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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Axmann on February 23, 2016, at 1:37:55
Hello,
After a trial of Parnate, which improved my mood significantly but caused intolerable insomnia which I couldn't stick through, I am feeling incredibly demotivated by the current state of psychiatry.
I have had life-long dysthymia, depression, and ADD-PI. SSRIs/SNRIs help a lot with my appetite and sleep, but obliterate my motivation, passion, drive, and libido, and make my ADD meds much less effective. In addition, I have a short/long version of the SLC6A4 (SERT) gene, but I am not sure how this should influence my treatment.
I need a novel treatment strategy that both improves my mood and helps with anxiety but doesn't make me stupid and numb.
I have some alternatives in mind:
-Tianeptine
-Ropinirole
-Curcimin
-Rhodiola rosea
-L-TryptophanBut I need some additional advice. I am really at wit's end here and I need relief.
Posted by Horse on February 23, 2016, at 11:39:57
In reply to Alternatives for anhedonic depression and anxiety?, posted by Axmann on February 23, 2016, at 1:37:55
I can't speak to much of the meds and supplements you've listed, and you've likely tried Wellbutrin at a maximum dose, but it is what came to mind. It's used for ssri induced libido problems and can help with ADD. (I have inattentive as well.) Might provoke anxiety. Dysthymia can be tough to treat. Wellbutrin helped me with that for awhile, too. Wanted to lend my support.
Posted by Christ_empowered on February 24, 2016, at 0:11:25
In reply to Re: Alternatives for anhedonic depression and anxiety?, posted by Horse on February 23, 2016, at 11:39:57
Psychiatry isn't really, you know...science. Have you tried stimulants? Wellbutrin helps some people. Sometimes, wellbutrin+ssri=very good results, even remission. Same for wellbutrin+remeron.
If you take stimulants, I think wellbutrin mellows them out. I vaguely recall reading that they still help, but the effect is milder. I don't know if that would apply to Provigil.
Other than that...remeron might be a good add on to an snri. Effexor+Remeron=cali rocketfuel; I've also read that cymbalta+remeron=effective, although it can push people into (hypo)mania.
That's really all I have for you. Hope things get better.
Posted by Hugh on February 27, 2016, at 12:12:12
In reply to Alternatives for anhedonic depression and anxiety?, posted by Axmann on February 23, 2016, at 1:37:55
If you try curcumin, the kind I'd recommend is Super Bio-Curcumin. This is much more absorbable than other forms of curcumin. I'd also recommend magnesium l-threonate. This is the most absorbable form of magnesium.
If you're looking for a novel treatment that improves your mood and anxiety and doesn't make you "stupid and numb," I'd recommend neurofeedback.
Posted by Tomatheus on February 27, 2016, at 14:28:47
In reply to Re: Alternatives for anhedonic depression and anxiety?, posted by Hugh on February 27, 2016, at 12:12:12
I concur with what Hugh said regarding curcumin. As far as I can tell, the type of curcumin that's used in the Super Bio-Curcumin product that Hugh was referring to is BCM-95, which to my knowledge is the version of curcumin that's been studied more extensively for depression in humans than any other form of curcumin. And as Hugh was saying, BCM-95 has been found to be better absorbed than other forms of curcumin. A study by Antony et al. (2008) found that BCM-95 had 6.93 times the bioavailability of "normal curcumin" and 6.3 times the bioavailability of a curcumin-lecithin-piperine formula. The two human trials that I'm aware of that evaluated the clinical effects of BCM-95 in patients with depression consist of a six-week study that found the efficacy of 1 g/day of BCM-95 to be statistically comparable to that of fluoxetine (Prozac) (Sanmukhani et al., 2014), as well as an eight-week study that found 1 g/day of BCM-95 to be no more effective than placebo after four weeks but significantly more effective than placebo after eight weeks (Lopresti et al., 2014). I know that there are a lot of different curcumin products that are commercially available, many of which say that they boost the bioavailability of curcumin by different methods. It would be my guess that each product has its pros and cons, and I haven't looked at all of the products in enough detail to offer much of a comparison of the pros and cons of all of the different versions of curcumin. However, I will say that two of the "pros" of BCM-95 are its superior bioavailability compared to "normal curcumin" and a curcumin-lecithin-piperine formula, as well as the fact that it's been studied more extensively for depression in humans than other forms of curcumin, at least to my knowledge.
I currently take curcumin (and yes, it's the BCM-95 version), and although it seemed to boost my energy and concentration and to help me sleep less excessively at first, the benefits that I had noticed at first have faded, and I'm not sure that the curcumin still offers me any mental health benefits. I do, however, also experience lower back pain, and I can say that I think the curcumin that I take is helping me in this area, because I've tried discontinuing curcumin a few times now, only to notice a strong worsening of my back pain each time I tried discontinuing the supplement.
At any rate, Axmann, I basically just wanted to write to concur with Hugh's point about curcumin and also to share some of my thoughts about the supplement with you. I wish you luck with any medication or supplement trials that you may undertake, and I hope that you'll find a treatment regimen that will offer you some of the benefits that you're looking for.
Tomatheus
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REFERENCES
Antony, B., Merina, B., Iyer, V.S., Judy, N., Lennertz, K., & Joyal, S. (2008). A pilot cross-over study to evaluate human oral bioavailability of BCM-95(R)CG (Biocurcumax TM), a novel bioenhanced preparation of curcumin. Indian Journal of Pharmaceutical Sciences, 70, 445-449. Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792534/
Lopresti, A.L., Maes, M., Maker, G.L., Hood, S.D., & Drummond, P.D. (2014). Curcumin for the treatment of major depression: A randomized, double-blind, placebo controlled study. Journal of Affective Disorders, 167, 368-375. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/25046624
Sanmukhani, J., Satodia, V., Trivedi, J., Patel, T., Tiwari, D., Panchal, B., et al. (2014). Efficacy and safety of curcumin in major depressive disorder: A randomized controlled trial. Phytotherapy Research, 28, 579-585. Abstract: http://www.ncbi.nlm.nih.gov/pubmed/23832433
Posted by J Kelly on March 1, 2016, at 15:46:44
In reply to Alternatives for anhedonic depression and anxiety?, posted by Axmann on February 23, 2016, at 1:37:55
Hi Axmann,
not sure if this helps but this got me to a tolerable state of mind:
10mg Zyprexa
90mg Ritalin
3mg klonopinI had to reduce the Zyprexa due to weight gain (came right off when I reduced it).
My pdoc decided I should wean off Ritalin and Klonopin. It didn't go well but i'm down to 5mg Zyprexa, 60mg Ritalin, and .5mg Klonopin.
Jade
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