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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sukarno on November 4, 2010, at 1:51:42
I tapered off Stablon and quit on 28 April 2010 and started feeling much more anxious and depressed in July and August. The symptoms keep getting worse despite light therapy.
Even immediately after discontinuing Stablon I felt symptoms returning but I wonder how long this will last. Maybe it is the original depression returning.
It's awful and the price of Stablon is going up so I'm not sure if I can try that. I do have pramipexole (Mirapex / Sifrol) here, but am afraid to take it because of side effects I have read on various websites.
I can't quite understand why there isn't a generic available since Stablon has been on the market for over 20 years. There must be profit in it because it sells out quickly at the pharmacy. Hmm..What to do? I can't take SSRIs because I had upper GI bleeding from taking low dose Prozac. My psychiatrist is afraid of trying other SSRIs because they could cause this to happen. My stomach bothers me constantly anyway. Also, the withdrawal syndrome associated with SSRIs is terrifying.
I wonder if it is better to be nearly broke, but on Stablon, or keep "saving money" but feeling awful all the time.
Depression is worse in the morning too. It is quite severe... like I am afraid I will just drop dead because of all the strain on my heart. I only look forward to sleeping because at least in my dreams I don't feel horrible.
I do have some expired amineptine (Survector), but it is only crumbled remnants of what used to be half or whole tablets. I'm not sure if that would be safe to take and I only have a small amount. It might help depression for a day or two. :-( I remember it was rapid acting and resolved my depression within 6 hours of taking it but the relief only lasted a day or two.
Posted by Phillipa on November 4, 2010, at 10:50:02
In reply to Quit Stablon 6 months ago -- rebound symptoms!, posted by sukarno on November 4, 2010, at 1:51:42
Seriously I thought your anxiety was your problem didn't know about the depression. Hope you get some answers. Phillipa
Posted by sukarno on November 4, 2010, at 14:50:06
In reply to Re: Quit Stablon 6 months ago -- rebound symptoms! » sukarno, posted by Phillipa on November 4, 2010, at 10:50:02
Hi Phillipa. I hope you are in the best of health and doing well. :-)
I should just buy the Stablon even though it is expensive. It isn't worth it to feel like this.
Things didn't seem to bother me as much on Stablon. There was some apathy, but nothing like SSRIs. It just buffered me a bit from the anxiety and depression.
Are you still on Luvox?
Posted by Cydnie on November 4, 2010, at 16:03:41
In reply to Quit Stablon 6 months ago -- rebound symptoms!, posted by sukarno on November 4, 2010, at 1:51:42
Hi Sukarno:
I'm not sure I can help but give my reactions to my meds (everyone's different). I took mirapex and was in the most wonderful mood that day and my doc told me if I had no side effects, to titrate higher. Mistake! (for me at least!) Worst migraine of my life, and I was on my first vacation since my baby was born, and in bed! Horrible, worst. I just can't seem to tolerate dopamine agonists though they are amazing for my moods! So maybe if you start really slow. I know you wrote you have some amineptine that worked really fast for you last time - why did you stop? You wrote it only lasted a day or 2, did that mean you had to take it again then, or just didn't help the next time? I am NO DOCTOR, but I am so depressed right now I would take the amineptine in a heartbeat to help me through. In case it helps. But again, you might get better suggestions on safety from someone else. I would assume expired may mean at worst it may not work as well, but someone else may be able to answer that. But again, I am so curious if you stopped because it stopped working entirely before? Hope I helped at least with the mirapex info, take care!
Posted by Conundrum on November 6, 2010, at 15:34:02
In reply to Quit Stablon 6 months ago -- rebound symptoms!, posted by sukarno on November 4, 2010, at 1:51:42
What other antidepressants have you tried? What about wellbutrin or TCAs? The TCAs are pretty cheap. Nortriptyline is available for $3.50 online. Parnate?
> I tapered off Stablon and quit on 28 April 2010 and started feeling much more anxious and depressed in July and August. The symptoms keep getting worse despite light therapy.
>
> Even immediately after discontinuing Stablon I felt symptoms returning but I wonder how long this will last. Maybe it is the original depression returning.
