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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Tepiaca on October 9, 2005, at 2:11:48
I am visiting a new doctor 1 month ago since I broke up with my life´s only girlfriend.
First he sent me to take a rorschach test with a psychologist. The test showed that I had a major depression ( it was obvious ).
I told him that social phobia is the reason why I can´t have a normal life.
I dont know what is he thinking, but he wants me off Nardil. I said that I couldn´t do it in this moment because I am on a severe depression, and I´ll have to wait 14 days to try another kind of medicine that only God knows if It could help me. It is too risky dont you think?. Why he didn´t think in this?After I rejected to leave Nardil in this moment, he told me to wait 1 more month and then try another medicine. He made me a prescription for TOLVON 30mg.
I really have no idea if this medicine could help with Social Phobia. He is thinking more in relieving my depression I supposse. I dont know if leaving Nardil in month is a good option.
What do you think guys?
Do you believe it would be a good option ??
Do you believe TOLVON is better than Nardil ???
Posted by Declan on October 9, 2005, at 3:01:20
In reply to Doctor wants me off Nardil..., posted by Tepiaca on October 9, 2005, at 2:11:48
Hi Tep
Maybe the idea is that mianserin/Tolvon will have fewer sexual side effects than Nardil (as would Parnate). Maybe your doctor is thinking like this. I tried mirtazapine (similar in some respects?) but didn't have the stomach for it.
Declan
Posted by blueberry on October 9, 2005, at 5:22:55
In reply to Doctor wants me off Nardil..., posted by Tepiaca on October 9, 2005, at 2:11:48
If the nardil is not preventing major depression or social phobia, then it's hard to see what the sense is in staying with it. I don't know, if I was on a med that wasn't working well, I would be ready to move on to something else. If the nardil was working fairly well and there were only some nagging residual symptoms hanging around, then I would be tempted to augment it with something. But from your post it sounds like it just isn't doing much. Of course, the option of a higher dose might be something to consider as well. I wish we all didn't feel so bad. I feel for you. I know how painful it is.
Posted by Jedi on October 9, 2005, at 9:01:53
In reply to Doctor wants me off Nardil..., posted by Tepiaca on October 9, 2005, at 2:11:48
> I am visiting a new doctor 1 month ago since I broke up with my life´s only girlfriend. ...
Hi Tepiaca,
IMHO eliminating Nardil at this fragile moment in your life would be a bad mistake. If you have social anxiety and atypical depression the other medication is not going to work better. By the time you do a two week washout, you may be in the hospital. Even though the test results showed major depression, if you have been through the type of endogenous atypical depression where you don't leave your bed except for a few hours a day, you know what I mean. The loss of your girlfriend is causing a triple slam for you. Exogenous depression on top of the preexisting endogenous depression and social anxiety. I would find a doctor who was not afraid to add a tricyclic (perhaps nortriptyline) to the Nardil. Sounds to me like this new doctor is MAOI phobic. They are everywhere.
Good Luck,
Jedi
Posted by Tepiaca on October 9, 2005, at 10:24:45
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by Declan on October 9, 2005, at 3:01:20
> Hi Tep
> Maybe the idea is that mianserin/Tolvon will have fewer sexual side effects than Nardil (as would Parnate). Maybe your doctor is thinking like this. I tried mirtazapine (similar in some respects?) but didn't have the stomach for it.
> DeclanHi dec, thank you for your thougths.
I dont know, dec. I never complained about sexual side effects. It was always fear and that I did not have a normal social life.
He has never give someone Nardil,no experience with MAOIS. Maybe he´s afraidbesides your stomach problems? how you did on Mirtazapine??
Thank you
TEP
Posted by Tepiaca on October 9, 2005, at 10:41:34
In reply to Re: Doctor wants me off Nardil..., posted by blueberry on October 9, 2005, at 5:22:55
> If the nardil is not preventing major depression or social phobia, then it's hard to see what the sense is in staying with it. I don't know, if I was on a med that wasn't working well, I would be ready to move on to something else. If the nardil was working fairly well and there were only some nagging residual symptoms hanging around, then I would be tempted to augment it with something. But from your post it sounds like it just isn't doing much. Of course, the option of a higher dose might be something to consider as well. I wish we all didn't feel so bad. I feel for you. I know how painful it is.
Thank you blue
Nardil has been the best drug for me in my life.
I have been on it for 2 years.
A big problem is that doctors don´t use it here and they are afraid of making a mistake.
I have no problem with trying a new med. Im just afraid of feeling so bad again. In some way Nardil has controlled my depression and Phobia.
Posted by Tepiaca on October 9, 2005, at 10:52:52
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by Jedi on October 9, 2005, at 9:01:53
> > I am visiting a new doctor 1 month ago since I broke up with my life´s only girlfriend. ...
>
> Hi Tepiaca,
> IMHO eliminating Nardil at this fragile moment in your life would be a bad mistake. If you have social anxiety and atypical depression the other medication is not going to work better. By the time you do a two week washout, you may be in the hospital.
