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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 43. Go back in thread:
Posted by Racer on July 26, 2005, at 23:44:40
In reply to Re: Personal QNs( Re: Might a stimulant help?, posted by Phillipa on July 26, 2005, at 21:09:28
> OH MAN! Racer, I'm sorry forgot about your eating disorder. I meant muscular, well defined bodies not like the shrunken faced fashion models. Sorry, i definitely wasn't thinking. Not good. Fondly,Phillipa
Machts nichts, Phillipa. I know that you aren't trying to take a dig, and I know that you're usually very thoughtful and courteous. Don't worry your head about it, 'K?
Posted by Racer on July 26, 2005, at 23:48:50
In reply to Personal QNs( Re: Might a stimulant help?, posted by alohashirt on July 26, 2005, at 20:36:20
>
> How old are you?Middle aged -- early 40s, which I find very hard to believe...
> Are you male?
Not when I checked last, but I'm not prejudiced. Some of my best friends are male, and I'm even married to one... ;-D
> Have you had your testosterone count measured?
No, that's something I might want to think about, though -- testosterone does affect women, too.
> Have you had thyroid measured?
Yes, this is something my doctor is pretty interested in, and says that he will sometimes bump patients up to slightly hyperthyroid to get full response to ADs. Any experience with that yourself?
Thanks for your response.
Posted by Sarah T. on July 26, 2005, at 23:59:02
In reply to Might a stimulant help?, posted by Racer on July 26, 2005, at 13:50:24
Hi Racer,
I think that a stimulant might help, but the first thing that came to mind was whether there is something in your current regimen that might be causing the amotivation and lethargy? Could it be the Cymbalta? Have you tried lowering the dose?
Posted by partlycloudy on July 27, 2005, at 5:40:36
In reply to Might a stimulant help?, posted by Racer on July 26, 2005, at 13:50:24
Is the Provigil not a stimulant? Do you drink coffee or tea? I'm like you in that I'd hate to have to add another med if there was something myself I could do to feel better.
I know that it's not easy for you to get out of the house for regular exercise, but it is making a difference for my energy level, once I actually throw myself out there.
Is there any way you can structure another pilates class or yoga into your week to get out and moving? It's the chicken and the egg dilema for me - not having enough energy to get off the sofa to exercise; but having exercised, I do feel better for it. And are you taking in enough nourishment to fuel yourself? I have found that Cymbalta works much better for me when I've got the other elements going, you know?
partlycloudy
Posted by Nickengland on July 27, 2005, at 8:29:45
In reply to Might a stimulant help?, posted by Racer on July 26, 2005, at 13:50:24
Hi Racer,
Like I said before, its hard for me to say if a stimulant would help as I have no experience of them...(I guess the only way you would find out is to try one)
That said, I forget to mention something that may well help you now in the short-term, perhaps also in the long-term if the answer is a stimulant will help..
L-Tyrosine ~ I've been using it recently as from what i've been reading its like the closest thing I can get to using a 'natural' stimulant. It helps a little, albeit mild - and the best thing no-side effects.
If a stimulant will help - maybe L-tyrosine will help in the short-term before you can get one prescribed. Its an amino acid.
Kind regards
Nick
Posted by partlycloudy on July 27, 2005, at 13:15:47
In reply to Re: Might a stimulant help? » Racer, posted by partlycloudy on July 27, 2005, at 5:40:36
> Is the Provigil not a stimulant? Do you drink coffee or tea? I'm like you in that I'd hate to have to add another med if there was something myself I could do to feel better.
>
> I know that it's not easy for you to get out of the house for regular exercise, but it is making a difference for my energy level, once I actually throw myself out there.
> Is there any way you can structure another pilates class or yoga into your week to get out and moving? It's the chicken and the egg dilema for me - not having enough energy to get off the sofa to exercise; but having exercised, I do feel better for it. And are you taking in enough nourishment to fuel yourself? I have found that Cymbalta works much better for me when I've got the other elements going, you know?
