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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by greywolf on March 19, 2009, at 8:56:34
It's been a while since I posted. Following VNS surgery, I was recently hospitalized and received ECT treatments, to no avail. Now I'm home and on Parnate again, along with Xanax. Nothing seems to be working. I am as unhappy as I've ever been in my life. Anyone know of any knew tx for tx resistant depression with a bipolar component?
Posted by SLS on March 19, 2009, at 9:11:32
In reply to Back after hospitalization, posted by greywolf on March 19, 2009, at 8:56:34
> It's been a while since I posted. Following VNS surgery, I was recently hospitalized and received ECT treatments, to no avail. Now I'm home and on Parnate again, along with Xanax. Nothing seems to be working. I am as unhappy as I've ever been in my life. Anyone know of any knew tx for tx resistant depression with a bipolar component?
I am currently having success with:
Parnate 80mg
desipramine 350mg
Lamictal 200mg
Abilify 20mgThe dosage of desipramine is particularly high, however, blood tests indicate that I am a rapid metabolizer of tricyclics.
- Scott
Posted by Phillipa on March 19, 2009, at 10:50:03
In reply to Re: Back after hospitalization » greywolf, posted by SLS on March 19, 2009, at 9:11:32
I'm sorry Greywolf was hoping as were you that the surgery would be the ticket for you. Love Phillipa
Posted by sam K on March 19, 2009, at 14:30:54
In reply to Re: Back after hospitalization » SLS, posted by Phillipa on March 19, 2009, at 10:50:03
i was wondering where you went. the vns guy! Im trully sorry you have to go through the hopelessness and pain. im not religious but Ill pray for you
Posted by bleauberry on March 19, 2009, at 17:03:15
In reply to Back after hospitalization, posted by greywolf on March 19, 2009, at 8:56:34
I'm so sorry to hear things are not well at the moment.
I failed 12 sessions of bilateral ECT, so you are not alone.
At one of the websites where patients rate their medicines, one person commented how they had failed every combination known to man including ECT, but when they tried Milnacipran it worked. I also experienced the same thing, beginning before the first week was over, but noticably kicking in by the end of the second week. Pretty darn good for a single med after failing ECT and all kinds of exotic combinations.
If you've done well on Parnate before, maybe this time it just needs the magic missing ingredient. Whether that is Abilify or Ritalin or Klonopin or a TCA or whatever, I don't know.
Have you ever been exposed to an environment where ticks live? You would not by a long shot be the first person with totally disabling untreatable depression that was actually fully engulfed in Lyme disease. This might sound weird, but if there is even the slightest possibility you might have been exposed to ticks at some time in your life, you might want to ask the doc for a blind trial of 500mg Tetracycline once a day or once every other day. That is a very low dose, but a good diagnostic dose. If you feel either a lot better almost right away, followed by worse a couple days later, or if you feel a lot worse right away, then you know without a doubt something is up that has been missed.
Docs have no problem dishing out dozens of powerful brain drugs one after the other, without any tests or confirmation or anything. Pure guesswork. And yet, they want a clearcut diagnosis of Lyme before treating it. Totally absurd. They have zero proof you have low serotonin or any other kind of chemical imbalance. Yet they will blindly try you on something to see if it balances something. It is a clinical diagnosis. Today's lab tests are frequently in error. The best single confirmatory test is a blind trial of an antibiotic, Tetracycline being a good starting point.
I only mention this because it is overlooked probably 90% of the time, and never even considered usually. If one of your doctors somewhere along the line did consider Lyme and tested you for it and your test was negative, that was completely totally meaningless. Better take a closer look.
My doctor says some of his seriously ill Lyme patients had only depression or only anxiety as their only symptom. Symptoms usually involve pain and fatigue as well. But sometimes just depression. My doc was very bold in stating to me, "I have never had a patient's depression I could not fix." The weird thing is, he does it mostly with antibiotics and not psych drugs. That is how grossly overlooked this stuff is.
