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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by nickguy on August 8, 2006, at 21:18:18
so I've had depression and anxiety for about 4 years, and been on tons of drugs that haven't helped. Right now, I'm taking klonopin 1 mg daily, ativan 1.5 mg as needed, and I've been on zoloft for 2 months now and it hasn't give me much benefit. The ativan and klonopin work o.k for me. Mostly just relieve me of stress and help me to socialize, although they cause me to get black out drunk and into bad circumstances. Anyway, heres my med history:
paxil, zoloft, lexapro (twice), cymbalta, effexor, wellbutrin, lithium, lamictal, gabitril, desipramine, provigil, seroquel- sometimes in combos sometimes not.
My new pysch is awesome and is willing to try many things. I know an MAOI seems logical, but I don't know if I feel like dealing with medical bracelets and only having two drinks. I'm considering the RIMA moclobemide. He mentioned stimulants, but I don't think I'd be comfotable with amphetamines. I'm thinking of considering Mirapex or another dopamine agonist. Remeron combined with effexor is another option I guess. Anybody have any other ideas or similiar situations/experience?
Posted by Phillipa on August 9, 2006, at 11:33:48
In reply to sorry for another one, but what else for me?, posted by nickguy on August 8, 2006, at 21:18:18
Have you considered low dose EMSAM? Love Phillipa
Posted by nickguy on August 9, 2006, at 12:28:44
In reply to Re: sorry for another one, but what else for me? » nickguy, posted by Phillipa on August 9, 2006, at 11:33:48
I have. I guess it could be worth a shot, although I don't hear of many people staying on the lowest dose.
Posted by Phillipa on August 9, 2006, at 20:00:03
In reply to Re: sorry for another one, but what else for me?, posted by nickguy on August 9, 2006, at 12:28:44
I wonder why? Do you think their depression is just much worse. How bad is yours and is anxiety what leads to the depression like mine? My pdoc thought a small piece of the patch was all I'd need. Love Phillipa
Posted by nickguy on August 9, 2006, at 21:57:04
In reply to Re: sorry for another one, but what else for me? » nickguy, posted by Phillipa on August 9, 2006, at 20:00:03
I don't know. For me it goes both ways, anxiety leads to depression and vice versa. I guess I could try a low dose emsam, but concerncing emsam, my doctor said he'd rather just try an old proven MAOI.
Posted by Phillipa on August 9, 2006, at 22:01:14
In reply to Re: sorry for another one, but what else for me?, posted by nickguy on August 9, 2006, at 21:57:04
How much you wanna bet he hasn't been visited by the drug reps yet on EMSAM? Love Phillipa
Posted by nickguy on August 10, 2006, at 14:00:39
In reply to Re: sorry for another one, but what else for me? » nickguy, posted by Phillipa on August 9, 2006, at 22:01:14
what else?
Posted by Racer on August 10, 2006, at 20:06:42
In reply to sorry for another one, but what else for me?, posted by nickguy on August 8, 2006, at 21:18:18
It's hard to make any suggestions, since you didn't mention if anything on the list helped at all, what sorts of problems you had with them, etc. It would be a lot easier if you told us that, say, the Wellbutrin helped a bit, but increased your anxiety; or the Paxil caused ennui.
Generally, though, as a guess, I think I'd consider nortriptyline, an MAOI (or the RIMA), or the Remeron/Effexor combo. (Or just try Remeron alone? It's worth starting it alone, to see what effect it has.)
I know that's not all that helpful, but good luck.
Posted by nickguy on August 10, 2006, at 21:21:02
In reply to Re: sorry for another one, but what else for me? » nickguy, posted by Racer on August 10, 2006, at 20:06:42
I'm sorry for the lack of clarity. Not one AD has had any effect on me, neither have the seroquel or anti-convulsants. I have social anxiety and depression and they've done nothing. Right now I'm taking klonopin, which is not doing much and zoloft 200 mg which is also doing nothing. I'd like to also mention that I've hardly had any side effects from ANY of those meds, besides desipramine which gave me dry mouth and anxiety. I take my ativan now to deal with stress, depression, and anxiety which is probably not healthy but I don't abuse it.
I'm just beginning to give up on meds, and starting to feel that maybe my path in life is coping with a difficult life, being lonely, and trying to find God despite all this. I know if meds coudl help me, I woudl take them, but after all I've been through I hardly doubt they'll do anything. (I mean, they haven't even given me side effects, they've all seemed like placebos) Ativan helps, but it won't get my through these problems.
