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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 78 to 102 of 105. Go back in thread:
Posted by SLS on August 25, 2006, at 6:21:25
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Racer on August 24, 2006, at 10:39:53
> As well as talking to your doctor about buprenorphine, how about asking about tianepine?
Ah. I forgot to plant that seed. I've never mentioned this drug to him. Thanks. Do you have in place a plan to acquire it?
I can't help but to want to go back to taking Nardil for what little it helps me. I just want a break.
- Scott
Posted by SLS on August 25, 2006, at 6:30:32
In reply to So how did it go today Scott?, posted by JahL on August 24, 2006, at 14:57:19
> Sorry, I'm back to my old thread-hijacking ways!
>
> What was the doc's reaction?Basically, I left there with a prescription for pregabalin 75mg with the intent to move up to higher dosages later. There is a chance that it won't be covered by my prescription plan. If it is not, I might not take it.
I discussed with him the use of buprenorphine. He was aware that it was used by some doctors, but didn't seem too keen on it. He said that I should send him some stuff on it. We also discussed adding Nardil to what I am currently taking. He didn't like adding it to nortriptyline, but I think I convinced him to give it a try. I anticipate a mild serotonin syndrome developing, but what the heck. It really represents a dead end, but I would just like to feel better than I am now. I see him in two weeks. I guess I have a lot to think about.
- Scott
Posted by SLS on August 25, 2006, at 7:01:27
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Maximus on August 24, 2006, at 14:52:23
Hi Maximus.
> Scotty, if i may ask, for how long have you been disabled and been unable to work?15 years.
Crap.
> May be it is the time to take the heavy artillery's approach once again. I suggest the hospitalization. Thus you might get ECT + a complete overhaul of your medication. A bit scary, i know, but probably necessary...
Thank.
I'm not sure. I've already tried ECT. I can't see myself going through that again. My doctor brought up VNS again. I have already been in a hospital situation a few times. I have allowed them over six months on two occasions to work on me. At the moment, I can't think of anything they could do that hasn't been done already.
> Buddy, i do apologize in advance for my personal point of view.
No apologies necessary!
:-)
> I just think you deserve better.
I would have to agree with you.
> Actually i would just stop to tease yourself with experimental medecines. They just don't seem to work.
This one doctor had it right in 1987. He combined Parnate + desipramine. He just got too smart for his (my) own good and decided at some point that only one drug would be necessary. I naively followed his directions word for word for many months. Then I self-medicated. When I tried going back to the original combination, it no longer worked.
> Be well!Thanks. You do the same.
- Scott
Posted by mayzee on August 25, 2006, at 12:33:53
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued, posted by SLS on August 25, 2006, at 6:15:56
> The worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
>Hi Scott,
I'm only familiar with the newer ADs (SSRIs/SNRIs/etc.) and have always been told that it takes at least 4+ weeks to feel the AD effect. Is Sibutramine different in that you should get the effect much sooner?
I am so sorry that it didn't work for you. I hope that you can find something soon to make you feel better.
Warm regards,
mayzee
Posted by SLS on August 25, 2006, at 17:28:40
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued » SLS, posted by mayzee on August 25, 2006, at 12:33:53
> > The worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
> I'm only familiar with the newer ADs (SSRIs/SNRIs/etc.) and have always been told that it takes at least 4+ weeks to feel the AD effect. Is Sibutramine different in that you should get the effect much sooner?Hi Mayzee.
You are right. I would not expect sibutramine to be any different from Effexor in this regard. However, I did not expect the drug to make me feel markedly worse. I just don't have the fortitude at this juncture to subject myself to any more of that. I just got done spending weeks feeling worse because of Wellbutrin. I know I can't afford to leave any stone left unturned. However, I think stopping the sibutramine was the right thing to do. I was reacting quite badly to it.
Thanks for your interest.
- Scott
Posted by Maximus on August 25, 2006, at 20:35:11
In reply to Re: Sibutramine (Meridia) - Day 19 » Maximus, posted by SLS on August 25, 2006, at 7:01:27
Thanks for the informations. Now i understand a lot better your situation. You are a gentleman. That is what we call a genuine case of treatment resistant.
Well, you know yourself better than us, so continue to fight this ugly illness.
Last thing, i think the VNS implant would be a good bet.
Bye.
Posted by Phillipa on August 25, 2006, at 20:41:26
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Maximus on August 25, 2006, at 20:35:11
Only problem as my doc talked to me about it now I could be wrong. But I was told that you still needed to take meds. And the implant a devise in your brain. And you can never have an MRI? See that's the part I don't get. Love Phillipa
Posted by ed_uk on August 26, 2006, at 14:33:26
In reply to Re: Sibutramine (Meridia) - Day 19 » ed_uk, posted by JahL on August 24, 2006, at 14:10:59
Hi J
>Long time! How are ya?
Quite well. I don't need to see a pdoc anymore thankfully :)
>'Affective Psychoses'
Perhaps he has a 1970s psych text book? ;-)
>My only hope is my old private pdoc who I paged today. I have no idea what my chances are.
