![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Spoc on June 11, 2005, at 8:27:07
Hi, am on day 4 of 40 mg. Strattera, to become 80 mg. after a week. Given for a condition that docs have tended to describe as closest to some mix of ADD and OCD, yet clearly neither. Overcomplicated/overly comprehensive thought processes, that prevent efficient functioning and/or multitasking; but just as often marked by unwanted hyperfocus. Also, lack of motivation and occasional mild depression that is probably a ramification of this.
I know it can be heck for awhile to get on this or any psy drug, but what I'm wondering is if it's within "normal" range to feel exceptionally depressed while getting on it. I don't feel like I'm in a chemically-induced fog (I would actually prefer that); I just feel more depressed than I've ever been, like for the first time I really could just stay in bed (but be restless, miserable, and unable to relax and enjoy a book or movie or something, even there). And I'm either more confused than ever or just don't have enough motivation to get anything done at all, can't decide which.
I've heard it's best to take Strattera dosing much slower than many docs do, but thought 40 mg. was not THAT rapid; and that even if it kind of is, I would be more likely to be feeling an excess of other side effects, like sleepiness, stomach complaints, dizziness, whatever... But I didn't expect this...? Is it reasonable to believe that in a few weeks I might go from increased depression and confusion to improvement in those areas, or is this a pretty bad indicator?
Thanks for any comments....
Posted by Spoc on June 11, 2005, at 8:37:59
In reply to Depression while getting on Strattera?, posted by Spoc on June 11, 2005, at 8:27:07
... for most of the past two years, as a pinch-hit, I have been taking 50 mg. of tramadol in the AM, and occasionally another 25 mg. later. It usually seemed to even me out and help on most levels, without feeling like I was "on something." So at the same time as starting strattera, I was stopping that. But at 50 to 75 mg./day I wouldn't expect withdrawals -- while on it I had occasionally checked up on that by stopping it for a couple days. I would feel a bit restless, more scattered, decreased overall well-being, but nothing major...
Posted by Jazzed on June 11, 2005, at 23:21:12
In reply to Re: P.S., a possible factor?, posted by Spoc on June 11, 2005, at 8:37:59
I did really well on 40 mg of Strattera, great motivation, felt good, but had urinary hesitance which bothered me, and sweating - way too much for the time of year. YUK! Anyway, I was also supposed to bump up to 80 after one week. After being at 80 for 3 days I started to get these suicidal thoughts pop into my head out of the blue, and I hadn't been like that before. It got worse over the next 3 days, so I called my doc and stopped. Most of what I've read, from a patients pov is that it should be titrated up VERY slowly, but the docs I've talked to say no. I think I'd go with the people who are actually on the medication, since they have first hand knowledge. You know Strattera was originally an AD that never got off the ground for some reason. Are you taking it for ADD or depression?
www.addforums.com has a whole area devoted to Strattera. Also, you have to check out www.crazymeds.org for info on psych drugs.
Jazzed
Posted by Spoc on June 12, 2005, at 5:22:41
In reply to Re: P.S., a possible factor? » Spoc, posted by Jazzed on June 11, 2005, at 23:21:12
> Most of what I've read, from a patients pov is that it should be titrated up VERY slowly, but the docs I've talked to say no. I think I'd go with the people who are actually on the medication, since they have first hand knowledge. You know Strattera was originally an AD that never got off the ground for some reason. Are you taking it for ADD or depression?
A little of both... docs and myself have agreed that whatever afflicts my thought processes can best be described as a little like ADD and a little like OCD, but neither in a typical or classic sense. And I think I get depressed sometimes more as a result of how my entire life is stunted by that.
I did see the crazymeds info and agree that there is a big place in things for hearing about the experiences of actual users, in sources that are clearly pretty reliable and have a knowledgeable population that serves as a system of checks and balances. Especially if a problem has already presented on its own, as it has here. I just hope my new p-pharm will not be annoyed when I start quoting from message boards.
I haven't been up to doing the research I normally would, but did refresh my memory on the fact that in practice, 40 mg. really is high to start. I can't go through another day this way, will stop and call my doc Monday and ask if he even thinks I should bother starting over again at 18 or 25 mg. I saw that many feel extremely lethargic, tired, or have other side effects at high initial doses, but don't think I saw them referring to major depression (if they hadn't been prior). I am ready to sit through a lot for the right payoff, but can't imagine this deplorable mental state ever switching to feeling good.
One thing I am still curious about is, if someone can force themselves to stick out the too-high initial dosing, will they eventually arrive at the exact same level of effectiveness (or ineffectiveness) as they would have going slower.
FYI, if it sheds any clues, Wellbutrin, Ritalin and Adderral have all also made me irritable if not depressed. Maybe I am hitting the entirely wrong receptors for me, but SSRIs have made me flat and not noticeably improved...
> www.addforums.com has a whole area devoted to Strattera.Thanks and thanks for your response. I will check that one out too.
