![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 101 to 125 of 133. Go back in thread:
Posted by Shar on April 8, 2001, at 23:56:05
In reply to Re: treatment resistant depression--ditto » Shar, posted by sweetmarie on April 3, 2001, at 6:14:16
Sweet -- just saw your post.
The combo (listed below) is still better than anything has been in years. I do not feel depression free, I am probably what some people would call "blue" most of the time. However, compared to where I've been and the various combos I've tried, and the hassles of getting off and on, side effects etc. - this is very good.
Years--I've been depressed since I was about 12-13, maybe 14 years old. That is 35 years of fairly unremitting plain old chronic depression (more than just blue) with episodes of severe, breathtakingly horrible depression.
Always lots of suicidal ideation. Even now; however I am squared away with the suicide issue, it's not an option.
Hope you are well-
Shar> > My pdoc recently added .5 mg Risperdal to my cocktail of wellbutrin sr and effexor xr, and klnonpin at night. It worked (I felt relief from depression) within a few days. We upped it to .75 because I was having the "feeling ok then the bottom falls out" plus "rage reactions" and doc said increase could help me stay feeling better for 24 hours, plus rage reaction could be a rx to withdrawal when .50 couldn't get me thru 24 hours.
> >
> > BTW, I have not felt this good in years. Years! It is incredible. Zoloft also worked well for me, but pooped out. I am praying this will not poop out.
> >
>
> Shar,
>
> Haven`t heard from you in awhile. I was wondering whether the combination you went onto (the Ritalin, Welbutrin, Efexor and Klonpin) has continues to work, i.e. has it managed to sustain you? Also, How long is `years`? That probably sounds a bit of a stupid question, but I hope you know what I mean.
>
> Anyway, I hope it`s still doing the trick; let me know,
>
> Anna.
Posted by sweetmarie on April 9, 2001, at 4:46:56
In reply to Re: treatment resistant depression--ditto » sweetmarie, posted by Shar on April 8, 2001, at 23:56:05
> Sweet -- just saw your post.
>
> The combo (listed below) is still better than anything has been in years. I do not feel depression free, I am probably what some people would call "blue" most of the time. However, compared to where I've been and the various combos I've tried, and the hassles of getting off and on, side effects etc. - this is very good.
>
> Years--I've been depressed since I was about 12-13, maybe 14 years old. That is 35 years of fairly unremitting plain old chronic depression (more than just blue) with episodes of severe, breathtakingly horrible depression.
>
> Always lots of suicidal ideation. Even now; however I am squared away with the suicide issue, it's not an option.
>
Shar,Thanks for the reply. I`m glad that your meds are still working (or, at least working better than others have).
It sounds to me like you have Dysthymia - a fancy name for `pretty much always had a tendency for low mood`. The reason I say this is that I have had a very similar experience, with the depression beginning at an early age, and never really going away. I`ve had periods of very severe depression too, including the current one which has been raging for about 3 years now(`officially`, although I know that it started way before that).
Anyway, labels are only really any use up to a point. Depression is depression, and it`s a complete and utter nightmare, full-stop.
It must be a releif to be back to just plain old feeling `down`. I know that this sounds ridiculous, but I really look back fondly on the days when I was kind of mildly depressed. I didn`t even know the half of it back then. So, I imagine it must be a huge relief. It`s tragic that it should be so, but `small mercies` and all that.
I`ve been told by my specialist that, whilst they can almost certainly do something about the severe depression, the underlying low mood (the Dysthymia, which is a kind of genetic thing) is not so easy to eradicate. I was quite dismayed when I heard this, but I was speaking to my sister about this, and she said that she reckoned that I`d feel so relieved that I wasn`t suicidal any more (well, not suicidal as such - more wanting to die all the time, which is different I know), that I`d be able to tackle `problem areas` in my life, and thus go some way to alleviating the low mood tendency. What I mean, for example, is not going into another stressful job. I`ve always had stressful jobs, but I realise now that I can`t cope with stress at all. So, I suppose what I`m saying is that there are certain things I can put into place to help redirect any potential recurrence of this hideous pit I`ve been in for so long.
