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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by Bob on August 27, 2009, at 11:47:07
Does anyone know if Trivastal is available in the US?
Does Trivastal have the drowsiness and/or sleep attack problems of drugs like Mirapex?
Is there any type of withdrawal associated with Trivastal?
Posted by clipper40 on August 27, 2009, at 15:00:15
In reply to Tivastal?, posted by Bob on August 27, 2009, at 11:47:07
It's not available in the U.S. I haven't heard that it has any of the sleep problem during the day - probably because of noradrenergic activity (which Mirapex and Requip don't have). I'm still doing research on the withdrawal issue. As you know I've heard from a couple of people who didn't have a withdrawal problem on it but it looks like they were on low dosage for not that long a period of time. I found one study that claimed the withdrawal effect was comparable to that of bromocriptine but I really don't know much about bromocriptine's withdrawal so I don't quite know how to interpret that.
Posted by SLS on August 27, 2009, at 15:09:59
In reply to Re: Tivastal? » Bob, posted by clipper40 on August 27, 2009, at 15:00:15
> I haven't heard that it has any of the sleep problem during the day - probably because of noradrenergic activity (which Mirapex and Requip don't have)
Interesting. What effects does piribedil have on NE?
Thanks.
- Scott
Posted by Bob on August 27, 2009, at 16:02:34
In reply to Re: Tivastal? » clipper40, posted by SLS on August 27, 2009, at 15:09:59
> > I haven't heard that it has any of the sleep problem during the day - probably because of noradrenergic activity (which Mirapex and Requip don't have)
>
> Interesting. What effects does piribedil have on NE?
>
> Thanks.
>
>
> - ScottI think it interacts with an alpha-1 receptor?
Posted by SLS on August 27, 2009, at 16:19:23
In reply to Re: Tivastal? » SLS, posted by Bob on August 27, 2009, at 16:02:34
I did some Googling and discovered that piribedil blocks NE alpha-2 receptors - just like Remeron. Apparently, it also stimulates D3 receptors as well as D2. It looks like a pretty good drug.
- Scott
Posted by Phillipa on August 27, 2009, at 21:17:49
In reply to Re: Tivastal?, posted by SLS on August 27, 2009, at 16:19:23
Reqip at .5mg and low dose atypical, and desi also low dose, vyannase seriously cured any old babbler from his crippling depressing back practicing law. No complaints either of sleepiness or lack of sleep. Just a side note. Phillipa
Posted by clipper40 on August 27, 2009, at 22:58:42
In reply to Re: Tivastal?, posted by SLS on August 27, 2009, at 16:19:23
I see you're way ahead of me with the answer as usual. :)
It does look like a good drug on paper. Just the fact that it prevents the daytime falling asleep problem that Mirapex and Requip have makes it sound better to me.
Posted by desolationrower on August 29, 2009, at 1:05:11
In reply to Re: Tivastal?, posted by SLS on August 27, 2009, at 16:19:23
> I did some Googling and discovered that piribedil blocks NE alpha-2 receptors - just like Remeron. Apparently, it also stimulates D3 receptors as well as D2. It looks like a pretty good drug.
>
>
> - Scottits probably helpful to think of it more like yohimbine. there isn't the heavy h1 antagonism offsetting the wakepromoting effects, like in remron..
Posted by Sigismund on August 29, 2009, at 15:37:36
In reply to Re: Tivastal?, posted by desolationrower on August 29, 2009, at 1:05:11
I found it less unpleasant than yohimbine. Probably lots of NE effect with that.
Posted by Darwin on August 30, 2009, at 14:17:45
In reply to Tivastal?, posted by Bob on August 27, 2009, at 11:47:07
I've read some favorable reports on Trivastal here on this forum but I don't recall anyone using Trivastal long term. So, I'm wondering if poop-out is a problem. Short term relief is appreciated but most of us are looking for solutions that will last the rest of our lives.
Posted by Sigismund on August 30, 2009, at 15:51:18
In reply to What about tolerance?, posted by Darwin on August 30, 2009, at 14:17:45
Well, if I'd needed more and had taken it, perhaps that would have happened. But that wasn't the case. I never needed much, one tablet a day was quite enough. I can't remember how long I spent on it. Probably 3 months.
