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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by UgottaHaveHOPE on July 17, 2006, at 13:44:38
SLS:
I went to a new pdoc a few weeks ago, actually one that was on that list of the top 40 in the USA. Like you recommended, I asked him to rule out BP II since my grandmother had it (well, she had BP I). He asked me if I had ever stayed awake for several days in a row, ever been on a shopping spree, etc. When I answered no to all and then listened to the rest of my story, he said in his opinion that GAD was my primary diagnosis.
Then I told him how the Seroquel had really helped me. He is a top drug researcher (one of the top), and he said he didn't understand why Seroquel was working for me, but since it was he wasn't going to switch me. I was impressed, because usually when you deal with such a well-known doc, you would think they would have to change at least something (no matter how minor) just to put their stamp on it.
I never did ask him what he would've put me on if the Seroquel wasn't working. Perhaps I will ask him that on my next visit in Aug.
By the way, thanks for all your responses all the time. Michael
Posted by Phillipa on July 17, 2006, at 17:47:59
In reply to SLS ... my visit to the pdoc, posted by UgottaHaveHOPE on July 17, 2006, at 13:44:38
I wonder if Scott would say if it ain't broken don't fix it? Love Phillipa
Posted by UgottaHaveHOPE on July 18, 2006, at 10:54:28
In reply to Re: SLS ... my visit to the pdoc » UgottaHaveHOPE, posted by Phillipa on July 17, 2006, at 17:47:59
read first post please sir. im interested in your thoughts about that. Thanks, Michael
Posted by SLS on July 18, 2006, at 12:17:15
In reply to SLS ... my visit to the pdoc, posted by UgottaHaveHOPE on July 17, 2006, at 13:44:38
Hi Michael.
> I went to a new pdoc a few weeks ago, actually one that was on that list of the top 40 in the USA. Like you recommended, I asked him to rule out BP II since my grandmother had it (well, she had BP I). He asked me if I had ever stayed awake for several days in a row, ever been on a shopping spree, etc. When I answered no to all and then listened to the rest of my story, he said in his opinion that GAD was my primary diagnosis.
>
> Then I told him how the Seroquel had really helped me. He is a top drug researcher (one of the top), and he said he didn't understand why Seroquel was working for me, but since it was he wasn't going to switch me. I was impressed, because usually when you deal with such a well-known doc, you would think they would have to change at least something (no matter how minor) just to put their stamp on it.
>
> I never did ask him what he would've put me on if the Seroquel wasn't working. Perhaps I will ask him that on my next visit in Aug.
>
> By the way, thanks for all your responses all the time. Michael
I know someone whose bipolar disorder looks very much like a cross between a bipolar II with a psychotic depression. Seroquel works wonders for the hypomanic anxiety and racing-thoughts that go along with her illness. When she is ill, she is constantly drinking Pepto-Bismol in an attempt to settle her anxiety-induced upset stomach. She does not spend money or have a reduced need for sleep. She also takes Wellbutrin, Neurontin, and Abilify. I am not convinced that these latter two drugs are necessary, but since she is feeling well, no one is ready to experiment at this point in time.It is possible that you do indeed have a form of bipolar disorder that responds to neuroleptic antipsychotics as mood stabilizers. Many doctors now jump at the chance to diagnose anyone who complains of comorbid depression with anxiety and racing thoughts as having a bipolar spectrum illness. I am not sure I like this very much. However, in your case, it might fit.
Have you ever taken any other neuroleptic antipsychotics?
Now that you are in a better place and can think in a more organized fashion, can you better describe what you experienced while you were ill and what changed when you began taking Seroquel?
- Scott
Posted by UgottaHaveHope on July 18, 2006, at 15:17:50
In reply to Re: SLS ... my visit to the pdoc, posted by SLS on July 18, 2006, at 12:17:15
Scott, thanks so much for your reply.
Is Lamictal an AP? If so, that would be the only other one I tried and it didn't have any effect.
For the past nine years, I have been ravaged by anxiety. How would I describe? It's like walking through a haunted house, knowing I am going to get scared, but not know when (if that makes sense). It's like I have all of this fear and I don't know why (the root). I feel a lot of anxious energy (or "bad" adrenaline) in my body, and I start thinking about why I am feeling this way. When that happens, it totally disrupts my train of thought. It causes a downward spiral. I want to retreat and that makes me depressed.