That`s the theory, anyway. Whether it will work out like that, is another story entirely. First and foremost, I need to be in a position to actually be able to see the outside of my flat now and again, instead of lying in bed all the time, feeling completely crap and unable to do anything. That in itself will be a major achievement.
Anyway, I`m really glad that you are still doing O.K.
Cheers,
Anna.
> >
Posted by sweetmarie on April 9, 2001, at 6:25:54
In reply to Re: treatment resistant depression , posted by SLS on April 6, 2001, at 8:01:39
Every now and then I will check myself to see if my current state of mind (happiness vs unhappiness) is truly due to my circumstances, or whether it is due to a psychosocial issue. "It's you" also covers biological mental illness.
Which, of course is no small matter, although it`s sometimes hard to comprehend that it`s your brain that is creating all this havoc (just doesn`t seem possible). >
> I'm almost out the door to go on a trip to Oklahoma City. Maybe I'll see a tornado.
Did you see one? Did you end up the other side of the rainbow like Dorothy? (You know, the place where `skies are blue` and `troubles melt like lemon drops` etc.) >
> "The measure of achievement lies not in how high the mountain,
> but in how hard the climb.
>
> The measure of success lies only in how high one feels he must
> climb to get there."
>
That`s good, I like that one. >Still no response to the Lamictal - 2 and a half weeks, and counting ...
Anna.
Posted by Shar on April 10, 2001, at 20:00:11
In reply to Re: treatment resistant depression--ditto, posted by sweetmarie on April 9, 2001, at 4:46:56
Sweet:
> It sounds to me like you have Dysthymia
..........Dysthymia is my dx-> It must be a releif to be back to just plain old feeling `down`. ........It is indeed. I think what I have noticed most is that I am not devoid of energy. That's made the most day-to-day difference. So going to the post office isn't this agonizing routine; I just go.
the underlying low mood (the Dysthymia, which is a kind of genetic thing) is not so easy to eradicate.........This is what I have been told also. I have accepted the idea that I may always be blue, and stopped yearning for complete relief; that has helped. I am trying to learn to be here now (a tip of the hat to Ram) more often than not, and not spend a lot of time in the past or future. I do still dissociate some in more stressful situations.
>
> Anyway, I`m really glad that you are still doing O.K........I appreciate your encouragement. I hope you will find some relief soon. Blue beats the hell out of the Pit.Shar
Posted by sweetmarie on April 11, 2001, at 15:34:16
In reply to Re: treatment resistant depression-- » sweetmarie, posted by Shar on April 10, 2001, at 20:00:11
Shar,
> It must be a relief to be back to just plain old feeling `down`. ........It is indeed. I think what I have noticed most is that I am not devoid of energy. That's made the most day-to-day difference. So going to the post office isn't this agonizing routine; I just go.
I can`t remember when I last felt like that (although there must have been a time when it was the case).
I have accepted the idea that I may always be blue, and stopped yearning for complete relief; that has helped. I am trying to learn to be here now (a tip of the hat to Ram)
who/what is RAM? and I thought that `be here now` was an album by Oasis (joke).
more often than not, and not spend a lot of time in the past or future. I do still dissociate some in more stressful situations.
What does dissociate mean? Well, I know what it means, but not in emotional terms.
> > Anyway, I`m really glad that you are still doing O.K........I appreciate your encouragement. I hope you will find some relief soon. Blue beats the hell out of the Pit.
I`m sure it does. I look forward to the day (hopefully it won`t be too long)when I`ll find out.
When you say `blue`, do you mean `sad` or `mildly depressed`?
One more thing about Dysthymia: the professor that will be treating me, wants me to do a course of CBT when I am well enough to do it. I`ve heard this is an effective way of helping Dysthymia, on the basis of `learned` behaviour over a prolonged time caused by this underlying depression.
Cheers,
Anna
p.s. Had you been `looking` for a long time before you found this combo?
Posted by sweetmarie on April 12, 2001, at 15:13:33
In reply to Re: treatment resistant depression-- » sweetmarie, posted by Shar on April 10, 2001, at 20:00:11
To everyone who has been so helpful to me on this thread:
I`ve had my hospital admission date, and it`s next Tuesday. I don`t think that there is Internet access there, so apart from the odd posting before Tues, I won`t be around for the support that everyone has so kindly given me.