Posted by bleauberry on August 31, 2009, at 21:15:42
In reply to Tivastal?, posted by Bob on August 27, 2009, at 11:47:07
Easy to order mailorder from overseas.
Its NE component prevents sleep attacks.
Don't know about tolerance.
It is a good AD fast acting benign med, at least in my limited experience with it.
Posted by Bob on August 31, 2009, at 21:21:15
In reply to Re: Tivastal?, posted by bleauberry on August 31, 2009, at 21:15:42
> Easy to order mailorder from overseas.
>
> Its NE component prevents sleep attacks.
>
> Don't know about tolerance.
>
> It is a good AD fast acting benign med, at least in my limited experience with it.Can I ask why you stopped using it?
Posted by bleauberry on September 1, 2009, at 17:40:40
In reply to Re: Tivastal? » bleauberry, posted by Bob on August 31, 2009, at 21:21:15
> > Easy to order mailorder from overseas.
> >
> > Its NE component prevents sleep attacks.
> >
> > Don't know about tolerance.
> >
> > It is a good AD fast acting benign med, at least in my limited experience with it.
>
> Can I ask why you stopped using it?
>
>
That's a tough question.I'm in a long process of treating known problems. Psychiatric meds complicate the picture and cause setbacks.
I never intended on getting on Trivastal. I just wanted to know if it was something I could keep in my emergency kit for a really bad time. It is one of the very few that fits that bill.
After my 15 year experience with psych meds, I am strongly gunshy at this point. I have come to respect and fear their power.
Posted by Bob on September 1, 2009, at 20:55:20
In reply to Re: Tivastal? » Bob, posted by bleauberry on September 1, 2009, at 17:40:40
> I never intended on getting on Trivastal. I just wanted to know if it was something I could keep in my emergency kit for a really bad time. It is one of the very few that fits that bill.
>
> After my 15 year experience with psych meds, I am strongly gunshy at this point. I have come to respect and fear their power.
>
That last paragraph states my feelings as well. I can only tolerate low doses of these things any longer and I have to go very slowly when titrating the doses. It's rough.You have picked some meds to be in an 'emergency kit' for bad times? What kinds of drugs do you have in there?
Posted by bleauberry on September 3, 2009, at 19:25:29
In reply to Re: Tivastal? » bleauberry, posted by Bob on September 1, 2009, at 20:55:20
>
> > I never intended on getting on Trivastal. I just wanted to know if it was something I could keep in my emergency kit for a really bad time. It is one of the very few that fits that bill.
> >
> > After my 15 year experience with psych meds, I am strongly gunshy at this point. I have come to respect and fear their power.
> >
>
>
> That last paragraph states my feelings as well. I can only tolerate low doses of these things any longer and I have to go very slowly when titrating the doses. It's rough.
>
> You have picked some meds to be in an 'emergency kit' for bad times? What kinds of drugs do you have in there?Well let's see.
Parnate 2.5mg or 5mg will buy me a new lease on life within about 36 hours of a single dose and last about 3 days, after an initial worsening the first 6 hours during the amphetamine part of it.
Milnacipran at 6mg twice a day usually starts to work on day 2 at removing some of the deep darkness.
Ritalin works within about an hour, 2.5mg to 5mg.
St Johns Wort sometimes, not reliably, 150mg within 72 hours.
Rhodiola Rosea within hours.
I hate Cymbalta because it makes me more depressed the longer I'm on it, but I have to admit that first 1 to 3 days at a mere 5mg are quite a relief from the darkness.
Trivastal next day benefits felt slightly.
Curcumin next day benefits felt slightly.
Obviously I prefer the natural plants of the earth mentioned above. If I feel the need for pharmacological intervention, Ritalin is my first choice, Parnate my second choice.
I am too sensitive to be on meds continuously, even at miniscule doses. My immune system or whatever just frieks out. I get side effects that someone else might not get unless they took double or triple the maximum dose.
