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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Rocks Cry Out on April 1, 2002, at 21:36:12
Thank you for reading my post.
I am unipolar depressed. I am looking for a medication to take, but I don't know of anything I haven't tried. I have tried complete 6-week trials with viable doses of these medications:
--Mood Stabilizers--
Lithium
Divalproex
Carbamazepine
Gabapentin
Lamotrigine
Topiramate
Verapamil
Tiagabine
Zonisamide
Phenytoin--Antidepressants--
Paroxetine
Sertraline
Fluvoxamine
Fluoxetine
Venlafaxine
Mirtazapine
Buspirone
Desipramine
Nortriptyline
Clomipramine
Trimipramine
Doxepin
Tranylcypromine
Selegiline
Nefazodone
Buproprion
Maprotiline
Amoxapine--Atypical Neuroleptics--
Olanzapine
Risperidone
Quietiapine
ZiprasidoneOTHERS:
--Parkinsons' Drugs--
Ropinirole
Pramipexole
BromocriptinePindolol
T4 Supplementation
T3 Supplementation--Foreign Medicines--
Reboxetine
Moclobemide
Dothiepin
Mianserin
Amisulpride
Tianeptine
Sibutramine
Lofepramine--Natural--
Kava Kava
Valerian Root
Saint John's Wort
L-tryptophan
5-HTP
Omega 3s
B12HELP!
Posted by Dr. Kramer on April 2, 2002, at 11:25:09
In reply to Kramer: I'm the most treatment-resistant case , posted by Rocks Cry Out on April 1, 2002, at 21:36:12
> Thank you for reading my post.
>
> I am unipolar depressed. I am looking for a medication to take, but I don't know of anything I haven't tried. I have tried complete 6-week trials with viable doses of these medications:
>
> --Mood Stabilizers--
> Lithium
> Divalproex
> Carbamazepine
> Gabapentin
> Lamotrigine
> Topiramate
> Verapamil
> Tiagabine
> Zonisamide
> Phenytoin
>
> --Antidepressants--
> Paroxetine
> Sertraline
> Fluvoxamine
> Fluoxetine
> Venlafaxine
> Mirtazapine
> Buspirone
> Desipramine
> Nortriptyline
> Clomipramine
> Trimipramine
> Doxepin
> Tranylcypromine
> Selegiline
> Nefazodone
> Buproprion
> Maprotiline
> Amoxapine
>
> --Atypical Neuroleptics--
> Olanzapine
> Risperidone
> Quietiapine
> Ziprasidone
>
> OTHERS:
>
> --Parkinsons' Drugs--
> Ropinirole
> Pramipexole
> Bromocriptine
>
> Pindolol
> T4 Supplementation
> T3 Supplementation
>
> --Foreign Medicines--
> Reboxetine
> Moclobemide
> Dothiepin
> Mianserin
> Amisulpride
> Tianeptine
> Sibutramine
> Lofepramine
>
> --Natural--
> Kava Kava
> Valerian Root
> Saint John's Wort
> L-tryptophan
> 5-HTP
> Omega 3s
> B12
>
> HELP!I'm not sure what you expect me to say here, except yes, that's pretty much every med I've ever heard of, and the kind of psychopharm consultation you need is well beyond what can be posted on a board such as this.
Posted by JGm on April 2, 2002, at 11:35:40
In reply to Re: Kramer: I'm the most treatment-resistant case , posted by Dr. Kramer on April 2, 2002, at 11:25:09
Posted by fachad on April 2, 2002, at 15:17:58
In reply to Kramer: I'm the most treatment-resistant case , posted by Rocks Cry Out on April 1, 2002, at 21:36:12
Out of all the slew of meds, you have not tried Dexedrine or Ritalin.
That is a MAJOR omission, IMHO.
Those medications are not "first line" antidepressants for political among other reasons, but they are extremely effective in some cases.
For me they worked, and are still working 7 years later, even though I miserably failed full trials of:
Elavil
Prozac
Wellbutrin
Paxil
Desipramine
Zoloft
Effexor
SerzoneI did have to add a small dose of Prozac to my Ritalin last year because of a depression that developed from (Dr. ordered and approved) pain meds, but other that that I have achieved and maintained virtually total remission of my depressive symptoms for 7+ years on CNS stimulants alone.
The low dose Prozac gave me bad side effects, including sexual problems and really bad insomnia. How ironic that I had been taking amphetamines for years and sleeping fine – but add little Prozac and suddenly I’ve got treatment resistant insomnia.