Posted by Jazzed on June 12, 2005, at 11:18:41
In reply to Re: P.S., a possible factor? » Jazzed, posted by Spoc on June 12, 2005, at 5:22:41
> I just hope my new p-pharm will not be annoyed when I start quoting from message boards.
You don't have to quote from the message boards, (or don't tell him you are!) just tell him what you're experiencing, and ask him if you can start at a lower dose, and titrate up more slowly. Seems like a reasonable request to me.
>
> I haven't been up to doing the research I normally would, but did refresh my memory on the fact that in practice, 40 mg. really is high to start.This is my understanding too from people's actual experience, but both my p-doc, and my GP say no, it's the starting dose. I know at the Amen Clinic, they start you at 18 or 25, and you go up slowly from there. What's the harm with asking if you could try starting lower?
>I can't go through another day this way, will stop and call my doc Monday and ask if he even thinks I should bother starting over again at 18 or 25 mg.I sure don't blame you! I wouldn't want to feel that way either. Surely there's no harm in asking if you could try it that way!
>
> One thing I am still curious about is, if someone can force themselves to stick out the too-high initial dosing, will they eventually arrive at the exact same level of effectiveness (or ineffectiveness) as they would have going slower.
This I don't know about, but might be something on the www.addforums.com web site, in the Strattera area.>
> FYI, if it sheds any clues, Wellbutrin, Ritalin and Adderral have all also made me irritable if not depressed. Maybe I am hitting the entirely wrong receptors for me, but SSRIs have made me flat and not noticeably improved...
>That's odd, what were your doses on the adderall and ritalin? I got depressed when my adderall wore off when the dose was too high, and depressed when the strattera dose was raised. Haven't tried wellbutrin, although my gp did give me a prescription, and I have it. Might be you need to soak in the serotonin more , and not the norepinephrine or dopamine. As long as you're not on an SSRI you could try supplementing with 100 mg of 5 HTP, which you can get at a health food store, to see if it makes you feel any better. It works on the serotonin. But don't ever take it if you're on an SSRI, it can cause serotonin syndrome.
Good luck, keep me posted on what the doc says, and how it goes with the meds.
Jazzed
Posted by Cairo on June 12, 2005, at 12:19:59
In reply to Depression while getting on Strattera?, posted by Spoc on June 11, 2005, at 8:27:07
Strattera induced melancholic depression in my teen daughter. And we never even got to 20mg! Symptoms got worse as we gradually increased the dose, and abated when we weaned her off. She also has ADD, mild OCD symptoms, social anxiety. I think anything that stimulates her stress symptom too much (psychostimulants included) cause anxiety or make her dysthymia worse.
Provigil has been OK. It increases energy and alertness, but it's not as good as the stimulants on attention. But insofar as her alertness is better, it helps attention somewhat. She takes it along with an SSRI and it seems to augment the AD effect as well as making her a little more prosocial, too.
Good luck!
Cairo
> Hi, am on day 4 of 40 mg. Strattera, to become 80 mg. after a week. Given for a condition that docs have tended to describe as closest to some mix of ADD and OCD, yet clearly neither. Overcomplicated/overly comprehensive thought processes, that prevent efficient functioning and/or multitasking; but just as often marked by unwanted hyperfocus. Also, lack of motivation and occasional mild depression that is probably a ramification of this.
>
> I know it can be heck for awhile to get on this or any psy drug, but what I'm wondering is if it's within "normal" range to feel exceptionally depressed while getting on it. I don't feel like I'm in a chemically-induced fog (I would actually prefer that); I just feel more depressed than I've ever been, like for the first time I really could just stay in bed (but be restless, miserable, and unable to relax and enjoy a book or movie or something, even there). And I'm either more confused than ever or just don't have enough motivation to get anything done at all, can't decide which.
>
> I've heard it's best to take Strattera dosing much slower than many docs do, but thought 40 mg. was not THAT rapid; and that even if it kind of is, I would be more likely to be feeling an excess of other side effects, like sleepiness, stomach complaints, dizziness, whatever... But I didn't expect this...? Is it reasonable to believe that in a few weeks I might go from increased depression and confusion to improvement in those areas, or is this a pretty bad indicator?
>
> Thanks for any comments....
Posted by Spoc on June 13, 2005, at 8:17:28
In reply to Re: Depression while getting on Strattera?, posted by Cairo on June 12, 2005, at 12:19:59
Thank you both, every little bit helps, and there are ideas in there I'd like to put on my discussion/possibilities list for when I talk to my pdoc. I just started with him, and he is young, fresh and trained with the best, so hopefully he's more open-minded and less fed up with patient input than some long-practicing docs become in time. If he doesn't come to such things on his own, I know I'll be compelled to start mentioning points made at places like crazymeds. In this case, about possible insufficient norepinephrine to reuptake, or problems with MAO. It's probably not just one or two med trials I'll need to get through. Strattera is likely only the first of several things he may have to have me try, since no one has ever had a very clear idea of what my problem is and what may help.
