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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 uncouth on October 9, 2011, at 21:53:55
Hi, I know there are a few long threads, but I don't have time to read them right now before my pdoc appt. tomorrow. We will be talking about viibryd.
Can someone(s) give me a quick summary on what they think about Viibryd so far? Not just their own experience, but what they've learned in their research and conversations?
Strange it only has one dose, too. My point of comparision would be Cymbalta/Venlafaxine. How does it compare? What is the subjective experience? Does the 5ht1a action actually really truly prevent or resolve some of the anhedonia, apathy, loss of libido action?
Your response is appreciated...
Posted by SLS on October 9, 2011, at 22:45:15
In reply to Quick summary on VIIBRYD so far?, posted by uncouth on October 9, 2011, at 21:53:55
> Hi, I know there are a few long threads, but I don't have time to read them right now before my pdoc appt. tomorrow. We will be talking about viibryd.
>
> Can someone(s) give me a quick summary on what they think about Viibryd so far? Not just their own experience, but what they've learned in their research and conversations?
>
> Strange it only has one dose, too. My point of comparision would be Cymbalta/Venlafaxine. How does it compare? What is the subjective experience? Does the 5ht1a action actually really truly prevent or resolve some of the anhedonia, apathy, loss of libido action?
>
> Your response is appreciated...
My response is that your biology is unique, and that it would be an undesirable outcome that you should skip trying a novel drug that would work for you based upon the well-intentioned but unsupported theorizing by contributors to Psycho-Babble.Viibryd seems to be working for me without weight-gain, sexual impairments, or anticholinergic side effects. Be prepared for some startup nausea and anxiety. These effects can dissipate within a week or two. Use the starter pack to titrate the dosage gradually.
- Scott
Posted by Laney on October 9, 2011, at 22:55:05
In reply to Re: Quick summary on VIIBRYD so far? » uncouth, posted by SLS on October 9, 2011, at 22:45:15
Scott,
How would you compare it to Cymbalta or Effexor? I'm very happy it's had such a favorable response with you. I also hope this with Uncouth!
Laney
Posted by SLS on October 9, 2011, at 23:32:00
In reply to Re: Quick summary on VIIBRYD so far? » SLS, posted by Laney on October 9, 2011, at 22:55:05
> Scott,
>
> How would you compare it to Cymbalta or Effexor? I'm very happy it's had such a favorable response with you. I also hope this with Uncouth!
>
> LaneyFor ME, Viibryd is exerting a moderate antidepressant effect without producing those side effects commonly reported by people taking Effexor or Cymbalta. It is a very clean drug for ME. Time will tell if apathy or flat affect develop with this drug.
For Uncouth: Why does Viibryd treat depression effectively while a combination of buspirone and a SSRI does not? Why is gepirone not effective?
I am sure that scientists are coming closer to being able answer such questions definitively. I don't think they are there yet, though. I know that I am not.
I know I am being evasive and irritating, but I think it is important to recognize the difference between what we know and what we don't know. For now, we use empirical observations that yield educated guesses by establishing associations. The brain is still a black box when it comes to understanding mental illness and the physiology behind the therapeutic effects of psychotropic drugs. If you react negatively to SRI drugs, perhaps you will react negatively to Viibryd. That is an educated guess established through association. I cannot tell you that I am sure that you will react negatively to Viibryd, so I will not tell you not to try it. I remain uncertain. I accept uncertainty. I embrace uncertainty. It gives me hope. It also prevents me from being too smart for my own good. By taking this stance, I agreed to try Viibryd at the recommendation of my doctor, despite my suspicion that drugs like gepirone (SRI + 5-HT1a partial agonist) were not robustly effective in treating depression. It appears that I was wrong. I guess I can live with that.
