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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by SLS on January 15, 2023, at 15:31:50
Hi.
* I accidentally posted this along someone else's thread.
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I hope this gives everyone surety that they haven't tried everything.
Can anyone with mathematical skills work out how many permutations there are for combining any 4 drugs as a treatment?
What about 5?
This was the logic that helped keep me going.
I know it is easy and compelling to think that you've tried everything. Let's see what a mathematician comes up with.
Would 1000 alternative combinations of 4 drugs give you hope. Maybe just a little?
Let me tell you from personal experience that it doesn't always work, but still...
Even though I can guarantee that you could never try all of the permutations of the listed medications in a lifetime, I cannot guarantee that you will respond to any of the first 1000 combinations on the mathematician's list. How do you know that your next treatment won't work?
The following is my list of drugs tried. There are 87 of them. I may have missed a few, but not many. I can't imagine how many trials of different combinations of these drugs I have tried. Scary. Can you imagine how many combinations of drugs I have assaulted my brain with in 40 years non-stop?
I am very afraid, though. Nardil seems to poop-out on people, even after decades of remission. I want guarantees.
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1982 - 2020adinazolam
agomelatine
alprazolam
amitriptyline
amoxapine
amphetamine
aripiprazole
asenapine
brexpiprazole
bromocriptine
bupropion
carbamazepine
cariprazine
chloral hydrate
chlorpromazine
clomipramine
clonazepam
clorgyline
desipramine
desvenlafaxine
dexmethylphenidate
doxycycline
duloxetine
escitalopram
fluoxetine
fluphenazine
gabapentin
idazoxan
iloperidone
imipramine
indalpine
isocarboxezid
ketamine
lamotrigine
levetiracetam
lisdexamfetamine
lithium
lorazepam
lurasidone
memantine
methylfolate
methylphenadate
mifepristone
milnacipran
minocycline
mirtazapine
moclobemide
modafinil
monocycline
naltrexone
nomifensine
nortriptyline
olanzapine
oxcarbazepine
paroxetine
pemoline
perphanazine
phenelzine
prazosin
pregabalin
protriptyline
quetiapine
reboxetine
risperidone
selegiline
sertraline
sibutramine
sulpiride
temazepam
thioridazine
thyroxine T4
tiagabine
topiramate
tranylcypromine
trazodone
triazolam
triiodothyronine T3
trimipramine
valproate
venlafaxine
vilazodone
viqualine
vortioxetine
zaleplon
ziprasidone
zolpidem
zonisamide
- Scott
Posted by undopaminergic on January 16, 2023, at 10:16:23
In reply to Choose any 4 drugs to combine for remission., posted by SLS on January 15, 2023, at 15:31:50
> Hi.
>
> * I accidentally posted this along someone else's thread.
>
...
> The following is my list of drugs tried. There are 87 of them. I may have missed a few, but not many. I can't imagine how many trials of different combinations of these drugs I have tried. Scary. Can you imagine how many combinations of drugs I have assaulted my brain with in 40 years non-stop?
>I didn't realise it was a list of only drugs you had tried. Sorry about the confusion in my reply on the other thread.
-undopaminergic
Posted by Lamdage22 on January 18, 2023, at 5:13:13
In reply to Choose any 4 drugs to combine for remission., posted by SLS on January 15, 2023, at 15:31:50
How do you get a drug that has never been marketed? 'Viqualine'? Do you know why it wasn't marketed?
Posted by undopaminergic on January 18, 2023, at 6:51:13
In reply to Re: Choose any 4 drugs to combine for remission., posted by Lamdage22 on January 18, 2023, at 5:13:13
> How do you get a drug that has never been marketed? 'Viqualine'? Do you know why it wasn't marketed?
>I found this:
https://www.echemi.com/produce/pr22032112213-best-price-viqualine-cas-no72714-74-0.htmlThere are probably more sites offering it. It can be expensive though.
-undopaminergic
Posted by undopaminergic on January 18, 2023, at 11:51:47
In reply to Re: Choose any 4 drugs to combine for remission., posted by Lamdage22 on January 18, 2023, at 5:13:13
> 'Viqualine'? Do you know why it wasn't marketed?