The CNS stimulants have far fewer side effects than the classical antidepressants. They do not cause dry mouth, constipation, diarrhea, GI distress, weight gain, or sexual problems. Also, they are available as inexpensive generics. They usually start working very quickly.
One final note: do not count on feeling "energized" by these drugs. That effect wears off in a few months for most people. The antidepressant effect does NOT wear off when the stimulant effect does, it goes on indefinitely, or at least it has for me. 7 years with poop-out is pretty good, considering the averages.
Of course, Your Mileage May Vary.
> Thank you for reading my post.
>
> I am unipolar depressed. I am looking for a medication to take, but I don't know of anything I haven't tried. I have tried complete 6-week trials with viable doses of these medications:
>
> --Mood Stabilizers--
> Lithium
> Divalproex
> Carbamazepine
> Gabapentin
> Lamotrigine
> Topiramate
> Verapamil
> Tiagabine
> Zonisamide
> Phenytoin
>
> --Antidepressants--
> Paroxetine
> Sertraline
> Fluvoxamine
> Fluoxetine
> Venlafaxine
> Mirtazapine
> Buspirone
> Desipramine
> Nortriptyline
> Clomipramine
> Trimipramine
> Doxepin
> Tranylcypromine
> Selegiline
> Nefazodone
> Buproprion
> Maprotiline
> Amoxapine
>
> --Atypical Neuroleptics--
> Olanzapine
> Risperidone
> Quietiapine
> Ziprasidone
>
> OTHERS:
>
> --Parkinsons' Drugs--
> Ropinirole
> Pramipexole
> Bromocriptine
>
> Pindolol
> T4 Supplementation
> T3 Supplementation
>
> --Foreign Medicines--
> Reboxetine
> Moclobemide
> Dothiepin
> Mianserin
> Amisulpride
> Tianeptine
> Sibutramine
> Lofepramine
>
> --Natural--
> Kava Kava
> Valerian Root
> Saint John's Wort
> L-tryptophan
> 5-HTP
> Omega 3s
> B12
>
> HELP!
Posted by OldSchool on April 2, 2002, at 17:58:10
In reply to Kramer: I'm the most treatment-resistant case , posted by Rocks Cry Out on April 1, 2002, at 21:36:12
> Thank you for reading my post.
>
> I am unipolar depressed. I am looking for a medication to take, but I don't know of anything I haven't tried. I have tried complete 6-week trials with viable doses of these medications:
>
> --Mood Stabilizers--
> Lithium
> Divalproex
> Carbamazepine
> Gabapentin
> Lamotrigine
> Topiramate
> Verapamil
> Tiagabine
> Zonisamide
> Phenytoin
>
> --Antidepressants--
> Paroxetine
> Sertraline
> Fluvoxamine
> Fluoxetine
> Venlafaxine
> Mirtazapine
> Buspirone
> Desipramine
> Nortriptyline
> Clomipramine
> Trimipramine
> Doxepin
> Tranylcypromine
> Selegiline
> Nefazodone
> Buproprion
> Maprotiline
> Amoxapine
>
> --Atypical Neuroleptics--
> Olanzapine
> Risperidone
> Quietiapine
> Ziprasidone
>
> OTHERS:
>
> --Parkinsons' Drugs--
> Ropinirole
> Pramipexole
> Bromocriptine
>
> Pindolol
> T4 Supplementation
> T3 Supplementation
>
> --Foreign Medicines--
> Reboxetine
> Moclobemide
> Dothiepin
> Mianserin
> Amisulpride
> Tianeptine
> Sibutramine
> Lofepramine
>
> --Natural--
> Kava Kava
> Valerian Root
> Saint John's Wort
> L-tryptophan
> 5-HTP
> Omega 3s
> B12
>
> HELP!
Rocks, you need bilateral ECT.Old School
Posted by Zo on April 3, 2002, at 0:52:05
In reply to Kramer: I'm the most treatment-resistant case , posted by Rocks Cry Out on April 1, 2002, at 21:36:12
It may seem trivial, compared to the size of your list,but I'd be DEAD without Dexedrine. It does something for my brain that is as necessary as air and water, and without it, I suffered continually and immensely. It targets something I just don't have.
Interestingly, there is a genetic glitch on one of the dopamine aelles (sp?) discovered but a few years ago --- I think the researcher won a Nobel? . . and my family is shot thru with ADD, addictions and other dopamine-related dysfunctions.
I'd do Adderall, but it doesn't quite hit the sweet spot. Just added Provigil, and a whole new area lit up. . .