I have a call in to him to ask if we can at least (way!) lower the dose, but sure wouldn't mind if he said maybe we should just skip this one. Maybe it is time for me to stop protesting trying another SSRI, probably something like Luvox. At least this time I know I have a doc who will not balk at adding other things to offset the shortcomings and side effects I've had with them before.
Jazzed, I tried Wellbutrin twice for about four to six weeks each time. Can't recall which formulation it was, think I started at 150 mg. then went up to 300. Ritalin I tried at 5 mg. 2 or 3 times a day and couldn't even get on 10 mg. Adderall I also tried at a very very low dose and just couldn't take it. Strangely, for several weeks initially the Ritalin DID have a very calming (almost sedating) effect on me, and I could better prioritize and make all the little decisions in a day that for most are automatic and unconscious. Then it started doing nothing besides agitating me (while still at the initial dose, and raising it made it worse), all benefit disappeared. The Adderall was agitating right out of the gate. All made me depressed, but it was a different kind than now with the Strattera, it was a pacing, kind of hostile, "mobile" depression (rather than paralyzed, hopeless, stare-at-ceiling type).
Will update when applicable. Thanks again!
Posted by Jazzed on June 13, 2005, at 15:52:15
In reply to Re: Depression while getting on Strattera?, posted by Spoc on June 13, 2005, at 8:17:28
> I just started with him, and he is young, fresh and trained with the best, so hopefully he's more open-minded and less fed up with patient input than some long-practicing docs become in time.
My doc is older, and seems very open minded. More concerned with how something did or didn't work for me, than how it's supposed to work. If I experiment a little, he doesn't seem to mind. I'm pretty saavy about my healthcare though, so maybe that comes through, and I'm definitely not an addictive type.
>
>At least this time I know I have a doc who will not balk at adding other things to offset the shortcomings and side effects I've had with them before.Yeah, sounds like your doc is willing to try different things with you. That's good. It will take some time, trial, and maybe combos.
Good luck with that!>
All made me depressed, but it was a different kind than now with the Strattera, it was a pacing, kind of hostile, "mobile" depression (rather than paralyzed, hopeless, stare-at-ceiling type).That is just so weird. I guess your doc knows about all of that, and how you were affected. Did he have any ideas as to why? I'm really curious! When I took too much Adderall, the depression was a black hole, no hope, suicidal thing. When I took Strattera the depression was feeling minorly sad, and suicidal thoughts just popping into my head out of the blue. Weird. Fortunately, that's all gone now, and the meds seem to be fine. I hope you get to that place too, and do keep me posted, I look forward to hearing how it goes, and what the doc says.
Jazzed
Posted by Spoc on June 14, 2005, at 8:03:35
In reply to Re: Depression while getting on Strattera?, posted by Jazzed on June 13, 2005, at 15:52:15
> My doc is older, and seems very open minded. More concerned with how something did or didn't work for me, than how it's supposed to work. If I experiment a little, he doesn't seem to mind. I'm pretty saavy about my healthcare though, so maybe that comes through, and I'm definitely not an addictive type.
That describes me pretty well too; mainly *ability* to grasp and assess data on the first (rather than current range of knowledge); and ditto on the second. But I guess I have to give him time to know those things, since he just met me.
I think when I hit a point where I can tell we are on the right track, that something is at least helping me somewhat, I may start tweaking a bit on my own. I am pretty comfortable doing that too, and have managed to keep my head above water while not seeing anyone that way.
Well anyway, pdoc called me back last night, told me to stop rather than go down on the Strattera ("never say never," but not now). Indicated that those who have an immediate problem or problem with that dosage tend to have the things like stomach upset, sleeplessness or tiredness, not what I felt. I did sneak in that I'd seen a great deal of "anecdotal" evidence that many need to start at the pace of hair growing; and that I saw that insufficient norepinephrine or problems with MAO can be culprits... That I saw l-tyrosine amongst other things might help... And... while he didn't cop an attitude about it, I can see that (very unfortunately IMO, but I DO understand) he would not exactly welcome hearing that kind of thing often.
I suppose if I adopt a policy of taking whatever anecdotal evidence I want him to comment on and trying to support it with at least something from a fairly reliable source too, he may "have to" listen. (For instance, here, the fact that apparently the Amen Clinic agrees on the dosing thing. That one would be easy, and I may try to find something to print out, but am conflicted about trying the Strat again.) But I don't know if I have it in me now to be doing that regularly, as we run through what will probably be lots of things.
And, all evidence so far is that he really is a "top-notch" guy; and while young, he has very close access to his mentor, a very seasoned top-notch guy. So unless nothing goes anywhere for eons, maybe I should force myself to let him drive. ;-)
So. I am scheduled to see him next on 7/1, and he said he will consider everything carefully and make a plan of action. After two days off the stuff I still felt pretty rotten, but I think it's finally getting better. I still wonder if it's possible that coming off the tramadol underneath it could have been a factor, but it really was just so low of a dose... However I suppose I should be tough and not revert to that in the next two weeks, so I don't ever have to even wonder again. (Drat! I know it would get me out of the red and at least to zero, and after the last week I could really use that. Oh well.)
