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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 148 to 172 of 281. Go back in thread:
Posted by Bob on October 4, 2009, at 22:43:42
In reply to Re: Going back to old-school - lithium. » Bob, posted by SLS on October 4, 2009, at 5:23:14
> > Scott -
> >
> > Do you have any experience with amitriptyline? Although it's dirty, it's apparently effective.
> >
> > Bob
>
>
> The success rate of amitriptyline probably exceeds that of Effexor. Aside from the pronounced anticholinergic side effects, some people experience profound sedation and somnolence with amitriptyline. I hated the way I felt on it. However, others seem unaffected and do extremely well. If you do experience sedation immediately upon taking amitriptyline, that does not mean that you will be affected long-term. Sedation often resolves with continued use. The anticholinergic side effects can mitigate as well.
>
>
> - Scott
Did you experience the sedation/somnolence?
Posted by SLS on October 8, 2009, at 6:11:59
In reply to Re: Going back to old-school - lithium. » SLS, posted by Bob on October 4, 2009, at 22:43:42
Doing better.
:-)
Currently:
Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
lithium 600mg
Patience seems to have paid off.
- Scott
Posted by sowhysosad on October 8, 2009, at 9:26:45
In reply to Re: Going back to old-school - lithium., posted by SLS on October 8, 2009, at 6:11:59
> Doing better.
>
> :-)
>
> Currently:
>
> Parnate 80mg
> nortriptyline 150mg
> Lamictal 200mg
> lithium 600mg
>
>
> Patience seems to have paid off.
>
>
> - ScottGreat news.
So you decided not to restart the Abilify then?
Posted by SLS on October 8, 2009, at 10:04:06
In reply to Re: Going back to old-school - lithium. » SLS, posted by sowhysosad on October 8, 2009, at 9:26:45
> > Doing better.
> >
> > :-)
> >
> > Currently:
> >
> > Parnate 80mg
> > nortriptyline 150mg
> > Lamictal 200mg
> > lithium 600mg
> >
> >
> > Patience seems to have paid off.
> >
> >
> > - Scott
>
> Great news.
>
> So you decided not to restart the Abilify then?
I almost ran back to Abilify out of fear, but decided to give the lithium a few more days. I think I got lucky.How are things with you?
- Scott
Posted by floatingbridge on October 8, 2009, at 19:58:47
In reply to Re: Going back to old-school - lithium., posted by SLS on October 8, 2009, at 6:11:59
Great news, Scott
:-D
fb
> Doing better.
>
> :-)
>
> Currently:
>
> Parnate 80mg
> nortriptyline 150mg
> Lamictal 200mg
> lithium 600mg
>
>
> Patience seems to have paid off.
>
>
> - Scott
Posted by sowhysosad on October 9, 2009, at 13:07:53
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by SLS on October 8, 2009, at 10:04:06
> How are things with you?
Not too bad, thanks for asking.
Had a heart-to-heart with my soon-to-be-ex wife a while back and smoothed things over. Contrary to her previous emotional coldness, it became clear she still loves me and doesn't want anyone else but I had to agree we just can't live together right now.
We may even continue our relationship on new terms. Being in that house is making me slump further into depression, so I'm looking forward to a fresh start in a new environment.
Meds-wise I really don't know what to do. Pdoc was supposed to be switching me from fluoxetine to another SSRI because of tachycardia, anxiety and dysphoria.
However, I'm now having a total rethink on SSRI's. They all seem to provoke the return of a movement disorder in my jaw, which in itself makes me miserable. And I suspect I may still be highly sensitive to serotonergics after rapidly discontinuing Lexapro a year ago.
I've pretty much just drifted off the fluoxetine but have had no withdrawal effects thanks to the long half-life of norfluoxetine.
The biggest improvement in mood I've had of late was by adding 1-1.5g of L-Tyrosine. I also hoped it might help the movement disorder by increasing dopamine levels in the substantia nigra and nigrostriatal pathway, but the improvement has been subtle at best.
If I can get to see the neuro again (no appointments available for months on end due to appalling NHS resources) I'd like to try an anticonvulsant, dopamine agonist or low-dose buspirone. That said, the movement disorder may spontaneously resolve as my brain returns to baseline after the fluoxetine. I had maybe an 80% improvement during a med-free period in the summer.
I might just add a tiny bit of 5-HTP or tryptophan at night to balance out the tyrosine in case the dopamine inhibits serotonin release.
Apologies for rambling! Any thoughts on what I should do, med-wise?
