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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 g_g_g_unit on December 20, 2008, at 8:50:29
hi. any advice please? have been suffering from extreme anhedonia (superimposed onto OCD) for the past couple of weeks. nothing can breathe wind into my sails. have completely destroyed a relationship with a girl because i am so emotionally constricted and un-fun to be around right now. seems to have risen out of nowhere? i am normally highly anxious/motivated/socially-orientated but lately have been feeling completely empty. a 2 year cycling of various SSRI's is the only cause i can think of? tried to drink myself into a stupor but even alcohol can't generate feeling in me right now. i've ordered deprenyl because it feels like a dopamine deficiency but am scared to mess with that system? can't hospitalize myself because i'd rather my parents didn't know. my pdoc is back on the 13th of January, having promised a nardil trial, yet waiting for the next 4 weeks feels unbearable. please help. should i see my GP?
Posted by SLS on December 20, 2008, at 9:15:15
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
For suicidal emergencies, I would suggest trying Zyprexa on a temporary basis. It works very fast. If it helps, I would then consider using Abilify or Geodon to augment the other drugs you are taking. This way, you can avoid the weight gain and risk of developing diabetes that goes along with Zyprexa.
- Scott
Posted by rjlockhart04-08 on December 20, 2008, at 11:02:04
In reply to Re: suicidal, posted by SLS on December 20, 2008, at 9:15:15
Lithium.......
That's the only advice i can give you. Lithium is an anti-suidcial medication. But, it doenst work all the the time.
Always in my posts, a stimulant to improve mental thinking about the situation....Dexedrine? Adderall (less recommened, has more side effects)
And definently, from what i'm hearing, alprazolam, or diazapam can help with emotional states.
Anti-psych medications can will make you feel worse. Seroquel, Haldol, PhenoThroizides....basically in general, they "take life away".
If i could hear more about what's going on, maybe i could help. But this is just a quick, help for medications.
stay in there, these times will break through.
rj
Posted by SLS on December 20, 2008, at 11:12:20
In reply to Re: suicidal, posted by rjlockhart04-08 on December 20, 2008, at 11:02:04
> Anti-psych medications can will make you feel worse. Seroquel, Haldol, PhenoThroizides....basically in general, they "take life away".
I must disagree.
I don't think that such a sweeping condemnation of such a wide variety of drugs is justified. These drugs can actually "give life". I consider myself fortunate that Abilify and Zyprexa have been invented.
It is tempting to judge the place a drug will have in someone's treatment regime based upon how we have reacted to that same drug ourselves.
- Scott
Posted by Jay_Bravest_Face on December 20, 2008, at 11:28:39
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
I'd agree with Scott (SLS)..you really, REALLY need to stabilize your mood right now. I think Zyprexa is likely the best choice. I often take it at the start for a few days at 10-15 mg's, then ramp down to 5, even 2.5 as I feel better. That initial dose helps 'reset' the loop-feedback system somehow.
Geodon *maybe* in higher doses. I would honestly strongly advise **against** anything activating like a dopamine agonist type of med like you where suggesting.
Please, please seek professional help. Not to take away from your pain, but many of us know similarly what it is to have those horrific thoughts, and would do anything to help you feel better. Please get some help and take very, *extra* good care of yourself.Jay
Posted by bleauberry on December 20, 2008, at 11:31:13
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
I agree with SLS, Zyprexa is a good one to buy some time. Call your GP, explain the situation in a heartfelt way with honesty, and ask him respectfully to call your pharmacy with a phone prescription of 6 pills of 5mg Zyprexa. Try 2.5mg to start and feel it out from there. It is not likely a cure, but will buy you some time to relax and not dwell as you wait. You can even take it as needed, not necessarily every day.
All the neurotransmitter systems are intricately linked together. One cannot directly impact one without indirectly impacting the others. So while you have hesitation in messing with dopamine, keep in mind that with various ssris, as you pointed out, you already have.
Honestly I have seen very few anecdotal reports of deprenyl helping anyone very much. Most people do get an initial lift from it due to its small short-lived metabolite amphetamine component, but that often fades quickly. I think claims on the internet about deprenyl are overstated almost to the point of hype. Sure it sounds great on paper, but try finding people at forums like this one saying how good it was. Very rare. If you are into ordering your own meds, much better choices in my mind would be Amisulpride and/or Milnacipran.