Posted by nickguy on August 10, 2006, at 22:23:46
In reply to Re: sorry for another one, but what else for me?, posted by nickguy on August 10, 2006, at 21:21:02
I've augmented with lithium, lamictal, effoxor, klonopin, gabitril.
Posted by nickguy on August 10, 2006, at 22:27:23
In reply to Re: sorry for another one, but what else for me?, posted by nickguy on August 10, 2006, at 21:21:02
I'm a post-a-maniac right now, because I want to know whta the f*ck else is out there. I'm all f*cked up on pain pills, drinks, and ativan because I'm dropping.
What about mirapex? dopamine agonists? I love to drink so I cant see myself taking an MAOI...besides moclobemide. Remeron, I've taken plenty of norepeniphrine uptake inhibitors. If theres no other options than f*ck this, I'll deal with it.
Posted by Phillipa on August 10, 2006, at 22:34:31
In reply to sorry for another one, but what else for me?, posted by nickguy on August 8, 2006, at 21:18:18
Nick I'm so sorry. I'm not a med expert. I wish I could help. Love Phillipa
Posted by nickguy on August 11, 2006, at 17:17:05
In reply to Re: sorry for another one, but what else for me? » nickguy, posted by Phillipa on August 10, 2006, at 22:34:31
Don't be sorry, I really appreciated your input
Posted by llrrrpp on August 13, 2006, at 16:38:00
In reply to Re: sorry for another one, but what else for me?, posted by nickguy on August 11, 2006, at 17:17:05
you said that your pdoc was considering stimulants. I am taking modafinil (provigil) to help with daytime sleepyness caused by cymbalta 90 mg and seroquel 12.5 mg.
I am recovering from severe depression this spring. For a while I was taking 60 mg cymbalta, which was moderately ok... since I've upped the dosage to 90 mg and added the provigil I feel really good. I don't have jitters like i did on ephedra or lots of caffeine.
My mom takes provigil 200 mg like me. She has sleep apnea and narcolepsy. She says that she gets an antidepressant effect from the provigil, which is good because she gets depressed a lot.
best of luck to you nickguy. Sounds like you're in a tough place right now. I'm glad you've got a pdoc that's flexible and creative.
-ll
Posted by nickguy on August 13, 2006, at 21:58:54
In reply to Re: sorry for another one, but what else for me? » nickguy, posted by llrrrpp on August 13, 2006, at 16:38:00
thank you for responding, I really appreciate it. It's hard to come up with ideas. Anyway, I took provigil for a couple weeks at an adequate dose and felt zero effect from it.
Posted by llrrrpp on August 13, 2006, at 22:05:44
In reply to already taken provigil, posted by nickguy on August 13, 2006, at 21:58:54
Too bad- well, perhaps you'll be able to take an amphetamine-type stimulant with better effects. If you've tried many other options, it could be worth a shot.
best to you,
-ll
Posted by Crazy Horse on August 15, 2006, at 9:55:51
In reply to already taken provigil, posted by nickguy on August 13, 2006, at 21:58:54
> thank you for responding, I really appreciate it. It's hard to come up with ideas. Anyway, I took provigil for a couple weeks at an adequate dose and felt zero effect from it.
Has anyone or a Doctor ever told you perhaps you are a poor absorber of medicine? I am a poor absorber and have been thru a whole gammit of meds just like you with no effect at all.
I know you love to drink..this is very common for someone with your type of problems. However, alcohol is a depressant and just exasperates your problem. I know first hand, as i drank pretty heavy for about 16 yrs. hell, who wouldn't with the sh*t we have had to live with!
Okay, because i am a poor absorber, EMSAM..the new MAOI transdermal patch is working pretty well for me, as it goes straight into the blood, bypasses the gut/poor absorbtion problem.
Anyway, something for you to think about. My automatic guess when reading your intial thread/posts was, this guy is a poor absorber.
I wish you only the best!-Monte
Posted by Phillipa on August 15, 2006, at 20:33:54
In reply to Re: already taken provigil, posted by Crazy Horse on August 15, 2006, at 9:55:51
Monte is this why 5-6beers a night with .5xanax I felt wonderful. Love Phillipa
This is the end of the thread.
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