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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Monica L on October 28, 2009, at 16:05:52
So I've decided to quit everyhting I'm on and start an MAOI. I know I need a minimum of a two week detox. So one the first questions I'd like to ask, Is there anything out there that I can take to make the two week transition easier for me? I take Buspar, which I have to completely stop right? I'm tapering off Paxil 15 mg every other day so far, this has been going on for a week. Do I have to be completely of the Paxil for a full two weeks? I also take 40 mg Ritalin once in the morning, if I'm correct, I can keep taking that right? So the buspar and paxil are my main concerns. I'm willing to endure the two weeks of hell and my husband is willing to support me. I don't have to work or anything, but I do have two young children to take care of. I would also like to mention that I've had 6 ECT treatments done within the last month. I have to say they have helped somewhat, but not completely. I just feel like after having them done, a bunch of baggage has been erased. I still feel like I don't take an active part in life. Not much brings me joy and happiness. I have such an easy life to live and I have everything I could ever ask for. But I can't help but look at others and see the obvious, that I'm missing out on so much, on so much of the little things. I feel invisable. Like it's all here for me and all I can do is wish I knew how to live and appreciate it all. So this is why I'm ready now more than ever to take the next step, which I thought was the ECT, and now hope it's the MAOI's.
Any information would be greatly appreciated....
Posted by Maxime on October 28, 2009, at 16:58:28
In reply to Could use all advice and experiences, posted by Monica L on October 28, 2009, at 16:05:52
Hi Monica
You can take Nortriptaline while your body is clearing out and continue to take it while you are on the Parnate.
Posted by Monica L on October 28, 2009, at 17:02:35
In reply to Re: Could use all advice and experiences » Monica L, posted by Maxime on October 28, 2009, at 16:58:28
> Hi Monica
>
> You can take Nortriptaline while your body is clearing out and continue to take it while you are on the Parnate.Thank you for the info., how long for the nortriptaline to usually take effect?
Posted by Phidippus on October 28, 2009, at 17:42:57
In reply to Could use all advice and experiences, posted by Monica L on October 28, 2009, at 16:05:52
>I can't help but look at others and see the >obvious, that I'm missing out on so much, on so >much of the little things. I feel invisable. Like >it's all here for me and all I can do is wish
I wonder how much time you spend ruminating. There is a particular brand of OCD called Pure O wherein the sufferer spends much of their time in their head telling themselves things that are largely untrue, such as, "I'm invisible." What I recommend you do is find a therapist who specializes in treating OCD and maybe finding a way to think a way out of the hole you're in. ECT is not really a recommended treatment for OCD, btw. Your response to ECT makes me think that the 'baggage' that was gotten rid of was just an accumulation of ruminations you had. My point is, maybe you're thinking is getting you numb.
Just my two cents.
P
Posted by Monica L on October 28, 2009, at 18:23:23
In reply to Re: Could use all advice and experiences, posted by Phidippus on October 28, 2009, at 17:42:57
> >I can't help but look at others and see the >obvious, that I'm missing out on so much, on so >much of the little things. I feel invisable. Like >it's all here for me and all I can do is wish
>
> I wonder how much time you spend ruminating. There is a particular brand of OCD called Pure O wherein the sufferer spends much of their time in their head telling themselves things that are largely untrue, such as, "I'm invisible." What I recommend you do is find a therapist who specializes in treating OCD and maybe finding a way to think a way out of the hole you're in. ECT is not really a recommended treatment for OCD, btw. Your response to ECT makes me think that the 'baggage' that was gotten rid of was just an accumulation of ruminations you had. My point is, maybe you're thinking is getting you numb.
>
> Just my two cents.
>
> PWhat exactly is ruminating? I mean, I think I know what it is and I think I do a lot of it, almost constantly. I had an appointment with a therapist today but I cancelled it, don't ask me why. Everytime I go to a therapist they just sort of take over and won't stop talking. I know I need help. I just don't know where to start.
Posted by Phidippus on October 28, 2009, at 18:37:16
In reply to Re: Could use all advice and experiences, posted by Monica L on October 28, 2009, at 18:23:23
Ruminations are worries. Do you spend a lot of time worrying about what's wrong with you, what's wrong with life, what's wrong with others? Do you have thoughts that keep on coming back into your mind? Do you have trouble stopping on thinking about bad things?
These kinds of thoughts require special therapy. What state are you in?
P
Posted by Phillipa on October 28, 2009, at 18:51:11
In reply to Re: Could use all advice and experiences, posted by Monica L on October 28, 2009, at 18:23:23
Monica assuming your doc has okayed the maois which one you plan on trying? Phillipa
Posted by Monica L on October 28, 2009, at 18:55:03
In reply to Re: Could use all advice and experiences, posted by Phidippus on October 28, 2009, at 18:37:16
> Ruminations are worries. Do you spend a lot of time worrying about what's wrong with you, what's wrong with life, what's wrong with others? Do you have thoughts that keep on coming back into your mind? Do you have trouble stopping on thinking about bad things?
>
> These kinds of thoughts require special therapy. What state are you in?