> partlycloudy
>
>I think my post sounded harsh - "You Must Exercise" - I didn't mean to preach, sweetie.
pc
Posted by Ilene on July 27, 2005, at 14:27:24
In reply to Guess I forgot to mention... » ed_uk, posted by Racer on July 26, 2005, at 17:37:13
Gave me unexpected, close up views of my carpetting. NOT a good thing -- way past time for new flooring... Hypotension is a big problem for me, and all the TCAs I've tried have created problems for me because of it. (My BP runs very low to begin with, and I have a problem at the best of times with orthostasis. For that matter, if I stand up for too long, I'll sometimes drop...) I asked Dr EyeCandy about Florinef last year, which he said was utterly impossible, ever. I also asked Dr CattleProd about it, and he said that if it came down to it, he'd have to do some research on it, but he was fine trying it if we needed to. He just didn't think that we'd have to go to anything that would cause problems, because we had so many other options left.
Did Dr EyeCandy tell you what was wrong w/ Florinef? I've taken it for a couple of years. It's the only med that I take that I know is doing something, because I don't get light-headed or see stars like I used to. I've never actually passed out, fortunately.
Take care, I.
Posted by ed_uk on July 27, 2005, at 17:23:53
In reply to Guess I forgot to mention... » ed_uk, posted by Racer on July 26, 2005, at 17:37:13
Hi Racie,
Are you concerned that a stim might reduce your appetite?
~ed x
Posted by ed_uk on July 27, 2005, at 17:26:35
In reply to Re: Guess I forgot to mention... » Racer, posted by ed_uk on July 27, 2005, at 17:23:53
>Are you concerned that a stim might reduce your appetite?
Sorry, you already replied to that!
~Ed x
Posted by Bill LL on July 28, 2005, at 12:05:39
In reply to Might a stimulant help?, posted by Racer on July 26, 2005, at 13:50:24
I think the addition of a stimulant could increase your motivation. On the other hand, I think they usually decrease one's appetite. Would that be a problem since your are anorexic?
> Right now, what I'm fighting isn't so much depression, as total and complete amotivation. I can hardly manage to walk across the room, it feels like! I find myself just sitting here in front of the computer, idling away the day, just because I can't quite manage to do anything else... Even reading is often more energy than I really want to put into anything...
>
> I'm taking 60mg Cymbalta -- which is my suspect in causing this -- 300mg Wellbutrin XL, and 100mg Provigil. My dx is major depression, anxiety, anorexia.
>
> Any thoughts on stimulants to increase motivation? If so, any recommendations?
>
> I just know SOMETHING has to change -- and soon. Right now, I'm "racing" so slowly I may as well go back to bed!
>
> Thanks.
Posted by Racer on July 28, 2005, at 12:57:45
In reply to Florinef » Racer, posted by Ilene on July 27, 2005, at 14:27:24
> >
> Did Dr EyeCandy tell you what was wrong w/ Florinef? I've taken it for a couple of years. It's the only med that I take that I know is doing something, because I don't get light-headed or see stars like I used to. I've never actually passed out, fortunately.
>
> Take care, I.Dr EyeCandy -- a/k/a Dr Let'sNotEvenUseThatLanguage -- started in with explaining (lecturing) about how it affected mineracorticoids as well as glucocorticoids... When I asked for that to be translated into something the rest of us might understand, he said, "It has a lot of effects."
Bottom Line: Don't worry about what Dr EyeCandy had to say about it. It's a perfectly good drug, and if your doctor prescribes it, it's not likely to be a problem. Dr EyeCandy is not a doctor whose opinions I have much respect for -- else I would not have reported him to the Medical Board.
Posted by xanablu on July 29, 2005, at 22:51:29
In reply to Re: Might a stimulant help? » Racer, posted by ed_uk on July 26, 2005, at 15:03:40
Ed
i was on desipramine several yrs. ago, prescribed 100mgs daily for fibro pain. I knew i was depressed st the time, hoever the desip was neither stimulating, nor any relief for pain & did nada for depression.I now know that I am ADD with long-term recalcitrant depression and anxiety, I believe, primarily due to not being treated for (or dx'd with) ADD until i was 45.
Do u know what the therapeutic dosage of desip is for atypical depression? Thanks so much!
Xanablu
Posted by xanablu on July 29, 2005, at 23:05:09
In reply to Florinef » Racer, posted by Ilene on July 27, 2005, at 14:27:24
Ilene~
I am in the U.S. Might I inquire, what is Florinef-the chemical name? I've not heard of this med. Thannx!
xanabblu
Posted by Ilene on July 29, 2005, at 23:16:57
In reply to Re: Florinef » Ilene, posted by xanablu on July 29, 2005, at 23:05:09
The chemical name of Florinef is fludrocortisone. I use it for a type of low blood pressure called neurally mediated hypotension.