Posted by Bob on September 3, 2009, at 21:53:46
In reply to Re: Tivastal? » Bob, posted by bleauberry on September 3, 2009, at 19:25:29
>
> I am too sensitive to be on meds continuously, even at miniscule doses. My immune system or whatever just frieks out. I get side effects that someone else might not get unless they took double or triple the maximum dose.
>
>I too have an extreme problem tolerating meds for a long time. Eventually my condition deteriorates to a very poor state physically, and my mental condition turns to significant apathy and malaise. Unfortunately being off all meds is absolutely risking death for me, and constantly going on and off is slowly killing me. It's not good. Not good at all.
I guess from what you've said concerning your 'emergency kit' of standby meds that you spend periods of time not taking anything and when you hit a crisis you turn to a few days on one of your meds?
Posted by bleauberry on September 4, 2009, at 21:39:35
In reply to Re: Tivastal? » bleauberry, posted by Bob on September 3, 2009, at 21:53:46
> I too have an extreme problem tolerating meds for a long time. Eventually my condition deteriorates to a very poor state physically, and my mental condition turns to significant apathy and malaise. Unfortunately being off all meds is absolutely risking death for me, and constantly going on and off is slowly killing me. It's not good. Not good at all.
>
> I guess from what you've said concerning your 'emergency kit' of standby meds that you spend periods of time not taking anything and when you hit a crisis you turn to a few days on one of your meds?
>
>The apathy and malaise you described are not uncommon with longterm meds. So that didn't raise any warning flags. But when you mentioned the physical deterioration, that is a huge yellow warning flag that something else is going on here. What exactly, I don't know. It would take an Integrative MD to help you explore and test things. Heavy metals, Lyme, Candida, those are top contenders. For sure, a psychiatrist is not going to pay one iota of attention at finding out what is wrong.
I'm off meds almost all the time. I'm trying to treat known conditions. And even though I am not well, psych meds only complicate the picture and in one way or another make it worse. Kind of a catch22 situation. On rare occasions, I do reach for the emergency kit.
Healing, whether it be a weight loss program, cancer chemotherapy, heavy metal detox, Candida, various bacterial invaders, whatever, often comes with what they call a "healing crisis", where the patient feels worse instead of better as the healing process moves forward. There are many logical scientific explanations as to why that happens, and it is a very good sign, but it is also sometimes to the brink of unbearable.
I must confess the most potent arsenal in the tool kit is prayer to Jesus Christ. You know, I've never seen any miracles. Never felt any miracles. All I know is that when I have called on Him in desperation, somehow a day ahead of me that looked impossible was made possible.
Posted by Bob on September 5, 2009, at 16:30:11
In reply to Re: Tivastal?, posted by bleauberry on September 4, 2009, at 21:39:35
> The apathy and malaise you described are not uncommon with longterm meds. So that didn't raise any warning flags. But when you mentioned the physical deterioration, that is a huge yellow warning flag that something else is going on here. What exactly, I don't know. It would take an Integrative MD to help you explore and test things. Heavy metals, Lyme, Candida, those are top contenders. For sure, a psychiatrist is not going to pay one iota of attention at finding out what is wrong.
No doubt, and as you say the psych doc isn't going to pursue other things. Unfortunately I've tried to find out about other possible things for years now - quite exhaustively in fact. I've gotten tested for Lyme on two different occasions, I've seen an endocrinologist for an exhaustive work-up, I've had two head MRI's to check for brain abnormalities, had major exhaustive blood panels done on three occasions, had checks for cortisol levels, blood glucose, thyroid, heart and respiratory tests, tried vitamin supplements of all sorts, and the list goes on. I have not really heard of the heavy metals thing or candida except from you. Don't really know how to pursue those. Up until now however, not a single physical pathology has shown itself in all that testing. I guess that's a good thing, but I'm still suffering.
> I'm off meds almost all the time. I'm trying to treat known conditions. And even though I am not well, psych meds only complicate the picture and in one way or another make it worse. Kind of a catch22 situation. On rare occasions, I do reach for the emergency kit.