Can't remember if I mentioned this but another "funny" thing is that I was driven to binge on sugar and simple carbs big time while on the Strat. But I suspect I was only trying to feel SOMETHING besides misery, and to distract myself, rather than actually having cravings. I am the type to use food for comfort when stressed.
Sorry to ramble and thanks for your support and interest, I appreciate it. :-)
Posted by Jazzed on June 14, 2005, at 8:51:47
In reply to Re: Depression while getting on Strattera?, posted by Spoc on June 14, 2005, at 8:03:35
> I can see that (very unfortunately IMO, but I DO understand) he would not exactly welcome hearing that kind of thing often.
I don't do it with my doc either because I figure if everyone did that, he'd never get through an appt.! LOL And, he has to feel that I trust him to know what's right/best/what can be tried and what can't.
BTW, how long are your med check appts? Mine are only 10 min. long. Hard to tell him a whole lot in that amount of time!>
For instance, here, the fact that apparently the Amen Clinic agrees on the dosing thing. That one would be easy, and I may try to find something to print out,A lot of docs might not agree with the Amen stuff. My doc doesn't seem to put much creedance in the SPECT scans. I do, but he doesn't. I figure if you can see the brain and how it functions, if you know the areas you're targeting, and you can see the diff. on and off the meds., then how can it NOT be a good tool?
>but am conflicted about trying the Strat again.)I wouldn't even bother with the Strattera again, at least until you've run through all your other options, esp. since it made you feel so miserable.
>
> And, all evidence so far is that he really is a "top-notch" guy; and while young, he has very close access to his mentor, a very seasoned top-notch guy. So unless nothing goes anywhere for eons, maybe I should force myself to let him drive. ;-)I think that's a good idea to let him drive. Sounds like he's good, knowledgeable, and he's open, what more could someone ask for?
>
> So. I am scheduled to see him next on 7/1, and he said he will consider everything carefully and make a plan of action.Sounds like he's concerned, and will research your options for you. Also sounds like he's willing to talk things over and let you know what's going on. I'd like that.
>After two days off the stuff I still felt pretty rotten, but I think it's finally getting better. I still wonder if it's possible that coming off the tramadol underneath it could have been a factor,I don't know anything about tramadol, what's it for and what's it do? With sugar cravings, you might be low on serotonin. Might mention that to your doc - sugar cravings that is, not the serotonin! LOL
>
> Can't remember if I mentioned this but another "funny" thing is that I was driven to binge on sugar and simple carbs big time while on the Strat. But I suspect I was only trying to feel SOMETHING besides misery, and to distract myself, rather than actually having cravings. I am the type to use food for comfort when stressed.I crave food too, esp sweets when I'm depressed, stressed, bored, etc.... It a medication of sorts.
>
> Sorry to ramble and thanks for your support and interest, I appreciate it. :-)Not rambling at all, glad I can help/listen/lend support.
Jazzy
Posted by ConfuzyQ on June 14, 2005, at 11:24:22
In reply to Re: Depression while getting on Strattera?, posted by Jazzed on June 14, 2005, at 8:51:47
... I must be feeling better, until today all the involved mouse clicking would have sent me back to the couch. ;-)
> BTW, how long are your med check appts? Mine are only 10 min. long. Hard to tell him a whole lot in that amount of time!
I've only seen him once so far, for our initial consult last Tuesday. It was 1.5 hours and may have even been longer if we hadn't had a waiting room mixup. And it was very reasonable $$ for that amount of time. I am hoping that until we at least have SOME reason to think something we're trying is helping, the appts. will continue to be at least 30 or 45 mins, but don't know. I think I will call and find out how much time I can expect to have on 7/1!
> I wouldn't even bother with the Strattera again, at least until you've run through all your other options, esp. since it made you feel so miserable.
Yes, and here's to finally having a pdoc whose meds concentration is evidenced by even HAVING samples on hand, so I didn't have to buy it or rack up more pharmacy records. Where I am, most pdocs seem to just write a script for something garden variety and then channel you towards psychoanalysis or psychotherapy with them.
> I don't know anything about tramadol, what's it for and what's it do?It's very controversial for psy purposes. I was taking 25 to 75 mg./day, but if I was taking the so-called "therapeutic" dose of about 400 mg. a day (or any dose, if I posted this more "loudly"), many here might sternly warn and debate me. It's a synthetic opiate approved for pain, that there has been some credible research into for its use in depression, OCD, several things (I also read that it has similar actions to and works on the same neurotransmitters as Effexor). But it works right away when you take it and it has many less of the kinds of side effects associated with typical ADs. At least at the dose I've been able to limit myself to, it's like being able to have help only when I need it.
Currently it's not scheduled because the FDA still has it classified as having a low potential for abuse. Apparently most people can't catch much of a "buzz" from it even if they try (I don't notice anything besides feeling more level, but never tried higher amounts); and it gives many a head or stomach ache. While it's used for pain, it's not the equivalent of popping things like vicodin or codeine to improve things in your head. I also don't think the research has been on its usefulness as a last-ditch, total emergency treatment like buprenorphine (sp?), but as a viable regular option.
