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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 34. This is the beginning of the thread.
Posted by Dinah on February 25, 2005, at 10:25:51
My therapist is concerned that I'm in clinical depression, and he's aware that I'm noncompliant with SSRI's because of head buzzing, ear ringing, increased migraines, increased irritable bowel syndrome, etc. So he suggested suggesting an MAOI inhibitor.
Do they have similar side effects? Norepinephrine effects? Can I eat peanut butter?
Posted by AuntieMel on February 25, 2005, at 14:13:05
In reply to MAOI Inhibitor - Side effects?, posted by Dinah on February 25, 2005, at 10:25:51
I can't help you but isn't gg on an maoi?
Posted by TamaraJ on February 25, 2005, at 14:32:15
In reply to MAOI Inhibitor - Side effects?, posted by Dinah on February 25, 2005, at 10:25:51
I seem to recall a rather lengthy thread late last year on MAOI diet. I'll see if I can find it for you in the interim of others responding. If I remember correctly, King Vultan and others said they didn't have a problem with peanut butter.
Posted by Dinah on February 25, 2005, at 14:37:16
In reply to MAOI Inhibitor - Side effects?, posted by Dinah on February 25, 2005, at 10:25:51
He says he doesn't prescribe it because it's too dangerous. He offered me Cymbalta, but I refused because my research showed me it's pretty much Effexor, and I did horribly on Effexor (and nortriptyline and Wellbutrin).
Since the SSRI's just add feeling bad onto feeling sad, I'm just out of luck A-D wise.
Thanks anyway, guys.
Posted by TamaraJ on February 25, 2005, at 14:48:10
In reply to Pdoc ruled it out, posted by Dinah on February 25, 2005, at 14:37:16
Sorry if you have already answered this question, but has your pdoc considered one of the other TCAs such as Imipramine (Tofranil) or Clomipramine (Anafranil) or even desipramine?
> He says he doesn't prescribe it because it's too dangerous. He offered me Cymbalta, but I refused because my research showed me it's pretty much Effexor, and I did horribly on Effexor (and nortriptyline and Wellbutrin).
>
> Since the SSRI's just add feeling bad onto feeling sad, I'm just out of luck A-D wise.
>
> Thanks anyway, guys.
Posted by SLS on February 25, 2005, at 14:52:30
In reply to Pdoc ruled it out, posted by Dinah on February 25, 2005, at 14:37:16
> He says he doesn't prescribe it because it's too dangerous.
Ok, that was the punchline, but what was the joke?This is not at all funny.
- Scott
Posted by SLS on February 25, 2005, at 15:11:48
In reply to Pdoc ruled it out, posted by Dinah on February 25, 2005, at 14:37:16
> > He says he doesn't prescribe it because it's too dangerous.
That's like a cardiac surgeon saying that he never prescribes bypass surgery after other treatments have failed because the procedure is too dangerous.
- Scott
Posted by gardenergirl on February 25, 2005, at 16:00:03
In reply to Pdoc ruled out treating me with what works. » Dinah, posted by SLS on February 25, 2005, at 15:11:48
And actually, my migraines have pretty much disappeared since I started Nardil, an MAOI.
I think it's only dangerous if you prescribing it to someone who either willfully does not follow the dietary and medicine precautions or who is not capable due to an intelligence deficit to comprehend the instructions.
gg
Posted by Dinah on February 25, 2005, at 16:19:20
In reply to Pdoc ruled out treating me with what works. » Dinah, posted by SLS on February 25, 2005, at 15:11:48
lol.
Scott, I had to laugh at your change of subject line.
I was a bit taken aback, I must admit. Overall I like him, but mostly because he lets me do almost nothing which is what I prefer. But he's also usually willing to try whatever suggestions I bring in - neurontin, nortryptiline were my ideas and neither were useful I admit. He wouldn't let me try verapamil after Mouse had such success with it. He thought it would affect my ability to work too much. He's also not too crazy about the Provigil prescribed by my neurologist, and I doubt he'd refill it.
But I was surprised at his flat refusal to consider this. He was so adamant that he actually sounded annoyed at my therapist for suggesting it and saying that he had seen it have good results with people that other AD's hadn't worked for.
He also sounded annoyed that I knew what Cymbalta was.
It occurs to me to try to find another pdoc. But this one prescribes me Klonopin and therapy. It may be a pain in the neck to find another therapist that will. I can't imagine life without Klonopin.
