications...and often very unconventional doses and drug choices are what is needed.
With all of these warnings about the SSRI’s/SNRI’s, I am now very cautious and even suspect of them. It seems you where one of the “lucky” ones to get stuck with Effexor....even though I imagine it is good for many, in a subset of the population I think it can make things just god-awful horrid.
Right now, don’t worry too much about the “labels”, just focus on what helps your symptoms..and you will feel much better. Have you tried atypical antipsychotics possibly with an antidepressant? Or with a tricyclic antidepressant? How about a good dose of a mood stabalizer or even a combo of two along with an antidepressant?
You have every right to *utilize* these and all psych meds as needed, and don’t let any doctor tell you different. Like my Dad say’s...”Fire ‘em!”..really, because if they are doing no good, they are wasting your time. Please let us know what you think..or if you have any questions.
Best,
Jay
Posted by gardenergirl on April 5, 2004, at 21:40:17
In reply to Re: MAOI'S /ECT/ ATYPICAL DEP.Please read (kinda long) » snapper, posted by jay on April 5, 2004, at 20:45:28
Snapper,
It sounds like you have been through the wringer and then some. I'm glad your living situation is better now. I can understand your concerns about meds and SE's, but I wonder specifically what your concerns about Nardil are? I take 45mg of Nardil, and my SE's have all but gone away. I no longer have anorgasmia, urinary retention, constipation, myoclonic jerks, or staggering gait (as Mattdds called, "the Nardil shuffle"). The only SE's that remain are hypereflexia, which means I sometimes get the knee-jerk response really hard just by tapping my thigh or setting something in my lap, and also a craving for sweets, which has led to a 20 pound weight gain.These SE's I can definitely live with! Even the others were tolerable in trade for treating my atypical depression. I am glad though that most have finally disappeared.
Also, there is evidence to suggest that psychotherapy in conjunction with medication can be very effective with anxiety and mood disorders. Have you had much luck or experience with psychotherapy?
Just some thoughts...
gg
Posted by snapper on April 5, 2004, at 21:52:22
In reply to Re: MAOI'S /ECT/ ATYPICAL DEP.Please read (kinda long) » snapper, posted by jay on April 5, 2004, at 20:45:28
Hi Jay, thanks for your response. I have tried several AP's in the past. I have tried a couple of the TCA's, and do not wish to go back to them because they dry you out and I have a pretty hard time as it is with the whole cholinergic thing any how!! in 1991, the second or third med I was put on was Doxepin and it sedated me and made me fatter and then I awoke one morning feeling "better than normal" a little hypo-mania!! and I thought at the time... hey! I feel great! This must be what it feels like to feel 'normal'I stupidly cut short the med and thought "I was Cured" went back to drinking cuz I Felt so good! God, what a frustrating cycle!! Little did I know. Back in those days , I was Very Psych drug naive! I litterally thought that they would -fix my "faulty chemistry" -lol! I even reinstated 2 or 3 maybe 4 other times to no avail! It is also not that I am so upset about the labels, it is just so hard trying to find a combo that I can live with its' S/E's.
Mood stabilizers-?- tried them all and either did very little or nothing at all. One of the biggest problems is that my head is just like one big pressure cooker! I am just now 3 days away from completely D/C'ing Lamictal, because it was causing pretty intense aches and pains in my mucsles and neck and shoulders as well as causing headaches which did not help the 'head thing'.I think it may have been helping a little with my mood and some of my cognition etc, but I had to cut it short. I would love to fire my p-doc but being on SSDI does'nt give me a lot of options at the moment-he's a really 'nice guy' and genuinely seems intent upon trying to help me, and even offered to see if I wanted to check w/another doc or neurologist to see if we were missing anything, I said I have already seen 2 out of the 3 docs in the Mental Health Clinic -( the other one I was seeing referred me to him !!) and given my "history of "MI" that there probably was'nt anything being "missed". maybe I am wrong- its' almost like I wish I could find something "wrong" so it could be fixed. Had catscan and eeg- and everything was ok - Still would like to have an MRI. I have given most all of the Major Psych Meds, a fair shake over the last 14 years- excl. Serzone- which is probably a mute point anyhow. Hence his statement that he did'nt have anyhting more to really offer me. I know that he probably just laughs to him self when I go to see him-thinking oh great here comes "neurotic me"! I have been hospitalized 7 or 8 different times and none of them really did any good ( perhaps with the exception of the one visit for 2 weeks last fall when I seemed almost intent upon doing myself in, and part of the reason my dep. and anxiety got so much more intense is that I was tring to go of off all meds to see what would happen.The doc and I figured lets see what will happen-let me tell you, I went off of effexor 1st then tried to slowly go off of klonopin and I think it should maybe have been the other way around like keep FXR in place then DC the K. I do know that the time that I was off of Klonopin I don't remember a time of more intense worsening of depression/anxiety and SI!) The meds deal is just a crapshoot-I did have some -semi-normal time in the midst of all this hell, just nothing that was very life affirming! I have even been "addicted to adderall" which is probably the most helpful thing next to the Parnate that I have ever been on, however I slowly but surely found out that it was just making my symptoms more mixed and aggravated my underlying soft BP II symptoms! Who knows, maybe I am just doomed to live this way the rest of my days!!
