Posted by bulldog2 on January 25, 2010, at 17:29:29
In reply to Peanut's Stanford Med List, posted by inanimate peanut on January 21, 2010, at 23:04:19
> Ok, here is the long awaited miracle list from Stanford:
>
> Group 1:
> 1. Provigil
> 2. Cytomel
> 3. Mirapex
>
> Group 2 (no particular order)
> -Saphris
> -switch MAOIs to Marplan or Nardil
> -add Dynakirk or Nimodepine (calcium channel blockers)
> -add Depakote or Tegretol
>
> Group 3 (no particular order)
> Clozaril (would be higher except for side effects)
> ECT (to help with washout)
> washout from Parnate back to SSRIs
>
> Why Peanut hates Stanford's List (negativity warning-- I'm very depressed right now which is coloring my impressions):
> 1. Provigil-- already tried it, didn't help-- Stanford doc says maybe dose not high enough; I think there's a snowball's chance in hell that this is the case. I think I'm going to waste 4 weeks of my time on a drug that's already proven not to work for me. Don't forget my March 26 deadline-- God knows I can't
>
> 2. Cytomel-- I think this has a small chance of working. I also know that my endocrinologist wouldn't even listen to me about prescribing it. My pdoc won't prescribe since I'm under the care of an endo already for my thyroid. I can go ahead and try every endo in town at $40 a pop until I find one that will try something that may or may not work (which I am seriously considering)
>
> 3. Mirapex- I don't think there's much evidence on this one. I also know you start at .125 and increase by .125 every 5 days until you get to the dose of 1.75. This is due to nausea, which doesn't sound fun. This also is not working with my deadline issues.
>
> -Saphris- it's new enough that he doesn't know if it will help or not so I might as well try it-- how encouraging.
>
> -switching MAOIs-- Are you freaking kidding me? If I go off a drug it will not work after I go back on it. I've got probably 40 more years to live with this disorder. I'm going to need every drug there is when the others poop out-- why would I waste a perfectly good drug on the slight chance another would work better? I'll probably be on Marplan and Nardil someday when Parnate no longer works. As long as it's working, you'll never see me leave Parnate.
>
> -Dynokirk or Nimodipine-- has anyone even heard of these being used? This sounds like the land of "a couple of small studies showed some promise..." I need to look into it more, but I'm not holding my breath
>
> -Depakote or Tegretol-- I'm not cycling; I pretty much just stay depressed. There's some small evidence that Depakote helps bipolar depression. I'm not looking forward to the weight gain.
>
> -Clozaril-- I know that this works for alot of people. I've not heard of it working for bipolar depression. I've also heard that you need a stimulant to even get through life with its sedation, and my doc won't prescribe stimulants with Parnate. Again with the weight gain, which is actually the least of my concerns here.
>
> -ECT- I won't even discuss this at this point. I looked at it again earlier this year. I considered it when I was in hell. If the parnate stopped working and nothing else would work, I would consider it again. As long as something is partially working, it's not an option for me.
>
> -switching to SSRIs- I don't really have any that are left to work, which is why I switched to Parnate in the first place. Also see above about running out of meds to try in 40 years
>
> So, that's it. That's my life, I don't like it. I think the odds are stacked against me. I think we're throwing out last 5 balls at the wall and hoping something will stick. That's not comforting. Stanford doc says he usually doesn't see the disorder so severe in someone my age-- that was crushing when I thought of the implications for my future.
>
> Why some of my favorites were rejected:
> 1. Nortriptyline- this has always been my best option-- Stanford doc is with my doc on this one-- too dangerous
> 2. Remeron- Stanford doc is worse than my doc on this one-- too dangerous
> 3. Neurontin and Zonisamide- says neither are mood stabilizers-- says Neurontin is an anxiety med only
> 4. Stimulants-- too dangerous
>
> Never mind the fact that if these were all really this dangerous, some of my favorite babblers would be dead.
>
> All in all, I wish I hadn't gone. I liked it better when I had my med list that had more options. But, if anyone has been on the social board, you know I am more than a little biased right now, and I understand that, so take what I say with a grain of salt.
>
> I don't know-- I'll probably just work through the list in the order he gave me, with the exception of switching to a different MAOI, which I refuse to do.
>
> Well, what do you think?
>
>I really don't think these lists are all that bad. They are actually very reasonable. They seem to be synergistic combos. I think we need to give peanut hope they can work rather than just agree with her.The place has a good rep.
poster:bulldog2
thread:934632
URL: http://www.dr-bob.org/babble/20100122/msgs/934968.html