I.
Posted by xanablu on July 29, 2005, at 23:27:48
In reply to Might a stimulant help?, posted by Racer on July 26, 2005, at 13:50:24
hi Racer-
I do have a dx of ADD along w/dep & GAD.
All r long-term~say35-40 yrs (I'm 49) and I tried a doz. different AD's and combos thereof, but my depression which is mostexemplified by mental dullness, amotivation and anergia was nevwr alleviated until a stimulant was added. My ADD b/c much more evident after I had my 1st (& only) child at 40 and is even worse now that I am in perimenopause.
I have not really had much appetite since taking care of my mom during her illness w/alzheimer's. She passed in 2001, 14 mos. after my dad died of heart attack in 2000.I have a child, so I have a built-in reminder that food is necessary for my health and survival. I have found dexedrine spansules 15mgs, 2x's daily , w/Dextrostat immediate release 5 mgs as a fill-in if necessary, during early evening to carry me over to beddy-bye time to be my best stim choice. I have also been rx'd ritalin (horrifying), Adderall (o.k., but dev'd tolerance very quickl;y-fell asleep on 120 mgs!), and Desoxyn IR (methamphetamine-a bit harsh). I find dexedrine the perfect fit for me and I have used it for nearly 2 1/2 yrs. I have decreased from a high dsage of up to 80 mgs. daily down to about 35-45.
I also use 2-3 mgs. klonopin (gen), 40 mgs. Inderal (gen), and 10-20 mgs. Lexapro, which I have just dropped due to needing to find a new p. doc, as mine has cut his clientele by 30%.I also used phentermine at one time (a non-amphetamine CNS stim) about a yr. after my child was born and, it was the only drug I was on at the time. It made me a bit too 'nervy' but helped my (then unknown) ADD and depression tremendously.
Hope this helps~xanablu
Posted by ed_uk on July 30, 2005, at 3:09:37
In reply to Re: Might a stimulant help? » Racer, posted by xanablu on July 29, 2005, at 23:27:48
Hi!
How did Desoxyn compare with Dexedrine? I'm just curious about how it affected you because not many people get prescribed Desoxyn these days.
~Ed
Posted by ed_uk on July 30, 2005, at 3:15:35
In reply to Re: Might a stimulant help?, posted by xanablu on July 29, 2005, at 22:51:29
Hi X,
>i was on desipramine several yrs. ago, prescribed 100mgs daily for fibro pain. I knew i was depressed st the time, hoever the desip was neither stimulating, nor any relief for pain & did nada for depression.
You could try increasing the dose to ~200mg if you can tolerate it. I doubt it will help though if 100mg did nothing. I'm sorry it didn't help :-(
~Ed
Posted by xanablu on August 2, 2005, at 23:44:17
In reply to Re: Might a stimulant help? » xanablu, posted by ed_uk on July 30, 2005, at 3:09:37
hi Ed~
I was amazed when I mentioned to my pdoc that 4 15mg. Dex spansules and 1-4 Dexstrost mg.IR daily, as needed (he gave me elbow room to adjust within these very generous parameters, and I am 5' 4" tall, weighing in at 124-126lbs.) could not keep me upright and mobile. He thusly handed me something that looked like a credit card. -how- cute, I thought.
{My husband was completely furious w/me for being ill-we married when I b/c pregnant, and he didn't really believe it, anyway, b/c if I was on meds, I shd. be WELL, right? That's the only reason I mentioned my problem, at all, to my p-doc. Because I knew that the previous 5 yrs. had been grueling & my resources were totally depleted...I needed a LONG introspective rest-not to mention I was also on 375mgs. of Effexor, which I had tried a few years earlier & it had been a TOTAL knock- out drug for me. I had tried it previously under under my g.p. and it made me sleep some-20-odd hrs. a day. Not good. My g.p. took me off it after 10 days. I did not yet have the ADD dx, therefore no stimulus for -any- awareness/cognition.]
Anyway, when I examined this little 'gift card' and I realized it was for 120 Desoxyn 5mg.{pharmaceutical methamphetamine) immediate release, well, I must say, I nearly fell thru the floor!!! And, it was -freebies- SHEESH! I remember p-doc calmly saying, w/perhaps a small wry smile, 'See if these don't make you jump off that couch,'. I remained serene and kindly thanked him.
