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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by fido on March 18, 2015, at 19:17:53
I see my pdoc on Friday. Actually I was planning to ask for lamictal.
I thought maybe I could try zoloft as a new antidepressant and lamictal.Now I just read in a med book that zoloft does NOT mix well with lamictal cause of liver metabolism!
Great, this means zoloft is out of the game and this means that the ONLY SSRI left I could try would be prozac and prozac
on the other hand does NOT mix well with amphetamines (which I need for adhd) also because of liver metabolism!Great now what do I do? Basically my whole plan is gone now. Now I dont even know which antidepressant to try next cause there
isn't much left. Paxil is NO option cause of withdrawal issues and I already tried Lexapro. Fluvox is also no option cause I drink much coffee.
I feel SO crappy right now. Totally discouraged. I mean if I dont know what to try next I dont even have to see my doc.
He definitely isnt going to make helpful suggestions he will just come up with something out of his hat. Oh my.
I also read in a med book about lamictal it said that there is NO proof that lamictal helps with unipolar depression
and it also talked about side effects and potentially lethal skin rashes. Now I'm totally scared.
It also said that lamictal can actually make you more suicidal and is NOT suited for treating acute depression!Bottom line is I have NO damn clue wether trying lamictal is worth the risk or not. What if it makes me suicidal? What if I go on
it and then out of the blue I'm full blown suicidal? Or what if I go on it and think that I tolerate it and then all of a sudden in a situation where I would not have been suicidal I become suicidal because of lamictal? This basically seems like an absolutely incalculable risk to me.
Posted by Christ_empowered on March 18, 2015, at 19:20:36
In reply to Lamictal: Absolutely no clue what to do :(, posted by fido on March 18, 2015, at 19:17:53
supplements? psychotherapy?
Posted by fido on March 18, 2015, at 19:24:15
In reply to Lamictal: Absolutely no clue what to do :(, posted by fido on March 18, 2015, at 19:17:53
I only know that I needed amphetamines for adhd and this means that SSRI-wise prozac is no option.
But if I want to try another ssri then I'd have to try zoloft. But if I try zoloft I cannot try lamictal! ARGH!
And the SNRI are also no option anymore. I tried cymbalta and it sucked and I dont want to try effexor cause of withdrawal issues and I also doubt it would work when cymbalta failed. Basically there really isn't much left.And mixing amphetamines with a TCA is probably also risky my doc will not do this which means that I can also forget about trying another TCA after anafranil had too strong side effects.
Posted by fido on March 18, 2015, at 19:25:22
In reply to Re: Lamictal: Absolutely no clue what to do :(, posted by Christ_empowered on March 18, 2015, at 19:20:36
@ christempowered
Therapy are you kidding? I am done with this BS.
Wasted too much time and money with useless leechers which only want my money.Supplements, no. I take supps already but I have real depression. Fish oil and stuff like that do nothing for me.
Posted by baseball55 on March 18, 2015, at 21:02:25
In reply to Lamictal: Absolutely no clue what to do :(, posted by fido on March 18, 2015, at 19:17:53
> Now I just read in a med book that zoloft does NOT mix well with lamictal cause of liver metabolism!
I don't know about zoloft, but I have mixed lamictal with SSRI's with no liver issues. I have also mixed lamictal with adderall with no liver issues. I have never heard anything about lamictal causing liver toxicity. Maybe I'm ignorant, but I have dealt with a few doctors and a few pharmacists and this has never come up. Is the book you read a credible source? Is it talking about remote possibilities (many drugs, even OTC drugs, can cause liver toxicity in rare instances)? What does your p-doc say about this?
> He definitely isnt going to make helpful suggestions he will just come up with something out of his hat. Oh my.
Are you sure about this? Can you find a more hands-on p-doc?
> I also read in a med book about lamictal it said that there is NO proof that lamictal helps with unipolar depression
> and it also talked about side effects and potentially lethal skin rashes. Now I'm totally scared.