>
> It's awful and the price of Stablon is going up so I'm not sure if I can try that. I do have pramipexole (Mirapex / Sifrol) here, but am afraid to take it because of side effects I have read on various websites.
>
> I can't quite understand why there isn't a generic available since Stablon has been on the market for over 20 years. There must be profit in it because it sells out quickly at the pharmacy. Hmm..
>
> What to do? I can't take SSRIs because I had upper GI bleeding from taking low dose Prozac. My psychiatrist is afraid of trying other SSRIs because they could cause this to happen. My stomach bothers me constantly anyway. Also, the withdrawal syndrome associated with SSRIs is terrifying.
>
> I wonder if it is better to be nearly broke, but on Stablon, or keep "saving money" but feeling awful all the time.
>
> Depression is worse in the morning too. It is quite severe... like I am afraid I will just drop dead because of all the strain on my heart. I only look forward to sleeping because at least in my dreams I don't feel horrible.
>
> I do have some expired amineptine (Survector), but it is only crumbled remnants of what used to be half or whole tablets. I'm not sure if that would be safe to take and I only have a small amount. It might help depression for a day or two. :-( I remember it was rapid acting and resolved my depression within 6 hours of taking it but the relief only lasted a day or two.
Posted by sukarno on November 6, 2010, at 16:47:58
In reply to Re: Quit Stablon 6 months ago -- rebound symptoms! » sukarno, posted by Cydnie on November 4, 2010, at 16:03:41
Hi. :-) What dose of Mirapex were you on? I think they start out with 0.125mg 1 to 3 times/day initially.
I tried amineptine in 2005 at a low dose of 25mg/day when I had a decent supply. It worked, but I quit because my stomach was burning all the time and when I sat up to eat breakfast I began to feel out of breath like I was exerting myself although I hadn't exercised or anything of that sort.
Then I started to sweat all over and felt myself about to faint (blood felt as if it rushed to my extremities.. hands and feet felt like heavy weights), so I ended up on my back on the floor and felt better. That scared me enough to call the doctor to my house. She took my pulse and just said something about orthostatic hypotension, so I quit taking it.
It could have been a panic attack as I am prone to them. That stuff really cranked me up but not on the first day. The first day I felt relaxed and all my joints and muscles felt loosened up as if I had taken a muscle relaxant. I could walk around and didn't feel tired at all, although I did not feel a stimulant effect at that time. My pulse was normal too. The stimulant effect started a few days into treatment and if I remember correctly I quit on day 5.
It really did lift my mood though. Maybe if I would have just taken more Valium to counteract the inner tension caused by amineptine, I could have reached a good balance.
I just found 24 tablets of Stablon in the original foil strips that I had forgotten about and took one 2 1/2 hours ago. I don't know how I'll afford it, but I'll find a way.
Even if Stablon wasn't a good antidepressant for me, it always worked as a decent anxiolytic. I feel so tense these days that perhaps that is exacerbating the depression. In the evenings I don't feel depressed, but in the mornings it is awful.
Do you feel more depressed in the morning too right after you wake up? I wake up in the morning and feel like "oh god.. another day.. I can't deal with this" and then switch on my lightbox which helps but not enough.
Posted by sukarno on November 6, 2010, at 16:56:48
In reply to Re: Quit Stablon 6 months ago -- rebound symptoms!, posted by Conundrum on November 6, 2010, at 15:34:02
I tried nortriptyline 20 years ago and it was great for my anxiety and depression. I would call it a silver bullet and my own "gold standard" for my condition except that it gave me a rapid heartbeat and sometimes "skipped beats" which are probably palpitations. I'm not sure if that was dangerous but it was too scary so I quit.
Maybe I should have just cut the dose in half and kept taking it. That was the best drug I ever took because not only did it help with anxiety and depression, it also gave me lots of ambition and motivation. I could think so clearly and my grades were 4.0.
I asked the psychiatrist if he could import it here but he wasn't sure of the legality of doing so. He was a bit worried about the cardiotoxicity and my previous experience with it.
He seems to think meditation and "changing the way I think" will be good enough. (He's a Zen Buddhist) He could be right, but that takes time and a lot of dedication and right now I need some quick relief.
