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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 101 to 125 of 201. Go back in thread:
Posted by SLS on October 1, 2011, at 7:40:13
In reply to Re: Viibrid Treatment » SLS, posted by jhj on October 1, 2011, at 6:48:01
>
> hi
>
> i am not sure.
>
> I think if the antidepressant effect is sustained for reasonable period of time i.e.few months may be.
>
> jhj
Frederick Quitkin, MD (RIP) addressed the phenomenology of placebo the effect and its effects on the assessment of clinical antidepressant trials. He and his research team published a few articles about this. One of the things that they reported was that placebo responders "relapsed" rather quickly compared to those taking active antidepressant compounds.As for me, I don't think that I have the potential to feel better on placebo. Recently, I tried a series of nutriceuticals in an effort to improve my chances of responding to my ongoing drug treatment. I was pretty convinced that the vitamins and supplements would make a big difference. Some made me feel worse, while the rest were without effect. I should think that I would have had a placebo "response" to these things because of how optimistic I was that they would work as well for me as they did for the friend of mine who suggested I take them.
There are at least two reasons why I might be less apt than others to feel improved on placebo.
1. I am bipolar.
2. My depression is rated as very severe. I score over 35 on depression scales - Hamilton Rating Scale for Depression (HRSD).
I am glad that you posted your feedback about my medical condition. Thanks you.
- Scott
Posted by Conundrum on October 1, 2011, at 9:33:55
In reply to Re: Viibrid Treatment, posted by SLS on September 30, 2011, at 7:50:07
Awesome Scott. :D
Are you taking advantage of the good feelings? Going out and doing things?
Posted by Phillipa on October 1, 2011, at 19:19:20
In reply to Re: Viibrid Treatment, posted by Conundrum on October 1, 2011, at 9:33:55
Scott how's it going today? Phillipa
Posted by SLS on October 1, 2011, at 19:21:26
In reply to Re: Viibrid Treatment, posted by Conundrum on October 1, 2011, at 9:33:55
> Awesome Scott. :D
>
> Are you taking advantage of the good feelings? Going out and doing things?
YES!I went to an antique car show with a friend today and took pictures. It was nice to feel well enough to WANT to go somewhere and be around people. The Viibryd is still helping, and I am feeling better than I did on Nardil. I expect to feel very well in a few months. Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
Thanks for asking...
- Scott
Posted by zonked on October 1, 2011, at 19:50:06
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
>
> YES!
>
> I went to an antique car show with a friend today and took pictures. It was nice to feel well enough to WANT to go somewhere and be around people. The Viibryd is still helping, and I am feeling better than I did on Nardil. I expect to feel very well in a few months. Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
>
> Thanks for asking...
>
>
> - ScottOh wow. I am really glad for you, and I hereby wish to all relevant deities that the torturous "blip" responses you've gotten are finally over.
I'll be keeping an eye on your progress (I would anyway); I have heard a lot of good about this one... on other boards, as well.
Scott, has low energy or concentration ever been symptoms for you? I know it's early, but how is treatment affecting these symptoms (if you have them).
You know, if Viibryd is as good for old-fashioned MDD as it may be for TRD, Forest could have a blockbuster on its hands. I think the reason we haven't seen much press is because major marketing hasn't started.
(Anyone want to predict the animations they use in the commercials this time?)
I digress. The fact that you are enjoying something that you SHOULD enjoy rather than dragging yourself along and not "feeling" it (boy do I know what that's like) is pretty damned good news.
-z
Posted by Phillipa on October 1, 2011, at 21:04:51
In reply to Re: Viibrid Treatment » SLS, posted by zonked on October 1, 2011, at 19:50:06
Scott congrats knew this med would work!!! Phillipa
Posted by FrustratedMama on October 1, 2011, at 21:21:59
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
So so so happy for you!!!! Your posts always help me - glad you are getting some relief!
Posted by floatingbridge on October 1, 2011, at 21:26:15
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
Yay!
