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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by PCB on June 15, 2020, at 19:27:50
Hey Everyone,
Has anyone else get on psychiatric meds only to have things like high blood pressure, diabetes, arthritis, etc. develop from those the medication? As if a mood disorder is not hard enough to deal with, to have the psych medications make you physically sick on top of that is just horrendous. I have been posting for 25 years looking for an alternate to Nardil with no success (nor has anyone ever wrote me or posted a solution to replace Nardil). I am down to marijuana, cytomel and weight loss surgery as solutions.
So anyone have to chose between mental health with psych med leaving you physically unhealthy? How did you deal with it? Should I switch to an ssri or snri with less weight gain, but have most of my depression untreated?
PS the other thing I have seen is many docs not offer potent psych meds to like Nardil, TCAs, ECT so these side effect never occur. So many patient are left with a majority of their psych symptoms untreated :(
Posted by Lamdage22 on June 15, 2020, at 22:02:38
In reply to Choosing Between Mental and Physical Health, posted by PCB on June 15, 2020, at 19:27:50
Have you tried Metformin for weight loss?
Posted by PCB on June 15, 2020, at 22:47:36
In reply to Re: Choosing Between Mental and Physical Health, posted by Lamdage22 on June 15, 2020, at 22:02:38
> Have you tried Metformin for weight loss?
Thanks for the reply. I have not. I have read the studies and metformin was not effective for weight loss (even topamax, but pdoc will give them despite the lack of efficacy). FDA approved weight loss meds are Qsymia, Contrave. Alli. They all cause minimal weight loss and must be taken for life. Some can worsen BP and anxiety with phentermine.
If my HgA1c went up, I would consider meformin. But I hate adding meformin with my other 5 meds. So base line, I need Nardil and Klonopin. But due to insomnia from Nardil, I have to add ambien. And to lower the dose of Nardil from 60 to 50 mg, I added low dose lithium and Lamictal. So due to Nardils side effects I add 3 meds for a total of 5 meds. Metformin would be 6th med with no evidence that it causes significant weight loss.
Do know any different from what I said above? Thank you
Posted by Lamdage22 on June 16, 2020, at 0:53:50
In reply to Re: Choosing Between Mental and Physical Health, posted by PCB on June 15, 2020, at 22:47:36
It helps me for sure. 6 meds is really a lot though.
Posted by Lamdage22 on June 16, 2020, at 1:05:47
In reply to Re: Choosing Between Mental and Physical Health, posted by Lamdage22 on June 16, 2020, at 0:53:50
I wouldn't say there is no evidence. It works for some, it doesn't work for others.
Posted by SLS on June 17, 2020, at 8:30:11
In reply to Re: Choosing Between Mental and Physical Health, posted by PCB on June 15, 2020, at 22:47:36
What dosage of lamotrigine are you taking? I see far too many people not taking at least 200 mg/day. For me, whenever I have tried to reduce the dosage from 300 mg/day to 200 mg/day, I relapse pretty hard. 200 mg/day seems to be the sweet-spot for most people.
- Scott
Posted by PCB on June 17, 2020, at 21:39:59
In reply to Re: Choosing Between Mental and Physical Health » PCB, posted by SLS on June 17, 2020, at 8:30:11
> What dosage of lamotrigine are you taking? I see far too many people not taking at least 200 mg/day. For me, whenever I have tried to reduce the dosage from 300 mg/day to 200 mg/day, I relapse pretty hard. 200 mg/day seems to be the sweet-spot for most people.
>
>
> - Scott60 mg of Nardil is where I feel good. But I also gain 50 lbs, insomnia and sexual dysfunction. So after feeling good for 3 months, my girlfriend will break up with me due to the weight gain and impotence. And my friend distance themselves with my weight gain. So I drop Nardil to 45 me where I am just barely able to work and add 3 cups of coffee for energy.
I did try Lamictal up to 300 mg with about 25% improvement. So after my 30+ medication trials, ECT, exercise .... I was left with Nardil 50 mg and 3 cups of coffee to just manage work. No friends, no girlfriends, no social life.
