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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Frustratedmama on June 15, 2009, at 16:39:59
Ok, so I am just going to say I must have treatment resistant irritability. Any suggestions? anyone? this sucks!
Posted by linkadge on June 15, 2009, at 16:47:12
In reply to Treatment Resistant Irritability, posted by Frustratedmama on June 15, 2009, at 16:39:59
What are you taking? Anything?
Linkadge
Posted by Frustratedmama on June 15, 2009, at 17:38:57
In reply to Re: Treatment Resistant Irritability, posted by linkadge on June 15, 2009, at 16:47:12
yes, taking verapamil, lunesta, adderall (low dose for adhd) and cytomel (also very low dose for borderline thyroid levels). Without the adderall and cytomel I am so lethargic unfocused and unmotivated that I get nothing accomplished. I am actually more irritable and depressed without them then on them.... However, I am still irritable and grumpy and overall feel like crap most of the time... Crave carbs too!
Posted by linkadge on June 15, 2009, at 17:46:10
In reply to Re: Treatment Resistant Irritability, posted by Frustratedmama on June 15, 2009, at 17:38:57
Not sure. Have you tried 5-htp? It can help with irritability and less likely to induce cycling than an SSRI. Chromium may help the carb cravings, but some find it too activating with stims. How has the verapamil affected the irritability? If it helps, magnesium may help too.
Linkadge
Posted by Frustratedmama on June 15, 2009, at 18:10:18
In reply to Re: Treatment Resistant Irritability, posted by linkadge on June 15, 2009, at 17:46:10
> Not sure. Have you tried 5-htp? It can help with irritability and less likely to induce cycling than an SSRI. Chromium may help the carb cravings, but some find it too activating with stims. How has the verapamil affected the irritability? If it helps, magnesium may help too.
>
> Linkadge
>
> I will try chromium and magnesium- tried 5-htp years ago without much effect but this is worse than it was then so might try that too!!!! thanks for the advice
Posted by Phillipa on June 15, 2009, at 18:15:03
In reply to Re: Treatment Resistant Irritability » linkadge, posted by Frustratedmama on June 15, 2009, at 18:10:18
And you've been on the mood stabalizers correct? Phillipa
Posted by Frustratedmama on June 15, 2009, at 18:19:29
In reply to Re: Treatment Resistant Irritability » Frustratedmama, posted by Phillipa on June 15, 2009, at 18:15:03
> And you've been on the mood stabalizers correct? Phillipa
yeah, but ready to retry all of them if needed - this is really bad this time!!!! It was recommended that I try ECT but no way- not after reading above posts and doing some more research
Posted by linkadge on June 15, 2009, at 19:16:51
In reply to Re: Treatment Resistant Irritability » linkadge, posted by Frustratedmama on June 15, 2009, at 18:10:18
Have you ever had your blood sugar tested? My mother had bad irritability till she found out she had type-2 diabetes.
The irritability has resolved as the blood sugar has.
Linkadge
Posted by linkadge on June 15, 2009, at 20:15:10
In reply to Re: Treatment Resistant Irritability, posted by Frustratedmama on June 15, 2009, at 18:19:29
ECT hasn't really been studied in irritability. Unless there is significant depression or mania I don't see why ECT would be suggested. Some docs just use ECT for everything.
Linkadge
Posted by alchemy on June 16, 2009, at 0:52:02
In reply to Treatment Resistant Irritability, posted by Frustratedmama on June 15, 2009, at 16:39:59
Can you list what you have tried?
Meds that are suppose to decrease irritability/agitation usually increased it for me. (Zyprexa, Seroquel, Topamax).
I'm sure this doesn't relate to your experience, but just as an fyi, I'm on Lamictal, Wellbutrin, Celexa & Xanax. So for me, it is probably the Celexa & Xanax that helps. And maybe a mood stabilizer.
Have you tried Xanax?
Regarding ECT. It was a miracle for me in two situations. One was actually from a Geodon trial. I was really depressed and felt I was going crazy. 5-6 ECTs and I felt awesome, actually even out of my constant depression for about a week. I tried maintenance, but that doesn't seem to work for me. I guess it's when my brain is really f*** up that it does miracle rearanging or something. Anyway, on one of my "maintenance" ECTs it actually made me more irritable. I'm not sure what the success rate on ECT improving irritability, but that's my experience.
Posted by morganpmiller on June 16, 2009, at 1:06:56
In reply to Re: Treatment Resistant Irritability, posted by alchemy on June 16, 2009, at 0:52:02
So you had ECT and it worked great huh..sorry I'm not trying to hijack this thread.
did you do unilateral or bilateral?
i have also been turned off by the posts on ECT.
