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Dr. Bob is Robert Hsiung, MD,
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Posted by Slinky on April 1, 2005, at 20:07:59
In reply to I got up at 5pm....., posted by ed_uk on April 1, 2005, at 14:05:40
,,I've had this sleeping pattern for eons..it's become a way of life for me..well, no life really.
I'm passed normality.
Good luck with MAIOS.~~Slinky
Posted by zeugma on April 1, 2005, at 21:15:23
In reply to I got up at 5pm....., posted by ed_uk on April 1, 2005, at 14:05:40
Hi ed,
It might help to take a sedating AD like trazodone at the same time every night. This way you'll get more sleep at night. I believe that sleep during the day is a lot less restorative than sleep at night. It will only lessen the lethargy a little, but it will help normalize the circadian cycle.
I've slept for 24 hours at a time on several occasions. There's nothing weirder than having an entire day go by without a single waking moment.
Also, you can take trazodone with an MAOI.
-z
Posted by KaraS on April 1, 2005, at 21:26:08
In reply to I got up at 5pm....., posted by ed_uk on April 1, 2005, at 14:05:40
Dear Ed,
So sorry to hear about your struggle. I know what it's like to fight to get out of bed each day - that horrible moment when you wake up and realize where you are and what your situation is. It's the worst. I am better off when I am forced to get up for some reason. When I sleep longer than 8 hours I feel so much more depressed and then the cycle continues downward - but then I'm sure you know all about that. I wish you could come to the U.S. for treatment. Is there any chance you could continue your studies here? We'd love to have you! (There aren't nearly enough funny, smart, caring people such as yourself here.)
Kara
Posted by Spriggy on April 1, 2005, at 21:48:42
In reply to Re: Above post to Maxime (nm), posted by ed_uk on April 1, 2005, at 18:32:57
If push comes to shove and you want your doctor's attention to see you REALLY need something ASAP. I think I have found the magic recipe.
Take off all your clothes and run through the streets of your town totally naked.
THEN, after the police have arrested you, explain what happened to your doctor and THEN ask for a specific medicine to treat your condition.
You might think I'm joking but I know for a fact it works.
Posted by Sarah T. on April 2, 2005, at 0:32:40
In reply to I got up at 5pm....., posted by ed_uk on April 1, 2005, at 14:05:40
Hi Ed,
I sympathize with you completely. I have extraordinary difficulty with my circadian rhythms. I have actually wished I could visit England or some place else in Europe for a few weeks. Then, when I returned to the U.S., my inner clock would be 6 or more hours ahead. Of course, the next challenge would be staying on that schedule, but I figure I'd deal with that when the time came.
From your post, I couldn't quite figure out what medicines you're on now. Are your current medications exacerbating your sleep/wake difficulties? You mentioned that you want to take an MAOI. Have you ever been on an MAOI before?
Do you have Daylight Savings Time in the U.K.? This weekend (at 2 a.m. Sunday morning, April 3rd), most of the states in the U.S. will change to Daylight Savings Time. We have to set our clocks one hour ahead, which means we lose an hour of sleep. We'll get that hour back next fall when we return to Standard Time, but that's no consolation now. I don't know how I'm going to get up an hour earlier. I can barely get out of bed an hour later! I'm thinking about trying melatonin in another desperate effort to change my circadian clock, but I'm afraid it will make me more depressed.
I do hope you had some good dreams during those sixteen hours of sleep. Sometimes dreaming is fun, sort of like going to the movies!
You're NOT alone, Ed.
Posted by ed_uk on April 2, 2005, at 5:35:33
In reply to Re: I got up at 5pm...I sorta know how you feel » ed_uk, posted by Slinky on April 1, 2005, at 20:07:59
Hi!
>I'm passed normality.
Me too :-S
Regards,
Ed.
Posted by ed_uk on April 2, 2005, at 5:40:21
In reply to Re: I got up at 5pm..... » ed_uk, posted by zeugma on April 1, 2005, at 21:15:23
Hi Z!
>It might help to take a sedating AD like trazodone at the same time every night. This way you'll get more sleep at night.
I think you could be right but trazodone often causes a 'hangover' and makes it difficult to wake up in the morning- I'd be worried about that happening to me. I could ask for Provigil but I'm pretty sure my pdoc wouldn't even consider it. All 'stimulants' are seen as being the 'Devil's drugs' here, everything gets 'treated' with Effexor.
>I've slept for 24 hours at a time on several occasions.
At the most, I've probably slept about 19hrs, this was not uncommon when I was depressed.
Kind regards,
Ed.