Posted by floatingbridge on October 9, 2009, at 13:48:14
In reply to Re: Going back to old-school - lithium. » SLS, posted by sowhysosad on October 9, 2009, at 13:07:53
Sowhysosad,
I'm pleased to hear that you are able to be working with your wife. Depression is tough on the whole family. When I was at my worst, I almost lost my long-time husband due to the strain (and yes, my behavior). We are doing better than ever now. I'm getting better treatment, acting out less, and he spent some time really listening and 'groking' what 'it' was like for me. no 'snapping out of it' as they say.
I'm very relieved for you.
fb
Posted by sowhysosad on October 9, 2009, at 13:57:03
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by floatingbridge on October 9, 2009, at 13:48:14
Thanks fb!
> We are doing better than ever now. I'm getting better treatment, acting out less, and he spent some time really listening and 'groking' what 'it' was like for me.That's great news.
Posted by SLS on October 14, 2009, at 5:08:07
In reply to Re: Going back to old-school - lithium. » floatingbridge, posted by sowhysosad on October 9, 2009, at 13:57:03
I'm still alive, but things feel as if they have stalled and plateaued. I don't know whether to intervene now or allow things to work for awhile longer. I am still less than 50% improved. I am grateful to feel better, but my life is not likely to change much at this point. I feel that I need to feel a bit better before seeking employment.
- Scott
Posted by sowhysosad on October 14, 2009, at 12:48:07
In reply to Re: Going back to old-school - lithium., posted by SLS on October 14, 2009, at 5:08:07
> I'm still alive, but things feel as if they have stalled and plateaued.
But you're not any worse since you bounced back post-Abilify?
> I feel that I need to feel a bit better before seeking employment.
I'm in a similar situation. I feel that I would benefit from the routine of a regular job, but I'm scared to commit myself in case I deteriorate and suffer the embarrassment of having to quit early on.
Posted by SLS on October 14, 2009, at 15:40:58
In reply to Re: Going back to old-school - lithium. » SLS, posted by sowhysosad on October 14, 2009, at 12:48:07
> > I'm still alive, but things feel as if they have stalled and plateaued.
>
> But you're not any worse since you bounced back post-Abilify?That's correct. I seem to be no worse for having stopped the Abilify.
> > I feel that I need to feel a bit better before seeking employment.
> I'm in a similar situation. I feel that I would benefit from the routine of a regular job, but I'm scared to commit myself in case I deteriorate and suffer the embarrassment of having to quit early on.The hardest part is to get started. I'm not ready yet. I hope I haven't become too accustomed to being unemployed and collecting disability.
- Scott
Posted by Bob on October 14, 2009, at 18:35:13
In reply to Re: Going back to old-school - lithium. » SLS, posted by sowhysosad on October 14, 2009, at 12:48:07
>
> > I feel that I need to feel a bit better before seeking employment.
>
> I'm in a similar situation. I feel that I would benefit from the routine of a regular job, but I'm scared to commit myself in case I deteriorate and suffer the embarrassment of having to quit early on.
Ain't that the truth! I have this thought almost every day. I was disappointing a lot of people, not to mention myself, at the end of my employment before I finally acquired disability. A sense of obligation, responsiblity and commitment only go so far. My problem was serious enough that it eventually overwhelmed me.
Posted by sowhysosad on October 14, 2009, at 19:42:39
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by Bob on October 14, 2009, at 18:35:13
> I was disappointing a lot of people, not to mention myself, at the end of my employment before I finally acquired disability. A sense of obligation, responsiblity and commitment only go so far. My problem was serious enough that it eventually overwhelmed me.
Yeah, I had a little taster of that last year when I lost a freelance job because of this depression.
I'd only been there a couple of months and it was only two days a week, but it was still disappointing. I recall turning up one day but having to leave as I was completely unable to function!
This time around I just want a no-brainer, minimum-wage kind of job, so it would be particularly humiliating not to be able to stick it out.
Posted by sowhysosad on October 14, 2009, at 19:44:34
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by SLS on October 14, 2009, at 15:40:58
> The hardest part is to get started. I'm not ready yet. I hope I haven't become too accustomed to being unemployed and collecting disability.
I'm sure you'll be fine when the time is right but, as you say, you need to be 100% ready to make the leap.
Posted by Phillipa on October 14, 2009, at 19:44:48
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by SLS on October 14, 2009, at 15:40:58
Scott thanks!!!! Phillipa
Posted by Maxime on October 15, 2009, at 13:06:26
In reply to Re: Going back to old-school - lithium. » SLS, posted by sowhysosad on October 14, 2009, at 12:48:07
Scott, you try and do some volunteer work. It will keep you busy and you can work when you want to work. I find doing volunteer work essential for mental health.