When I handed -the card- to my very opened-minded pharmacist, he simply smiled wanly,
promptly filled it, (in 'drive thru' I might add) and handed the Rx to me w/a 'Have a good day'. I just shook my head in amazement and drove away, free and clear.Unfortunately, the Dexosyn it did nothing extraordinary for me.
I believe the simple fact was that NO DRUG cd. have stimulated me thru that my rather uncommon 375mg. daily effexor haze (don't most most people complain of Eff. being TOO stimulating all by itself?}. But I was experiencing such deep grief and depression from the loss of my parents, 14 months apart, I think maybe I needed that effexor for 9 months. I needed to cocoon within myself, process my grief, and let time pass. Time and Eff. did help me a great deal in healing that wound, and now, when I think of, or speak of my darling parents, it is always with pride, honor & joy--not with uncontrollable weeping.The stimulation factor of Dexosyn vs. brand name Dextrostat IR seemed the same, yet I find Dexedrine spansules 15mg. with the Dexstrostat 5mg. the most comfortable fit for me. The Desoxyn felt a bit harsh. And, the Dex. spansules do last about 11-12 hrs for me. I feel the rather primitive '2nd' release of the spansules around 6 hrs. after early a.m. dosing almost regular as clockwork, and I welcome it. I usually take my 2nd. clonazepam and 2nd propanolol and another 15mg. spansule at that time. Well, actually, I take the clono and propo then, and the Dexedrine about 30" later. That little 2nd release dex spansule chest flutter gives my ADD/easily distracted mind just the reminder it needs, that, as Nurse Ratchet wd. say, it's "Medication time, medication time everyone, medication time." Ah, the 'Cuckoo's Nest, haven't been there yet, but who knows what lies in my future. Hopefully not that.
I did not gain the courage to admit my depression, or whatever, until, I unexpectedly, gave birth, at 40, and I knew I could no longer 'fake it'. I had long ago decided that I was not 'well' enuf to care for a child, when I had already had problems simply maintaining myself! Also, caring for my parents during my child's 1st 5 years meant I HAD to put myself in the hands of the med'l profession. It was so frightening--but,after 5 yrs. I did get the correct DX. Plus, my child is thriving 8 yrs. later and my parents are at peace, and I have hope for a real future these days, even tho I'll soon be 50.
AND, I will staunchly defend a life on meds (if they are working) to no life at all, for the rest of my born days. And, I am so very thankful that adult ADD has actually and (only recently) become in some areas of the world an accepted and aggressively treated diagnosis. I do believe that it is my core disorder, and the other problems appeared due to the fact that it went un-dx'd for 35 yrs.
Sorry for the monologue. There was more, but, my paragraph placement was so confused, I deleted it!
Thank God, huh?Hope u r well~xanablu
Posted by xanablu on August 2, 2005, at 23:45:51
In reply to Re: Might a stimulant help? » xanablu, posted by ed_uk on July 30, 2005, at 3:15:35
Thanks for the info, Ed. I felt as much, but was unsure.
~xanablu
Posted by ed_uk on August 3, 2005, at 14:46:03
In reply to Re: Might a stimulant help? » ed_uk, posted by xanablu on August 2, 2005, at 23:44:17
Hi xanablu,
>Anyway, when I examined this little 'gift card' and I realized it was for 120 Desoxyn 5mg.{pharmaceutical methamphetamine) immediate release, well, I must say, I nearly fell thru the floor!!!
LOL, that made me laugh!
>'drive thru'
Wow, we don't have drive thru pharmacies here.
>effexor haze
I find it sedating too, especially after the first few weeks.
Thank you for the info about Desoxyn :-)
Kind regards
~Ed
Posted by xanablu on August 3, 2005, at 18:40:52
In reply to Re: Might a stimulant help? » xanablu, posted by ed_uk on August 3, 2005, at 14:46:03
hi ed~
I really believe that many patients/people/docs, etc. may be under the false assumption that methamphetamine is the most potent and 'out there' stimulant around, due to the catastrophic damage amatuerly produced 'crystal meth' has wreaked in its (at least USA) pandemic presence during the last 15 yrs. or so. Of course, they are smoking and shooting the homemade concoction, and at rather large doses, so I've read.