On my own, I added 450 lithium because that always seemed to help. I noticed to that if I took Lamictal 50 mg for 3 day I go a temporary boost, which faded away after 3 days. So I took the bus to work and I would bring crumbs of Lamictal about 10 mg each. 1 crumb in the morning okay, 2 better, 3 better and 4 worse.
So that is all the medication my doc have advised have failed me and I am always left to research and come up with my own concoctions. So for the last 10 years I have been on Nardil 50, Lamictal 37.5 to augment, lithium 450 to augment, ambien for nardils insomnia and Klonopin .5 for panic attacks.
And I am still only 25% improved from TMS induced depression for which the doc said it was impossible and that actually I better continue TMS so the depresssion does not get worse. I feel so wronged by that doctor.
So Im giving it one more week to hopefully fade, but I honestly though 1 weeks after the last TMS would have resolved my symptoms. Really the only solution god forbid with be ECT again. Nardil did stop working when I was always changing the dose and after a year, stopped working. ECT was the only thing that saved me.
Wish pdoc spent a little more time and effort with our cases. I feel I have alittle bipolarity and day 1 and 2 TMS agitation was probably a little up swing and then day 3 til now Im in a downswing. I gave the pdoc all my information on a silver platter to help her make my treatment decisions easier. But she seem to focused on getting me TMS and billing and forgetting me. I think this depression will where off, but if not I will probably need ECT which could have been provented if the pdoc take an extra 5 minutes each day to check on me. Actually she did need to, I contacted her to tell her what was going on and she still did not make appropriate medical decisions.
So unfortunately many of my questions go unanswered here at pbabble except for a few kind souls. I guess I am back to being a guinea pig, doing my own research, collecting my own data and advocating for thinks I never ever never would have imaged like ECT ..... just to feel 70%.
I wish everyone here the best of luck and hope you dont have to concoct you own treatment, tell TMS doctors when to stop, when to do right sided and when medications are appropriate.
Posted by ed_uk2010 on June 20, 2020, at 15:43:17
In reply to Re: Choosing Between Mental and Physical Health » PCB, posted by SLS on June 17, 2020, at 8:30:11
> What dosage of lamotrigine are you taking? I see far too many people not taking at least 200 mg/day. For me, whenever I have tried to reduce the dosage from 300 mg/day to 200 mg/day, I relapse pretty hard. 200 mg/day seems to be the sweet-spot for most people.
>
>
> - ScottThere's a strong tendency to under-dosing with drugs which require a lot of titration, because the titration is often never completed.
Posted by SLS on June 21, 2020, at 10:34:21
In reply to Re: Choosing Between Mental and Physical Health » SLS, posted by ed_uk2010 on June 20, 2020, at 15:43:17
> > What dosage of lamotrigine are you taking? I see far too many people not taking at least 200 mg/day. For me, whenever I have tried to reduce the dosage from 300 mg/day to 200 mg/day, I relapse pretty hard. 200 mg/day seems to be the sweet-spot for most people.
> >
> >
> > - Scott
>
> There's a strong tendency to under-dosing with drugs which require a lot of titration, because the titration is often never completed.
I think the concern regarding memory and cognitive impairments might prevent some people from testing higher dosages. I can understand that. However, it was my experience that any impairments that occurred in the beginning of treatment disappeared - even at 300 mg/day. Unfortunately, I was successful in convincing my doctor to keep the dosage at 150 mg/day in 2007. I was so close to being well 13 years ago.
Same:Nardil 90 mg/day
Different:
2007 - Nortriptyline 150 mg/day = too high; Today, 100 mg/day.
2007 - Lamotrigine 150 mg/day = too low; Today, 300 mg/day
2007 - No lithium; Today, lithium 300 mg/day (lithium 450 mg/day exacerbates depression).
Lesson? Don't exclude dosage experiments as you might cause yourself to miss an opportunity.
- Scott
This is the end of the thread.
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