Posted by alchemy on June 16, 2009, at 1:20:58
In reply to Re: Treatment Resistant Irritability, posted by morganpmiller on June 16, 2009, at 1:06:56
> So you had ECT and it worked great huh..sorry I'm not trying to hijack this thread.
>
> did you do unilateral or bilateral?
>
> i have also been turned off by the posts on ECT.I'm glad you asked because the posts here are usually quite anti-ect. I just posted on your previous blog as well. I did unilateral. I did have some memory loss, some of which came back. But on a few occasions I would have ECT in the morning & be into work by 10. Everyone is different of course, but the success rate is pretty high, and I know of other people where it has saved them. Feel free to ask me any more questions.
Posted by floatingbridge on June 16, 2009, at 16:47:56
In reply to Re: Treatment Resistant Irritability » morganpmiller, posted by alchemy on June 16, 2009, at 1:20:58
FM,
Just consider me a broken record, but could you throw a benzo into the mix to give you relief while sorting your situation out? (Okay, so now I AM a benzo-pusher!)
Posted by Frustratedmama on June 16, 2009, at 17:37:59
In reply to Re: Treatment Resistant Irritability, posted by floatingbridge on June 16, 2009, at 16:47:56
I have had blood sugar tested and it was normal (I think I have had every test known to mankind trying to explain why I feel this way and for some reason nothing comes out as the "reason") So, I am back to the med-go-round (I am thinking of adding a benzo as this sucks! (I know I am a chronic complainer on here- but really, enough is enough- I want to be normal again- whatever, that is!)
I have not read any research supporting ECT for irritability and since I can't afford the memory loss- forget it~
But for now, life goes on- I hate it, but hey, who am I, right? I just wish I could be happy for a day even! I am so sick of this! I am getting fatter by the minute too, which adds to the feelings of worthlessness!
Posted by Frustratedmama on June 16, 2009, at 18:07:21
In reply to Re: Treatment Resistant Irritability, posted by alchemy on June 16, 2009, at 0:52:02
> Can you list what you have tried?
I have tried so many and think I may have listed them before but here goes....TCA's: Nortyptyline- dry mouth- several cavities so had to stop!
SSRI's: Prozac, Paxil, Zoloft, Celexa, Lexapro, and Luvox- Prozac and Paxil worked wonderfully once upon a time, Celexa did too then pooped out- Lexapro- not so much, and Luvox- nothing! None of these work now at all :(
Buspar: worked in past- this time made things worse- more anxious
Effexor XR: worked wonders years ago- then pooped out and worst withdrawl symptoms ever (although paxil was close)
Trazodone and Serzone- both had their effects with some helpfullness in the past- not so much lately
Wellbutrin- worked to some degree (long time ago though)
Parnate- anxious- didn't try long.....
Selegiline- didn't workStraterra- can't remember why it didn't work
beta blocker- no help
Clonidine- dry mouth- stopped
Ritalin, Aderall, Dexedrine, Provigil, Vyvanse, Adderall XR- all helped some- Adderall XR seems to be the best for my adhdNeurontin- used for sleep years ago
Deapakote- FATIGUED- souldn't function
Lithium- nausea and not much help
Topamax- more depressed
Lamictal- worked for a while but pooped out and side effects were not fun.....
Gabitril- didn't work
Lyrica- no effect
Phenobarb- no helpful effect
Tegretol- headaches!Valium and Libirum were helpful but not lately....
Tranxene- not as good as the others.....
Xanax- couldn't tolerate even low doseGeodon, Zyprexa, and Abilify: made me feel really weird and out of control- like i was tripping on acid- at least what I would imagine a bad trip to be.....
Risperdal- extreme muscle tenderness at a low dose
Ambien and Restoril- used in past as sleep aid
Currently taking:
Lunesta to sleep
Verapamil for mood stability (yeah, right! although is somewhat helpful....)
Cytomel for borderline thyroid levels
Adderall xr for adhd
Stool softener (than you verapamil)
Zyrtec (for allergies)I may have missed some but this is my history (spans over 16 years and 4 pdocs with a few consults)
I have also been in therapy for this entire span and so far if the meds are working then guess what- therapy works- of meds aren't then either is therapy..... HMMMMM.... makes you wonder, huh?I so wish this was something i could change but no amount of dbt is helping!!!!! I am ready to throw it all in and just be done with it! But I won't - not today......