>
I cant even begin to tell you everything I worry about. I worry about EVERYTHING. The way I look, the way I dress, my house how I cant keep it looking decent, how I never finish anything!!! Is this cause I continue to ruminate, is that why I can't get anything done, ever? I always worry something bad is going to happen, to my kids, to my marriage. I feel like such a failure, I can't finish college courses, nothing is fulfilling to me. We just moved here to North Carolina and I worry about not making any friends. I worry no one will like me or I will do something wrong. I can't keep order in anything I do. I'm always on edge waiting for something horrible to happen. Sorry, but I could go on and on. I just know life isn't supposed to be like this, and I'm tired of and I want to give up. I wouldn't be missed, I'm useless.
> P
Posted by Monica L on October 28, 2009, at 18:56:48
In reply to Re: Could use all advice and experiences » Monica L, posted by Phillipa on October 28, 2009, at 18:51:11
I was wanting to try Parnate...what do you think?
Posted by Phidippus on October 28, 2009, at 19:54:00
In reply to Re: Could use all advice and experiences, posted by Monica L on October 28, 2009, at 18:55:03
I'm really concerned that you have OCD. Your compulsion-the C in OCD-is to worry. If not OCD, you seem to have a great deal of anxiety, either of which is making you very depressed. Another confusing fact is you may not be depressed, just too worried to enjoy life.
First line treatment of OCD is ERP (Exposure and Ritual Prevention). Your ritual is to worry. Finding a good therapist who specializes in anxiety disorders, OCD and ERP will help you manage your anxiety so you don't get so depressed. Here's a link to find a therapist in your state: http://therapists.psychologytoday.com/rms/prof_results.php?state=NC&spec=15. Finding a therapist who incorporates humor in their practice is a big bonus.
ECT is not generally recommended for anxiety disorders, however your depressive symptoms may have called for it. If you don't learn how to manage your anxiety, you're just going to end up in the same hole, regardless of what medication you take.
In treating OCD, SSRIs are first line treatment and are augmented with atypical antipsychotics. If the SSRIs don't work, other antidepressants are used, including MAOIs, but they are far down the list. Other augmentation strategies exist. SSRIs are usually prescribed in doses twice the amount prescribed for depression and take longer to work.
Bottom line is, you are going to have to go at this two ways: with therapy specifically aimed at managing your anxiety and with medication. Its work, but you can feel better.
If medications and therapy don't work, well there's always deep brain stimulation and psychosurgery. Yay!
P
Posted by Phillipa on October 28, 2009, at 22:42:04
In reply to Re: Could use all advice and experiences, posted by Monica L on October 28, 2009, at 18:56:48
First I'm also in NC and I think rest in babblemail material. Hope your's is on mine is just click my name in color screen appears and message board scroll down to the bottom and send it to me. Love Phillipa
Posted by Phillipa on October 28, 2009, at 22:44:01
In reply to Re: Could use all advice and experiences » Monica L, posted by Phillipa on October 28, 2009, at 22:42:04
Monica yours is off mine's on please write. And turn yours one at the registration board click yes want babblemail. Thanks got some stuff to say about the state. Love Phillipa
Posted by Maxime on October 29, 2009, at 16:45:47
In reply to Re: Could use all advice and experiences, posted by Monica L on October 28, 2009, at 17:02:35
> > Hi Monica
> >
> > You can take Nortriptaline while your body is clearing out and continue to take it while you are on the Parnate.
>
> Thank you for the info., how long for the nortriptaline to usually take effect?
>Sorry, I don't know how long it takes to work.
Posted by Maxime on October 29, 2009, at 16:47:23
In reply to Re: Could use all advice and experiences, posted by Monica L on October 28, 2009, at 18:55:03
> > Ruminations are worries. Do you spend a lot of time worrying about what's wrong with you, what's wrong with life, what's wrong with others? Do you have thoughts that keep on coming back into your mind? Do you have trouble stopping on thinking about bad things?
> >
> > These kinds of thoughts require special therapy. What state are you in?
> >
>
>
> I cant even begin to tell you everything I worry about. I worry about EVERYTHING. The way I look, the way I dress, my house how I cant keep it looking decent, how I never finish anything!!! Is this cause I continue to ruminate, is that why I can't get anything done, ever? I always worry something bad is going to happen, to my kids, to my marriage. I feel like such a failure, I can't finish college courses, nothing is fulfilling to me. We just moved here to North Carolina and I worry about not making any friends. I worry no one will like me or I will do something wrong. I can't keep order in anything I do. I'm always on edge waiting for something horrible to happen. Sorry, but I could go on and on. I just know life isn't supposed to be like this, and I'm tired of and I want to give up. I wouldn't be missed, I'm useless.
> > P
>
>God, I could have written that. :(
Posted by ColoradoSnowflake on October 29, 2009, at 17:36:23
In reply to Re: Could use all advice and experiences » Monica L, posted by Maxime on October 29, 2009, at 16:47:23
Monica,
I know how you feel. I do that, too. But on Parnate it is almost gone!!
