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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by g_g_g_unit on May 9, 2012, at 7:51:09
So, I mentioned earlier that I'd considered self-medicating by adding Memantine to Parnate as a way to a) improve OCD and b) potentially preserve the stimulating/anti-anhedonic effect. The inspiration for the idea came from desolationrower, though I think he ended up discontinuing the Memantine due to side-effects.
Anyway, after much deliberation, I'm not sure it's something I could comfortably go through with because I don't know how I'd explain a spontaneous improvement (were it to occur) to my psychiatrist.
But I also don't know how to go about phrasing my request.
1. Firstly, I don't think there are any formal studies proving Memantine prevents stimulant tolerance, but there is a wealth of anecdotal evidence. Still, I'm not sure the line - "oh, I read some dude on a forum had positive results" is scientifically persuasive.
2. Do psychiatrists really care about anhedonia? I've never bothered bringing it up since most accounts suggest they don't. Does "I want to preserve the anti-anhedonic effects" basically sound like "I want to be high all the time"?
3. There is, of course, the OCD angle. Yet I have little doubt that my psychiatrist would suggest I wait until we reach a therapeutic dose of Parnate, at which point I suspect the stimulant/anti-anhedonic effect would fade .. unless I'm wrong in that respect? But I have certainly found that since hitting 40mg, and experiencing an absence of a stimulating effect, things seem much more grey/boring.
I suppose the most obvious question would be to ask him how much experience he has with Parnate, and its efficacy in ADHD (since that's his specialty). I just don't understand why, after a year and a half of working together, I'm still scared of the guy. I suspect some transference is going on (he is a father figure), and maybe it's also just a cumulative effect of being treated badly by other psychiatrists in general, but it's still rather strange ..
I wish I could find a more experimental psychiatrist, but how would I begin? Med schools? The one other dude I've been referred to, who was head of a private hospital, was even worse than my current one. The only truly liberal one I've seen was a woman trained in Russia, but she was so caustic and obnoxious that I couldn't stand seeing her again after our visit session.
Posted by phidippus on May 9, 2012, at 22:22:09
In reply to help making difficult request to p-doc, posted by g_g_g_unit on May 9, 2012, at 7:51:09
You're still riding this train? Just ask him for the damn drug. You're having all sorts of weird worries about just asking him "at which point I suspect the stimulant/anti-anhedonic effect would fade .. unless I'm wrong in that respect?" Thinking way too long and hard on a simple matter.
Eric
Posted by g_g_g_unit on May 10, 2012, at 0:55:07
In reply to Re: help making difficult request to p-doc » g_g_g_unit, posted by phidippus on May 9, 2012, at 22:22:09
I'm not sure how you can determine that I'm "thinking too hard". My psychiatrist works methodically. I've asked him for Memantine before. He said no, and if he were to prescribe it, he would refer me to an OCD specialist to do so. Secondly, there would be no justification to prescribe it (in his mind) until I'd been on Parnate for some period of time, at which point the stimulation most likely would have faded. And then what? Waste 3-4-5 more months in limbo, either titrating off and/or searching for some new combination?
If you're going to belittle me and my concerns, then don't reply. I don't find it helpful.
Posted by phidippus on May 10, 2012, at 19:45:19
In reply to Re: help making difficult request to p-doc » phidippus, posted by g_g_g_unit on May 10, 2012, at 0:55:07
Why is the stimulation going to fade out?
Eric
This is the end of the thread.
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