It`s an `open-ended` stay of at least a month, and I reckon I`ll be there longer.
Anyway the point of this was just to say thank you very much to everyone who has been so kind to me, during this very bad period in my life. I expect that I`ll be back here as soon as I`m `out`, but till then,
bye,
Anna.
Posted by Shar on April 12, 2001, at 23:26:16
In reply to Re: treatment resistant depression-- » Shar, posted by sweetmarie on April 11, 2001, at 15:34:16
Sweet--
> who/what is RAM? and I thought that `be here now` was an album by Oasis (joke).
........hehehe.....Ram is Ram Dass who wrote a book called "Be Here Now." I know his approach is not western; I believe he is a guru or yogi or something similar.
> What does dissociate mean? Well, I know what it means, but not in emotional terms.
.......to me dissociate means that I am not in my body. It is more like a trance-like state, or staring a lot; definitely not in the moment. But not a complete loss of function. One instance is arriving at work and remembering nothing about the drive into the city. And crossing my fingers that all the lights I went through were green.....
>
> When you say `blue`, do you mean `sad` or `mildly depressed`?.......I use blue as "mildly depressed." I use colors to describe my depression, from black to clear. Clear is the absence of depression. I felt clear on Zoloft until it pooped out (much to my great dismay). 'And what color are we today?' a former pdoc of mine used to ask.
>
> One more thing about Dysthymia: the professor that will be treating me, wants me to do a course of CBT when I am well enough to do it........What does CBT look like in action?
>
> p.s. Had you been `looking` for a long time before you found this combo?.......I had been looking for quite a while. Probably total time was 7 years before now. During that time I had used some meds with limited success, but kept trying for more relief. Thank god(s) for Risperdal, the last thing that was added to my cocktail.
......I read your post about going in to the hospital and would like to encourage you for stepping toward some potentially very helpful stuff. If you are scared, my thoughts are with you. On this board we have many people that have been in the hospital and come out just fine. I'm holding your hand.
Take care,
Shar
Posted by sweetmarie on April 13, 2001, at 11:58:48
In reply to Re: treatment resistant depression-- » sweetmarie, posted by Shar on April 12, 2001, at 23:26:16
Ram is Ram Dass who wrote a book called "Be Here Now."
They bloody nicked it (Oasis)! I knew they were too stupid to think up such a profound title.
I know his approach is not western; I believe he is a guru or yogi or something similar.
I have heard of him, but never read his stuff. In general I don`t read `self-help` or philosophical stuff, which is probably fairly silly. I imagine that I am missing out on quite a lot. >
> .......to me dissociate means that I am not in my body. It is more like a trance-like state, or staring a lot; definitely not in the moment. But not a complete loss of function. One instance is arriving at work and remembering nothing about the drive into the city. And crossing my fingers that all the lights I went through were green.....
I know that one. I frighten myself sometimes when I am driving (on the very rare occasions that I am well enough to leave the house), as I find that my eyes are sort of `glazed over` and that I am staring at the adverts on the side of the road, or at the car next to me, or the car behind me through the rear view mirror. I kind of drive on autopilot, and constantly miss things, e.g. cars stopping in front of me etc. It`s not such a good idea to drive when you`re poorly.
Is this kind of what you mean?
> > When you say `blue`, do you mean `sad` or `mildly depressed`?
>
> .......I use blue as "mildly depressed." I use colors to describe my depression, from black to clear. Clear is the absence of depression. I felt clear on Zoloft until it pooped out (much to my great dismay). 'And what color are we today?' a former pdoc of mine used to ask.You use the expression `pooped out` - can this happen with all meds? The colour thing is a good guide; my psychiatrist used to get me to draw a graph, but I gave up as it looked like I was constantly flatlining at zero! Not very encouraging.
> > One more thing about Dysthymia: the professor that will be treating me, wants me to do a course of CBT when I am well enough to do it.
> .......What does CBT look like in action?