Posted by Conundrum on October 2, 2011, at 1:17:56
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
> > Awesome Scott. :D
> >
> > Are you taking advantage of the good feelings? Going out and doing things?
>
>
> YES!
>
> I went to an antique car show with a friend today and took pictures. It was nice to feel well enough to WANT to go somewhere and be around people. The Viibryd is still helping, and I am feeling better than I did on Nardil. I expect to feel very well in a few months. Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
>
> Thanks for asking...
>
>
> - ScottThats great! You have a lot of living to catch up on! :)
Posted by SLS on October 2, 2011, at 4:34:40
In reply to Re: Viibrid Treatment, posted by Conundrum on October 2, 2011, at 1:17:56
> Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
> Thats great! You have a lot of living to catch up on! :)
Yes. You understand.Thanks.
- Scott
Posted by Phillipa on October 2, 2011, at 19:12:43
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 2, 2011, at 4:34:40
So day 7 higher dose and still working fabulous. Phillipa
Posted by Seige on October 4, 2011, at 4:40:21
In reply to Re: Viibrid Treatment » SLS, posted by Phillipa on October 2, 2011, at 19:12:43
Great to hear you have found some relief SLS.
Posted by morgan miller on October 4, 2011, at 11:30:25
In reply to Re: Viibrid Treatment, posted by Seige on October 4, 2011, at 4:40:21
Hope the improvement continues!
Morgan
Posted by SLS on October 4, 2011, at 11:33:35
In reply to Re: Viibrid Treatment, posted by morgan miller on October 4, 2011, at 11:30:25
Posted by huxley on October 5, 2011, at 4:10:34
In reply to 40%, posted by SLS on August 23, 2011, at 6:42:25
> Hi All.
>
> Patience.
>
> Apparently, my brain has taken another major step in its process of recovery and healing. I am perhaps 40% improved. It has been a year since I began taking Nardil. I was afraid that I might be "stuck" at 35%. So, what explains this protracted process? I haven't encountered anyone else who has had to wait so long to recover from MDD or BD depression. My doctor feels that this is the product of severity and the length of time spent in the depressive state.
>
> Patience.
>
>
> - ScottHi Scott,
I hope you don't take this post as an attack or that it is offensive to you.
Have you thought that maybe you have damaged your brain with the amount of drugs you have taken and that your extended depressive state is actually caused by the very thing that is purporting to cure it?
Seems to me that it would be quite easy to destabilize the delicately balanced complex brain equilibrium.
Posted by SLS on October 5, 2011, at 5:54:46
In reply to Re: 40%, posted by huxley on October 5, 2011, at 4:10:34
Hi Huxley.
> Hi Scott,
>
> I hope you don't take this post as an attack or that it is offensive to you.
>
> Have you thought that maybe you have damaged your brain with the amount of drugs you have taken and that your extended depressive state is actually caused by the very thing that is purporting to cure it?
>
> Seems to me that it would be quite easy to destabilize the delicately balanced complex brain equilibrium.
No offense taken. I am extrememly happy and feel fortunate that you should offer me feedback about my illness. To a great degree, you are absolutely right. It seems rather obvious that repeated antidepressant drug exposures induce a resistance to an array of treatments. Unfortunately, my treatment resistance and pattern of tachyphylaxis (poop-out) showed up with the very first drug I tried: imipramine.As you so accurately portray, I have grown more and more resistant to treatment. My only extended remission was achieved using a combination of Parnate and desipramine. My doctor at that time proceeded to withdraw these medications after 9 months of remission out of concern for the appearance of mania. Of course, in retrospect, this was a decision that was to cost me two decades of my life. I never responded to that treatment ever again, despite trying it multiple times.
Question: What better choice did I have but to treat the depression with what has been available?
Thanks for your thoughtful feedback.
