![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by JohnX2 on March 4, 2002, at 18:16:52
Hi Jill,Sorry if this is long.
Ok, for starters I think we may want to do a little
bit of interrogation on your history. I hope you
don't mind. Its easier for people to give suggestions/
experiences if they can see the trends in your
treatment and maybe say "hey, I went down that
path, here's what happened with me".Please remember. EVERYOBODY is different. It is
ABSOLUTELY IMPOSSIBLE for anybody to tell you with
certainty how you will respond to a medication.
One person's failure on a medication does not
imply your failure, one persons success does not
imply your success. What we do have are statistical
trends on what medicines TEND/LEAN towards working
the best in a given situation. And to save yourself
the most pain and suffering it is best to start
with these routes. No guarantee of success, but
we want to skew the odds in your favor. An accurate
diagnosis is the most crucial piece of information.Probably you already know this, but maybe other
people making a lot of posts using up bandwidth
don't. Anyways, this is why we have such a large
array of medicines on the counter.So back to summarizing your history (sorry
if I haven't really stayed on top of your
earlier posts):I have:
1) social phobia/generalized anxiety
2) depression (apathy)
3) pain ??
4) you mentioned ADHD, anything here?Now were missing some pieces of the Jill K
puzzle in these areas:1) maybe a little more insight into your depression/anxiety
Would you categorize it as Major Depression (feeling
really empty inside, can't experience pleasure at all,
think about dying)? Or are you primarily anxious and
maybe lacking motivation, interest in life, fearful
of social settings etc?2) What were all the medicines you tried in the past
and what were the outcomes?Have you tried any of the default SSRIs (Zoloft,Celexa,etc).
Failures?Tried MAOIs (Nardil is often prescribed for social phobiam
Parnate, Deprynyl are other options)?Ever tried an atypical antipsychotic like
Zyprexa/Geodon?What are your main concerns regarding starting a new
medication? That it will have bad side effects, it won't
effectively address your depression, etc?What kind of pain symptoms are you having?
Of all your problems, were are you hurting most?
Sorry for all the questions. But I think they
really would help us to give you better support.I'm not an expert in Social Phobia, I have a
gold card in pain and depression though.Best wishes.
John
Posted by Jason911 on March 4, 2002, at 18:45:19
In reply to new help Jill K. thread, posted by JohnX2 on March 4, 2002, at 18:16:52
I'm going to add my little tid-bits to the post that John so wonderfully wrote: Some things in here could maybe help John though,
> Hi Jill,
>
> Sorry if this is long.
>
> Ok, for starters I think we may want to do a little
> bit of interrogation on your history. I hope you
> don't mind. Its easier for people to give suggestions/
> experiences if they can see the trends in your
> treatment and maybe say "hey, I went down that
> path, here's what happened with me".
>
> Please remember. EVERYOBODY is different. It is
> ABSOLUTELY IMPOSSIBLE for anybody to tell you with
> certainty how you will respond to a medication.
> One person's failure on a medication does not
> imply your failure, one persons success does not
> imply your success. What we do have are statistical
> trends on what medicines TEND/LEAN towards working
> the best in a given situation. And to save yourself
> the most pain and suffering it is best to start
> with these routes. No guarantee of success, but
> we want to skew the odds in your favor. An accurate
> diagnosis is the most crucial piece of information.:::: This is absolutely true and the foundation of Psycho-Babble ::::::
>
> Probably you already know this, but maybe other
> people making a lot of posts using up bandwidth
> don't. Anyways, this is why we have such a large
> array of medicines on the counter.
:::::Many of which cause side-effects:::::
>
> So back to summarizing your history (sorry
> if I haven't really stayed on top of your
> earlier posts):
>
> I have:
>
> 1) social phobia/generalized anxiety::::Klonopin. Klonopin. Klonopin. It just works.:::::
>
2) depression (apathy):::::I say give selegiline a try with 500mg phenylalanine daily-just give it a try-no side-effects!!! Except for maybe insomnia from too much stimulation and awareness but if on Klonopin there wold be no worries here:::::
>
3) pain ??
:::::Advil?:::::::
>
4) you mentioned ADHD, anything here?
>
:::::I'm against stims (Adderall, etc.)Wellbutrin maybe?::::::
>
Now were missing some pieces of the Jill K
> puzzle in these areas:
>
> 1) maybe a little more insight into your depression/anxiety
>
> Would you categorize it as Major Depression (feeling
> really empty inside, can't experience pleasure at all,
> think about dying)? Or are you primarily anxious and
> maybe lacking motivation, interest in life, fearful
> of social settings etc?