Posted by morganpmiller on June 17, 2009, at 1:17:02
In reply to Re: Treatment Resistant Irritability, posted by Frustratedmama on June 16, 2009, at 18:07:21
Why not try the one of the meds that worked before? Even if you feel 60 percent better, that is better than this. I made the mistake of getting off a medication one time because I thought it wasn't helping. I realized later that I felt normal and I was functioning and I needed to do other things to take care of depression/anxiety. I know many here will agree with me, but I just don't believe in the "poop out". I just don't think it happens as much as people think. If you have depression but you are still functioning and working out or able to do other things you enjoy, never get off your med just because you are feeling more depressed or anxious.
I'm in bad shape also so I can relate to you in a big way. I'm actually on the verge of hospitalization. Hope you feel better soon!
Posted by morganpmiller on June 17, 2009, at 4:31:31
In reply to Re: Treatment Resistant Irritability, posted by morganpmiller on June 17, 2009, at 1:17:02
> Why not try the one of the meds that worked before? Even if you feel 60 percent better, that is better than this. I made the mistake of getting off a medication one time because I thought it wasn't helping. I realized later that I felt normal and I was functioning and I needed to do other things to take care of depression/anxiety. I know many here will agree with me, but I just don't believe in the "poop out". I just don't think it happens as much as people think. If you have depression but you are still functioning and working out or able to do other things you enjoy, never get off your med just because you are feeling more depressed or anxious.
>
> I'm in bad shape also so I can relate to you in a big way. I'm actually on the verge of hospitalization. Hope you feel better soon!BTW..I meant to say that many would not agree with my opinion of the whole "poop out" phenomenon.
Posted by SLS on June 17, 2009, at 5:17:07
In reply to Treatment Resistant Irritability, posted by Frustratedmama on June 15, 2009, at 16:39:59
> Ok, so I am just going to say I must have treatment resistant irritability. Any suggestions? anyone? this sucks!
Are you prone to impulses of anger, overly aggressive or hostile?
If so, you could try Zoloft or Trileptal.
- Scott
Posted by Frustratedmama on June 17, 2009, at 6:15:16
In reply to Re: Treatment Resistant Irritability, posted by SLS on June 17, 2009, at 5:17:07
> Are you prone to impulses of anger, overly aggressive or hostile?
YES!!!!!!!
>
> If so, you could try Zoloft or Trileptal.
>
> Thanks for the suggestions! I am going to call pdoc today- can't wait til monday!
> - Scott
Posted by Frustratedmama on June 17, 2009, at 6:16:58
In reply to Re: Treatment Resistant Irritability, posted by morganpmiller on June 17, 2009, at 4:31:31
I know what you mean, as I was better than I am now when I thought meds pooped out- at least then I could still function- although I lost enjoyment- everything became flattened and dull and I felt worthless even on meds that made me feel better..... However, this rage and irritbaility is by far worse than that!
Posted by alchemy on June 17, 2009, at 10:09:45
In reply to Re: Treatment Resistant Irritability, posted by Frustratedmama on June 16, 2009, at 18:07:21
I am so sorry, you have been on the med circuit. I guess I agree with the idea of re-trying some of the meds.
- Would you say that your irritability was the same before the Adderall?
- Klonopin? (sp?) That's a weird reaction to Xanax.
- Did you take the Prozac or Paxil with a mood stabilizer? It looks like the only ones that might be helpful are Verapamil and Lamictal if you could tolerate the side effects.
- Hormones? Birth control could make things worse or better. Progesterone is a more calming hormone.(and I can sympathize with Effexor withdrawals & antipsychotic hell)
Posted by desolationrower on June 19, 2009, at 18:28:54
In reply to Re: Treatment Resistant Irritability, posted by alchemy on June 17, 2009, at 10:09:45
no no take MY advice
-d/r
Posted by Frustratedmama on June 19, 2009, at 19:38:20
In reply to Re: Treatment Resistant Irritability, posted by desolationrower on June 19, 2009, at 18:28:54
Hey d/r:
Pdoc looked in my records and we tried tenex before with no success; so he is recommending gabapentin. However, he is also considering a trial on prazosin (as it is similar to tenex) - any thoughts on that one? ....
Posted by desolationrower on June 24, 2009, at 19:52:54
In reply to d/r: Please read :) » desolationrower, posted by Frustratedmama on June 19, 2009, at 19:38:20
hey, sorry i don't read everyday.
Do you remember how you reacted? a particular side effect?
prazosin is basically Clonidine, without the mechanisms it shares in common with guanfacine. (so guanfacine+prazosin=clonidine)
-d/r
Posted by Frustratedmama on June 24, 2009, at 21:02:47
In reply to Re: d/r: Please read :), posted by desolationrower on June 24, 2009, at 19:52:54
All I remember about clonidine is dry mouth.... Didn't last too long..... Can't remember if it helped
Thanks for response!
FM
This is the end of the thread.
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