CBT (Cognitive Behavioural Therapy) is about changing ways of looking at things.situations etc. The theory is that people who have long-term problems with depression, have learned negative trains of thought (or, from another angle, negative trains of thought have produced depression). My understanding of CBT is that it is a way of intercepting negative thoughts/feelings simultaneously they enter the mind, and replacing them with positive thoughts/feelings. It certainly SOUNDS good, but I am very skeptical of it`s effectiveness. Basically, I wonder if those walls that we have been surrounding ourselves with (well, me anyway) for so long (34 years in my case), are actually open to that kind of change. I mean, they feel pretty inpenetrable to me. I`m cynical though - I`ve had lots of therapy over the years, and can`t be bothered really. I MUST go into this with an open mind, though (repeat 100 times!) So that`s it basically.
> > p.s. Had you been `looking` for a long time before you found this combo?
>
> .......I had been looking for quite a while. Probably total time was 7 years before now. During that time I had used some meds with limited success, but kept trying for more relief. Thank god(s) for Risperdal, the last thing that was added to my cocktail.What a relief. I`ve been on different meds for nearly 11 years now, and all but the first one have totally failed to work. I myself haven`t worked (done a job) for 3 years now. Even ECT didn`t shift it. Hopefully, my `time` is not far away. >
> ......I read your post about going in to the hospital and would like to encourage you for stepping toward some potentially very helpful stuff. If you are scared, my thoughts are with you. On this board we have many people that have been in the hospital and come out just fine. I'm holding your hand.
Thanks, Shar - just what I needed to hear. >
Cheers,
Anna.
Posted by Noa on April 14, 2001, at 12:21:55
In reply to Re: treatment resistant depression-- » Shar, posted by sweetmarie on April 13, 2001, at 11:58:48
Sweetmarie--good luck in hospital.
Posted by sweetmarie on April 14, 2001, at 13:46:47
In reply to Re: treatment resistant depression--, posted by Noa on April 14, 2001, at 12:21:55
> Sweetmarie--good luck in hospital.
Thanks very much (much appreciated),Anna.
Posted by sweetmarie on April 15, 2001, at 11:32:37
In reply to Re: going into hospital » Shar, posted by sweetmarie on April 12, 2001, at 15:13:33
This is it - final posting.
Thank you VERY VERY VERY much to everyone who has responded to me.
So now I`m off to hospital, and
in the words of Morrissey:
`please please please let me get what I want ... this time`
and in the words of Arnie:
`I`ll be back`
and to everyone:
keep on keeping on
Thanks once again - this board has been a tremendous help, and I wish everyone the very best of health.
And thanks to Dr Bob for being a diamond geezer.
Anna.
Posted by Dr. Bob on April 15, 2001, at 14:51:25
In reply to FINALLY GOING » sweetmarie, posted by sweetmarie on April 15, 2001, at 11:32:37
> And thanks to Dr Bob for being a diamond geezer.
Come again? :-)
Bob
PS: Good luck!
Posted by sweetmarie on April 15, 2001, at 15:41:04
In reply to Re: a what? » sweetmarie, posted by Dr. Bob on April 15, 2001, at 14:51:25
> > And thanks to Dr Bob for being a diamond geezer.
It`s a cockney expression for a jolly good chap.
> PS: Good luck!
Thanks,
Anna.
Posted by ShelliR on April 15, 2001, at 18:02:18
In reply to FINALLY GOING » sweetmarie, posted by sweetmarie on April 15, 2001, at 11:32:37
> `please please please let me get what I want ... this time`
Anna, we're all wishing that for you.Looking forward to hearing from you when you return to the world at large.
