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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 68 to 92 of 105. Go back in thread:
Posted by SLS on August 24, 2006, at 8:52:56
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by JahL on August 24, 2006, at 8:35:15
Hi Jah.
I read with great interest your thread regarding your experiment with buprenorphine. I hope it "sticks". :-) I am going to discuss the use of buprenorphine with my doctor today.
I skipped my last night's dose and this morning's dose of sibutramine. I feel somewhat better, but it still comes in waves. The half-life of this stuff (active metabolites) is about 12 hours. I don't know what to do next.
- Scott
> > Depression continues to worsen.
> >
> > I am feeling worse in a way that I attribute to a drug-induced exacerbation.
>
> Hi Scott.
>
> I'm sorry the Sibutramine hasn't worked out for you. That sucks big-time. After all this time - and with all the help you provide on this board - I think you really, finally, deserve some blessed relief (as does everybody else of course).
>
> Sorry to quickly change the subject, but I'd be interested in your thoughts on my Buprenorphine thread further down this page.
>
> You, perhaps more than anyone, know how much pain I've endured, as I do with you. Racer aside (and it's nice to see another oldie return), you're pretty much the only one from 'back in the day' to have stuck with this board.
>
> Again, I'd be interested in your thoughts. You might even have some interest with regard to your own condition.
>
> Wishing you similar success,
>
> Jah.
Posted by Racer on August 24, 2006, at 10:39:53
In reply to Re: Sibutramine (Meridia) - Day 19 » JahL, posted by SLS on August 24, 2006, at 8:52:56
As well as talking to your doctor about buprenorphine, how about asking about tianepine? The other people who've taken here on this board seem to find it helpful, and it's a very different mechanism of action from the other drugs most of us have tried. Despite the difficulties in getting it, it really might be worth it.
It's high on my list, as I think I've told you, and I'll probably bring it up with the fancy doctor I see next month. (Although I won't be trying anything new for a while, as I think we've discussed...)
I'm so sorry the sibutramine hasn't worked out for you. It's partly selfish, but I was really hoping it would.
Posted by Racer on August 24, 2006, at 10:41:44
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by JahL on August 24, 2006, at 8:35:15
> >
> Racer aside (and it's nice to see another oldie return), you're pretty much the only one from 'back in the day' to have stuck with this board.
>Thanks, Jah. It felt really good to read that.
Posted by ed_uk on August 24, 2006, at 13:37:05
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by JahL on August 24, 2006, at 8:35:15
Hi J
Do you know of a doctor who will prescribe buprenorphine for you?
Ed
Posted by JahL on August 24, 2006, at 14:10:59
In reply to Re: Sibutramine (Meridia) - Day 19 » JahL, posted by ed_uk on August 24, 2006, at 13:37:05
Hi Ed.
Long time! How are ya?
> Do you know of a doctor who will prescribe buprenorphine for you?I don't have a pdoc anymore. My last one retired and his replacement was (and still is) an idiot. The smug, ill-mannered 'individual' told me he 'didn't believe in treating Bipolar with drugs' (!!). Seven years wasted at med school then. I had to walk out on him before I did some damage. I wasn't a happy chappy.
My new GP isn't much better ("you're on too many drugs blah, blah") and he can't differentiate between Bipolar and 'Affective Psychoses' (that's what he keeps putting on my notes despite my protestations).
My only hope is my old private pdoc who I paged today. I have no idea what my chances are.
Why, do you have any ideas?
I've lost track of where you are treatment-wise. Is it all under control?
Cheers,
J.
Posted by Maximus on August 24, 2006, at 14:52:23
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
> Depression continues to worsen.
>
> I am feeling worse in a way that I attribute to a drug-induced exacerbation. There is a worsening of vegetative symptoms and a heaviness of thought that is almost painful. I have decided to suspend taking sibutramine until speaking with my doctor tomorrow.
Sincerely sorry dude,Scotty, if i may ask, for how long have you been disabled and been unable to work?
May be it is the time to take the heavy artillery's approach once again. I suggest the hospitalization. Thus you might get ECT + a complete overhaul of your medication. A bit scary, i know, but probably necessary...
Buddy, i do apologize in advance for my personal point of view. I just think you deserve better. Actually i would just stop to tease yourself with experimental medecines. They just don't seem to work.
Be well!