- Scott
Posted by Phillipa on October 10, 2011, at 0:24:08
In reply to Re: Quick summary on VIIBRYD so far?, posted by SLS on October 9, 2011, at 23:32:00
Scott guess what I'm glad you could be wrong as so far so good for you. That's the important thing not being right or wrong. It's an interesting med and as I read the review from others on drug.com it seems that something is very different with this med. Not being that scientific or versed like you that's a layman's take. Phillipa
Posted by jono_in_adelaide on October 10, 2011, at 0:29:10
In reply to Re: Quick summary on VIIBRYD so far? » uncouth, posted by SLS on October 9, 2011, at 22:45:15
I agree with SLS - of you arnt satisfied with your current treatment, then ask if you can try it, you have nothing to lose and much to gain
The fact tha it did work for SLS or didnt work for someone else have no bearing on wheter or not it will work for you, you'll need to try it and see how it suits you as an individual
Posted by Chairman_MAO on October 10, 2011, at 7:40:39
In reply to Re: Quick summary on VIIBRYD so far?, posted by SLS on October 9, 2011, at 23:32:00
>If you react negatively to SRI drugs, perhaps you will react negatively to Viibryd.That's what happened to me. I really wanted to be "compliant", and I only even tried this thing because I am finally seeing the doctor that I absolutely trust again. I could not make it past day 10; the anxiety and dysphoria was so severe (despite being on 4mg clonazepam) that I was scared to raise the dose to 20mg. I also felt a sense of physical malaise. When SSRIs do "work" for me, I tend to just get a flat affect and my ADD is worsened (positive effect of psychostimulants attenuated). I put a call into him at day 10 telling him that I just couldn't take it, asking what should I do, and to please call me back. He never returned it. I just got his trust back enough to get my Dexedrine again and I am so scared of him viewing me as "non-compliant".
I just want Nardil or Marplan back like I used to have (with the Dexedrine). He wants me off of clonazepam. Fine, I'll do that (ugh), but I need something that actually works for my anxiety/agoraphobia. I do not have major depression.
Now I wish I never stopped taking Nardil, although it's been nice to lose 40lbs+.
> That is an educated guess established through association. I cannot tell you that I am sure that you will react negatively to Viibryd, so I will not tell you not to try it. I remain uncertain. I accept uncertainty. I embrace uncertainty. It gives me hope. It also prevents me from being too smart for my own good. By taking this stance, I agreed to try Viibryd at the recommendation of my doctor, despite my suspicion that drugs like gepirone (SRI + 5-HT1a partial agonist) were not robustly effective in treating depression.
That is exactly what I did. Everything I knew and had experienced said that this wouldn't work, but I took it because this guy is the only one I have access to who gives a damn, and I know he is competent. I tried it. I simply could not tolerate the dysphoria. You know that black box warning that says "may produce suicidal ideations"? Well, that's me. And it doesn't apply to MAOIs, just the SSRI drugs.I'm scared to tell him that because I don't know if that's the best way to get my MAOI + psychostimulant combination back. I've got the Dexedrine back, but he wanted me to try this first instead of an MAOI. I really want off the "med-go-round" because I've tried myriad SSRIs, a TCA, and 2 MAOIs. The primary problems are social phobia/agoraphobia and inattentive ADD. By far the best combination was d-amphetamine + phenelzine. I'd like to try Marplan instead because of the weight gain, but I'm wondering if I should just go back to Nardil anyway and try to watch my diet because Marplan might not be as effective.
I see him in two days. I am hoping that he's still willing to work with me, and it's become somewhat of an obsession. I do not have a lot of resources and this is by far the best doctor I have access to. There is no one else I have access to would would dare do things like touch an MAOI + psychostimulant combination (he is a professor of psychopharmacology at a medical school).
I'm trying to stay positive. If the titration pack allowed at starting at way lower doses and going up very slowly, I might ahve been able to tolerate it. But I'm not sure that the end result would have been anything to go wild about, because, as I said, the primary problem is anxiety/social phobia. With regard to the depressive spectrum, I am dysthymic. The psychostimulants are enough to help that along with the ADD.
I'm glad it's working out for you. I'm trying not to drive myself crazy thinking about this until Wednesday.
All the best.