The Nortriptyline works right away, the first day. So you have some AD in your system during the washout period for maoi. My pdoc had me continue to take the nortriptyline after I started the Parnate. It's worked very well. I have some fatigue so I also take Provigil.
Good luck!
Gayle
Parnate 70mg
Nortriptyline 25-50mg
Provigil 100-200mg
Posted by Monica L on October 30, 2009, at 16:11:08
In reply to Re: Could use all advice and experiences, posted by ColoradoSnowflake on October 29, 2009, at 17:36:23
> Monica,
>
> I know how you feel. I do that, too. But on Parnate it is almost gone!!
>
> The Nortriptyline works right away, the first day. So you have some AD in your system during the washout period for maoi. My pdoc had me continue to take the nortriptyline after I started the Parnate. It's worked very well. I have some fatigue so I also take Provigil.
>
> Good luck!
>
> Gayle
>
> Parnate 70mg
> Nortriptyline 25-50mg
> Provigil 100-200mg
>Thanks for the advice!! I'm just now getting over this stomach flu thing so I had to cancel going to see my Dr, now I'm going on next thursday. I hope to come up with a plan on coming off this paxil to get on parnate. It really worries me how messed up I get if I don't take the paxil for only two days, and that's cause I only take 40 mg. Does the Parnate help you with motivation? That's one of my big issues that bring me down.
I really want to thank everyone for the advice here. I know having the support from here will really help when I start coming off the paxil and making the switch to an MAOI...
Monica
Posted by ColoradoSnowflake on October 31, 2009, at 11:49:07
In reply to Re: Could use all advice and experiences, posted by Monica L on October 30, 2009, at 16:11:08
Yes Monica, the Parnate does help me with motivation a lot. And I can keep going and going. That's one of the really good things I've had with Parnate. It took some feeling really cr*ppy to get to this point, but now it's GOOD!
Getting off that Paxil might be a challenge, but worth it.
I now sleep really really well on 25 mg Nortriptyline. I have to make myself go to bed or I'll keep going, stay up too late and sleep too late in the morning.I'm going into my 7th month on Parnate.
Good luck !Gayle
Posted by floatingbridge on November 1, 2009, at 11:39:21
In reply to Could use all advice and experiences, posted by Monica L on October 28, 2009, at 16:05:52
Monica,
I hear that you need help asap--many poster here have had great success with maoi's and have some sound advice to share.
Once you are on the upswing again (yes, it will happen to you) then consider some therapy, maybe along the lines Phiddippus mentioned. I 'ruminate' all the time, and my thoughts drive me nuts--really. There is a term 'automatic negative thoughts'. We all have then. For some, sadly, they are louder than for others.
I say, get stable and work on depression anxiety first.
Get well soon--you will, and please let us know what's going on with you.
fb
Posted by Monica L on November 2, 2009, at 16:32:25
In reply to Re: Could use all advice and experiences » Monica L, posted by floatingbridge on November 1, 2009, at 11:39:21
I'm going to look into the therapy, I probably have a book on it somewhere. I notice how in the morning I'm usually ok, I think it's cause when I first wake up I haven't had the chance to ruminate. Then I notice how as my day goes on, thoughts just pile upon each other and my mood gets worse. I can't believe how my mind won't shut down, it's constant thoughts in my head, worries about anything and everything. The thoughts or whatever they are, keep me from doing a lot of things.
Does anyone know if I can take Ritalin 40 mg while I'm coming off the Paxil to start the MAOI?
Also, I have to be off the Paxil for two weeks? Is that as I'm weaning off it or is that 2 complete weeks of not taking any Paxil whatsoever?Thanks--Monica
Posted by ColoradoSnowflake on November 2, 2009, at 19:57:19
In reply to Re: Could use all advice and experiences » Monica L, posted by floatingbridge on November 1, 2009, at 11:39:21
Yes Monica, you have to be totally off Paxil for two weeks. That's called the "washout" period.
My pdoc had me taking Nortriptyline during that time and I still take it with Parnate. It gave me some AD in my system during the washout which was good.I have had those negative thoughts also. I call it my committee in my brain. They are always terribly negative. It's awful. It could totally paralyze me I would be so afraid what I was doing would turn out bad.
I don't have any of that on Parnate. It shut the committee up!! Yahoo!!
Good luck Monica!
Gayle
Posted by Phidippus on November 2, 2009, at 20:24:12
In reply to Re: Could use all advice and experiences, posted by Monica L on November 2, 2009, at 16:32:25
> I'm going to look into the therapy, I probably have a book on it somewhere.
I would recommend the book IMP OF THE MIND by Lee Baer Ph.D. Though you may not have the kinds of bad thoughts discussed in the book, it still seems like the Imp is well and active in your mind. MAKE THERAPY A PRIORITY with someone who specializes in anxiety disorders.
> Does anyone know if I can take Ritalin 40 mg while I'm coming off the Paxil to start the MAOI?
Its not adviseable as Ritalin modulates monoamine oxidization.
> Also, I have to be off the Paxil for two weeks?
You need to titrate down the Paxil until your not taking it 2 weeks prior to starting the MAOI. Have you tried Luvox?
P
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