Posted by ed_uk on April 2, 2005, at 5:41:13
In reply to Re: I got up at 5pm..... » ed_uk, posted by KaraS on April 1, 2005, at 21:26:08
Hi Kara!
Thank you for your kind words :-)
Ed xx
Posted by ed_uk on April 2, 2005, at 5:42:24
In reply to hey ED... try this, posted by Spriggy on April 1, 2005, at 21:48:42
LOL Spriggy it's true- but I'd get an antipsychotic, not an MAOI!!
Ed x
Posted by ed_uk on April 2, 2005, at 5:46:00
In reply to Re: I got up at 5pm..... » ed_uk, posted by Sarah T. on April 2, 2005, at 0:32:40
Hi Sarah!
Thank you for your kind words :-)
>From your post, I couldn't quite figure out what medicines you're on now. Are your current medications exacerbating your sleep/wake difficulties? You mentioned that you want to take an MAOI. Have you ever been on an MAOI before?
I'm just on lofepramine 140mg/day, it doesn't really affect my sleeping at all. I've taken moclobemide (Manerix) but it didn't help, my pdoc wouldn't prescribe a 'proper' MAOI, he'd never prescribed one before and he wasn't going to start with me!
>Do you have Daylight Savings Time in the U.K.?
Oh yes, we had to put the clocks forward! YUCK.
Kind regards,
Ed.
Posted by TamaraJ on April 2, 2005, at 10:11:32
In reply to Re: I got up at 5pm..... » zeugma, posted by ed_uk on April 2, 2005, at 5:40:21
Hi Ed,
> I think you could be right but trazodone often causes a 'hangover' and makes it difficult to wake up in the morning- I'd be worried about that happening to me.
>
~~ FWIW, I tried Trazadone last spring, and the 'hangover' was terrible for me. I was only taking 25mg, which I took as early as about 10pm. Even on that low dose, I couldn't function before noon the next day! I would just keep fading in and out of sleep all morning. And, even after the effects wore off, I was sluggish, lethargic and down for the remainder of the day. That being said, my body may well have adjusted to the effects of the traz after having taken it for a longer period of time, but I wasn't willing to go through that horrid hangover effect any longer.You might want to talk to Larry about Melatonin, if you can get it over the counter in the UK. I think ome people do quite well using it to regulate their sleep cycles.
Take care Ed.
All the best,
Tamara
Posted by ed_uk on April 2, 2005, at 11:13:39
In reply to Re: I got up at 5pm..... » ed_uk, posted by TamaraJ on April 2, 2005, at 10:11:32
Hi Tamara!
>You might want to talk to Larry about Melatonin, if you can get it over the counter in the UK. I think ome people do quite well using it to regulate their sleep cycles.
You could be right, it might help :-) It's a shame that it's not available over the counter here. It's not approved in the UK so doctors rarely prescribe it.
Ed xxxxxxxxx
Posted by Sarah T. on April 2, 2005, at 13:05:06
In reply to Re: I got up at 5pm...I sorta know how you feel » ed_uk, posted by Slinky on April 1, 2005, at 20:07:59
> ,,> I'm passed normality.
>> ~~SlinkySlinky, that means you're supra-normal!
Posted by Bob on April 2, 2005, at 13:55:16
In reply to Re: I got up at 5pm..... » TamaraJ, posted by ed_uk on April 2, 2005, at 11:13:39
I have always wondered about whether others out there were suffering from the same ridiculous sleep cycle problems I have been dealing with for so many, many years. Any medecine with an SRI component in it eventually causes me to sleep a minimum of 10 hours, and many times 15, 16, 18, etc. To me, it's always been the worst feeling in the world to wake up so late and realize you've missed the entire day. What's even more infuriating is to realize that most people don't get this problem when they take these meds. The worse one of all for me was Effexor. Then of course, when I tried to get off, the withdrawl practically crushed me. I tried all kinds of ways to keep myself awake, including stimulants, melatonin, 5-HTP, and other compounds. Some of them worked for a little while (melatonin and stimulants), but evenutally they all faded out, and I was left sleeping 15 or so hours per day. I don't think I've ever come across one doctor or fellow patient who was able to help me with this. Ironically, one day on this board, I saw a thread about MAOIs where the poster claimed they made him sleep all the time. That was disheartening.
Bob
Posted by ed_uk on April 2, 2005, at 14:34:23
In reply to Re: I got up at 5pm..... » ed_uk, posted by Bob on April 2, 2005, at 13:55:16
Hi Bob!
>Ironically, one day on this board, I saw a thread about MAOIs where the poster claimed they made him sleep all the time.
Although MAOIs *can* cause people to sleep excessively, they can also reduce hypersomnia in other people. Do you think you'll try one? Perhaps Parnate.