Now, in reality it seems many people do get addicted (but I'm guessing, not necessarily because they all kept using it for a "buzz"). It will probably soon become scheduled. But the classic argument comes up over "addiction vs. habituation/dependence; and withdrawals vs. discontinuation syndrome. Is there really a diff." If one uses it for long enough (at least at a considerable dose), they probably WILL have considerable discomfort if not agony coming off it, but that is not a unique predicament and maybe just a matter of what's more important/worth it. (I used to go off it a couple days here and there to make sure I wasn't at that point.) Similar to coming off other meds, at least the discomfort can be lessened with Prozac. Long term effects may not be known, but what else is new.
(In case anyone is reading and objecting, note that I am not asking my doc to consider advising a "therapeutic" -- or any -- dose of tramadol for me. Have just used a trace to keep me minimally glued together, and it's been a lifesaver for that. Never tempted in two-plus years to go up, even though I could see how much it helped even in low dose. OTOH, if I'd been more miserable all this time maybe I would worked harder to find the right help sooner and and and... nevermind! ;)
> With sugar cravings, you might be low on serotonin. Might mention that to your doc -
Yes I agree that makes a LOT of sense!
I'll be sure to come back here to post when something new develops! :-)
Posted by Jazzed on June 15, 2005, at 13:30:31
In reply to Re: (ex-Spoc here, just changed my name) » Jazzed, posted by ConfuzyQ on June 14, 2005, at 11:24:22
LOL, In my so ADD way, I'm so glad you put your new name! I responded to you when you posted about the change, but do you think for one second I would've remembered!
Wow, you are so lucky to have decent lengthed med check appts. I really like my doc, and he's so busy there's no way he could ever see all his patients if the appts were longer, but sometimes I'm afraid I'm not going to be able to tell him everything I want to tell him. Mine are 10, sometimes 20 min. long. 20 is good, but 10? Forget it! I checked with some of the other p-docs, and 30 seems to be pretty routine.
Nice to have samples, isn't it? My doc also seems to have samples, or I've been given coupons for freebies. Your p-doc does counseling? Mine only does diagnosis and meds. Wish he did counseling, but it might get too intense for me. He doesn't seem to miss ANYTHING!!!
Hey, who could really argue with the Tramadol if it's working for you? Sounds like you really needed to find something that works, hope you can find the right ADD med too. I guess the addiction, if any, would be more physical and that happens with all the ADs anyway, so why not stick with something you know works, and you haven't had to increase, so seems pretty logical to me. Do any other docs give you a hard time about it? I take Vicodin for migraines, and haven't had to increase, or get more than what the doc prescribes. I can see where someone might get addicted if they like feeling spaced out and slow, but not if you want to feel like you're in control, like me.
Talk with ya later!
Jazzy
Posted by ConfuzyQ on June 15, 2005, at 16:44:18
In reply to Re: (ex-Spoc here, just changed my name), posted by Jazzed on June 15, 2005, at 13:30:31
> Wow, you are so lucky to have decent lengthed med check appts.
That remains to be seen! The initial consult, which is all I've had, was long. And since we have no idea what direction to go in yet (not even sure if "it's" more like ADD or OCD), I can only hope I won't be put on 10 or even 20 minutes already! But I might.
> Your p-doc does counseling? Mine only does diagnosis and meds. Wish he did counseling, but it might get too intense for me. He doesn't seem to miss ANYTHING!!!
I found out that this seems to vary by region or state or something. In most areas they do tend to do the meds part only. But where I am, they usually offer/push for both. The talk part with a psychiatrist can be a lot... different than with a psychologist. Can't speak for all of them of course. And I better stop speaking on it period, or we will be redirected! ;-)
> Tramadol... Do any other docs give you a hard time about it?
I have, um, been doing it solo. Researched and went for it. I told one doc about it and he took it in stride because I wasn't asking him for it, and he believed I didn't have a problem with it; but he knew nothing about tramadol or the research. Another was much less than thrilled, but also had never heard of the research. This last time I mentioned it as something that I "happened to notice makes me feel more level and better than anything else ever has, when I take it for *pain.* THEN, I found out there had been research on it as an AD!!" (wink wink). I really don't expect anyone to ever prescribe it for me, its official day will likely never come. But I need to get it into the conversation somehow, because it works in some of the same ways as some other ADs, so it could be a clue to my chemistry that I don't want to be missed.
I want very much to be completely honest and think I soon will, but I was strongly warned that most docs might get the wrong idea about me immediately if I said anything (too soon at least). Many are not aware of the research at all (and I don't mean to cite the fact that it exists as proof of anything at this point, just that credible sources have found it credible to look into; and came to favorable conclusions). Then there's the fact that I would do it on my own... And just to be "safe" many docs would probably assume such a person was using too much or trying to use it for kicks too. I doubt tramadol will ever make it as an approved AD or become widely used off-label for that purpose, it's just too controversial but I don't think it should be. I guess it's because some can get high off it and do. But I don't think it would present bigger problems that way than things like Valium, klonopin and Xanax do. Maybe less even.