Thanks for your reply-any other ideas - I am open-
but like I said , my present pdoc seems to think I am just expecting too much out of the meds!!
thanks again
Snapper
Posted by snapper on April 5, 2004, at 22:16:23
In reply to Re: MAOI'S /ECT/ ATYPICAL DEP.Please read (kinda long), posted by gardenergirl on April 5, 2004, at 21:40:17
> Snapper,
> It sounds like you have been through the wringer and then some. I'm glad your living situation is better now. I can understand your concerns about meds and SE's, but I wonder specifically what your concerns about Nardil are? I take 45mg of Nardil, and my SE's have all but gone away. I no longer have anorgasmia, urinary retention, constipation, myoclonic jerks, or staggering gait (as Mattdds called, "the Nardil shuffle"). The only SE's that remain are hypereflexia, which means I sometimes get the knee-jerk response really hard just by tapping my thigh or setting something in my lap, and also a craving for sweets, which has led to a 20 pound weight gain.
>
> These SE's I can definitely live with! Even the others were tolerable in trade for treating my atypical depression. I am glad though that most have finally disappeared.
>
> Also, there is evidence to suggest that psychotherapy in conjunction with medication can be very effective with anxiety and mood disorders. Have you had much luck or experience with psychotherapy?
>
> Just some thoughts...
>
> ggHi gg, thanks for your reply also. I did try Nardil in I think 94' and I don't know if I did 'nt tolerate it or give it an adequete trial or both. I guess one of my 'fears' which is probably related to my OCD is what if I eat the wrong thing and cause a reaction!! what if. Also I may be thinking that because my short term memory is so bad (cuz of the depression) that I would forget and get hungry cuz of the cravings that I know due happen on AD's and accidentally eat cheese - who knows , maybe If my depression were effectively treated>> then maybe my memory might be much better and I would'nt have to worry about the possibility of a bad reaction-just some theororizing and over-thinking on my part. As far as Psycho-therapy... I have been to several over the years, and I truly believed that I (my brain ) was too scrambled to make any sense of therapy!! Maybe if I was on the "right AD" then therapy might well do me some good! BTW do you have any co-morbid conditions or anxiety disorders in addition to your Atyp . Dep and if so ..then did you find that when Nardil was effective did the other problems tend to subside?
thanks
snapper
Posted by Keith Talent on April 6, 2004, at 2:51:53
In reply to Re: MAOI'S /ECT/ ATYPICAL DEP.Please read (kinda long), posted by snapper on April 5, 2004, at 22:16:23
How about:
- the most tolerable SSRI for you
- the most acceptable stimulant for you
- clonazepam
?
(as much of each as you need)
Posted by gardenergirl on April 6, 2004, at 22:43:47
In reply to Re: MAOI'S /ECT/ ATYPICAL DEP.Please read (kinda long), posted by snapper on April 5, 2004, at 22:16:23
snapper,
I can understand worrying about the cheese reaction, especially if you are anxious to begin with and are having cognitive changes. I admit I blew it over Thanksgiving when I was concentrating on avoiding cheese and looking for soft foods since I had just had some painful dental work done. I never considered that the giblets may have been used in the gravy or dressing. I got a bad migraine, that subsided in about two hours when my BP went back down.Some people will carry an emergency drug to counter a hypertensive reaction if necessary. The research is mixed on whether this is wise or helpful. But I may ask for a scrip if my doc agrees, just in case.
I do not have any co-morbid disorders to the best of my knowledge. My depression did have an anxious quality to it, however, because I realized I felt truly confident once on the Nardil. So working back from that, I must have been anxious.
Incidentally, I did used to get tension headaches and migraines quite frequently. Since on the Nardil, with the exception of the giblet reaction, I have not had a migraine and almost no headaches. I may have to throw away my industrial-sized bottle of Tylenol if it goes bad before I need to take them all. :)
It may be that therapy can help once you are stabilized on an antidepressant. I know it took me years to feel ready to do therapy. I'm so glad I did, because one, I learned what I have and got on Nardil, and two, I really am getting better in a way that feels more long-lasting than any AD treatment alone has.
Good luck to you. I pray there is a combo out there that is right for you.
gg
This is the end of the thread.
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