Ed.
Posted by Bob on April 2, 2005, at 14:53:20
In reply to Re: I got up at 5pm..... » Bob, posted by ed_uk on April 2, 2005, at 14:34:23
> Hi Bob!
>
> >Ironically, one day on this board, I saw a thread about MAOIs where the poster claimed they made him sleep all the time.
>
> Although MAOIs *can* cause people to sleep excessively, they can also reduce hypersomnia in other people. Do you think you'll try one? Perhaps Parnate.
>
> Ed.I don't know what I'll do next. Just about everything I've tried in my life has been a disaster, including between 35 and 40 psychoactives. Believe it or not, I'm currently near the end of a cycle of ECT treatments, for the first time ever. I don't have a lot of confidence in it right now. The day of the treatments (at least the first part) I feel great, and practically cured. Then the days after are difficult, with anxious depression, and confusion. I'm losing faith.
The only major class of meds I've never tried are MAOIs, but I am so prone to side effects, and so sensitive to withdrawl, that I'm not sure it wouldn't be my worst experience to date. I can't really rule anything out, but I'm not looking foward to it, anyway.
I can't believe how much this condition sucks.
Posted by ed_uk on April 2, 2005, at 15:08:48
In reply to Re: I got up at 5pm..... » ed_uk, posted by Bob on April 2, 2005, at 14:53:20
Hello Bob,
I'm sorry to hear that the ECT isn't providing you with any sustained benefits.
>The only major class of meds I've never tried are MAOIs, but I am so prone to side effects, and so sensitive to withdrawl, that I'm not sure it wouldn't be my worst experience to date.
Many people respond to MAOIs after nothing else has helped, several people on this board have found that. Tricyclic antidepressants are often ineffective for people with hypersomnia, MAOIs can work well in these people. Please don't give up.
Kind regards,
Ed.
Posted by TamaraJ on April 2, 2005, at 18:03:32
In reply to Re: I got up at 5pm..... » TamaraJ, posted by ed_uk on April 2, 2005, at 11:13:39
> Hi Ed!
>
> You could be right, it might help :-) It's a shame that it's not available over the counter here. It's not approved in the UK so doctors rarely prescribe it.
>
~~ If you wanted to try it, perhaps you could order from an on-line, natural supplements supplier. Or is it restricted for import into the UK and can only be prescribed by a physician?Also, I know you are aware of the research done on using thyroid meds to augment ADs. Perhaps that is something that your pdoc might consider, if you can make a strong enough argument for a trial (there seems to be quite a bit of research to substantiate its effectiveness as an augmenting agent). Anyway, I am just including the following website because it seems to have a lot of info on studies done on augmenting with thyroid meds.
http://www.modern-psychiatry.com/thyroid.htm
Take care,Tamara
xxx
Posted by ed_uk on April 2, 2005, at 18:30:11
In reply to Re: I got up at 5pm..... » ed_uk, posted by TamaraJ on April 2, 2005, at 18:03:32
Hi Tamara!
>Or is it restricted for import into the UK and can only be prescribed by a physician?
Yes, I think it's restricted. I could import it anyway though, I very much doubt I would get into trouble. Thank you for the suggestion :-)
> Perhaps that is something that your pdoc might consider........
I will ask at my next appointment- in a couple of weeks. Thank you for the link, it was very good. Just out of curiousity, do you still have dessicated thyroid in Canada? It hasn't been available in the UK for decades! I think they call it 'Armour' in the US but I could be wrong.
Ed xxxx
Posted by banga on April 2, 2005, at 18:47:27
In reply to Re: I got up at 5pm..... » TamaraJ, posted by ed_uk on April 2, 2005, at 18:30:11
I think they call it 'Armour' in the US but I could be wrong.
>
> Ed xxxxHi Ed!
It is, indeed, armour thyroid in the US...B.
Posted by KaraS on April 2, 2005, at 21:01:03
In reply to Re: I got up at 5pm..... » TamaraJ, posted by ed_uk on April 2, 2005, at 18:30:11
I think they call it 'Armour' in the US but I could be wrong.
>
> Ed xxxx
There are actually a couple of other natural dessicated thyroid meds in the U.S. They are Westhroid and Naturethroid. They are both made by the same company. The Naturethroid has fillers that are more hypoallergenic. I haven't tried either of them yet though some holistic doctors do prefer them over Armour.
Posted by Bob on April 3, 2005, at 10:16:24
In reply to Re: I got up at 5pm..... » Bob, posted by ed_uk on April 2, 2005, at 15:08:48
> Hello Bob,
>
> I'm sorry to hear that the ECT isn't providing you with any sustained benefits.
