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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 iris2 on September 9, 2004, at 11:09:52
Scott,
I wanted your opinion about something.
Andrewb asked the following:"..amisulpride provides significant benefit.."This "significant" part is difficult for me to answer. For over two years now I have been very depressed with no real hope because I did not think I could ever take any antidepressants and tolerate them again because of my interstitial cystitis(I.C.). I decided to try again. Now the Amisulpride has provided a 'shift' in my mood. I would not say a huge change or it is an end all, but given that it will be rare that I can take anythng at all should I see this as significant or am I settling and should look for something better. I am looking but the question is about adjunctive Amisulpride. I will only be able to know if another med is better if I discontinue it first. I started Milnacipran for 1&1/2 days and it seemed like I could not tolerate it but I was already having problems with the Amisulpride and had just decreased the dosage. I have to wait a week or so and try it when I am not having any bladder symptoms so I can be sure what the cause is.
irene
Posted by SLS on September 9, 2004, at 16:59:59
In reply to To Scott, posted by iris2 on September 9, 2004, at 11:09:52
Hi Denise.
> This "significant" part is difficult for me to answer. For over two years now I have been very depressed with no real hope because I did not think I could ever take any antidepressants and tolerate them again because of my interstitial cystitis(I.C.).
Do you know the mechanisms by which these drugs exacerbate IC?
> I decided to try again. Now the Amisulpride has provided a 'shift' in my mood. I would not say a huge change or it is an end all, but given that it will be rare that I can take anythng at all should I see this as significant or am I settling and should look for something better.
I guess that's a quality of life issue. To what degree is depression interfering with your ability to function and enjoy life?
> I am looking but the question is about adjunctive Amisulpride. I will only be able to know if another med is better if I discontinue it first.
I think you should find an ideal dosage of amisulpride, and allow yourself to stabilize on it. Then, you can continue to pursue treatments that you can add to it. Off the top of my head, I can't think of any treatments for depression that amisulpride would interfere with. Don't worry about determining which one drug is best right now. If amisulpride mitigates your depression, I would continue with it. If you remove it, not only will you feel worse again, you might miss the possibility that it be a necessary component to an effective combination. Of course, it is possible that you will receive diminishing returns with amisulpride over time. You might need to evaluate from time to time its role in your treatment. You can always try removing it temporarily to see if it is contributing to an improvement.
> I started Milnacipran for 1&1/2 days and it seemed like I could not tolerate it but I was already having problems with the Amisulpride and had just decreased the dosage. I have to wait a week or so and try it when I am not having any bladder symptoms so I can be sure what the cause is.
I am confused.
Is there an increase in IC urgency with milnacipran? What about with amisulpride? Is urgency a problem, or is it just frequency? Can pH affect your symptoms of IC?
I'm afraid I have no answers for you - only more questions.
I'm sorry if you've answered this question already, but have you tried Adderall?
- Scott
Posted by SLS on September 9, 2004, at 17:03:38
In reply to Re: To Scott » iris2, posted by SLS on September 9, 2004, at 16:59:59
Posted by iris2 on September 9, 2004, at 20:35:06
In reply to Re: To Scott » iris2, posted by SLS on September 9, 2004, at 16:59:59
> Do you know the mechanisms by which these drugs exacerbate IC?
No I wish I did.
>
> > I started Milnacipran for 1&1/2 days and it seemed like I could not tolerate it but I was already having problems with the Amisulpride and had just decreased the dosage. I have to wait a week or so and try it when I am not having any bladder symptoms so I can be sure what the cause is.
>
> I am confused.
>
> Is there an increase in IC urgency with milnacipran? What about with amisulpride? Is urgency a problem, or is it just frequency? Can pH affect your symptoms of IC?
>
INcrease in urgency/frequency with higher dose of Amisulpride. I did not give enough time after decreasing the dose to stabilize on it so that I did not know for sure if the Milnacipran when added caused this alos ( and pain) or not.
> I'm afraid I have no answers for you - only more questions.