What does Seroquel do? It's like being shot with an elephant dart. It makes me sluggish and sleepy. And since I am so wired up, it sort of equalizes me out. I am tired for parts of the day, but it is well worth the trade-off of feeling "on the edge" all day. Seroquel also regulates my sleep, which is crucial. When I don't get my sleep, it makes everything 100 times worse.
I hope some of that made sense, and as always I would appreciate your insight. Thanks man, Michael
Posted by SLS on July 18, 2006, at 18:36:49
In reply to Re: SLS - reply, posted by UgottaHaveHope on July 18, 2006, at 15:17:50
Hi Michael.
I don't know.
My first reaction is to agree with your doctor that your condition is predominantly one of anxiety and not of mania, although that does not preclude a comorbid bipolar disorder. The trouble with wanting to give a diagnoses over the Internet is:
1. I am not a doctor
2. I don't have enough information about you
3. I am not a doctorHave you had your thyroid checked? Perhaps you are hyperthyroid.
Let us say that you have an Axis I disorder. Let us say that it is an anxiety disorder. As you describe your experience, it would probably be GAD (Generalized Anxiety Disorder)
What drugs have you tried so far, and at what dosages? How did they affect you?
Seroquel seems to be a very poor answer, even though it might be the best one you have come up with so far. It isn't really reducing your level of anxiety so much as it is reducing your state of awareness due to its soporific properties.
It's time to find a better solution.
- Scott
Posted by UgottaHaveHope on July 19, 2006, at 0:38:39
In reply to Re: SLS - reply, posted by SLS on July 18, 2006, at 18:36:49
SLS, thanks for your reply. I realize you are not a doctor, and I truly appreciate your thoughts and ideas about my situation.
I have tried Serzone, Prozac, Paxil, Lexapro, Lamictal, Buspar, Adderall, Valium, Xanax, Lithium, Nueronton, Zoloft, Celexa, Luvox ... and none of them really ever touched the anxiety.
Seroquel is the only drug that has ever had a direct hit on the anxiety.
I do find it very interesting with your statement "It [Seroquel] isn't really reducing your level of anxiety so much as it is reducing your state of awareness due to its soporific properties."
I do find it very interesting because when I saw that new pdoc, who is considered one of the top in the USA, he said he had no clue why Seroquel was working. And if anyone would know, this guy would ... he's one of the top drug researchers in the world.
That was my first and only visit with him. I will go back within in a month to see him again. I will ask him what would he normally prescribe for GAD or my situation (didn't have time on first appt. due to initial interview). SLS, what would you prescribe (just wondering your opinion)for me or think someone in my sitation should try???????
Again, thanks for your feedback, and if you need me to ask this guy anything for you, please let me know either through this board or sportscarvell@yahoo.com
Posted by mbaumann on July 19, 2006, at 3:40:13
In reply to SLS - what do you think abou this?, posted by UgottaHaveHope on July 19, 2006, at 0:38:39
Seroquel sustained release (not avalable yet) is currently tested in Phase III against Generalized Anxiety Disorder, so it doesn`t seem too odd that it is working for you.
Markus
Posted by SLS on July 19, 2006, at 6:25:42
In reply to SLS - what do you think abou this?, posted by UgottaHaveHope on July 19, 2006, at 0:38:39
Effexor.
> and if you need me to ask this guy anything for you, please let me know either through this board or...
Thank you so much!!!
- Scott
Posted by SLS on July 19, 2006, at 8:18:39
In reply to Re: SLS - what do you think abou this? » UgottaHaveHope, posted by SLS on July 19, 2006, at 6:25:42
> Effexor.
If you've already tried that, then Nardil.
- Scott
Posted by mayzee on July 19, 2006, at 17:30:01
In reply to Re: SLS - what do you think abou this? » UgottaHaveHope, posted by SLS on July 19, 2006, at 6:25:42
Maybe UgottaHaveHope's pdoc would know the answer to your oral selegiline/Emsam transdermal equivalency puzzle! :)
>
> > and if you need me to ask this guy anything for you, please let me know either through this board or...
>
> Thank you so much!!!
>
>
> - Scott
>
Posted by UgottaHaveHOPE on July 19, 2006, at 18:53:37
In reply to Re: SLS - what do you think abou this?, posted by SLS on July 19, 2006, at 8:18:39
I have also tried Effexor (sorry left it out). That gave me too much energy.
Interesting about Nardil. Have you ever tried? If so, what effecct did it have on you? Would you try ENSAM before Nardil? Thanks, SLS
Posted by SLS on July 19, 2006, at 19:22:00
In reply to SLS SLS SLS SLS SLS SLS SLS SLS, posted by UgottaHaveHOPE on July 19, 2006, at 18:53:37
> I have also tried Effexor (sorry left it out). That gave me too much energy.