>I came across the answer here:
https://en.wikipedia.org/wiki/IndalpineApparently, the developer (Pharmuka) of the drug got taken over (by Rhone Poulenc). The new owner withdrew indalpine from the market and cancelled development of viqualine and pipequaline.
-undopaminergic
Posted by Lamdage22 on January 18, 2023, at 13:10:34
In reply to Re: Choose any 4 drugs to combine for remission., posted by undopaminergic on January 18, 2023, at 11:51:47
It sounds interesting, I won't order it from some potentially sleazy company though.
Posted by Lamdage22 on January 18, 2023, at 13:22:07
In reply to Re: Choose any 4 drugs to combine for remission., posted by Lamdage22 on January 18, 2023, at 13:10:34
Interactions cut down the possibilities. I think pretty much anyones math will fail trying to account for that.
Posted by SLS on January 18, 2023, at 16:52:35
In reply to Re: Choose any 4 drugs to combine for remission., posted by undopaminergic on January 18, 2023, at 6:51:13
> > How do you get a drug that has never been marketed? 'Viqualine'? Do you know why it wasn't marketed?
> >
>
> I found this:
> https://www.echemi.com/produce/pr22032112213-best-price-viqualine-cas-no72714-74-0.html
>
> There are probably more sites offering it. It can be expensive though.
>
> -undopaminergic
>I can't believe that viqualine is available at all. It was never marketed anywhere in the world. I tried all three drugs in the Pharmuka PK50xx series of compounds. Only Indalpine came to market, and that was in France.
https://en.wikipedia.org/wiki/Indalpine
If you read the first paragraph, it mentions Baron Shopsin, MD. As my doctor beginning in 1983, I was one of the first guinea pigs to be treated with any kind of of serotonergic drug in the United States. Dr. Shopsin treated people outright (not blinded) with Indalpine, along with two other serotonergic compounds in development by Pharmuka of France. If you recall from my second lengthy "Consider the Source" post edit, I detailed my time as a patient of Dr. Baron Shopsin. Shopsin was a member of the first generation of psychopharmacologists, from whom I gained advanced knowledge of both clinical and biological psychiatry. Baron Shopsin was actually a protege of Nathan Klein at New York University. Klein is credited as being "the father of psychopharmacology". It is likely that I was the only person in the world to be exposed to all three compounds.
The following were the series of serotoninergic drugs in development by Pharmuka. They are listed in the order in which I tried them (Prozac was nowhere to be found):1. Indalpine: is a serotonin reuptake inhibitor. It was the only one of the Pharmuka serotonergic series that was approved for marketing as an antidepressant. I believe France was the only country where it was made available.
2. Viqualine (PK5058) had both serotonin reuptake inhibition and serotonin releasing properties.https://en.wikipedia.org/wiki/Viqualine
3. PK-5079 (as best as I can remember the number) was a serotinin releaser without serotonin reuptake inhibiting properties.
Just for instructional purposes, the first true SSRI to be marketed anywhere in the world was zimelidine (Zelmid) in 1982. I don't think it made its way outside of Europe. Most people have never heard of zimelidine. The reason for this is that zimelelidine was immediately withdrawn from market by the manufacturer once reports of GuillainBarré syndrome surfaced. In Europe, after zimelidine came fluvoxamine, and afterwards came fluoxetine. Fluoxetine was marketed in U.S. as Prozac. When the manufacturer of fluvoxamine (Luvox) finally made the decision to sell it in in the U.S., they figured that there were already enough "me-too" SSRI antidepressants being sold in the U.S. The company and opted to approve it for obsessive-compulsive disorder (OCD) instead. It was a wide-open niche.
- Scott
Posted by SLS on January 18, 2023, at 17:03:22
In reply to Re: Choose any 4 drugs to combine for remission., posted by Lamdage22 on January 18, 2023, at 13:22:07
> Interactions cut down the possibilities. I think pretty much anyones math will fail trying to account for that.