>
> I'm sorry if you've answered this question already, but have you tried Adderall?
I have not tried Adderall. I was thinking about it and Strattera. But everything I have tried besides the Ritalin that is stimulating causes problemsmost especially the amphetamines.Spices and anything that makes my urine acidic like cirus causes problems big time.
Thanks, I guess I see you as the all knowing one. Sorry if I am asking impossible questions
irene
Posted by Denise1904 on September 10, 2004, at 12:50:37
In reply to To Scott, posted by iris2 on September 9, 2004, at 11:09:52
Hi Iris,
I just wanted to say, I can understand in a way why you might not want to try another drug whilst taking amisulpride. I remember when I was trying out different ADs and they weren't working at all, 10mg of Zyprexa every now and again would really lift me out of my depression but I didn't want' to take zyprexa on a regular basis (you might question this) but I just didn't feel it was the right drug to take daily.
However, the psychicatrist wanted me to take the Zyprexa regularly whilst trying out different drugs but in away because the Zyprexa helped me I couldn't see the point of trying something else as well at the same time because then it's hard to know what effect each drug is having. So I can understand why you don't want to try than more than one drug at a time. but if the Amisulpride is only helping you a little bit and you do try something else and you feel much better then maybe you can stop the Amilsupride then and see how you feel.
I hope I haven't been rambling, I think I could have made my point in one sentence rather than three paragraphs :-) but don't feel very clear headed right now.
Denise
Posted by iris2 on September 10, 2004, at 13:19:06
In reply to Re: To Iris, posted by Denise1904 on September 10, 2004, at 12:50:37
Denise,
Thanks, you are not rambling.
I planned to stay on the Amisulpride while trying stuff to augment it. It is just that I took the Milnacipran too soon after decreasing the Amisulpride. I got bladder problems from interstitial cystitis from 100mg of Amisulpride so I decreased the dose. I did not wait long enough to be able to tell if the Milnaciran was causing bladder pain and frequency or if it might still be the Amisulpride.
Hope that makes sense.
I take other stuff still like Ritalin, Oxycontin and Valiuim on a fairly regular basis although it is as needed. I also have a script for Klonopin and Perphenazine to take as needed. So I am never really drug free. When I have tried I always end up in the hospital sometimes after a suicide attempt. So going off everything just is not an option. I have done it too many times with tragic results.
What are you taking now? Is it helping to your satisfaction?
irene
Posted by Denise1904 on September 10, 2004, at 15:58:14
In reply to Re: To Iris » Denise1904, posted by iris2 on September 10, 2004, at 13:19:06
Hi Iris,
Well now I am on 40mg of Seroxat which is definately helping with the anxiety and has taken the really strong urges to just end it all, infact sometimes I feel quite good on it but am always painfully aware if I skip a dose I start turning back into "Cinderella, Dr Jeckyll or is it Mr Hyde or Ursula Andress in that film "she" where she starts to age dramatically until she is just a pile of dust.
The Thing is (and this must sound ungrateful" I've never felt as good as I did when I used to take 20mg of Zyprexa and I am still hankering after that feeling. I mean now I feel perfectly capable at work, can talk to people and flirt all the time (which is something I never used to do) but I still don't really feel like myself. I still tire very easily and always sort of feel relieved when the day is over and have problems getting up in the morning.
Still I am no way as bad as I was two years ago, that was absolutely horrendous. It was awful and I don't ever want to feel like that again!
I'm sorry to hear about your instisitial cystisis (can't remember how to spell it) it's strange but my mum has been having really bad problems and she recently discovered that that is what she probably has too. It's not well heard of here in the UK.
What is your diagnosis and have you not found any antidepressants to help you yet? You say the Amisulpride is helping as do the other drugs (well if they must if they help you stop wanting to commit suicide" but it sounds to me as though you definately haven't found that something that will make you feel "right" again.
Have you ever found a drug that has really helped you? Have you tried Zyprexa 10mg, I swear by that if all else fails.
Denise
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