Posted by Dinah on February 25, 2005, at 16:20:26
In reply to Re: Pdoc ruled out treating me with what works., posted by gardenergirl on February 25, 2005, at 16:00:03
That's what I had read here too. But perhaps he's had a malpractice suit over it or something. (Am I cynical or what?)
Posted by Dinah on February 25, 2005, at 16:22:32
In reply to Re: Pdoc ruled it out » Dinah, posted by TamaraJ on February 25, 2005, at 14:48:10
Hmmm. I'll have to look into that. They're in the same class as nortryptiline? It didn't work too well for me.
But I recognize those names as drugs they used to use to treat OCD, and that's my primary diagnosis (I think - who knows anymore).
Posted by TamaraJ on February 25, 2005, at 16:27:11
In reply to Re: Pdoc ruled it out » TamaraJ, posted by Dinah on February 25, 2005, at 16:22:32
Yes, nort is a TCA, but I think the beauty of TCAs (if I am remembering correctly) is that they all work differently. So, if you can't tolerate nort, you may well be able to tolerate Tofranil.
Dinah, do you think your pdoc may be concerned about prescribing a MAOI because of your diabetes and the diet you have to follow for that? He no doubt has your best interests at heart.
Tamara
> Hmmm. I'll have to look into that. They're in the same class as nortryptiline? It didn't work too well for me.
>
> But I recognize those names as drugs they used to use to treat OCD, and that's my primary diagnosis (I think - who knows anymore).
Posted by Dinah on February 25, 2005, at 16:43:53
In reply to Re: Pdoc ruled it out » Dinah, posted by TamaraJ on February 25, 2005, at 16:27:11
If I remember correctly, he said that he doesn't prescribe it, not that he didn't want to prescribe it for me. It sounded like a global thing.
I'm sure he does have my best interests at heart. I'm just a bit discouraged.
Posted by TamaraJ on February 25, 2005, at 16:45:07
In reply to Re: Pdoc ruled it out » TamaraJ, posted by Dinah on February 25, 2005, at 16:43:53
Posted by Phillipa on February 25, 2005, at 17:47:48
In reply to I don't blame you :-( (nm) » Dinah, posted by TamaraJ on February 25, 2005, at 16:45:07
If it's OCD what about Luvox? There's a good Thread on the Board now about it. Hope this helps. Fondly, Phillipa
Posted by jay on February 25, 2005, at 21:21:56
In reply to Pdoc ruled it out, posted by Dinah on February 25, 2005, at 14:37:16
> He says he doesn't prescribe it because it's too dangerous. He offered me Cymbalta, but I refused because my research showed me it's pretty much Effexor, and I did horribly on Effexor (and nortriptyline and Wellbutrin).
>
> Since the SSRI's just add feeling bad onto feeling sad, I'm just out of luck A-D wise.
>
> Thanks anyway, guys.How is this for a combo? Prozac +Nortrip+Risperdal+Depakote(and maybe clonazepam)? I recall you talking about most of these drugs except for the Prozac. Thoughts?
Best,
Jay
Posted by Dinah on February 26, 2005, at 0:26:40
In reply to Re: Pdoc ruled it out...what about this? » Dinah, posted by jay on February 25, 2005, at 21:21:56
Nortriptyline disagreed with me, even with Depakote and Klonopin on board. It made me itchy jumpy. Norepinephrine is poison to me. I'm guessing Prozac would be similar to Luvox. And I generally take Risperdal as needed because I worry about tardive dyskenesia. A couple of my relatives have it, and it's no fun. It's a great drug as needed though.
It seems to just be antidepressants that I can't tolerate easily. I even eventually got used to Provigil on an as needed basis.
Thanks Jay. I think I'm just up a creek on this one.
Posted by Phillipa on February 26, 2005, at 0:30:52
In reply to Re: Pdoc ruled it out...what about this? » jay, posted by Dinah on February 26, 2005, at 0:26:40
Prozac is very stimulating and has a very long half-life. Luvox has a short half-life, and is not stimulating. It helps OCD as well as depression. Fondly, Phillipa
Posted by Dinah on February 26, 2005, at 0:32:01
In reply to Re: I don't blame you :-(, posted by Phillipa on February 25, 2005, at 17:47:48
Thanks Phillipa.
I was on Luvox for four years, and it certainly wasn't the worst drug I've been on. If I get desparate enough that I think it's death or Luvox, I'll take it.
But I don't like the increased migraines, IBS, GERD, ear ringing, head buzzing, stupids, apathy, anorgasmia, etc. Not to mention withdrawal. Especially withdrawal. I did it once and it's hard to imagine it's worth doing again.