Yes JEDI ! Im very afraid of this. I can´t understand Why he did not think about it ??
>> I would find a doctor who was not afraid to add a tricyclic (perhaps nortriptyline) to the Nardil. Sounds to me like this new doctor is MAOI phobic. They are everywhere.He just dont know how to use Nardil or any other MAOI. Only the reversible MAO Aurorix
his plan if start trying drug by drug until I found something .I dont If I can do this. I don´t feel capable of doing thisHe suggested TOLVON, but first he talk about CYMBALTA. I have never used this drugs.
What do you think about them ???
Posted by Jedi on October 9, 2005, at 11:57:45
In reply to Re: Doctor wants me off Nardil... » Jedi, posted by Tepiaca on October 9, 2005, at 10:52:52
> He suggested TOLVON, but first he talk about CYMBALTA. I have never used this drugs.
> What do you think about them ???
First, is there any way to contact your previous doctor and get him/her to continue the Nardil script until you can find a PDOC that is not MAOI phobic?I have never used either of the meds mentioned above. I have used the SNRI venlafaxine which is similar to Cymbalta in that it affects both serotonin and norepinephrine. I had a partial response to venlafaxine but I still had a bad case of anhedonia. I think I need the dopamine and Gaba affects that you get with Nardil.
Duloxetine and Venlafaxine-XR in the Treatment of Major Depressive Disorder: A Meta-Analysis of Randomized Clinical Trials (November).
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16189284&query_hl=2I've read that mianserin(Tolvon) is similar to mirtazapine and can cause fairly severe sedation when first taken. I really know very little about this medication.
JediPS "Mianserin is a tetracyclic antidepressant that is similar to the tricyclic anti-depressants (TCAs).
When depression occurs, there may be a decreased amount of the chemicals noradrenaline and serotonin released from nerve cells in the brain. When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood.
"Mianserin works by preventing the re-absorption of noradrenaline back into the nerve cells. It may also act to block certain receptors in the brain that bind released serotonin. This helps enhance and prolong the mood-lightening effect of any released noradrenaline and serotonin, thereby helping relieve depression.
The full benefits of treatment with mianserin may not appear for two to four weeks.
Side effects:
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Joint pain (arthralgia)
Seizures (convulsions)
Decreased production of blood cells by the bone marrow (bone marrow suppression)
Dizziness
Excessive fluid retention in the body tissues, resulting in swelling (oedema)
A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)
A mild degree of mania (hypomania)
Mild yellowing of the skin and eyes (mild jaundice)
Breast pain and tenderness or male breast enlargement
Disturbances of liver function
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
Mianserin should not be taken with a monoamine oxidase inhibitor (MAOI) antidepressant. Treatment with mianserin should not be started until 2 weeks after stopping a MAOI.
Mianserin may increase the anti-clotting effect of coumarin anticoagulants such as warfarin. The manufacturer recommends regular blood tests to monitor blood clotting ability.
Mianserin blood levels may be decreased by phenytoin.
Mianserin may increase the sedating effects of alcohol."
Posted by Declan on October 9, 2005, at 14:04:03
In reply to Re: Doctor wants me off Nardil... » Declan, posted by Tepiaca on October 9, 2005, at 10:24:45
Tep, I took mirtazapine(7.5mg) for one night and got a good sleep. I haven't taken it again. What was wrong with it for me? Stomache and head problems, but mainly I just didn't like the dysphoric psychdrug feel of it. If I had to leave Nardil I'd want to try Parnate, but I can imagine your chances of that.
Declan
Posted by Declan on October 9, 2005, at 14:11:39
In reply to Re: Doctor wants me off Nardil... » Jedi, posted by Tepiaca on October 9, 2005, at 10:52:52
He's going to start drug by drug until he finds something? Geez, Tep, I'd be worried too. And looking for other doctors (and pharmacists).
How much of your depression and social phobia has Nardil got rid of? Some but not all?
Declan
Posted by ed_uk on October 9, 2005, at 16:03:41
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by Jedi on October 9, 2005, at 11:57:45
Hi Tepi
Tolvon is very similar to Remeron. Have you ever taken Remeron?
~ed
Posted by ed_uk on October 9, 2005, at 16:04:19
In reply to Re: Doctor wants me off Nardil... » Jedi, posted by ed_uk on October 9, 2005, at 16:03:41
Posted by Phillipa on October 9, 2005, at 19:05:09
In reply to Re: Doctor wants me off Nardil... » Jedi, posted by ed_uk on October 9, 2005, at 16:03:41
Ahhh Tepicia, I'm so sorry you feel so bad. And changing meds at a time like this in your life is not the best time at all. Fondly, Phillipa
Posted by Tepiaca on October 10, 2005, at 20:42:40
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by Jedi on October 9, 2005, at 11:57:45
>
>
> First, is there any way to contact your previous doctor and get him/her to continue the Nardil script until you can find a PDOC that is not MAOI phobic?