> It also said that lamictal can actually make you more suicidal and is NOT suited for treating acute depression!Lamictal is used mostly to reduce suicidality. It is not really an anti-depressant, but a mood stabilizer and, along with lower-dose lithium, has a rep for calming suicidal thoughts. So I don't know why the book you read says it can increase suicidality. Also, the side effects were, for me, non-existent, though some have reported cognitive dulling. The rash is very serious, but very rare. Lamictal should be titrated slowly, from 25mg to 200mg over a few weeks in order to prevent and/or keep close watch for the low-probablity of a severe rash.
My advice - find a p-doc you can trust and then trust him/her. You can always find dire warnings about anything if you look for them.
Posted by fido on March 18, 2015, at 22:17:45
In reply to Re: Lamictal: Absolutely no clue what to do :(, posted by baseball55 on March 18, 2015, at 21:02:25
Hello,
the book was a book about psychopharmaceutical drugs which is mostly used by pdocs where I live.
It's not about liver toxicity but about metabolism. Zoloft & Lamictal seem to hinder each other and then you get toxic byproducts which raise the risk of serious skin rashes.I wish I knew an experienced pdoc but I dont. I mean I cant go to 10 different pdocs and then make my choice. It's a game of luck. Even if someone seems competent and nice at first then he could still turn out to suck later on.
Posted by Christ_empowered on March 18, 2015, at 22:33:46
In reply to Re: Lamictal: Absolutely no clue what to do :(, posted by fido on March 18, 2015, at 22:17:45
sorry if I seemed insensitive. Shrinks generally aren't all that great and the meds themselves aren't always reliable, but...
...do what you gotta do, right?
I've taken an amphetamine with a TCA. It was OK. Actually, combined with 10mgs Abilify, it was effective. I took Adderall and Tofranil-PM.
Posted by fido on March 18, 2015, at 23:17:52
In reply to Re: Lamictal: Absolutely no clue what to do :(, posted by Christ_empowered on March 18, 2015, at 22:33:46
Abilify seems scary to me. Too unpredictable in how it will work for a person.
Did your doc tell you that you can mix TCA and amphetamines? If my doc tells me that a certain combo is safe then I try it but if he doesnt know if it is safe and then rather tells me not to try it then this means that maybe it would have worked and I wasnt able to try it. That's why having a doc with much experience is so important. But my doc doesnt have much experience.
He usually looks up if a combo is safe or not in a book. This is disturbing to me.
Posted by Christ_empowered on March 19, 2015, at 9:51:57
In reply to Re: Lamictal: Absolutely no clue what to do :(, posted by fido on March 18, 2015, at 23:17:52
yeah, my doc prescribed all the meds for me. Tofranil had some definite side effects :-(
Posted by fido on March 19, 2015, at 18:33:24
In reply to Re: Lamictal: Absolutely no clue what to do :(, posted by Christ_empowered on March 19, 2015, at 9:51:57
Saw the doc today. Appointment was thursday not friday. Feeling absolutely miserable.
I need to find a new doc asap but chances of finding a better one are slim.
I asked him about lamictal and he once again started opening a book and flipping pages and first he sounded like I might try it
but then he said he thinks this won't help me. He said it's a mood stabilzer and usually sedating. He feels like this isn't right for me.
Great.That was basically how it went down. And then I sat there not really knowing what to say and I then said I dont know what to try next,
maybe another ssri? And he was like ok and wrote a prescription.Basically I could as well get my prescription from a doc in india who I email with. I am so damn angry and frustrated. THIS is simply a joke.
With doctors like him you're going nowhere. I cannot even imagine that he's able to really manage patients and get them better by SYSTEMATICALLY choosing the right drugs.
He doesn't seem to put any thinking into this at all. I could as well simply throw a dice and determine this way which drug to try next.He never even asks me how I feel. He has no damn clue! He only knows that I am depressed. I am so disillusioned.
This is the end of the thread.
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