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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by SLS on August 16, 2021, at 12:42:49
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Hello, fellow Babblers.
The first half of this post is relevant to the community as an example of successful treatment of a severe and seemingly intractable case of (bipolar) depression that has lasted 44 years and treated unsuccessfully for 41 years.I am currently improving rapidly, and as best as I can tell, I am headed for full remission.
I added Nardil about a year ago. The onset of improvement was rapid at first. But I found myself needing to play with the dosage constantly. Then, I became suspicions that my dosage of nortriptyline was TOO HIGH. I had been taking 100 mg/day for a bunch of years, assuming that my being within the right range of therapeutic blood levels indicated that I was being dosed properly. Nortriptyline is the ONLY tricyclic for which there is a narrow therapeutic window that one must be within. If you go above a certain dosage, you relapse. After stopping nortriptyline completely for one day and leaving the Nardil dosage the same at 90 mg/day I was pleasantly surprised to say the least. Bingo. My doctor advised me to restart nortriptyline at 50 mg/day. That was the right move, but I ended up relapsing. 75 mg/day is the magic number for me. I am now improving rapidly at a steady rate and at a steady dosage of Nardil.
Currently:Nardil - 90 mg/day
nortriptyline - 75 mg/day
Lamictal (brand name for lamotrigine) - 300 mg/day
Lithium - 300 mg/day
I had to wait 12 weeks after starting Nardil before an improvement emerged. Of course, much of this delay was the result of the titration process. However, this time, I purposely started with half a pill and increased the dosage very gradually in the hopes that I would not TRIGGER side effects in the first place. I was just following a hunch. The side effects I usually get from Nardil never appeared, even when taking 120 mg/day. Previously, I could not urinate and came close to going to the hospital on several occasions for a catheter. Postural hypotension often made me have to kneel on the ground from almost feinting. Anorgasmia was pretty much the same.An incredible blessing. I had come down to this one last treatment. My doctor and I had run out of ideas.
Now for the 2021 part:
In addition to finding my healing, I found someone - or rather she found me - who now lives in Vermont. I live in NJ. She said that she knew me, but I didn't have a clue as to where from. It turns out that she used to live in my home town and was my younger brother's prom date. I was actually in the same room with her. My brother brought her over to introduce her, but I didn't pay any attention to her. I was too busy trying to set up a humorous picture to be taken with my brother. I was shaking his hand in a really funny pose. Melissa stood pretty far away to give us room. Anyway, she took a liking to me (older brother syndrome) and never forgot me. I was her fantasy for a while, it seems.
41 years later...
I laugh now because I can truly say to my brother that I screwed his prom date. So, of course I said it to him. How could I not? For some reason, I failed to tickle his funny bone with that one. From what I understand, he didn't get "lucky" on prom night.
Melissa and I have been communicating since February. We have seen each other only four times. She had had a bad marriage and an even worse divorce. She wasn't sure that she would ever want to marry again. I wasn't happy to hear that, but I told her that I would take her any way I could get her, but not marrying would break my heart. I guess I should mention that I fell in love. Among so many other things, we have that in common. As we lied side by side in bed together to go to sleep, I told Melissa that I would try not to bring up the subject of marriage if and until she was ready. I had a very simple solution. I told her that if there ever came the right time for her, that *she* would have to ask *me* to marry *her*. At most, five seconds passed before she uttered my name.
Like I said, 2021 has been good to me so far.
Isnt it ridiculous for me to use such subdued language?
2021 is f*ck*ng great!
- Scott
Posted by Phillipa on August 16, 2021, at 18:49:49
In reply to 2021 has been good to me - a personal account., posted by SLS on August 16, 2021, at 12:42:49
Scott congrats to you. I honesty never thought I would hear this but I have now and am thrilled for you. You did it. And may happiness be your constant companion from now on. Hoping that the next post I see from you is that you and Melissa tied the knot! Phillipa!
Posted by SLS on August 16, 2021, at 18:52:12
In reply to Re: 2021 has been good to me - a personal account. » SLS, posted by Phillipa on August 16, 2021, at 18:49:49
Posted by Phillipa on August 16, 2021, at 20:33:21
In reply to Phillipa, you are the sweetest of souls. (nm) » Phillipa, posted by SLS on August 16, 2021, at 18:52:12
Happy Happy life Scott!
Posted by beckett2 on August 17, 2021, at 15:21:36
In reply to 2021 has been good to me - a personal account., posted by SLS on August 16, 2021, at 12:42:49
Congratulations Scott. This is wonderful news. I hope you are both very happy <3
Posted by SLS on August 17, 2021, at 15:56:41
In reply to Re: 2021 has been good to me - a personal account., posted by beckett2 on August 17, 2021, at 15:21:36
> Congratulations Scott. This is wonderful news. I hope you are both very happy <3
Thank you.
:-)
- Scott
Posted by Lamdage22 on August 18, 2021, at 1:58:58
In reply to Re: 2021 has been good to me - a personal account. » beckett2, posted by SLS on August 17, 2021, at 15:56:41
That is awesome. Especially considering that your regimen isnt radically different from what you did in the past. You were telling us it was too late for you.
Posted by undopaminergic on August 18, 2021, at 3:52:58
In reply to 2021 has been good to me - a personal account., posted by SLS on August 16, 2021, at 12:42:49
Hi Scott. Congratulations! Your story is inspiring. Almost makes me want to switch from trimipramine to nortriptyline, but I am well aware that what works for one person often (maybe usually) does not work for another.
I'm so used to trimipramine 150 mg now that I don't even know if it is helping any more. I want to increase the dose, but my current doctor doesn't want to. So, we agreed on trying lurasidone instead; this drug does not seem to be doing anything; I'm at 111 mg now. My next step, before giving up (at least for now) on antipsychotics in the role of antidepressants, is to try asenapine (Saphris, Sycrest).
I want to try a classic MAOI (already tried selegiline and rasagiline), preferably tranylcypromine, for depression, and for ADHD and/or cognitive impairment, I want to try dextroamphetamine (already tried methylphenidate). Alas, getting either of these drugs seems hopeless at present.
-undopaminergic
Posted by Roslynn on August 18, 2021, at 15:57:13
In reply to 2021 has been good to me - a personal account., posted by SLS on August 16, 2021, at 12:42:49
Scott, I am so happy for you!!
Sending hugs to you!
This is the end of the thread.
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