I think I'm just going to have to gut it out without an AD.
Posted by SLS on February 26, 2005, at 6:46:32
In reply to Re: I don't blame you :-( » Phillipa, posted by Dinah on February 26, 2005, at 0:32:01
Hi Dinah.
> I think I'm just going to have to gut it out without an AD.
Anafranil?
Zyprexa?
Pull yourself up by your bootstraps?
Out of curiosity, do you have OCPD? Maybe some of your difficulties can be addressed with more specific psychotherapeutics.
(I'm just reaching for sh*t)
What was it about nortriptyline that you found disagreeable?
To what degree does you OCD interfere with your day-to-day functioning?
- Scott
Posted by Dinah on February 26, 2005, at 8:56:37
In reply to Re: I don't blame you :-( » Dinah, posted by SLS on February 26, 2005, at 6:46:32
> Hi Dinah.
>
> > I think I'm just going to have to gut it out without an AD.
>
> Anafranil?
>
> Zyprexa?
>
> Pull yourself up by your bootstraps?Hope the depression will pass? I've only had extended periods of major depression two or three times in my life. My therapist thinks this is time four, but I think it might be too early to judge that.
>
> Out of curiosity, do you have OCPD? Maybe some of your difficulties can be addressed with more specific psychotherapeutics.No, I'm pretty sure my husband has that, and I soooo do not. :)
>
> (I'm just reaching for sh*t)
>
> What was it about nortriptyline that you found disagreeable?
>
Same as Effexor and to a greater degree Wellbutrin. Akasthesia (sp?) and the nasty sort of hypomania.> To what degree does you OCD interfere with your day-to-day functioning?
>
Not so much really. It's largely under control. It was my initial diagnosis, but responded well to cognitive behavior therapy.I'm not sure DSM-IV has a good category for me. In general, I just have a highly reactive nervous system, and I have problems with mood regulation and lots of anxiety. But right now, I am depressed. At least I think I might be. Suicidal thinking, not grooming myself, having trouble concentrating on work or anything else, sleeping too much, or sometimes too little. Still, it's hard to pull the strands of everything going on. Grief at my father's death, physical reactions to diabetes and food, and disgust at myself for not accomplishing my work for whichever reason is accurate. There are alternate explanations to depression, I think.
>
> - Scott
>
Thanks Scott. I appreciate it. But I'm pretty sure I'm hopeless in the medication area. My therapist is pushing me to get an AD, and every once in a while I get excited about a new possibility. But every new drug looks like a repackage of a prior one. I haven't seen any truly new ones in a while. I can't bear another norepinephrine induced agitation. Not even as a trial. If things are bad enough long enough, I might break down and take the Luvox. But it's hard to look down the road and say I might feel better in six to eight weeks, when I know that right now I just feel lousy on top of whatever I felt before.I'm really not a general pain in the rear about meds. I'm happy with my mood stabilizer and anti-anxiety drug. And I don't mind taking antipsychotics (for agitation) and Provigil (a stimulant?) as needed. They just need to do some improvements in the antidepressant drug arena.
Posted by Phillipa on February 26, 2005, at 11:07:05
In reply to Re: I don't blame you :-(, posted by Dinah on February 26, 2005, at 8:56:37
Scott, What is OCPD? Fondly, Phillipa
Posted by SLS on February 26, 2005, at 14:06:17
In reply to Re: I don't blame you :-(, posted by Phillipa on February 26, 2005, at 11:07:05
> Scott, What is OCPD? Fondly, Phillipa
It stands for obsessive compulsive personality disorder. I believe it is an Axis II diagnosis in the DSM.
"A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts"
- Scott
Posted by TamaraJ on February 26, 2005, at 17:03:43
In reply to Re: I don't blame you :-(, posted by Dinah on February 26, 2005, at 8:56:37
Dinah,
I know of another poster (Jas)) who has a sensitivity to ADs and her pdoc has prescribed L-Tryptophan (works on serotonin) for her. She has been having good results with it without the side effects. Some trial and error getting the right dose, but we go through that with ADs as well.
Tamara
Posted by Phillipa on February 26, 2005, at 17:08:06
In reply to Re: I don't blame you :-( » Dinah, posted by TamaraJ on February 26, 2005, at 17:03:43
Thanks Scott, That's what I thought it meant. I didn't know they had added the P though. Fondly, Phillipa
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