Shelli
Posted by dove on April 16, 2001, at 11:19:24
In reply to Re: FINALLY GOING » sweetmarie, posted by ShelliR on April 15, 2001, at 18:02:18
Dearest Anna,
My prayers, thoughts, and hopes are with you. Please know that we will all be here when and if you need us. You have given so much to this board, you've shared so much of yourself, your struggles that I just want to say "Thank You" one more time :-)
Please come back and update us all!!! I will be watching for you! My best wishes, my best 'get something good outta this' vibes, and my prayers send I to you! And a BIG hug (((Anna)))
~dove
Posted by sweetmarie on June 17, 2001, at 8:38:02
In reply to Re: FINALLY GOING, posted by dove on April 16, 2001, at 11:19:24
> Dearest Anna,
>
> My prayers, thoughts, and hopes are with you. Please know that we will all be here when and if you need us. You have given so much to this board, you've shared so much of yourself, your struggles that I just want to say "Thank You" one more time :-)
>
> Please come back and update us all!!! I will be watching for you! My best wishes, my best 'get something good outta this' vibes, and my prayers send I to you! And a BIG hug (((Anna)))
>
> ~dove
Dear Dove (and everyone),Well, I`ve been at the hospital (specialist treatment resistant affective disorder unit) for 8 weeks now. It`s a really nice place, and completely unlike any other NHS hospital I`ve ever been in. The best thing is that there are only 10 patients there, and we all get a lot of individual attention from the nurses (who are all - with the exception of one - really nice).
The bad news is that I haven`t experienced a lift in mood (well, maybe a very small one). I`m very frustrated about this obviously, although I`m still told it`s `early days`.
I have a question regarding Venlafaxine/Mirtazapine (Efexor/Remeron - `Zispin` in this country). I have now been on Venlafaxine for 6 weeks, and Mirtazapine for 5 weeks. The Mirtazapine has remained steady at 30 mg, and the Venlafaxine has been gradually increased to 375 mg. I`ve been on this dose for a week now. This could be an impossible question to answer, but here goes -
Does anyone know whether length of time spent on a medication is `counted` from the highest dose, or from when the medication is first taken (at the lowest dose)? I have asked the nurses this question, but frankly they didn`t make all that much sense. I`d be really grateful for any info on this subject ...
Thanks also to Dove for the lovely sentiments - I really appreciate them.
Let me know.
Regards,
Anna.
Posted by Cam W. on June 17, 2001, at 9:10:10
In reply to Re: FINALLY GOING » dove, posted by sweetmarie on June 17, 2001, at 8:38:02
Marie - When mentioned in clinical reviews, the time one should remain taking an antidepressant is 6 months. This means that one should take an antidepressant for "at least" 6 months after remission is attained. It can take 4 to 12 weeks (or longer) to enter antidepressant-induced remission.
OTOH, in clinical trials, the time when starting an antidepressant is used as the starting date. Rarely, are these studies followed through to remission and recovery, but when they are, the studies still use the time when starting the drug, as a start date.
I think this is where the confusion comes in. Really, the date of remission should be judged the start of the antidepressant working, but this date is sort of fuzzy as entering remission is gradual. Therefore, many docs use the rule of thumb that, the first date that they see their patient is recovering (4 - 12 weeks into treatment), they will try to maintain that patient for at least another six months. Most docs nowadays just keep a person on an antidepressant for at least a year from the start date, and then evaluate the person at that time; using their clinical judgement to determine whether that person should remain on an antidepressant or whether it is time to try to take the person off of the antidepressant.
I suppose that it was this sort of wishy-washy answer that the nurses gave you, isn't it? None of these rules are written in stone, and it is really up to the judgement of the doctor. Research has bourne out though, that if people stop taking an antidepressant within 6 months of remission, there is approximately a 60% to 80% chance of relapsing. These figures are for first-time treatment-responsive depressions.
This is probably not the "rule of thumb" in treatment-resistant cases like yours, where long-term therapy, after (if) remission is achieved. So, to answer your question in the context of your treatment-resistant depression: it depends on how you do eventually respond to the medication.
I hope that this mess is of some help. - Cam
Posted by sweetmarie on June 18, 2001, at 5:52:26
In reply to Re: FINALLY GOING » sweetmarie, posted by Cam W. on June 17, 2001, at 9:10:10
> Marie - When mentioned in clinical reviews, the time one should remain taking an antidepressant is 6 months. This means that one should take an antidepressant for "at least" 6 months after remission is attained. It can take 4 to 12 weeks (or longer) to enter antidepressant-induced remission.