Any luck?
Regards
Ed
Posted by SLS on August 27, 2006, at 7:48:54
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued, posted by SLS on August 25, 2006, at 6:15:56
7 days @ 10mg
12 days @ 20mg
4 day @ 0mgIt appears that sibutramine has left me in a state that is worse than before I started it. I am more vegetative, and that feeling of cognitive "muddiness" persists along with mild anxiety. The half-life of the drug and its metabolites is about 12-14 hours, so I am not convinced that it is the drug itself that is making me feel worse.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by MARTY on August 27, 2006, at 14:24:25
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow., posted by SLS on August 4, 2006, at 22:03:09
Hi Scott,I have the luck of being followed by the most recognized/best Pdoc, specialized for Bipolar, in Canada. (That's confirm by a lot of Pdocs)
And so I just wanted to update you on the fact that your type of bipolarity is to be call TYPE 4 in 2010 DSM V.I know because I'm also in this club. Accompagnied by Anxiety and Social phobia.
Btw, I'll try Meridia and let you know how I do.
Take care,
Marty> > Scott, do you mind sharing what is your diagnosis (-es)?
> >
> > Wishing you great success with this,
> >
>
>
> Hi Mayzee.
>
> I have the type of bipolar disorder where you are depressed all of the time except for the rare occasion when a drug provokes a manic reaction. At one point, this was to be named Bipolar III. Now, I don't know what it is to be named in the new classification scheme.
>
>
> - Scott
Posted by SLS on August 27, 2006, at 14:41:15
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » SLS, posted by MARTY on August 27, 2006, at 14:24:25
Hi Marty.
Nice to see you again.
> Btw, I'll try Meridia and let you know how I do.
Good luck with it. Maybe it will treat you better than it did me.
- Scott
Posted by ed_uk on August 28, 2006, at 6:18:23
In reply to Re: Sibutramine (Meridia) - Day 23 - Discontinued, posted by SLS on August 27, 2006, at 7:48:54
Hi Scott
Do you plan to try buprenorphine soon?
Ed
Posted by SLS on August 28, 2006, at 7:36:37
In reply to Re: Sibutramine (Meridia) - Day 23 - Discontinued » SLS, posted by ed_uk on August 28, 2006, at 6:18:23
> Hi Scott
>
> Do you plan to try buprenorphine soon?
My doctor seems to be against the idea.
- Scott
Posted by SLS on August 28, 2006, at 20:56:17
In reply to Re: Sibutramine (Meridia) - Day 23 - Discontinued, posted by SLS on August 27, 2006, at 7:48:54
7 days @ 10mg
12 days @ 20mg
5 day @ 0mg
I feel worse today than I did yesterday. I think sibutramine produced changes in my brain that have resulted in a deterioration of my condition.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by Phillipa on August 28, 2006, at 20:58:10
In reply to Re: Sibutramine (Meridia) - Day 24 - Discontinued, posted by SLS on August 28, 2006, at 20:56:17
Scott what does your doc say? Love Jan
Posted by MARTY on August 29, 2006, at 2:15:15
In reply to Re: Sibutramine (Meridia) - Day 24 - Discontinued, posted by SLS on August 28, 2006, at 20:56:17
Hi Scott --What options are you looking into to counteract this 'perturbation' ? Will you leave the task to your brain homeostasis 'system' ?
Any ideas ?
Sorry your trial has worsen your condition.
I think this is a good time to give Lyrica a try.Marty
Posted by SLS on August 30, 2006, at 7:32:58
In reply to Re: Sibutramine (Meridia) - Day 24 - Discontinued, posted by SLS on August 28, 2006, at 20:56:17
7 days @ 10mg
12 days @ 20mg
6 day @ 0mg
I feel better today than I did yesterday. However, there is still some residual sibutramine-induced exacerbation of depression. Nevertheless, I am hopeful that this will continue to abate.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by MARTY on August 30, 2006, at 12:02:55
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued, posted by SLS on August 30, 2006, at 7:32:58
Btw Scott, how much did it cost you for 10mg pill and 20mg pill ?(I got my Meridia prescription yesterday from my pdoc. Can't wait to try, but I need the money first .. public insurance wouldn't cover it)
Marty
> 7 days @ 10mg
> 12 days @ 20mg
> 6 day @ 0mg
>
>
> I feel better today than I did yesterday. However, there is still some residual sibutramine-induced exacerbation of depression. Nevertheless, I am hopeful that this will continue to abate.
>
>
> Currently:
>
> nortriptyline 100mg
> Lamictal 150mg
> Topamax 100mg
> Abilify 10mg
>
>
> - Scott
>
Posted by SLS on August 30, 2006, at 16:58:42
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued » SLS, posted by MARTY on August 30, 2006, at 12:02:55
>
> Btw Scott, how much did it cost you for 10mg pill and 20mg pill ?Meridia comes in 5mg, 10mg, and 15mg capsules. The 10mg cost me $4.50.