>I had another period of feeling reasonable last night, but by this morning it was gone again. In a way it is hard to deal with, because I get little fleeting windows of feeling reasonable, and then they are gone. Maybe the good times will become more often, but I am somewhat dubious.
> >The only major class of meds I've never tried are MAOIs, but I am so prone to side effects, and so sensitive to withdrawl, that I'm not sure it wouldn't be my worst experience to date.
>
> Many people respond to MAOIs after nothing else has helped, several people on this board have found that. Tricyclic antidepressants are often ineffective for people with hypersomnia, MAOIs can work well in these people. Please don't give up.
>
> Kind regards,
> Ed.I've had significant problems with weight gain, hypersomnia, loss of sexuality, akathisia (at least sometimes), and even difficulty urinating sometimes with many meds. These include SSRIs, Tricyclics and Effexor. Trying meds like Lithium and Depakote have mainly produced problems with weight oversleeping, and sex. I don't think I would ever rule out MAOIs, but would be surprised if many of the same side-effects wouldn't be there, and it seems to me like some of the best things in life, such as sex and food, are severely cramped with these meds.
Posted by ed_uk on April 3, 2005, at 12:03:34
In reply to Re: I got up at 5pm..... » ed_uk, posted by Bob on April 3, 2005, at 10:16:24
Hi Bob,
>I had another period of feeling reasonable last night, but by this morning it was gone again. In a way it is hard to deal with, because I get little fleeting windows of feeling reasonable, and then they are gone. Maybe the good times will become more often, but I am somewhat dubious.
How far into your course of ECT are you? How often are you having it? 2-3 times a week?
>I don't think I would ever rule out MAOIs, but would be surprised if many of the same side-effects wouldn't be there, and it seems to me like some of the best things in life, such as sex and food, are severely cramped with these meds.
The MAOIs have a different mechanism of action to all of the other other antidepressants. Tranylcypromine (Parnate) would certainly be worth considering. Have you asked your psychiatrist about trying an MAOI? Since the MAOIs are completely different to any of the antidepressants you've tried so far, they could be very beneficial- you might be surprised. Optimist is currently doing well on a high dose of Parnate with no side effects at all.
Ed.
Posted by Bob on April 3, 2005, at 13:43:58
In reply to Re: I got up at 5pm..... » Bob, posted by ed_uk on April 3, 2005, at 12:03:34
> Hi Bob,
>
> How far into your course of ECT are you? How often are you having it? 2-3 times a week?I believe tomorrow's treatment will be number 13, but I'm not sure. At first they were M-W-F, and then they switched to M and F.
> The MAOIs have a different mechanism of action to all of the other other antidepressants. Tranylcypromine (Parnate) would certainly be worth considering. Have you asked your psychiatrist about trying an MAOI? Since the MAOIs are completely different to any of the antidepressants you've tried so far, they could be very beneficial- you might be surprised. Optimist is currently doing well on a high dose of Parnate with no side effects at all.
>
> Ed.No side-effects at all? Uhhhh, I dunno. Anyway, I have discussed MAOIs, but we decided to try this first. I have had such a terrible time with medecines, that I wanted to take a break. I realize that MAOIs may prove to be a magic bullet, but I've got to believe it's a long shot. What I'm really afraid of is what has always happened before: I get on a therapeutic dose of the stuff, and then a very unpleasant side effect develops, such as anger, agitation, or sexual obsession, or excessive weight gain, extreme lethargy/drowsiness, or whatever else. Then, I can't get off it quickly, so my life becomes a daily, living hell as I try to taper down. Past experiences like this have been nothing short of life threatening. Even if the med does work, I've never been on one that keeps working. Nevertheless, I won't rule them out.
Posted by ed_uk on April 3, 2005, at 14:11:52
In reply to Re: I got up at 5pm..... » ed_uk, posted by Bob on April 3, 2005, at 13:43:58
Hi Bob,
>I believe tomorrow's treatment will be number 13........
How many treatments will you be having? What side effects have you had so far?
>No side-effects at all? Uhhhh, I dunno.
He had some mild sexual dysfunction for a few days and then no side effects from then on. You can babblemail him if you like! Many people do have side effects from MAOIs, there's no doubt about that, I just wanted you to know that some people don't. Since the MAOIs are very different to any of the other antidepressants, you might find that you like them. Interestingly, some people seem to do much better on one MAOI than on another... the three main MAOIs are phenelzine (Nardil), tranylcypromine (Parnate) and isocarboxazid (Marplan).
Which antidepressants have caused you the worst side effects in the past?
Ed.
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