>
> OTOH, in clinical trials, the time when starting an antidepressant is used as the starting date. Rarely, are these studies followed through to remission and recovery, but when they are, the studies still use the time when starting the drug, as a start date.
>
> I think this is where the confusion comes in. Really, the date of remission should be judged the start of the antidepressant working, but this date is sort of fuzzy as entering remission is gradual. Therefore, many docs use the rule of thumb that, the first date that they see their patient is recovering (4 - 12 weeks into treatment), they will try to maintain that patient for at least another six months. Most docs nowadays just keep a person on an antidepressant for at least a year from the start date, and then evaluate the person at that time; using their clinical judgement to determine whether that person should remain on an antidepressant or whether it is time to try to take the person off of the antidepressant.
>
> I suppose that it was this sort of wishy-washy answer that the nurses gave you, isn't it? None of these rules are written in stone, and it is really up to the judgement of the doctor. Research has bourne out though, that if people stop taking an antidepressant within 6 months of remission, there is approximately a 60% to 80% chance of relapsing. These figures are for first-time treatment-responsive depressions.
>
> This is probably not the "rule of thumb" in treatment-resistant cases like yours, where long-term therapy, after (if) remission is achieved. So, to answer your question in the context of your treatment-resistant depression: it depends on how you do eventually respond to the medication.
>
> I hope that this mess is of some help. - CamHi Cam,
Thanks for your reply - it WAS of some help.
I think that the idea is that I remain on the successful combination (whether this is the combination I am currently on, or another - if any), long-term. I`ve suffered from moderate - severe depression for most of my life (I`m 34), and the current severe episode has lasted for over 3 years now. I have discontinued meds twice over the past 10 years with disastrous results, so I`m in no hurry to stop taking them any time soon.
The `4 - 12 weeks` you mention is useful; I`ve always been told that the time-span is 3 - 6 weeks. Having said that, I know that the longer the depressive episode has lasted, the longer it takes the meds to have an effect. What I was really after was when the `4 - 12 weeks` (or whatever) is measured from - i.e. is it measured from the onset of taking the med(s), or the beginning of taking the highest dose. In other words, is the period before (hopeful) efficacy measured from the beginning (when a patient begins taking the meds, at a low dose), or from when the meds have been `boosted` to the highest doseage.
Does this make sense? I hope you can get the gist of what I`m asking.
Any `light` on this gratefully appreciated.
Cheers,
Anna.
Posted by Cam W. on June 18, 2001, at 9:50:31
In reply to Re:Treatment Resistant Depression - Efexor/Remeron » Cam W., posted by sweetmarie on June 18, 2001, at 5:52:26
> The `4 - 12 weeks` you mention is useful; I`ve always been told that the time-span is 3 - 6 weeks. Having said that, I know that the longer the depressive episode has lasted, the longer it takes the meds to have an effect. What I was really after was when the `4 - 12 weeks` (or whatever) is measured from - i.e. is it measured from the onset of taking the med(s), or the beginning of taking the highest dose. In other words, is the period before (hopeful) efficacy measured from the beginning (when a patient begins taking the meds, at a low dose), or from when the meds have been `boosted` to the highest doseage.Anna - The answer to your time period question is: both are used, it depends on what the person who s talking. More often than not, clinicians (eg. your doc) mean from the time you start taking the antidepressant. Researchers who talk about staying on medication for 6 months mean, "6 months after remission". This would probably be from the time after the last dosage increase, as remission date is usually a range (ie. no on or off; depressed then not depressed).
Also, you should stay on medication for 4 to 8 weeks after the highest dose is attained to see if the medication will work for you; or 8 to 12 weeks from the start of therapy (which is roughly the same time frame). Again, the time frame that is used is dependent on who you are talking to. This is, of course, if you are able to tolerate the start-up side effects and are still able to function as much as need be.
- Cam
Posted by sweetmarie on June 18, 2001, at 10:45:21
In reply to Re:Treatment Resistant Depression - Efexor/Remeron » sweetmarie, posted by Cam W. on June 18, 2001, at 9:50:31
> Anna - The answer to your time period question is: both are used, it depends on what the person who s talking. More often than not, clinicians (eg. your doc) mean from the time you start taking the antidepressant. Researchers who talk about staying on medication for 6 months mean, "6 months after remission". This would probably be from the time after the last dosage increase, as remission date is usually a range (ie. no on or off; depressed then not depressed).