I'm not sure why Meridia made me feel worse. Maybe it was the downregulation of NE alpha-2 receptors as was reported in one study. Idazoxan, a NE alpha-2 antagonist, made me feel worse too.
How did you react to Remeron?
- Scott
Posted by SLS on August 30, 2006, at 17:15:23
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued, posted by SLS on August 30, 2006, at 7:32:58
7 days @ 10mg
12 days @ 20mg
7 day @ 0mg
I can see that this is not going to be a rapid or smooth disappearance of whatever worsened state sibutramine left me in. Today was almost as bad as two days ago. The middle of the day was the worst. It may be that sibutramine produced a downregulation of NE alpha-2 receptors as was reported in one study. This might be detrimental to me as the NE alpha-2 antagonist, idazoxan, exacerbated my depression significantly.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by MARTY on August 30, 2006, at 23:35:58
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued » MARTY, posted by SLS on August 30, 2006, at 16:58:42
Hi Scott --Before answering your question, I need to tell you something ... I'm just plain dead jealous of your psychopharmalogical knowledges/skills. Since how long do you "study" it ? What's your background/job/diploma/etc ? How much for an online course ? :D I'm barely joking ...
Remeron made me feel very uncomfortable. I took it only 2 times (2 pills).. I had some visual disturbance. Everything was yellowish (just like everything in the Matrix are grenish). My face was completely 'anesthesiate'. And when I tried to relax/sleep I had some bad RLS (Restles Legs Syndrome) which I don't have without Remeron (except between 7 - 11 years old, lightly.
And you, how do you react to Remeron ?
Btw, I just started Meridia tonight (3 hours ago actually).. I request it to one of my 2 Pdocs and he agreed. I'm on 10 mg at sleep time. It cost me about the same price, but in CAD$. So far I feel okay. I'm more awaken, more energy..
I currently take:
.5 Risperdal
20 Lexapro
37.5 Lamictal BID (150 pills cut in 4) trying to stop it
900 Lyrica (300 at breakfast, lunch and at bed time)
10 Meridia
Since we have some similarities in our profile, I wonder how I will do on Meridia. Did you lost some weight on it ? at worst I hope I can take it long enough to loose a couple pound (30 would be great) ...Marty
> > Btw Scott, how much did it cost you for 10mg pill and 20mg pill ?
>
> Meridia comes in 5mg, 10mg, and 15mg capsules. The 10mg cost me $4.50.
>
> I'm not sure why Meridia made me feel worse. Maybe it was the downregulation of NE alpha-2 receptors as was reported in one study. Idazoxan, a NE alpha-2 antagonist, made me feel worse too.
>
> How did you react to Remeron?
>
>
> - Scott
Posted by SLS on August 31, 2006, at 7:50:24
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued » SLS, posted by MARTY on August 30, 2006, at 23:35:58
> And you, how do you react to Remeron ?
I only tried Remeron for a few days. I was afraid to continue with it because I felt it made me worse almost immediately.
> Btw, I just started Meridia tonight (3 hours ago actually)..
Good luck with it.
Just be careful of serotonin syndrome because you are also taking Lexapro. Early warning signs might include muscle rigidity and mental confusion.
- Scott
---------------------------------------Serotonin Syndrome
Mental status changes
Confusion (51%)
Agitation (34%)
Hypomania (21%)
Anxiety (15%)
Coma (29%)Cardiovascular
Sinus tachycardia (36%)
Hypertension (35%)
Hypotension (15%)Gastrointestinal
Nausea (23%)
Diarrhea (8%)
Abdominal pain (4%)
Salivation (2%)Motor Abnormalities
Myoclonus (58%)
Hyperreflexia (52%)
Muscle rigidity (51%)
Restlessness (48%)
Tremor (43%)
Ataxia/incoordination (40%)
Shivering (26%)
Nystagmus (15%)
Seizures (12%)Other
Diaphoresis (45%)
Unreactive pupils (20%)
Tachypnea (26%)
Hyperpyrexia
Posted by ed_uk on August 31, 2006, at 14:24:44
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued » MARTY, posted by SLS on August 31, 2006, at 7:50:24
Hi Scott
Have you ever taken clonidine?
Ed
Posted by ed_uk on August 31, 2006, at 14:25:59
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued » SLS, posted by ed_uk on August 31, 2006, at 14:24:44
PS. Interestingly, although clonidine has been reported to induce depression in some patients, euphoria has also been reported as a side effect!
Ed
Posted by SLS on August 31, 2006, at 15:02:01
In reply to Re: Sibutramine (Meridia) - Day 25 - Discontinued, posted by ed_uk on August 31, 2006, at 14:25:59
> PS. Interestingly, although clonidine has been reported to induce depression in some patients, euphoria has also been reported as a side effect!
Hmm.
This I didn't know. I wish I had some to play with.
Thanks!
- Scott
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