>
> Interesting about Nardil. Have you ever tried? If so, what effecct did it have on you? Would you try ENSAM before Nardil? Thanks, SLSI would try Nardil before Emsam. It is a proven product for GAD. Besides, the amphetamine metabolites of Emsam might, but not necessarily, add to your anxiety.
As per another poster's suggestion, perhaps you could ask your doctor:
How much Eldepryl (oral selegiline) would one have to take to equal 6mg/24hr Emsam (transdermal selegiline patch) to arrive at the same blood level of selegiline?
Thanks!
- Scott
Posted by spriggy on July 22, 2006, at 23:55:56
In reply to Re: SLS SLS SLS SLS SLS SLS SLS SLS » UgottaHaveHOPE, posted by SLS on July 19, 2006, at 19:22:00
I have a quick question ( sorry to hijack this thread)..
You said Effexor would be a good one- I have a family history of bp- dad is bp, his mother was bp, etc..
My mother has severe depression and anxiety disorder.
I got it coming out of both ends. Lucky me.
Anyway, awhile back a dr. told me that because of my family history of bp, I shouldn't have anything touch " seratonin or norepinephrine (however you spell that big word)."
I have considered trying Effexor or Cymbalta but because of that statement, have been too scared.
Any thoughts?
I did horrific on Lexapro- slung me into the worst depression ever in my life (if that info helps any)...
thanks.
And back to your regular scheduled programming. LOL
Posted by SLS on July 23, 2006, at 0:30:08
In reply to SLS.. jumping in here... Effexor, posted by spriggy on July 22, 2006, at 23:55:56
Hi.
How are you feeling now?
What medications are you currently taking?
Lexapro, Effexor, and Cymbalta are all potent serotonin reuptake inhibitors. It is possible that you will react badly to any drug with this property. Wellbutrin is probably the drug most often chosen in a situation such as yours if mood stabilizers alone do not produce an adequate response.
- Scott> I have a quick question ( sorry to hijack this thread)..
>
> You said Effexor would be a good one- I have a family history of bp- dad is bp, his mother was bp, etc..
>
> My mother has severe depression and anxiety disorder.
>
> I got it coming out of both ends. Lucky me.
>
> Anyway, awhile back a dr. told me that because of my family history of bp, I shouldn't have anything touch " seratonin or norepinephrine (however you spell that big word)."
>
> I have considered trying Effexor or Cymbalta but because of that statement, have been too scared.
>
> Any thoughts?
>
> I did horrific on Lexapro- slung me into the worst depression ever in my life (if that info helps any)...
>
> thanks.
>
> And back to your regular scheduled programming. LOL
Posted by spriggy on July 23, 2006, at 2:10:36
In reply to Re: SLS.. jumping in here... Effexor » spriggy, posted by SLS on July 23, 2006, at 0:30:08
Right now, the only med I am on ( as far as mental meds, lol) is Ativan.
I take 1 mg at bedtime; actually started taking it for TMJ and lockjaw.
Other than that, I take 3 B-12 shots per week, am on a multi vitamin/mineral, take Acidophilus, and Hydrocodone for my chronic pain.
I just bought St. John's wort this weekend and decided to start taking 300 mg each night to just "see" if I notice any improvement.
I am having serious outburst of anger and irritability; I can't control myself. It's like PMS woman on steroids.
Not a pretty sight, I assure you.
I hate myself for being this way but can't seem to figure out why. It's like my fuse has grown super short and I am getting set off for not particular reason ( well other than it's 103 degrees here and we have no air conditioning and my period is 3 days later).
Other than that, no particular reason.
I've been depressed now for about 2 months.
Depressed in that I feel completely void, empty, nothing seems to make me happy anymore.
You could give me a check for a million dollars and I would not be moved in the least bit.
Totally not like me. I am usually a joyful, happy, fun person.
Any ideas?
I'm having some "female" issues right now; my cycles are messed up completely and I had a miscarriage about 3 months ago.
A connection with hormones maybe?
Somebody give me some chocolate.
Posted by Phillipa on July 23, 2006, at 20:52:47
In reply to Re: SLS.., posted by spriggy on July 23, 2006, at 2:10:36
Spriggy here's a cyber chocolate truffle. But seriously get your hormones checked. With the miscarriage can you get Post partum depression? I have no idea? Love Phillipa
This is the end of the thread.
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