> I take Vicodin for migraines, and haven't had to increase, or get more than what the doc prescribes. I can see where someone might get addicted if they like feeling spaced out and slow, but not if you want to feel like you're in control, like me.
Yes, I like to be in control too, and I am also always aware that something that feels "too" good can only lead to problems that will ultimately feel like CRAP and present huge problems, so why go there. But it's not just that with things like vicodin, they don't have the same type of actions on depression and OCD that made tramadol of interest for research.
Oh well, not taking it at all for now and won't, while I go through these other med trials.
Til next time! :-)
Posted by Jazzed on June 15, 2005, at 22:21:04
In reply to Re: (ex-Spoc here, just changed my name), posted by ConfuzyQ on June 15, 2005, at 16:44:18
> That remains to be seen! The initial consult, which is all I've had, was long. I can only hope I won't be put on 10 or even 20 minutes already! But I might.
My initial consult was 45 min., so I'd guess your med checks will be longer than mine too.
>
But where I am, they usually offer/push for both. The talk part with a psychiatrist can be a lot... different than with a psychologist.Wow, still wish mine would. He said managed care won't allow them to do the therapy. My med consults are $150, and the initial was $200, which was a 45 min. appt. Seems pricey to me, thankfully I have insurance, or we wouldn't be doing this!
> I have, um, been doing it solo.Okaaaaay! LOL I did the same thing b4 I started taking the 5 HTP, and it worked like a charm for me.
>
> I want very much to be completely honest and think I soon will, but I was strongly warned that most docs might get the wrong idea about me immediately if I said anything (too soon at least).Oh gosh, I went into my first appt. and told him everything that I'm currently taking and how I came to take it, and he wasn't phased in the least, but that just seems to be his way, and he is older, probably has seen it all!
But I don't think it would present bigger problems that way than things like Valium, klonopin and Xanax do. Maybe less even.
That's really too bad if it works so well. Hope someone out there will look at it. Wonder how many people on the boards have tried it, and if they had the same experience as you. I took Xanax a long time ago. Don't know how anyone could get addicted to that, it knocked me on my butt, and I was on a tiny dose. Forget that!
> Yes, I like to be in control too, and I am also always aware that something that feels "too" good can only lead to problems that will ultimately feel like CRAP and present huge problems, so why go there. But it's not just that with things like vicodin, they don't have the same type of actions on depression and OCD that made tramadol of interest for research.
Yep, I agree, and it's obvious it's not the same esp. since you've been taking the same dose for so long.Later!
Posted by Jazzed on June 15, 2005, at 22:22:39
In reply to Re: (ex-Spoc here, just changed my name), posted by ConfuzyQ on June 15, 2005, at 16:44:18
Re: Nardil + Effexor...I'm going for it!!!! » ace
Posted by Questionmark on June 15, 2005, at 18:41:48In reply to Nardil + Effexor...I'm going for it!!!!, posted by ace on June 12, 2005, at 1:45:31
i believe Effexor is a much more potent SRI (serotonin reuptake inhibitor) than Tramadol is. i could see how a little extra 5-HT reuptake inhibition would make you feel "that old Nardil euphoria," but i question whether it would be worthwhile. Even if it is, you should definitely be extremely cautious and start w/ a very very low dose of SSRI. But as ChairmanMAO said, i think you might be better off using 5-HTP or tryptophan (and/or maybe even something like inositol as well)-- while still being cautious w/ those.
After experimenting w/ minimally low doses of Paxil w/ my Nardil (very rarely & occasionally) to determine how much i might be able to safely take that would also be effective in the way i desired,... i got to the point of using a low dose of Paxil every now and then (again, very very rarely) to powerfully augment my Nardil and get a strong serotonergic effect for a day. i did this for various reasons, but primarily just when i wanted to be in a highly prosocial and happy state for whatever particular reason. (((i STRONGLY RECOMMEND AGAINST THIS PRACTICE FOR ANYONE HOWEVER, FOR A # OF REASONS))).
i would use about 2.5mg - 7mg-- maybe a bit higher (up to 10mg?), but i can't remember for sure-- when on either 45 or 60mg Nardil per day (those are the Nardil doses i have always been on). i have only done this several times or so.
So, firstly, you might be able to go above the absolute maximum doses of Effexor that Chairman MAO mentions (since Paxil is more potent than Effexor, by weight)-- depending on your current dose of Nardil and % MAO inhibition-- but, i really strongly caution against this... (unless maybe you know some brilliant psychopharmacologist who insists that it is fine and explains why).
...