- Scott
Posted by ihatedrugs on October 5, 2011, at 17:06:55
In reply to Re: 40%, posted by SLS on October 5, 2011, at 5:54:46
Scott
Have you ever considered ECT?
ihatedrugs
Posted by SLS on October 5, 2011, at 18:09:56
In reply to Re: 40% » SLS, posted by ihatedrugs on October 5, 2011, at 17:06:55
> Scott
>
> Have you ever considered ECT?
>
>
> ihatedrugs
Yes.I underwent a series of 15 treatments in 1991. The first 6 were unilateral left. The remaining 9 were bilateral. I have no idea what the dosage was. It proved ineffective. Max Fink told me that I could try the more current procedures in which unilateral right was used at higher dosages.
- Scott
Posted by Conundrum on October 5, 2011, at 18:59:22
In reply to Re: 40% » ihatedrugs, posted by SLS on October 5, 2011, at 18:09:56
> > Scott
> >
> > Have you ever considered ECT?
> >
> >
> > ihatedrugs
>
>
> Yes.
>
> I underwent a series of 15 treatments in 1991. The first 6 were unilateral left. The remaining 9 were bilateral. I have no idea what the dosage was. It proved ineffective. Max Fink told me that I could try the more current procedures in which unilateral right was used at higher dosages.
>
>
> - ScottIn Scott's last few posts he said that he was doing better on Viibryd. So why would he try ECT or be worried about brain damage?
Posted by zonked on October 5, 2011, at 20:11:53
In reply to Re: 40% » ihatedrugs, posted by SLS on October 5, 2011, at 18:09:56
Max Fink told me that I could try the more current procedures in which unilateral right was used at higher dosages.
>
>
> - ScottScott, you had personal contact with Fink? What did you make of him? Based on things he's written (one thing more or less advised the MD to tell the patient any memory loss was psychosomatic whether or not this was actually believed to be true, for his or her own benefit.), I think he's drinking his own ECT Kool-Aid too much.
Posted by huxley on October 6, 2011, at 2:46:01
In reply to Re: 40%, posted by SLS on October 5, 2011, at 5:54:46
> Hi Huxley.
>
> > Hi Scott,
> >
> > I hope you don't take this post as an attack or that it is offensive to you.
> >
> > Have you thought that maybe you have damaged your brain with the amount of drugs you have taken and that your extended depressive state is actually caused by the very thing that is purporting to cure it?
> >
> > Seems to me that it would be quite easy to destabilize the delicately balanced complex brain equilibrium.
>
>
> No offense taken. I am extrememly happy and feel fortunate that you should offer me feedback about my illness. To a great degree, you are absolutely right. It seems rather obvious that repeated antidepressant drug exposures induce a resistance to an array of treatments. Unfortunately, my treatment resistance and pattern of tachyphylaxis (poop-out) showed up with the very first drug I tried: imipramine.
>
> As you so accurately portray, I have grown more and more resistant to treatment. My only extended remission was achieved using a combination of Parnate and desipramine. My doctor at that time proceeded to withdraw these medications after 9 months of remission out of concern for the appearance of mania. Of course, in retrospect, this was a decision that was to cost me two decades of my life. I never responded to that treatment ever again, despite trying it multiple times.
>
> Question: What better choice did I have but to treat the depression with what has been available?
>
>
> Thanks for your thoughtful feedback.
>
>
> - Scott
>
>
>
>That is the million dollar question isn't it.
For myself I have found that a life with no nicotine, no alcohol, a healthy diet and plenty of exercise keeps me well enough.I just strongly suspect that medication is making many of us far worse of than we would be without it.
Posted by SLS on October 6, 2011, at 5:41:46
In reply to Re: 40%, posted by huxley on October 6, 2011, at 2:46:01
> > > I hope you don't take this post as an attack or that it is offensive to you.
> > >
> > > Have you thought that maybe you have damaged your brain with the amount of drugs you have taken and that your extended depressive state is actually caused by the very thing that is purporting to cure it?