Posted by JahL on August 24, 2006, at 14:57:19
In reply to Re: Sibutramine (Meridia) - Day 19 » ed_uk, posted by JahL on August 24, 2006, at 14:10:59
Sorry, I'm back to my old thread-hijacking ways!
What was the doc's reaction?
J.
Posted by Phillipa on August 24, 2006, at 20:28:55
In reply to Re: Sibutramine (Meridia) - Day 19 » JahL, posted by ed_uk on August 24, 2006, at 13:37:05
Ed that's the med they use in Charlotte for detox. My old group of pdoc's used it all the time. Love PJ O
Posted by Phillipa on August 24, 2006, at 20:31:54
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
Scott can you let us know what you doc said? Love Phillipa
Posted by SLS on August 25, 2006, at 6:15:56
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
7 days @ 10mg
12 days @ 20mg
1 day @ 0mgThe worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by SLS on August 25, 2006, at 6:21:25
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Racer on August 24, 2006, at 10:39:53
> As well as talking to your doctor about buprenorphine, how about asking about tianepine?
Ah. I forgot to plant that seed. I've never mentioned this drug to him. Thanks. Do you have in place a plan to acquire it?
I can't help but to want to go back to taking Nardil for what little it helps me. I just want a break.
- Scott
Posted by SLS on August 25, 2006, at 6:30:32
In reply to So how did it go today Scott?, posted by JahL on August 24, 2006, at 14:57:19
> Sorry, I'm back to my old thread-hijacking ways!
>
> What was the doc's reaction?Basically, I left there with a prescription for pregabalin 75mg with the intent to move up to higher dosages later. There is a chance that it won't be covered by my prescription plan. If it is not, I might not take it.
I discussed with him the use of buprenorphine. He was aware that it was used by some doctors, but didn't seem too keen on it. He said that I should send him some stuff on it. We also discussed adding Nardil to what I am currently taking. He didn't like adding it to nortriptyline, but I think I convinced him to give it a try. I anticipate a mild serotonin syndrome developing, but what the heck. It really represents a dead end, but I would just like to feel better than I am now. I see him in two weeks. I guess I have a lot to think about.
- Scott
Posted by SLS on August 25, 2006, at 7:01:27
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Maximus on August 24, 2006, at 14:52:23
Hi Maximus.
> Scotty, if i may ask, for how long have you been disabled and been unable to work?15 years.
Crap.
> May be it is the time to take the heavy artillery's approach once again. I suggest the hospitalization. Thus you might get ECT + a complete overhaul of your medication. A bit scary, i know, but probably necessary...
Thank.
I'm not sure. I've already tried ECT. I can't see myself going through that again. My doctor brought up VNS again. I have already been in a hospital situation a few times. I have allowed them over six months on two occasions to work on me. At the moment, I can't think of anything they could do that hasn't been done already.
> Buddy, i do apologize in advance for my personal point of view.
No apologies necessary!
:-)
> I just think you deserve better.
I would have to agree with you.
> Actually i would just stop to tease yourself with experimental medecines. They just don't seem to work.
This one doctor had it right in 1987. He combined Parnate + desipramine. He just got too smart for his (my) own good and decided at some point that only one drug would be necessary. I naively followed his directions word for word for many months. Then I self-medicated. When I tried going back to the original combination, it no longer worked.
> Be well!Thanks. You do the same.
- Scott
Posted by mayzee on August 25, 2006, at 12:33:53
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued, posted by SLS on August 25, 2006, at 6:15:56
> The worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
>Hi Scott,
I'm only familiar with the newer ADs (SSRIs/SNRIs/etc.) and have always been told that it takes at least 4+ weeks to feel the AD effect. Is Sibutramine different in that you should get the effect much sooner?
I am so sorry that it didn't work for you. I hope that you can find something soon to make you feel better.
Warm regards,
mayzee
Posted by SLS on August 25, 2006, at 17:28:40
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued » SLS, posted by mayzee on August 25, 2006, at 12:33:53
> > The worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
> I'm only familiar with the newer ADs (SSRIs/SNRIs/etc.) and have always been told that it takes at least 4+ weeks to feel the AD effect. Is Sibutramine different in that you should get the effect much sooner?Hi Mayzee.
You are right. I would not expect sibutramine to be any different from Effexor in this regard. However, I did not expect the drug to make me feel markedly worse. I just don't have the fortitude at this juncture to subject myself to any more of that. I just got done spending weeks feeling worse because of Wellbutrin. I know I can't afford to leave any stone left unturned. However, I think stopping the sibutramine was the right thing to do. I was reacting quite badly to it.