But, I'm no pharmacologist, so just a guess.
Do u know if it really is a 'bigger CNS gun' than any other of the amphetamines that r more often prescribed? Meaning, in comparison to, say, Adderall or dexamphetamine (dexedrine)?
And, have u any personal experience w/stims? I do not remember ur dx (sorry) and u are in the UK, right? Aren't stims pretty much 'verboten' there, at least for adults?
Just curious.well~back to packing & hauling~in the midst of a major move~in town~but, separating from my husband.
It's a jolt~but~ a much-needed one.
cheers~xana
Posted by Declan on August 4, 2005, at 2:25:10
In reply to Re: Might a stimulant help? » ed_uk, posted by xanablu on August 3, 2005, at 18:40:52
I've never really understood the methamphetamine in a special bracket thing. Is it because it has a longer half life? Could be more hazardous that way, I suppose. Apart from that the differences are minimal aren't they? Or is it because homemade methamphetamine is made from pseudoephedrine and is a public health issue?
Declan
Posted by ed_uk on August 4, 2005, at 13:28:53
In reply to Re: Might a stimulant help? » ed_uk, posted by xanablu on August 3, 2005, at 18:40:52
Hi Xanablu,
>methamphetamine is the most potent and 'out there' stimulant........
AFAIK, methamphetamine isn't normally any more 'alerting' than Dexedrine. It's often very euphoric when given by non-oral (!) routes of administration but so are other amphetamines.
Methamphetamine may be more neurotoxic than amphetamine. In addition, methamphetamine appears to stimulate serotonin release to a greater extent than amphetamine.
Unlike Dexedrine and Adderall, Desoxyn is not a well-established treatment for ADHD.
>And, have u any personal experience w/stims?
No. Stimulants are not prescribed (to adults) in the UK, except under exceptional circumstances eg. severe narcolepsy.
Kind regards
~Ed
Posted by Ryan2828 on August 6, 2005, at 4:11:25
In reply to Re: Might a stimulant help? » Racer, posted by Maximus on July 26, 2005, at 16:03:49
I relate to each problem you described, in fact I am on Effexor. I get so lethargic sometimes and lazy on Effexor that my eyes almost start to roll or close, I get distant vision, if that makes any sense! Without coffee I cannot concentrate on doing the simplest things including surf the internet.
Posted by paulbwell on August 9, 2005, at 19:12:24
In reply to Re: Might a stimulant help? » xanablu, posted by ed_uk on August 4, 2005, at 13:28:53
> Hi Xanablu,
>
> >methamphetamine is the most potent and 'out there' stimulant........
>
> AFAIK, methamphetamine isn't normally any more 'alerting' than Dexedrine. It's often very euphoric when given by non-oral (!) routes of administration but so are other amphetamines.
>
> Methamphetamine may be more neurotoxic than amphetamine. In addition, methamphetamine appears to stimulate serotonin release to a greater extent than amphetamine.
>
> Unlike Dexedrine and Adderall, Desoxyn is not a well-established treatment for ADHD.
>
> >And, have u any personal experience w/stims?
>
> No. Stimulants are not prescribed (to adults) in the UK, except under exceptional circumstances eg. severe narcolepsy.
>
> Kind regards
>
> ~EdHi Ya Ed!
A users perspective:
Ok here goes (sorry for being late, pharmacy NEVER EVER has desoxyn in stock):
Generic Dexedrine Spansules (barr labs):Pros:
- MUCH more motivation increase than Desoxyn.
- Spansules last 10 hours.
- Generic Spansules have a smooth "come down" at the end of the day, unlike immediate release Dexedrine.
Cons:- Increased heart rate (darn)
- No hunger.
--------------------------------------------Desoxyn:
Pros:
- Wakes you the hell up!
- Strong stuff, Hits hard (good if you have MASSIVE tolerance to regular stimulants)
- VERY LITTLE increases in heart rate (nice!)Cons:
- No motivation increase.
- Only comes in immediate release, so it lasts only 4 hours per dose.
- At the end of day gives a bad "come down". (Nervousness, Anxiety, Depression, Crappy Feelings.)
- Totally NO hunger...anorexia in a pill
(seriously).
Cheers
This is the end of the thread.
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