In the world of antidepressants there really isn't a fast-acting drug, but the first time I tried tianeptine it worked in approximately two weeks, so that isn't so bad. It will cost me about $100/month if I take it again (I just took one 2 1/2 hours ago). I guess it's better to be broke and somewhat happy than to have extra money but feeling anhedonia and worthless..hopeless.. as if people would be better off without me. I'd never harm myself but it feels like my body is shutting down on me. I had an episode of melancholia when I quit smoking years ago and that was the worst. I couldn't sleep or eat enough, felt cold all over and was a nervous wreck for at least a month.
I ended up inpatient for a few days but the psychiatrist only gave me Klonopin (clonazepam) and Vistaril (hydroxyzine) and sent me home.
Posted by Conundrum on November 6, 2010, at 18:51:43
In reply to Re: Quit Stablon 6 months ago -- rebound symptoms! » Conundrum, posted by sukarno on November 6, 2010, at 16:56:48
Um, sounds like you should be trying a lower dose nortriptyline. I think you live in Asia right? I don't know how much it costs to import, but its dirt cheap here. Sounds like you are taking more than 3 a day tianeptine right? Cuz I can get a month for about $55.
I don't think you should worry about how long it takes to work, but if it works and if you can afford it. It sounds like your life was easier on nortriptyline.
> I tried nortriptyline 20 years ago and it was great for my anxiety and depression. I would call it a silver bullet and my own "gold standard" for my condition except that it gave me a rapid heartbeat and sometimes "skipped beats" which are probably palpitations. I'm not sure if that was dangerous but it was too scary so I quit.
>
> Maybe I should have just cut the dose in half and kept taking it. That was the best drug I ever took because not only did it help with anxiety and depression, it also gave me lots of ambition and motivation. I could think so clearly and my grades were 4.0.
>
> I asked the psychiatrist if he could import it here but he wasn't sure of the legality of doing so. He was a bit worried about the cardiotoxicity and my previous experience with it.
>
> He seems to think meditation and "changing the way I think" will be good enough. (He's a Zen Buddhist) He could be right, but that takes time and a lot of dedication and right now I need some quick relief.
>
> In the world of antidepressants there really isn't a fast-acting drug, but the first time I tried tianeptine it worked in approximately two weeks, so that isn't so bad. It will cost me about $100/month if I take it again (I just took one 2 1/2 hours ago). I guess it's better to be broke and somewhat happy than to have extra money but feeling anhedonia and worthless..hopeless.. as if people would be better off without me. I'd never harm myself but it feels like my body is shutting down on me. I had an episode of melancholia when I quit smoking years ago and that was the worst. I couldn't sleep or eat enough, felt cold all over and was a nervous wreck for at least a month.
>
> I ended up inpatient for a few days but the psychiatrist only gave me Klonopin (clonazepam) and Vistaril (hydroxyzine) and sent me home.
Posted by sukarno on November 7, 2010, at 6:11:39
In reply to Re: Quit Stablon 6 months ago -- rebound symptoms!, posted by Conundrum on November 6, 2010, at 18:51:43
It may be placebo effect, but I woke up today feeling refreshed and more motivated. Music sounds better. I'm still depressed but I feel 25% improvement. I didn't feel like I needed my morning tea to get going and the lightbox feels much more powerful than before.
Well, even if this is placebo, I like it. :-)
Stablon's price increased from 55 cents/tablet at the cheapest pharmacies to 85 cents/tablet now.
I took one tablet before bedtime and when I woke up I took 1/2 tablet. I have heard of people doing well on 1/2 tablet three times a day. I'll see how that goes.
I was on the lowest dose of nortriptyline (I think it was 10mg). I suppose I could have emptied out half the capsule or taken it every other day instead of quitting altogether. It wasn't as bad on my heart as imipramine was. We have imipramine here under the trade name Tofranil but even in low doses it has too many cardiac side effects for me.
If Stablon poops out, which is my previous experience with it (a few weeks to a few months results in some tolerance and then the dosage needs to be increased to get the same antidepressant effect), I'll try getting nortriptyline or risking it with sertraline (Zoloft).