You're right. I never accounted for that. However, my guess is that the number of such interactions is going to be rare compared to the number of possibilities (permutations) extant.
Without working out the value, I'm pretty sure that the number of permutations reaches well into the 1000s if not 100,000s.
I still can't believe the number of drugs that *you* have been on that I never heard of.
- Scott
Posted by SLS on January 18, 2023, at 23:46:03
In reply to Re: Choose any 4 drugs to combine for remission. » SLS, posted by undopaminergic on January 16, 2023, at 10:16:23
I forgot to mention that Dr. Shopsin asked me to help him write a paper. He said I did better research than students at NYU who had a 170 I.Q. Unfortunately, he abruptly moved from Manhattan to Indianapolis, so I didn't have the opportunity to see my name on PubMed. Dr. Apter of Princeton University also asked me to write a paper. It was to be about buspirone. I had to tell him that I was far too cognitively impaired to be able to do it.
Jokingly, I say that Dr. Apter owes me some percentage of the millions of dollars he made because of something I said to him in 1994 while in the midst of a manic reaction to Nardil. I know it sounds funny and absurd, but I felt that he and I had figured out depression. I told him that he could take full credit for our discovery and the paper we would to write. Immediately after saying that, I told him that Alzheimer's Dementia was the disease that most urgently needed to be studied to find ways to treating it. This was in 1994.
I had originally stumbled upon literature describing Alzheimer's Dementia in 1983 or 1984. It was described as a rare, strange, and hideous disease. So, I spent some time every now and then to check out what was happening with Alzheimer's. Over the years, I followed the development of acetylcholine cholinesterase inhibitors as a treatment for Alzheimers. These drugs do for acetylcholine what MAOIs do for monoamine and indolemine neurotransmitters (NE, DA, 5-HT). Today, we
have three cholinesterase inhibitors approved for treating Alzheirmer's: donepezil, galantamine, and rivastigmine. There was initially a great deal of excitement about these drugs when they were first approved. Today, most neurologist consider them worthless, even when combined with memantine. I tried donepezil (Aricept). For me, it was inert.have https://www.spandidos-publications.com/10.3892/mmr.2019.10374
So, it turns out that more than 10 years after this conversation, I discovered that he had discontinued his private practice opened up a center for running clinical trials for Alzheimer's, including investigational drugs. Drug companies descended on him and paid Dr. Apter to run their clinical trials. I still correspond with him every so often. I never brought up the conversation we had in 1994.
I could use the money.
- Scott
Posted by Lamdage22 on January 19, 2023, at 0:45:55
In reply to Re: Choose any 4 drugs to combine for remission. » Lamdage22, posted by SLS on January 18, 2023, at 17:03:22
> I still can't believe the number of drugs that *you* have been on that I never heard of.
Do you mean UD? I only tried what doctors commonly believe to be helpful and safe with my set of problems. I do not believe to have plain and simple unipolar depression. Things are more complicated. Thus I cannot hope to be fixed by meds alone. I believe Psychotherapy can account for a many-faced problem more easily than meds.
I could improve one thing by taking something but worsen another etc. I cannot take a med for a specific symptom. It will do its thing for the whole brain. That is where the trouble starts. you know, if you have no symptoms other than depression symptoms, its easier.
Please don't ask the details, this would get too personal.
Posted by gman22 on January 21, 2023, at 20:32:24
In reply to Choose any 4 drugs to combine for remission., posted by SLS on January 15, 2023, at 15:31:50
https://www.biopsychiatry.com/ghb/authentic.htmlI didn't see this on the list, but I have seen it used successfully in at least 2 cases.
Posted by SLS on January 22, 2023, at 19:45:21
In reply to Re: Choose any 4 drugs to combine for remission., posted by gman22 on January 21, 2023, at 20:32:24
>
> https://www.biopsychiatry.com/ghb/authentic.html
>
> I didn't see this on the list, but I have seen it used successfully in at least 2 cases.That's a great article.
A very long time ago, there was a great deal of interest in GHB in the Psycho-Babble community. I don't recall any success stories, but perhaps people weren't taking it as the article recommends.
- Scott
This is the end of the thread.
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