>
> Also, you should stay on medication for 4 to 8 weeks after the highest dose is attained to see if the medication will work for you; or 8 to 12 weeks from the start of therapy (which is roughly the same time frame). Again, the time frame that is used is dependent on who you are talking to. This is, of course, if you are able to tolerate the start-up side effects and are still able to function as much as need be.
>
Cam,Thanks for that - it`s answered my question.
As I`ve been on Venlafaxine for 6 weeks now (1 week at 375 mg, which I think is as high as they are going to take it), and Mirtazapine for 5 weeks, I imagine that the combination will be guaged from 5 weeks ago (approx). So, I wouldn`t necessarily have noticed any alteration in mood yet.
The `spanner in the works` was that the professor (who is treating me) told me 3 weeks ago that he "expected me to be better in 3 - 4 weeks". Well, the 3 week period elapsd 3 days ago, and frankly I feel virtually no different to when I was first admitted to hospital (i.e. still majorly depressed). It has taken me years to learn NOT to ask the question "when will I be better?", as there is pretty much no meaningful response. So, when the professor volunteered this 3 - 4 week period, I immediately latched onto it, although I knew it to be tenuous. I don`t really know why I`m mentioning this, except to illustrate the nature of my consultant - i.e. very optimistic indeed. No bad thing, but realism is equally as necessary.
Anyway, thanks again. I`m going back to hospital now (I`m currently on home leave), and will `check in` again when I`m next home (next w/end, all being well).
Cheers once again,
Anna.
Posted by Wendy B. on June 20, 2001, at 9:47:05
In reply to Re:Treatment Resistant Depression - Efexor/Remeron, posted by sweetmarie on June 18, 2001, at 10:45:21
(message from Cam)
>
> Thanks for that - it`s answered my question.
>
> As I`ve been on Venlafaxine for 6 weeks now (1 week at 375 mg, which I think is as high as they are going to take it), and Mirtazapine for 5 weeks, I imagine that the combination will be guaged from 5 weeks ago (approx). So, I wouldn`t necessarily have noticed any alteration in mood yet.
>
> The `spanner in the works` was that the professor (who is treating me) told me 3 weeks ago that he "expected me to be better in 3 - 4 weeks". Well, the 3 week period elapsd 3 days ago, and frankly I feel virtually no different to when I was first admitted to hospital (i.e. still majorly depressed). It has taken me years to learn NOT to ask the question "when will I be better?", as there is pretty much no meaningful response. So, when the professor volunteered this 3 - 4 week period, I immediately latched onto it, although I knew it to be tenuous. I don`t really know why I`m mentioning this, except to illustrate the nature of my consultant - i.e. very optimistic indeed. No bad thing, but realism is equally as necessary.
>
> Anyway, thanks again. I`m going back to hospital now (I`m currently on home leave), and will `check in` again when I`m next home (next w/end, all being well).
>
> Cheers once again,
>
> Anna.
Hey Anna,
Hang tight, as they say in the states, meaning - don't give up yet... The 3-4 weeks was probably a bit optimistic, don't you think? It does take an 8-12 week trial to see if the meds will work, for most people. Your professor may have had easier cases prior to you! It's a very tough disease, and I think you're quite right about a dose of reality being necessary, too.I'm glad you're allowed "home leave" (does it feel like you're in the army?). I hope it helps make you feel a little more normalized. I am interested in your responses to being in hospital for such a long time. You seem relatively calm & stable, even when majorly depressed. Do you keep a journal of your experiences? I've heard it helps...
My hat goes off to you and my heart goes out to you. Please do check in when you're home, and we'll be waiting to hear from you with much hope,
Wendy
Posted by sweetmarie on June 22, 2001, at 14:25:15
In reply to Re:Treatment Resistant Depression - Efexor/Remeron » sweetmarie, posted by Wendy B. on June 20, 2001, at 9:47:05
> Hang tight, as they say in the states, meaning - don't give up yet... The 3-4 weeks was probably a bit optimistic, don't you think?That`s what I thought.