Thanks for your interest.
- Scott
Posted by Maximus on August 25, 2006, at 20:35:11
In reply to Re: Sibutramine (Meridia) - Day 19 » Maximus, posted by SLS on August 25, 2006, at 7:01:27
Thanks for the informations. Now i understand a lot better your situation. You are a gentleman. That is what we call a genuine case of treatment resistant.
Well, you know yourself better than us, so continue to fight this ugly illness.
Last thing, i think the VNS implant would be a good bet.
Bye.
Posted by Phillipa on August 25, 2006, at 20:41:26
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Maximus on August 25, 2006, at 20:35:11
Only problem as my doc talked to me about it now I could be wrong. But I was told that you still needed to take meds. And the implant a devise in your brain. And you can never have an MRI? See that's the part I don't get. Love Phillipa
Posted by ed_uk on August 26, 2006, at 14:33:26
In reply to Re: Sibutramine (Meridia) - Day 19 » ed_uk, posted by JahL on August 24, 2006, at 14:10:59
Hi J
>Long time! How are ya?
Quite well. I don't need to see a pdoc anymore thankfully :)
>'Affective Psychoses'
Perhaps he has a 1970s psych text book? ;-)
>My only hope is my old private pdoc who I paged today. I have no idea what my chances are.
Any luck?
Regards
Ed
Posted by SLS on August 27, 2006, at 7:48:54
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued, posted by SLS on August 25, 2006, at 6:15:56
7 days @ 10mg
12 days @ 20mg
4 day @ 0mgIt appears that sibutramine has left me in a state that is worse than before I started it. I am more vegetative, and that feeling of cognitive "muddiness" persists along with mild anxiety. The half-life of the drug and its metabolites is about 12-14 hours, so I am not convinced that it is the drug itself that is making me feel worse.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by MARTY on August 27, 2006, at 14:24:25
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow., posted by SLS on August 4, 2006, at 22:03:09
Hi Scott,I have the luck of being followed by the most recognized/best Pdoc, specialized for Bipolar, in Canada. (That's confirm by a lot of Pdocs)
And so I just wanted to update you on the fact that your type of bipolarity is to be call TYPE 4 in 2010 DSM V.I know because I'm also in this club. Accompagnied by Anxiety and Social phobia.
Btw, I'll try Meridia and let you know how I do.
Take care,
Marty> > Scott, do you mind sharing what is your diagnosis (-es)?
> >
> > Wishing you great success with this,
> >
>
>
> Hi Mayzee.
>
> I have the type of bipolar disorder where you are depressed all of the time except for the rare occasion when a drug provokes a manic reaction. At one point, this was to be named Bipolar III. Now, I don't know what it is to be named in the new classification scheme.
>
>
> - Scott
Posted by SLS on August 27, 2006, at 14:41:15
In reply to Re: Sibutramine (Meridia) - Starting it tomorrow. » SLS, posted by MARTY on August 27, 2006, at 14:24:25
Hi Marty.
Nice to see you again.
> Btw, I'll try Meridia and let you know how I do.
Good luck with it. Maybe it will treat you better than it did me.
- Scott
Posted by ed_uk on August 28, 2006, at 6:18:23
In reply to Re: Sibutramine (Meridia) - Day 23 - Discontinued, posted by SLS on August 27, 2006, at 7:48:54
Hi Scott
Do you plan to try buprenorphine soon?
Ed
Posted by SLS on August 28, 2006, at 7:36:37
In reply to Re: Sibutramine (Meridia) - Day 23 - Discontinued » SLS, posted by ed_uk on August 28, 2006, at 6:18:23
> Hi Scott
>
> Do you plan to try buprenorphine soon?
My doctor seems to be against the idea.
- Scott
Posted by SLS on August 28, 2006, at 20:56:17
In reply to Re: Sibutramine (Meridia) - Day 23 - Discontinued, posted by SLS on August 27, 2006, at 7:48:54
7 days @ 10mg
12 days @ 20mg
5 day @ 0mg
I feel worse today than I did yesterday. I think sibutramine produced changes in my brain that have resulted in a deterioration of my condition.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by Phillipa on August 28, 2006, at 20:58:10
In reply to Re: Sibutramine (Meridia) - Day 24 - Discontinued, posted by SLS on August 28, 2006, at 20:56:17
Scott what does your doc say? Love Jan
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