I have 5 tablets of Pfizer's brand name Zoloft here. It is $2.20/tablet for 50mg. I am ultra-sensitive to SSRIs, having only taken 0.5-1mg of Prozac elixir in 1995 and getting upper GI bleeding (black stools and nausea) two months into treatment. Prozac was awesome too, although it didn't motivate me like nortriptyline did. Prozac jolted me with anxiety at first and some sweating but after a few days my depression was completely gone and I felt numbed out a bit emotionally. No libido/desire (maybe a 95% reduction if I had to put a number on it).
I don't know if SSRIs would be right for me. If I am to believe all the reports I read, it seems like they poop out after a few years. Couldn't that be skewed though since people who have bad experiences are more likely to report them on boards like these (and elsewhere), but those with good experiences feel no need to say anything.
Do SSRIs work indefinitely for most people? If Stablon quits, I guess it will be a TCA or SSRI for me.
Posted by Conundrum on November 7, 2010, at 10:48:15
In reply to Re: Quit Stablon 6 months ago -- rebound symptoms! » Conundrum, posted by sukarno on November 7, 2010, at 6:11:39
Many people report poop outs with SSRIs. I'm glad its working for you. Only you know whether or not you can truly afford it. I know I couldn't keep getting it at those prices. Have you considered reboxetine? Is it available there? Its a NRI, that is not a tricyclic and probably a lot less cardiotoxic, might not be as effective as nortriptyline though.
I wish I could say stablon is making music sound better for me. I'm on 12.5 3x day. I just did a week on it. Hopefully there will be an AD kick. So far I just notice it mellows me out and in the beginning made me not care about doing things, which is the opposite of what I need.
> It may be placebo effect, but I woke up today feeling refreshed and more motivated. Music sounds better. I'm still depressed but I feel 25% improvement. I didn't feel like I needed my morning tea to get going and the lightbox feels much more powerful than before.
>
> Well, even if this is placebo, I like it. :-)
>
> Stablon's price increased from 55 cents/tablet at the cheapest pharmacies to 85 cents/tablet now.
>
> I took one tablet before bedtime and when I woke up I took 1/2 tablet. I have heard of people doing well on 1/2 tablet three times a day. I'll see how that goes.
>
> I was on the lowest dose of nortriptyline (I think it was 10mg). I suppose I could have emptied out half the capsule or taken it every other day instead of quitting altogether. It wasn't as bad on my heart as imipramine was. We have imipramine here under the trade name Tofranil but even in low doses it has too many cardiac side effects for me.
>
> If Stablon poops out, which is my previous experience with it (a few weeks to a few months results in some tolerance and then the dosage needs to be increased to get the same antidepressant effect), I'll try getting nortriptyline or risking it with sertraline (Zoloft).
>
> I have 5 tablets of Pfizer's brand name Zoloft here. It is $2.20/tablet for 50mg. I am ultra-sensitive to SSRIs, having only taken 0.5-1mg of Prozac elixir in 1995 and getting upper GI bleeding (black stools and nausea) two months into treatment. Prozac was awesome too, although it didn't motivate me like nortriptyline did. Prozac jolted me with anxiety at first and some sweating but after a few days my depression was completely gone and I felt numbed out a bit emotionally. No libido/desire (maybe a 95% reduction if I had to put a number on it).
>
> I don't know if SSRIs would be right for me. If I am to believe all the reports I read, it seems like they poop out after a few years. Couldn't that be skewed though since people who have bad experiences are more likely to report them on boards like these (and elsewhere), but those with good experiences feel no need to say anything.
>
> Do SSRIs work indefinitely for most people? If Stablon quits, I guess it will be a TCA or SSRI for me.
>
>
Posted by TenMan on November 8, 2010, at 7:57:36
In reply to Quit Stablon 6 months ago -- rebound symptoms!, posted by sukarno on November 4, 2010, at 1:51:42
Hi sukarno, sorry to hear about your problems. Thought I would recommend low dose phenytoin. If you haven't yet, check out Jack Dreyfus' website on the drug. wwww.remarkablemedicine.com
He was a wealthy financier who had what appears to be similar problems to you, morning anxiety, dread, and low dose phenytoin in the mornings fixed his problem so well that he went on to spend 10's of millions of dollars and write several books on the subject to spread the word.
It's a long shot, but you are probably willing to try anything to help, and the nice thing is a low dose of this drug is a pretty safe bet.
Take care and good luck.
This is the end of the thread.
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