I have tried every drug you've been on and every one in this discussion, so none of them are foreign to me. I say what I say because I know what their effects feel like.
The main priority right now is to buy some time until Jan 13. Among the suggestions you receive, the most important one is to keep a phone handy. If you find yourself planning a tragic move, you have to dial 9-1-1. Family and friends may at first be shocked at the development, but months later will be so proud and respectful of you. It shows that beyond your own suffering, you care about them more. Taking yourself out of this world will not remove any pain from them. It does the opposite of what a depressed person thinks it would do. It gives family and friends unbearable grief that will haunt them the rest of their lives, in a way that no other means of death would. A grief that is multitudes greater than the grief of knowing their loved one is struggling.
Posted by SLS on December 20, 2008, at 11:38:49
In reply to Re: suicidal » g_g_g_unit, posted by Jay_Bravest_Face on December 20, 2008, at 11:28:39
Hi J_B_F
I agree with you that now probably isn't the best time to experiment with Abilify or Geodon.
Good advice.
- Scott
Posted by Phillipa on December 20, 2008, at 12:14:06
In reply to Re: suicidal, posted by SLS on December 20, 2008, at 9:15:15
Scott why zyprexa for suicidal Ideation hear theis a lot.? Phillipa
Posted by Phillipa on December 20, 2008, at 12:16:36
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
g g g Unit please don't do anything to harm yourself I do Believe Scotts advise was good. But remember 911 if things get out of hand Holidays aren't the best of times for a lot of people myself included. Hang in please try? Love Phillipa
Posted by jms600 on December 20, 2008, at 12:28:25
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
What about imipramine? That's quite activating and (as far as I know) doesn't heavily affect the dopamine system. I guess it would have to be taken with another drug(s) to address all the issues.
Do you have to see your main doctor? Can't you ask to see another? At least then you will be getting treatment that much sooner.
Posted by SLS on December 20, 2008, at 13:25:49
In reply to Re: suicidal » SLS, posted by Phillipa on December 20, 2008, at 12:14:06
> Scott why zyprexa for suicidal Ideation hear theis a lot.? Phillipa
I don't know why it works. It just does.
I think we sometimes forget that the main goal is the establishment of health and not the establishment of theories. While theories can ultimately provide a basis for understanding, the best understanding is to know what works. Clinical observation is sometimes all we have to go on to get people well with a minimum of adverse effects.
I don't write much about neuropsychopharmacology anymore, regardless of my fascination with it. I just find it more productive to share the clinical observations of the practitioners I have spoken to and the clinical information now available on the Internet.
- Scott
Posted by Phillipa on December 20, 2008, at 13:29:13
In reply to Re: suicidal » Phillipa, posted by SLS on December 20, 2008, at 13:25:49
Scott and I'm glad cause the technical don't understand. It's the simple words that make sense thanks for answering. Love Jan
Posted by Jeroen on December 20, 2008, at 15:00:42
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
dont play with your dopamine!! witouth your doctor
i too lamictal and gave me a psychosis that i still have
i know you feel bad, but talk to your doctor seriously
Posted by SLS on December 20, 2008, at 15:12:45
In reply to dont play with your dopamine!!, posted by Jeroen on December 20, 2008, at 15:00:42
> dont play with your dopamine!! witouth your doctor
>
> i too lamictal and gave me a psychosis that i still have
>
> i know you feel bad, but talk to your doctor seriously
Have you ever tried Provigil (modafinil)? It works on glutamate in a way that is opposite to Lamictal.
- Scott
Posted by Jeroen on December 20, 2008, at 15:16:34
In reply to Re: dont play with your dopamine!! » Jeroen, posted by SLS on December 20, 2008, at 15:12:45
no i havent, and im too scared now to mess up the rest of my health
i react bad and poor to drugs and now i cant live witouth it
thats what evil wanted me to happen to me
Posted by SLS on December 20, 2008, at 17:13:39
In reply to Re: dont play with your dopamine!!, posted by Jeroen on December 20, 2008, at 15:16:34
> no i havent, and im too scared now to mess up the rest of my health
I can REALLY understand your reluctance to try anything new. After my horrendous experiences with certain drugs, I was very much shy to try things that I was unsure about.
Stick with what works for now.
Try new things when you are ready.
Maybe you won't need anything new.