Posted by Phillipa on October 10, 2011, at 18:45:41
In reply to Re: Quick summary on VIIBRYD so far? » SLS, posted by Chairman_MAO on October 10, 2011, at 7:40:39
So it's causing you more anxiety? As I"m the same just dysthymic? Phillipa
Posted by uncouth on October 10, 2011, at 18:51:45
In reply to Re: Quick summary on VIIBRYD so far? » SLS, posted by Chairman_MAO on October 10, 2011, at 7:40:39
I went to see pdoc today, we talked about my mood but also my obsessive screwing around with my supplements and research and compulsivity and feeling just not "in control" or "self-disciplined" and we agreed adding on an SSRI was worth a shot. I asked about Viibryd, and he said he was very unimpressed. I didn't catch (don't remember) precicely why but he just said its something trying to do something different with the same structure...it just wasn't worth it.
So we're going with paxil cr.
Posted by SLS on October 10, 2011, at 19:33:28
In reply to Re: Quick summary on VIIBRYD so far?, posted by uncouth on October 10, 2011, at 18:51:45
> I went to see pdoc today, we talked about my mood but also my obsessive screwing around with my supplements and research and compulsivity and feeling just not "in control" or "self-disciplined" and we agreed adding on an SSRI was worth a shot. I asked about Viibryd, and he said he was very unimpressed. I didn't catch (don't remember) precicely why but he just said its something trying to do something different with the same structure...it just wasn't worth it.
>
> So we're going with paxil cr.
At this juncture, I disagree with your doctor's characterization of Viibryd as being so unimpressive and similar to other drugs as to reject it from consideration. Yet, he wants to try another SSRI? Contradictory?Good luck with Paxil and LDN.
I believe both are worth trying. Please report on your progress with these treatments.
- Scott
Posted by Phillipa on October 10, 2011, at 21:20:20
In reply to Re: Quick summary on VIIBRYD so far? » uncouth, posted by SLS on October 10, 2011, at 19:33:28
I wonder why as usually the docs like to try the newest latest? Maybe the drug companies are not promoting? Phillipa
Posted by Chairman_MAO on October 11, 2011, at 12:18:04
In reply to Re: Quick summary on VIIBRYD so far? » uncouth, posted by SLS on October 10, 2011, at 19:33:28
> At this juncture, I disagree with your doctor's characterization of Viibryd as being so unimpressive and similar to other drugs as to reject it from consideration. Yet, he wants to try another SSRI? Contradictory?
I agree with SLS on this one. If you've failed other SSRIs, there _is_ a reason to try Viibryd--certainly more of a reason than to try another SSRI. The guy I see had me try it because he said he'd had good results with it and I'd never tried it before. I don't think I was clear enough that I wanted the treatment to target social phobia rather than depression, but I couldn't turn it down because I'd never tried it. I've worked with the guy for years, he's done the psychostimulant + MAOI combination before with me. After 10 days I could not deal with how utterly miserable I was; there was no way I was raising the dose past 10mg if 10mg made me feel like that. I was on the brink of having a panic attack at times--and I take 4mg of clonazepam per day.
I just want my damn MAOI back. You know those black box warnings on SSRIs about suicidal ideation, etc? That is what SSRIs do to me. Even if I'd waited the full 4-6 weeks, I still end up in a state where I feel jittery, restless, and numb. I had no idea there was any other type of experience until I tried an MAOI. I wish I never stopped taking the Nardil; big mistake, but it was a rough time in my life and I was fed up dealing with the doctor I had at the time.
Posted by SLS on October 11, 2011, at 12:50:30
In reply to Re: Quick summary on VIIBRYD so far? » SLS, posted by Chairman_MAO on October 11, 2011, at 12:18:04
> I wish I never stopped taking the Nardil; big mistake,
I've made quite a few of them myself. It was difficult for me to forgive myself and accept the consequences of the decisions I made that may have contributed to further my state of treatment resistance. You probably made a very logical decision based upon the limited amount of information you had at the time.
- Scott
Posted by zonked on October 11, 2011, at 18:54:36
In reply to Re: Quick summary on VIIBRYD so far? » uncouth, posted by SLS on October 10, 2011, at 19:33:28
SLS:
Did you get the Nardil-hugeness some people get? Are you finding it dropping out with your usual amount of exercise now that you've been off it a bit?
Glad to see that it still seems to be working for you - it's early, but encouraging.
I'd like to see what the askapatient.com scores look like 6mo-12mo from now.
-z
This is the end of the thread.
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