It's definitely good that you can remain off of psych meds for periods of time. I sure wish I could do that!
> Healing, whether it be a weight loss program, cancer chemotherapy, heavy metal detox, Candida, various bacterial invaders, whatever, often comes with what they call a "healing crisis", where the patient feels worse instead of better as the healing process moves forward. There are many logical scientific explanations as to why that happens, and it is a very good sign, but it is also sometimes to the brink of unbearable.
The problem for me with the 'healing crisis' is that one never knows whether they are experiencing an actual healing crisis or they are spiraling down to a place they may not be able to escape from.
Posted by bleauberry on September 5, 2009, at 19:20:42
In reply to Re: Tivastal? » bleauberry, posted by Bob on September 5, 2009, at 16:30:11
>
> Up until now however, not a single physical pathology has shown itself in all that testing.I believe all the tests you had were fairly useless. Even the Lyme tests were useless. For one thing, the mainstream routine medical tests are rather rigid and broad in interpretation.
For example the cortisol test...if your cortisol is within the so-called normal range (normal for who, an average sample or you, and every lab has a different normal range), well ok your cortisol is normal at 9am when you had your blood drawn. What was it at noon? 6pm? midnight? 6am? A single test tells absolutely nothing except that your adrenal glands are alive or dead. It is the 24-hour curve that is important, and its relationship to a general average of healthy people, not a single sample. The 4-sample saliva test does that. The Endos do not. They are bound by rigid insurance company guidelines and politics.
Even exhaustive blood testing won't show much. Someone who is on their death bed from either heavy metals or Lyme will not show much of a problem in their blood tests. The tests look at tons of important stuff, but not the right stuff.
Specialists are not a good way to go. Long story. Too limited in scope. Not usually creative. Handcuffed due to politics and economics. Good though for bread-and-butter garden variety obvious stuff. Inability to see the bigger picture through their narrow binoculars.
The doctors who have the widest scope and the familiarity of a whole world of medicine that routine doctors do not are the Integrative MDs. That is who you need. Not specialists.
The Lyme labwork is pitifully inaccurate. The most accurate is a Western Blot done specifically by Igenex Labs. If yours wasn't that, it was a waste of time and money. Lyme is primarily a clinical diagnosis...history, exposure, symptom patterns. There are thousands of people walking around (or not walking) with a diagnosis of Chronic Fatigue Syndrome, Treatment REsistant Depression, Bipolar, Fibromyalgia, and MS, who have those labels because they tested negative but are in fact infected. Their labels are wrong. Their diagnosis wrong.
Tests are useful in the big picture, but not diagnostic. The tests are even declared by the CDC as not to be used for definite diagnosis...they were designed for monitoring and surveilance which allows inaccuracy. Even with a lot of error, it is easy to spot an epidemic breaking out in particular State or Region. The tests are accurage enough for a general trend, but not individual diagnosis. Very long story, you would have to go google it and read about it yourself, but the various organisms of the tick have ingenious methods of avoiding detection by tests and your own immune system.
Testing can be made more accurate, assuming the Western Blot and Igenex, after one has been on antibiotics for some time and then stopped for a couple weeks. The reason is that during that time, the deceptive organisms were weakened and exposed. Now the immune system can see them, and now tests can to. It is amazing how many people entered treatment based on clinical exam but a negative lab diagnosis, then showed a highly positive lab diagnosis later in treatment.
Tricky stuff. I am not suggesting any particular disease or syndrome for you. I am only trying to make the point that huge errors are made in modern medicine much more frequently than the untrained unaware consumer knows.
>
>>
> It's definitely good that you can remain off of psych meds for periods of time. I sure wish I could do that!You will, no doubt. When there is a will and a desire, there is a way. You are smart. You will find the your way. The start is a local search for Integrative MDs or Integrative Nurse Practitioners. In the absence of them, Naturopaths even though not full-fledged MDs are good choices. Not to replace MDs, but to augment them. Like we augment meds. Same thing. Naturopaths have the tests for a ton of things routine MDs don't. They probably have the heavy metal urine test kit right in their office, as do the Integrative MDs.