The reasons for this: (1)Who knows what this does to your brain and neurochemistry, especially doing it daily {{[E.g., what if it eventually results in profound apathy and/or inhibition of DA transmission; what if it eventually results in profound 5-HT receptor adaption and tolerance; what if it results in 5-HT neurotoxicity and neuron death (similar to MDMA?)?]}}, (2)Your libido will be eradicated, (3)It may be damaging to your muscles and kidneys, if not more (read about physical effects of serotonin syndrome-- of which your med combo may be a constant at-least-mild form), (4)coma or death due to serotonin syndrome, (5)etc. (?).
Therefore, i advise against it.
Good luck though.
> 1. Effexor is like Tramadol, correct???
>
> 2. Tramadol makes me feel that old Nardil euphoria
>
> 3. Therefore, I'm going to go and try Nardil and Effexor together!
>
> Don't worry, i have Periactin and adalat on hand if any probs crop up!!!
>
> Please comment, experiences, call me an idiot, a lovely man, etc etc!!
>
> Ace!
Posted by Jazzed on June 15, 2005, at 22:25:31
In reply to Re: (ex-Spoc here, just changed my name), posted by ConfuzyQ on June 15, 2005, at 16:44:18
Re: tramadol
Posted by Jakeman on June 12, 2005, at 14:12:09In reply to Re: Nardil + Effexor...I'm going for it!!!! » ace, posted by Chairman_MAO on June 12, 2005, at 9:47:27
I've found that tramadol used occasionally will lift my depression within hours and make me feel more outgoing. Is it prescribed for depression for long-term use? Thanks
~Jake
Posted by Jazzed on June 16, 2005, at 8:06:20
In reply to Depression while getting on Strattera?, posted by Spoc on June 11, 2005, at 8:27:07
Check this out:
http://medcenter.uc.edu/news/ctramadol.ucm
http://remedyfind.com/rem.asp?ID=6430
At this site: http://www.mhc.com/Algorithms/Depression/pdiscoll.htm
I found this:Tramadol, a mu opiate receptor agonist, has recently been reported to augment antidepressant effects in patients with concomitant chronic pain syndromes.(5) Patients had failed many previous antidepressant trials alone and with potentiation. Dose was 25 mg tid for the first week and then 50 mg tid for two more weeks. Six of 12 had a good response. This drug should not be used in patients with a history of opiate addiction, as it may trigger relapse. It may also induce a withdrawal syndrome on discontinuation, and can produce seizures/ Anaphylactic reactions have occurred in patients who were allergic to codeine.
So, there's a lot of info out there on the other uses of Tramadol. I know you already knew all of this, but I found it interesting. I"ll have to try my Vicodin next time I feel depressed, and see what effect it has.
Jazzy
Posted by ConfuzyQ on June 16, 2005, at 8:28:30
In reply to Re: (ex-Spoc here, just changed my name) » ConfuzyQ, posted by Jazzed on June 15, 2005, at 22:21:04
(Hee hee, I'm getting nervy and putting the word up in lights after reading the thread you told me about. No one there was admonishing at the very mention of the word, so that was a good sign to me.) Thanks so much for pointing the thread out, I just posted to it, even though tramadol isn't the real subject there. If you ever want to do that again don't fight it! ;-) Sadly, I have to limit what I read here severely. I bookmark the few individual threads I start -- or somehow get on without regularly skimming whole pages -- then read only those. As much as information is a good thing, I'm working with a screwy set of tools, so one way or another I end up obsessively spending entire days or weeks here once I start looking at whole boards. :(
> Wow, still wish mine would (offer therapy). He said managed care won't allow them to do the therapy. My med consults are $150, and the initial was $200, which was a 45 min. appt. Seems pricey to me, thankfully I have insurance, or we wouldn't be doing this!
Aaaah, there you go. I am entirely self-pay :( so maybe I don't hear the same limits. Yes I agree it's probably a lot about your therapeutic chemistry with a certain person. If it's there they may be the best one for you, regardless. If I end up taking to my new pdoc in that way too, and I wouldn't be surprised if I did, I will probably start up some talk sessions with him too (like, what am I doing now, sign language or charades lol! You know what I mean ;).
> > I have, um, been doing it (taking tramadol) solo.
> Okaaaaay! LOL I did the same thing b4 I started taking the 5 HTP, and it worked like a charm for me.
Ha ha, I give myself and my guilty conscience away all over the place. After posting I realized you hadn't even been ASKING whether I was doing this on my own, and probably realized I was! You only asked if any docs give me grief about it. ;-)
> > I want very much to be completely honest and think I soon will,
> Oh gosh, I went into my first appt. and told him everything that I'm currently taking and how I came to take it, and he wasn't phased in the least, but that just seems to be his way, and he is older, probably has seen it all!
My nature is to tell all too, but this time I compromised on how I delivered the info (saying I noticed other beneficial responses when taking tram for pain), courtesy of the advice of some cyber friends who said I was reducing my chances right out of the gate of ever being trusted. It would be a real tragedy if I ended up limited from any meds because of such assumptions, since I really am naturally very conservative. For years I have often had many types of potentially very addictive things around for various prescribed purposes, but I almost never take them and usually end up throwing them out because they've expired... even though OF COURSE I know I could have used them to feel good only for the moment or for too many moments. (And if I'm never tempted to do that despite some of the moments I'VE had, I never will be!)