>MM, he is very far from me jedi. No one´s here use MAOIS anymore. MAOIS are not available here in the Market . Only old doctors used once but they have forgot how to use them correctly. Basically this 2 years on Nardil I have taken care of me on my own.
> . I think I need the dopamine and Gaba affects that you get with Nardil.
In some way I guess I also need that dopamine and Gaba effects. I was on Venlafaxine some time ago but it was nothing like Nardil.
>
> >
thank you for the info about MianserinGood luck brother
Tep
Posted by Tepiaca on October 10, 2005, at 20:46:06
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by Declan on October 9, 2005, at 14:04:03
> Tep, I took mirtazapine(7.5mg) for one night and got a good sleep. I haven't taken it again. What was wrong with it for me? Stomache and head problems, but mainly I just didn't like the dysphoric psychdrug feel of it. If I had to leave Nardil I'd want to try Parnate, but I can imagine your chances of that.
> Declan
Yes Dec, Parnate sounds very good to me, sounds better than Tolvon. I´ll have to think seriously what I am going to do nowThank you !
Posted by Tepiaca on October 10, 2005, at 20:50:10
In reply to Re: Doctor wants me off Nardil..., posted by Declan on October 9, 2005, at 14:11:39
> He's going to start drug by drug until he finds something? Geez, Tep, I'd be worried too. And looking for other doctors (and pharmacists).
it what he said. He is going to play russian rulette with me>
> How much of your depression and social phobia has Nardil got rid of? Some but not all?
mmm, like 80% of my depression and 65% of my SP>
> Declan
Posted by Tepiaca on October 10, 2005, at 20:54:24
In reply to Re: Doctor wants me off Nardil... » Jedi, posted by ed_uk on October 9, 2005, at 16:03:41
> Hi Tepi
>
> Tolvon is very similar to Remeron. Have you ever taken Remeron?
>
> ~edey ed, how you doing?
No I have never taken Remeron. Have you? What do you think of Tolvon ? is it a good drug?
Do you think is worth to leave Nardil to try Tolvon?
Tepi
Posted by Tepiaca on October 10, 2005, at 20:56:33
In reply to Re: Doctor wants me off Nardil... » ed_uk, posted by Phillipa on October 9, 2005, at 19:05:09
> Ahhh Tepicia, I'm so sorry you feel so bad. And changing meds at a time like this in your life is not the best time at all. Fondly, Phillipa
Phillipa you are so nice =) .
thank you very much for your help
Posted by Declan on October 10, 2005, at 21:30:11
In reply to Re: Doctor wants me off Nardil... » Declan, posted by Tepiaca on October 10, 2005, at 20:50:10
Tep, I dunno much about this, but I reckon 80% of your depression and 65% of your SP sounds like a good robust response. It would count as a success story on this board. You need information, a data base of MAOI Rxing doctors in Mexico and all that sort of stuff.
Declan
Posted by ed_uk on October 11, 2005, at 16:26:11
In reply to Re: Doctor wants me off Nardil... » ed_uk, posted by Tepiaca on October 10, 2005, at 20:54:24
Hi Tepi!
>ey ed, how you doing?
Not too bad thank you. My anxiety was under control but it's been worse again lately. I'm hoping that things are going to improve again soon :-)
>I have never taken Remeron. Have you?
Yes, it's very sleep-inducing. Very effective for insomnia! Weight gain is a big problem with Remeron :-(
>Do you think is worth to leave Nardil to try Tolvon?
Tolvon is good for insomnia... and sometimes depression. I don't think it's very good for SP though.
Saludos!
~Ed
Posted by Tepiaca on October 12, 2005, at 21:46:12
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by Declan on October 10, 2005, at 21:30:11
> Tep, I dunno much about this, but I reckon 80% of your depression and 65% of your SP sounds like a good robust response. It would count as a success story on this board. You need information, a data base of MAOI Rxing doctors in Mexico and all that sort of stuff.
> Declan
Yes dec, taking in count that I had only found like 40% relief in my depression and 20% in my Social Phobia with SSRIS . That is why since I started Nardil I have never stopped taking it.
Posted by Tepiaca on October 12, 2005, at 21:50:26
In reply to Re: Doctor wants me off Nardil... » Tepiaca, posted by ed_uk on October 11, 2005, at 16:26:11
> Not too bad thank you. My anxiety was under control but it's been worse again lately. I'm hoping that things are going to improve again soon :-)I hope too Ed :)
>
> >I have never taken Remeron. Have you?
>
> Yes, it's very sleep-inducing. Very effective for insomnia! Weight gain is a big problem with Remeron :-(ooh weigth gain , I dont like that
>
> >Do you think is worth to leave Nardil to try Tolvon?
>
> Tolvon is good for insomnia... and sometimes depression. I don't think it's very good for SP though.
>Me neither Ed. My family wants me to try it. I told them that in some weeks I will try it
> Saludos!
Saludos a Ti !!!Tepi
This is the end of the thread.
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