It does take an 8-12 week trial to see if the meds will work, for most people. Your professor may have had easier cases prior to you! It's a very tough disease, and I think you're quite right about a dose of reality being necessary, too.
>
> I'm glad you're allowed "home leave" (does it feel like you're in the army?). I hope it helps make you feel a little more normalized.Well ... not really - I spend the time at my parents` place. Pretty stressful (they think that I`m not doing enough for myself etc.).
I am interested in your responses to being in hospital for such a long time. You seem relatively calm & stable, even when majorly depressed.
Hmmm. Not really, but I`m not really able to express distress. To see me, you`d think that nothing was wrong - I`ve got the `I`m perfectly alright` act off to a tee. I`m not sure that this works in my favour.
Do you keep a journal of your experiences? I've heard it helps...
I kind of do - one of my `key` nurses gives me a weeks` schedule, where I complete each period of the day with what I`ve done, and rate my mood out of 10. This is quite useful.
>
> My hat goes off to you and my heart goes out to you. Please do check in when you're home, and we'll be waiting to hear from you with much hope,Thanks - it`s nice to know that others are bothered about me. I think that I`m a little better than I was on admission, i.e. I had my first 7 out of 10 last Saturday night. Still mostly 2s, 3s and 4s though. The Venlafaxine/Mirtazapine combo has now entered week 8, and according to the prof, the next step will be lowering the Venlafaxine dose, and increasing the Mirtazapine dose. We`ll see.
Thankyou ever so much for your interest and support - it`s much appreciated.
Anna.
Posted by sweetmarie on June 24, 2001, at 11:29:45
In reply to Re:Treatment Resistant Depression - Efexor/Remeron » Wendy B., posted by sweetmarie on June 22, 2001, at 14:25:15
I forgot to ask -The next line of attack if the Venlafaxine (375 mg) and Mirtazapine (30 mg) combo doesn`t work, is that the doses will be swapped around. I.e. The dose of the Venlafaxine will be reduced, and the Mirtazapine will be increased.
Anyone heard of this ? Could it work ? (Sounds spurious to me.)
Any answers gladly received.
Ta,
Anna.
Posted by sweetmarie on June 29, 2001, at 12:20:38
In reply to Re:Efexor/Remeron - Forgot To Ask, posted by sweetmarie on June 24, 2001, at 11:29:45
I haven`t received any replies to this post, so I`m re-posting it in the hope that someone can enlighten me. >
> I forgot to ask -
>
> The next line of attack if the Venlafaxine (375 mg) and Mirtazapine (30 mg) combo doesn`t work, is that the doses will be swapped around. I.e. The dose of the Venlafaxine will be reduced, and the Mirtazapine will be increased.
>
> Anyone heard of this ? Could it work ? (Sounds spurious to me.)
>
> Any answers gladly received.
>
> Ta,
>
> Anna.
Posted by teddy bishop on August 21, 2001, at 2:11:00
In reply to Re: treatment resistant depression, posted by JohnL on March 8, 2001, at 17:35:42
> I sound like a broken record because I say this so often, but as I see it there are a small handful of drugs that could prove very helpful to you. None of them have yet been tried. The only reason I suggest these drugs is because they have proven to be helpful to quite a few folks here that have had trouble with more straight forward treatments. Including me.
>
> The broken record drugs I'm referring to are Zyprexa, Amisulpride, Adrafinil, Risperdal, or any combination of two of them (not Zyprexa+Risperdal together though). Any of them, or any combination of them, seem to work especially well with a little bit of an SSRI in the background.
>
> The drugs you are on or have tried are far more harsh than any of these drugs I've mentioned. Since you can handle the side effects of the other drugs, then the ones I mentioned will seem like candy. Except for one thing. They will probably work.
>
> There are various theories as to what causes depression. The most popular one is a deficiency in neurotransmitters. Increasing them is what antidepressants do. You have pretty much exhausted that theory in your case. Time to explore other ones. That's where the drugs I mentioned come into play.
> John
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.