Best of luck,
Zo
Posted by Elizabeth on April 4, 2002, at 20:12:51
In reply to Re: Kramer: I'm the most treatment-resistant case , posted by Dr. Kramer on April 2, 2002, at 11:25:09
> I'm not sure what you expect me to say here, except yes, that's pretty much every med I've ever heard of, and the kind of psychopharm consultation you need is well beyond what can be posted on a board such as this.
I think that a lot of people with difficult-to-treat depression or dysthymia tend to feel like they're "the most treatment-resistant case," or something similar. One thing this board provides is the opportunity to find out that there are things you haven't tried. Whenever someone posts a long list of drugs they've tried, invariably, someone else will post a response to the effect of, "you didn't mention _____." As you can see, several people have posted responses of this sort in this thread.
On a related note, there's been a lot of discussion about a novel antidepressant treatment that seems very promising for many of us who haven't had much success with traditional approaches: the use of opioids (another thing that wasn't on Rocks's list). I've been taking buprenorphine for over a year with impressive results (for previously treatment-resistant melancholia). Lately a lot of people on PB seem to be interested in it. It seems clear to me that there are some people who need something different from (or more than) the various monoaminergic antidepressants. Do you have an opinion about this? I'd be particularly interested to hear if you have any comments on the ongoing discussion here on PB on the subject of opioids (mainly buprenorphine). I'd like to see this treatment become more mainstream (if nothing else, it would be much more convenient for me if retail pharmacies started carrying the stuff :-) ).
-elizabeth
Posted by katrina smith on April 5, 2002, at 19:01:20
In reply to Re: Kramer: I'm the most treatment-resistant case » Dr. Kramer, posted by Elizabeth on April 4, 2002, at 20:12:51
elizabeth, i read your post to kramer re the use of opioids. where do you get them? is that something you can say on this chat? i do have an appt. at mclean next week with a doc that did the study, but i'm 100% sure my pdoc won't go for it. what are the regs of importing meds? i've tried to find out with no avail. i'm ready to give up on this life. please help.
Posted by Dr. Bob on April 5, 2002, at 23:22:47
In reply to Re: Kramer: I'm the most treatment-resistant case, posted by katrina smith on April 5, 2002, at 19:01:20
> what are the regs of importing meds? i've tried to find out with no avail. i'm ready to give up on this life.
I hope you don't give up, but at the same time, please don't use this site to exchange information on how to import prescription medication without a prescription:
http://www.dr-bob.org/babble/faq.html#illegal
Thanks, and best wishes,
Bob
PS: Follow-ups regarding posting policies should be redirected to Psycho-Babble Administration.
Posted by Elizabeth on April 7, 2002, at 22:04:26
In reply to Re: Kramer: I'm the most treatment-resistant case, posted by katrina smith on April 5, 2002, at 19:01:20
> elizabeth, i read your post to kramer re the use of opioids. where do you get them?
I get them at a retail pharmacy; my psychiatrist prescribes them.
> i do have an appt. at mclean next week with a doc that did the study, but i'm 100% sure my pdoc won't go for it.
With Dr. Bodkin? I didn't know he was still seeing patients. He's a great guy, very smart. He's also highly regarded; I think that if he makes a recommendation to your pdoc, it will be taken seriously.
> what are the regs of importing meds? i've tried to find out with no avail. i'm ready to give up on this life. please help.
I don't know much about that. I think it's legal import a 3 month supply of a medication if you have a prescription for it, but I don't know all the details or whether this applies to controlled substances. Dr Bob doesn't want people to discuss ways to get medication illegally on the board (not without good reason).
Best of luck to you.
-elizabeth
Posted by katrina smith on April 8, 2002, at 18:56:44
In reply to Re: Kramer: I'm the most treatment-resistant case » katrina smith, posted by Elizabeth on April 7, 2002, at 22:04:26
elizabeth thank you for the post. I had a appt with one of dr. bodkins closest associates and yes he did mention using opiates, but still need to find someone to prescribe. i with it didn't have to be this difficult. I mean my psych will give me enough benzos to kill a horse, but when it comes to opiates-forget it!!! RIDICULOUS. i would like them to walk a day in my shoes. If it wasn't for my 9 yo disabled son, I would not remain on this earth. the pain emotional and physical is unbearable. such a positive statement, i know but i am frustrated. anyways hope you are well and thanks for the info. keep me informed. do you live in the boston area or is that to personal to ask. i could use a good, reliable, openminded psychiatrist. bye for now.
This is the end of the thread.
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