It is hard to know why it is us who were chosen to suffer such horrendous and poorly-understood illnesses. Personally, I believe that evil exists only in the minds of men. You are not an evil person. You are not being punished. I wish I could offer you a concrete reason why your painful path through the Universe was chosen for you. I don't. I doubt anyone really can. However, please recognize that you are in control of your own decision-making processes. In this regard, you are still choosing your own path.
I continue to wish you well. I only wish I were smart enough to know how to make you well. Eventually, you will come across someone who is. In the meantime, be proud of yourself of your achievement in life. It is not everyone who survives this illness as you have. For what it is worth, I find your continued efforts to find health in the midst of such illness to be EXTREMELY worthy of respect and admiration. I don't know if I could deal with your situation. I have not walked a single step in your shoes.
Survive. Rest when you must. Fight when you can. Recognize your achievements. You have much to be proud of.
- Scott
>
> i react bad and poor to drugs and now i cant live witouth it
>
>
> thats what evil wanted me to happen to me
Posted by Jay_Bravest_Face on December 20, 2008, at 17:16:19
In reply to Re: dont play with your dopamine!!, posted by Jeroen on December 20, 2008, at 15:16:34
> no i havent, and im too scared now to mess up the rest of my health
>
> i react bad and poor to drugs and now i cant live witouth it
>
>
> thats what evil wanted me to happen to meJeroen:
Have you tried a few of the other more 'atypical', and even slightly sedating mood stabalizers like Depakote/Epival, and Trileptal?
The Depakote comes in an ER version now, which is supposed to cause less side-effects. This same med also put out the fire of agitation and hypo-mania in me quite quickly. I am experimenting with Trileptal, and for now, find it works excellent as a bedtime med, and well into the next day. (I know..it is supposed to be 2x a day dosing.) I am trying to lower my antidepressant doses because they exacerbate my rapid cycling. Once you get that mood "stability" with the mentioned drugs, I found you really feel so much better. Klonipin (clonazepam) 1mg 2-3 times a day also helps greatly. Zyprexa is one of my other main meds. Zyprexa>Trileptal>Lyrica>Clonazepam really keep me feeling so much "down to earth"..after years of flying emotional ups and downs on antidepressants alone.Best wishes,
Jay
Posted by g_g_g_unit on December 20, 2008, at 17:35:52
In reply to dont play with your dopamine!!, posted by Jeroen on December 20, 2008, at 15:00:42
thank you for your replies everyone, i feel like you genuinely care and it's so reassuring to know that there's people out there who do. i am so embarassed about how i behaved last night, i just kept drinking and couldn't feel anything and now once again i am obsessing over any damage i might have done. these past few weeks have been a quest to *Feel* something. for a while i was doing well - was exercising regularly, had all but given up drinking, felt motivated, etc. yet also haunted by this nagging feeling that something was missing; i couldnt, and still cant, experience pleasure in anything, my social skills have deteriorated, so have my abilities as a writer. that's why i was chasing the dopamine angle; i know that just being able to write again, and experience pleasure in it, would help me more than any antipsychotic right now. it breaks my heart to not be able to enjoy what i love the most. the same applies to this girl, who got to know a certain me and has had to watch that me fade away. anyway, i finally took remeron to help me sleep and feel okay today. i am just so scared to face the coming weeks. each day is so empty and hard. i am scared to see my GP because while I was using him as my primary treatment source, i got frustrated with him just pushing tranquilizers on me. it's been at least 6 months since i saw him. would it be a faux pas to return to him now??
Posted by SLS on December 20, 2008, at 18:39:33
In reply to Re: dont play with your dopamine!!, posted by g_g_g_unit on December 20, 2008, at 17:35:52
Faux pas?
Who cares?
You need to take care of yourself. At this point in time, try not to worry how you might be judged by your doctor - or anyone else for that matter. I'm sure the doctor will care only about your health.
- Scott
Posted by cmorhoun on December 23, 2008, at 15:24:11
In reply to suicidal, posted by g_g_g_unit on December 20, 2008, at 8:50:29
I would recommend going to a health foods store and purchasing an amino acid suppliment and/or a liquid form of St. John's Wort. Both can be very energizing and may at least get you by for the next 4 weeks. Something as simple as a multi-vitamin, if you aren't taking one already, can help with energy as well. Bandaids but worthwhile.
This is the end of the thread.
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