Posted by Maxime on October 15, 2009, at 13:44:19
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by Maxime on October 15, 2009, at 13:06:26
Posted by SLS on October 15, 2009, at 14:38:46
In reply to Re: Going back to old-school - lithium. » sowhysosad, posted by Maxime on October 15, 2009, at 13:06:26
> Scott, you try and do some volunteer work. It will keep you busy and you can work when you want to work. I find doing volunteer work essential for mental health.
You're too smart. This has been suggested to me by numerous people in the mental health profession. I will call this week to find out what resources there are available locally. Thanks.
The last few days have been pretty crappy. I hope it is only a temporary worsening. I would hate to have to go back to Abiify, but I will if necessary.
- Scott
Posted by SLS on October 16, 2009, at 8:27:01
In reply to Re: Going back to old-school - lithium. » Maxime, posted by SLS on October 15, 2009, at 14:38:46
I have been deteriorating rapidly over the last week. Increasing my dosage of lithium to 900mg has not helped. My best guess is that my discontinuing Abilify has allowed for this worsening of depression to occur. Although I am not at all happy about having the need to take Abilify, I have decided to restart it.
- Scott
Posted by ColoradoSnowflake on October 16, 2009, at 10:25:39
In reply to Re: Going back to old-school - lithium., posted by SLS on October 16, 2009, at 8:27:01
Hi Scott:
I'm sorry you'll have to go back on the Abilify, but I commend you for doing whatever you need to in order to feel better.
I hope it will put you back where you were a few months ago; i.e. feeling pretty darned good!
I've missed your valuable input on things!
Good luck!
Gayle
Posted by ricker on October 16, 2009, at 11:35:09
In reply to Re: Going back to old-school - lithium., posted by SLS on October 16, 2009, at 8:27:01
> Although I am not at all happy about having the need to take Abilify, I have decided to restart it.
Hi Scott,
Sorry to hear about your decline in mood. I'm in the same boat with Zyprexa but have no other choices at the moment.
I keep telling myself it is a fair trade-off (weight gain) for the mood enhancement. I also try and remain optimistic in that our options will broaden with the discovery of newer, user friendly drugs coming down the pipeline?This time of year (Thanksgiving/Christmas/winter blues) seems to challenge my ability to remain optimistic, but I keep telling myself it's temporary! Hang in there my friend, you will overcome your temporary setback. If you need the Abilify then so be it, nothing to be down about.
All the best,
Rick
Posted by floatingbridge on October 16, 2009, at 18:59:52
In reply to Re: Going back to old-school - lithium., posted by SLS on October 16, 2009, at 8:27:01
Scott, I'm sorry to hear about your deterioration of mood and having to start abilify. Do you think a lower dose might be therapeutic and give you some of the benefits that seem negated at the higher dose (like weight gain). (My two cents worth.)
My best wishes for your renewed health and mood,
warmly,
fb
Posted by uncouth on October 16, 2009, at 19:27:56
In reply to Re: Going back to old-school - lithium. » SLS, posted by floatingbridge on October 16, 2009, at 18:59:52
scott have you tried zyprexa? i seem to be fairly similar to you in background and meds tried, and zyprexa has been significantly different than geodon and abilify for me. zyprexa at 5mg made abilify 10mg and geodon 120mg look like a sugar pill.
yeah, there's weight gain, but i don't think that's a reason to suffer!
Posted by Phillipa on October 16, 2009, at 19:42:13
In reply to Re: Going back to old-school - lithium., posted by SLS on October 16, 2009, at 8:27:01
Scott not to anger or upset you but you know I've been here since your cymbalta trial. I've noticed a pattern the last year at least. That is when you start to think about work again you seem to deteriorate. And same time of year. And the weather's been absolutely horrible. Love Phillipa and do hope the abilify begins to work quickly for you
Posted by SLS on October 18, 2009, at 6:30:45
In reply to Re: Going back to old-school - lithium., posted by uncouth on October 16, 2009, at 19:27:56
> scott have you tried zyprexa? i seem to be fairly similar to you in background and meds tried, and zyprexa has been significantly different than geodon and abilify for me. zyprexa at 5mg made abilify 10mg and geodon 120mg look like a sugar pill.
>
> yeah, there's weight gain, but i don't think that's a reason to suffer!I tried Zyprexa once. I think I started at 10mg. I experienced a brief improvement in the first week, and then watched it disappear. Raising the dosage did not help. However, I have not combined Zyprexa with the same drugs I am currently taking, so I guess it must remain as an alternative.
Thanks, Uncouth.
- Scott
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