>
>> The problem for me with the 'healing crisis' is that one never knows whether they are experiencing an actual healing crisis or they are spiraling down to a place they may not be able to escape from.
>Yeah me too. It is hard to tell a Herx reaction from a depressive flare-up reaction. I can't tell the difference actually. Both are real bad.
Posted by Phillipa on September 5, 2009, at 19:51:36
In reply to Re: Tivastal?, posted by bleauberry on September 5, 2009, at 19:20:42
MS MRI diagnosis shows the myelin sheaths that cover the nerves in the brain are not formed corrected and is a definitive test for MS add the patients symptoms also and MS goes into remission for many years at a time. Lymes doesn't not cause MS it's an autoimmune disease. Google MS. Phillipa
Posted by bleauberry on September 6, 2009, at 16:11:31
In reply to Re: Tivastal? » bleauberry, posted by Phillipa on September 5, 2009, at 19:51:36
> MS MRI diagnosis shows the myelin sheaths that cover the nerves in the brain are not formed corrected and is a definitive test for MS add the patients symptoms also and MS goes into remission for many years at a time. Lymes doesn't not cause MS it's an autoimmune disease. Google MS. Phillipa
As is the case in most of medicine, things aint that simple.
For example, "nerves in the brain are not formed correctly". How do we know that? Did we test the person at birth, age 1, age 10, age 20? Were they defective from the beginning, or did they suffer an environmental insult later in life? We don't know. For sure however, it hallmark evidence of a term to describe a certain set of symptoms, named MS.
Case stories are available that describe patients with positive MS MRIs, all the symptoms of MS, negative labs for Lyme, and a diagnosis of MS, yet the MRI brain damage was signifantly reduced or completely eliminated when the patient underwent suspected Lyme disease anyway.
Maybe the neurotoxins of the organisms caused the damage both by direct insult as well as indirect insult on other altered biochemical functions in the body? Maybe removing the cause allowed the miraculous healing powers of the human body to occur?
In any case, if you google this topic of MS versus Lyme, you will find enough evidence to see that real MS patients recovered from an apparently permanent irreversible disease when treated for Lyme disease. The diagnosis in these cases looked accurate...MRI, symptoms, everything. But they were wrong. It was Borellia the whole time. The MRIs later looked much improved or normal.
Another interesting point..."MS goes into remission for many years at a time". One of the mysteries of Lyme disease is that it too can display that behavior. If nothing else, it has to make an inquiring mind wonder if they aren't one and the same.
A final interesting point..."MS it's an autoimmune disease". True. But an autoimmune disease doesn't just fall from the sky. From where did it come? Will the autoimmune disease retreat when the causative agent of it is removed? Apparently in some people, yes.
I'm not making a case here either way. I'm just pointing out that "it aint that simple". When someone is cured of MS with Lyme treatment, it demands to stand back and ask, "What the heck?"
Posted by Phillipa on September 6, 2009, at 21:47:22
In reply to Re: Tivastal?, posted by bleauberry on September 6, 2009, at 16:11:31
BB seriously not trying to be uncivil or anything but is there nothing that is not lyme related? If so most on the board have lymes. I'm off this thread which was tivastal
Posted by elanor roosevelt on September 7, 2009, at 22:26:36
In reply to Re: Tivastal? » bleauberry, posted by Bob on September 3, 2009, at 21:53:46
I took Trivastal a while back.
First and foremost--take on a full stomach.Although the Trivastal(not the LA) did not last long for me, it did, at the time, allow me to see a bit of light and feel okay. It was helpful in getting me to feel good enough to explore more possibilities. I think there is an old thread b/t me and the atmlady about it.
The oddest thing was that after the effects started to fade for me, I would wake up in the middle of the night and just feel great for a while and then I would go back to sleep. Unfortunately I would often wake with a killer headache.
good luck
Posted by Phillipa on September 8, 2009, at 20:57:48
In reply to Re: Tivastal?, posted by elanor roosevelt on September 7, 2009, at 22:26:36
yes I remember atmlady. And the thread is trivestal. Phillipa
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