Maybe a wildshot. Maybe barking up the wrong tree. Dunno. For now, Milnacipran or something along with Parnate. Keep in mind though, that kind of depression that is so unresponsive to powerful stuff, it has a powerful cause. It is not just some fluke or some genetic flaw. There is something much more going on. That's when I think of Lyme or Lyme-like infections. Something with the power of a nuclear bomb. Not many things like that. Hidden microbes can certainly display that kind of power and be totally undetectable the whole while.
Hey, when you've failed ECT, it is time for a reality check...re-examine the diagnosis.
As a sidenote, the absolute best antidepressants I ever had, better than any psych drug and a world better than ECT, were:
DMSA...a heavy metal chelator.
Doxycyline...an antibiotic.What does that tell you? Come on. Anyone should be able to read between the lines there.
Posted by Bob on March 20, 2009, at 0:16:18
In reply to Back after hospitalization, posted by greywolf on March 19, 2009, at 8:56:34
> It's been a while since I posted. Following VNS surgery, I was recently hospitalized and received ECT treatments, to no avail. Now I'm home and on Parnate again, along with Xanax. Nothing seems to be working. I am as unhappy as I've ever been in my life. Anyone know of any knew tx for tx resistant depression with a bipolar component?
Greywolf,
Are you no longer being stimulated by the VNS, or is it still in the mix?
Bob
Posted by greywolf on March 20, 2009, at 9:08:02
In reply to Re: Back after hospitalization » greywolf, posted by Bob on March 20, 2009, at 0:16:18
Yes, the VNS is still in the mix. I have yet to get to max power, so I'm trying to keep my hopes up.
Greywolf
Posted by greywolf on March 20, 2009, at 9:11:13
In reply to Re: Back after hospitalization, posted by sam K on March 19, 2009, at 14:30:54
Thanks much.
Greywolf
Posted by greywolf on March 20, 2009, at 9:13:01
In reply to Re: Back after hospitalization, posted by bleauberry on March 19, 2009, at 17:03:15
Yes, I live in a wooded area with ticks. Never thought of getting tested for Lyme disease. Will check that out with my primary. Thanks for the idea.
Greywolf
> I'm so sorry to hear things are not well at the moment.
>
> I failed 12 sessions of bilateral ECT, so you are not alone.
>
> At one of the websites where patients rate their medicines, one person commented how they had failed every combination known to man including ECT, but when they tried Milnacipran it worked. I also experienced the same thing, beginning before the first week was over, but noticably kicking in by the end of the second week. Pretty darn good for a single med after failing ECT and all kinds of exotic combinations.
>
> If you've done well on Parnate before, maybe this time it just needs the magic missing ingredient. Whether that is Abilify or Ritalin or Klonopin or a TCA or whatever, I don't know.
>
> Have you ever been exposed to an environment where ticks live? You would not by a long shot be the first person with totally disabling untreatable depression that was actually fully engulfed in Lyme disease. This might sound weird, but if there is even the slightest possibility you might have been exposed to ticks at some time in your life, you might want to ask the doc for a blind trial of 500mg Tetracycline once a day or once every other day. That is a very low dose, but a good diagnostic dose. If you feel either a lot better almost right away, followed by worse a couple days later, or if you feel a lot worse right away, then you know without a doubt something is up that has been missed.
>
> Docs have no problem dishing out dozens of powerful brain drugs one after the other, without any tests or confirmation or anything. Pure guesswork. And yet, they want a clearcut diagnosis of Lyme before treating it. Totally absurd. They have zero proof you have low serotonin or any other kind of chemical imbalance. Yet they will blindly try you on something to see if it balances something. It is a clinical diagnosis. Today's lab tests are frequently in error. The best single confirmatory test is a blind trial of an antibiotic, Tetracycline being a good starting point.