> > >
> > > Seems to me that it would be quite easy to destabilize the delicately balanced complex brain equilibrium.> > No offense taken. I am extrememly happy and feel fortunate that you should offer me feedback about my illness. To a great degree, you are absolutely right. It seems rather obvious that repeated antidepressant drug exposures induce a resistance to an array of treatments. Unfortunately, my treatment resistance and pattern of tachyphylaxis (poop-out) showed up with the very first drug I tried: imipramine.
> >
> > As you so accurately portray, I have grown more and more resistant to treatment. My only extended remission was achieved using a combination of Parnate and desipramine. My doctor at that time proceeded to withdraw these medications after 9 months of remission out of concern for the appearance of mania. Of course, in retrospect, this was a decision that was to cost me two decades of my life. I never responded to that treatment ever again, despite trying it multiple times.
> >
> > Question: What better choice did I have but to treat the depression with what has been available?
> >
> >
> > Thanks for your thoughtful feedback.
> That is the million dollar question isn't it.
>
>
> For myself I have found that a life with no nicotine, no alcohol, a healthy diet and plenty of exercise keeps me well enough.That's great. I wish for you that you remain in good health.
I wish I could say the same for myself. I have tried what you describe, and it just doesn't make a dent in my condition. That is not to say that your methods don't work for some people. They do. Just not me. Perhaps bipolar disorder is less responsive to exercise.
> I just strongly suspect that medication is making many of us far worse of than we would be without it.
In the future, it should be possible to choose drugs based upon genetic tests. This should predict which drugs will help and which drugs will hurt.
- Scott
Posted by uncouth on October 6, 2011, at 19:13:23
In reply to Re: 40%, posted by SLS on October 5, 2011, at 5:54:46
Scott, that is interesting what you mention about being on parnate and desipramine and being withdrawn, then having it NEVER work again. Were you on that MAOI for a long time?
Are you familiar with David Foster Wallace's story? He was on Nardil for something like 15 years, and he and his pdoc thought, hey my life is going well, i just got married, i'm settled, i'm dealing with my success pretty well these days, and i just had a bad med food reaction, maybe its time to try something else, because hey we've had a lot of advances in depression treatments since they started me on nardil.
he withdrew, over a long period of time too, and about a year later killed himself. NOTHING -- NOTHING else worked, including ECT, and even rechallenging with MAOIs.
Have you heard of this long-term MAOI poop out, then NOT working when rechallenged happening to otehrs? I wonder what is behind it?
What do you think happens when MAOIs are discontinued in the brain?
Posted by floatingbridge on October 6, 2011, at 19:37:55
In reply to Re: 40% » SLS, posted by uncouth on October 6, 2011, at 19:13:23
Uncouth,
I heard a different story about DFW. His story is a complicated one like many of ours. He had a history of suicide attempts and urges. Not everyone of us contends with these urges at the same intensity. He is one high profile Nardil user. None of us here are exactly the same. And there is no way to predict
with certainty success or failure, though we don't stop trying :-)Opening to the possibility of success and the variuos forms success might take is both a talent and a skill one can develop. Accepting uncertainty in life is an act
and gift of grace in my opinion.I wish DFW had lived long enough to regain his stability because a year or less is such a short time when dealing with MI and medication.
Posted by floatingbridge on October 7, 2011, at 20:45:50
In reply to Re: 40% » SLS, posted by uncouth on October 6, 2011, at 19:13:23
Uncouth,
I heard a different story about DFW. His story is a complicated one like many of ours. He had a history of suicide attempts and urges. Not everyone of us contends with these urges at the same intensity. He is one high profile Nardil user. None of us here are exactly the same. And there is no way to predict
with certainty success or failure, though we don't stop trying :-)Opening to the possibility of success and the variuos forms success might take is both a talent and a skill one can develop. Accepting uncertainty in life is an act
and gift of grace in my opinion.I wish DFW had lived long enough to regain his stability because a year or less is such a short time when dealing with MI and medication.
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