> That's really too bad if it works so well. Hope someone out there will look at it. Wonder how many people on the boards have tried it, and if they had the same experience as you.
Maybe I should update myself on a lot of related things (including where tram stands now), here and at other boards and in other sources. But alas, I've got that obsessive/perfectionistic way of looking into things that I'm too tired of now... and it's probably irrelevant anyway, because my new pdoc will be taking me down enough meds roads that I might drain myself looking into, with tram never even being one of them. Even if I could find enough evidence to start swaying even him, I'd probably also want to have found that other docs really are starting to prescribe it this way too. (But I dread it ever getting scheduled, because if I don't find anything else that works as well and with as few side effects, I probably will always feel comfortable continuing it at the dose I use.)
I'm also afraid to post too much about it because I'm probably not up to the types of debates that can result -- I'd get too involved and give myself a headache. But I would welcome ones based on potential physiological harm that I don't know about (that is any worse than for many "approved" things! Everything has a price).
I sent a babblemail yesterday to a former regular poster who seemed to know more than anyone I've ever "met" does about tramadol, to ask my question about whether my low dose could have affected the Strattera outcome. But don't know if I'll hear back.
> I took Xanax a long time ago. Don't know how anyone could get addicted to that, it knocked me on my butt, and I was on a tiny dose. Forget that!
When it comes to those type drugs I've only used them occasionally for sleep; I can't imagine finding the way they make me feel helpful, during waking hours. Maybe in combo with something else, don't know, but not alone anyway.
CQ ;-)
Posted by ConfuzyQ on June 16, 2005, at 8:41:02
In reply to Re: Depression while getting on Strattera? » Spoc, posted by Jazzed on June 16, 2005, at 8:06:20
We just crossed in posting, I hadn't even seen this one yet! Thanks so much, you're a peach! :)
> I"ll have to try my Vicodin next time I feel depressed, and see what effect it has.
That's for some reason not the same thing at all, although much of the controversy is based on people assuming it is. I don't know the chemistry-speak to explain why (the fact that tram is a weak synthetic member of the opiate class is probably related), but Vicodin and the like don't have the same *therapeutic* action or potential, and are vastly easier to abuse. Sure, for most people Vicodin will get their head in a *very* good (TOO good) place, and that is no surprise at all. But it is not working in the same way on the brain; could not continue to be used for this without trouble of many kinds setting in; and is just not meant to be for these purposes.Gracias again! :)
Posted by Jazzed on June 16, 2005, at 11:55:39
In reply to Re: TRAMADOL and etc., posted by ConfuzyQ on June 16, 2005, at 8:28:30
>Thanks so much for pointing the thread out, I just posted to it,
You're welcome, yes, I saw your post. If I see anything more, I'll send it your way.
>so one way or another I end up obsessively spending entire days or weeks here once I start looking at whole boards. :(
>OMGosh! Tell me about it! It must be the ADD, I do the same thing!
> Aaaah, there you go. I am entirely self-pay :(OMGosh, I don't know how you do it! We have 4 of us on meds, and 3 in counseling, and 5 seeing the p-doc. There's no way we could do it if it was self pay!
> Ha ha, I give myself and my guilty conscience away all over the place. After posting I realized you hadn't even been ASKING whether I was doing this on my own, and probably realized I was! You only asked if any docs give me grief about it. ;-)That's okay, interesting to know you're going solo.
>
> My nature is to tell all too, but this time I compromised on how I delivered the info (saying I noticed other beneficial responses when taking tram for pain),I can certainly understand the thinking that you have to watch what you say. I agree that most of the time you really do. When they don't know you, what are they to think if we come out with everything. I don't know why I told this doc everything. I don't even remember why it came up.
and it's probably irrelevant anyway, because my new pdoc will be taking me down enough meds roads that I might drain myself looking into, with tram never even being one of them. Even if I could find enough evidence to start swaying even him, I'd probably also want to have found that other docs really are starting to prescribe it this way too. (But I dread it ever getting scheduled, because if I don't find anything else that works as well and with as few side effects, I probably will always feel comfortable continuing it at the dose I use.)Well, let's hope if you bring it up just every once in awhile that he'll get interested and look into himself.
>
> I'm also afraid to post too much about it because I'm probably not up to the types of debates that can result --Ah, just blow 'em off. It's just an opinion, and you're certainly entitled to yours!
> I sent a babblemail yesterday to a former regular poster who seemed to know more than anyone I've ever "met" does about tramadol, to ask my question about whether my low dose could have affected the Strattera outcome. But don't know if I'll hear back.
Are they still active? Look 'em up on the google search by "poster: "
>
> When it comes to those type drugs I've only used them occasionally for sleep; I can't imagine finding the way they make me feel helpful, during waking hours. Maybe in combo with something else, don't know, but not alone anyway.Yep, it would sure put me to sleep!
Later!
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