>
> I only mention this because it is overlooked probably 90% of the time, and never even considered usually. If one of your doctors somewhere along the line did consider Lyme and tested you for it and your test was negative, that was completely totally meaningless. Better take a closer look.
>
> My doctor says some of his seriously ill Lyme patients had only depression or only anxiety as their only symptom. Symptoms usually involve pain and fatigue as well. But sometimes just depression. My doc was very bold in stating to me, "I have never had a patient's depression I could not fix." The weird thing is, he does it mostly with antibiotics and not psych drugs. That is how grossly overlooked this stuff is.
>
> Maybe a wildshot. Maybe barking up the wrong tree. Dunno. For now, Milnacipran or something along with Parnate. Keep in mind though, that kind of depression that is so unresponsive to powerful stuff, it has a powerful cause. It is not just some fluke or some genetic flaw. There is something much more going on. That's when I think of Lyme or Lyme-like infections. Something with the power of a nuclear bomb. Not many things like that. Hidden microbes can certainly display that kind of power and be totally undetectable the whole while.
>
> Hey, when you've failed ECT, it is time for a reality check...re-examine the diagnosis.
>
> As a sidenote, the absolute best antidepressants I ever had, better than any psych drug and a world better than ECT, were:
> DMSA...a heavy metal chelator.
> Doxycyline...an antibiotic.
>
> What does that tell you? Come on. Anyone should be able to read between the lines there.
Posted by Bob on March 20, 2009, at 11:23:38
In reply to Re: Back after hospitalization, posted by greywolf on March 20, 2009, at 9:08:02
> Yes, the VNS is still in the mix. I have yet to get to max power, so I'm trying to keep my hopes up.
>
> Greywolf
So how do they know it's not the VNS stimulation that put you in the hospital?
Posted by B2chica on March 20, 2009, at 12:24:35
In reply to Back after hospitalization, posted by greywolf on March 19, 2009, at 8:56:34
very disappointed to hear VNS didn't work for you...so sorry you feel such pain.
what about rTMS? last i heard it was still experimental but haven't heard anything on it lately...
b2c
Posted by Bob on March 20, 2009, at 12:49:01
In reply to Re: Back after hospitalization, posted by greywolf on March 20, 2009, at 9:08:02
> Yes, the VNS is still in the mix. I have yet to get to max power, so I'm trying to keep my hopes up.
>
> Greywolf
My psychiatrist has a patient with VNS and he didn't show any improvement for over a year, and then apparently he started to improve. Haven't gotten an update recently, but I have heard anecdotal evidence of a long term effect with the VNS.
Posted by bleauberry on March 20, 2009, at 20:29:26
In reply to Re: Back after hospitalization » bleauberry, posted by greywolf on March 20, 2009, at 9:13:01
Well, like I said, do not...repeat...DO NOT rely on a test to tell you if you have Lyme or not. It has been clinically laboratory proven that a whopping 50% of people definitely infected test NEGATIVE on the Elisa test and the Western Blot test combined.
It is a CLINICAL diagnosis. If the doc isn't completely schooled on symptoms of Lyme, and how it mimics so many other diseases, you will have a painful road ahead of you.
No time or space or place to do it here. But to keep a very long instruction manual real short...a blind diagnostic trial of an anti-Lyme antibiotic will tell you all you need to know. Healthy people basically get a little bit of heartburn and that's about it. Infected people feel a lot more than that.
> Yes, I live in a wooded area with ticks. Never thought of getting tested for Lyme disease. Will check that out with my primary. Thanks for the idea.
>
> Greywolf
>
>
Posted by obsidian on March 20, 2009, at 21:32:05
In reply to Re: Back after hospitalization » greywolf, posted by bleauberry on March 20, 2009, at 20:29:26
I knew a guy who was mentally ill and misdiagnosed until it was finally figured out that the guy had lymes disease and it was not an easy diagnosis to come by.
This is the end of the thread.
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