>
> 2) What were all the medicines you tried in the past
> and what were the outcomes?
>
> Have you tried any of the default SSRIs (Zoloft,Celexa,etc).
> Failures?
>
::::I say try selegiline+phenylalanine before your try the SSRI's. I think the side-effects aren't worth not giving the selegiline+PEA combo a try. I think SSRI's are evil.::::> Tried MAOIs (Nardil is often prescribed for social phobiam
> Parnate, Deprynyl are other options)?::::The one I'd recommend??? Yep. Deprenyl!::::
>
> Ever tried an atypical antipsychotic like
> Zyprexa/Geodon?
>::::As for Zyprexa and friend of mine tried it and got tremors/ticks/involuntary movements in the face--woah.::::::::
>
What are your main concerns regarding starting a new medication? That it will have bad side effects, it won't
> effectively address your depression, etc?
>
::::Selegiline+Phenylalanine is basically side-effect free (major at least) and worth a try if you are worried about side-effects:::::
>
What kind of pain symptoms are you having?:::I believe the "pain" she was talking about was the suffering from her symptoms... i.e. emotional pain::::::
>
> Of all your problems, were are you hurting most?
>
> Sorry for all the questions. But I think they
> really would help us to give you better support.
>
> I'm not an expert in Social Phobia:::::Klonopin. Klonopin. Klonopin. Klonpin. Anxiety wonder pill!!!!!
I have a
> gold card in pain and depression though.
>
> Best wishes.
> John
::::and Jason911::::::
Posted by Jill K. on March 4, 2002, at 19:20:29
In reply to new help Jill K. thread, posted by JohnX2 on March 4, 2002, at 18:16:52
> Now were missing some pieces of the Jill K
> puzzle in these areas:
>
> 1) maybe a little more insight into your depression/anxietyI was shy and introverted growing up. I was always anxious in social situations. Last year in grad school I started getting panic attacks and I met my pdoc who started me on klonopin. With 0.5 mg, the panic left, with depression remaining.
> Would you categorize it as Major Depression (feeling
> really empty inside, can't experience pleasure at all,
> think about dying)? Or are you primarily anxious and
> maybe lacking motivation, interest in life, fearful
> of social settings etc?I was primarily anxious and fearful of social settings. With the 0.5 mg klonopin, much of the anxiety is gone. Now with 200mg of neurontin three times a day, it is all gone. Now I am just depressed. Sleep when I get home and on weekends. All my hobbies and interests and friends I have dropped ... no energy or motivation.
> 2) What were all the medicines you tried in the past
> and what were the outcomes?
>
> Have you tried any of the default SSRIs (Zoloft,Celexa,etc).
> Failures?I tried zoloft to 200 mg, feel numb and remained depressed. I also tried lamictal with no benefit and ritalin which increased my anxiety and then crashed after six hours.
>
> Tried MAOIs (Nardil is often prescribed for social phobiam
> Parnate, Deprynyl are other options)?
No> Ever tried an atypical antipsychotic like
> Zyprexa/Geodon?No
> What are your main concerns regarding starting a new
> medication? That it will have bad side effects, it won't
> effectively address your depression, etc?
>
> What kind of pain symptoms are you having?Pain is pure psychologic. I am so isolated and alone.
> Of all your problems, were are you hurting most?
>
I think I have 2 main problems (1) panic/social anxiety (2) apathic depression. If I increase klonopin/neurontin no more anxiety, but more depression. When I tried ritalin and zoloft less depression, but HUGE anxiety.> Sorry for all the questions. But I think they
> really would help us to give you better support.
>No Problem. I love the fact that someone is helping me. If anyone can help me, I will owe then my life, because I haven't had a life for so many years.
Your Friend,
Jill
Posted by JaneB on March 4, 2002, at 19:23:50
In reply to Re: new help Jill K. thread, posted by Jason911 on March 4, 2002, at 18:45:19
Klonopin sure has helped me in many areas: insomnia, anxiety, nightmares, social phobia, neck pain, heart palpitations, etc. JaneB
Posted by Jason911 on March 4, 2002, at 19:48:54
In reply to Here are the answers » JohnX2, posted by Jill K. on March 4, 2002, at 19:20:29
I am going to add my thoughts::::
>
> > Now were missing some pieces of the Jill K
> > puzzle in these areas:
> >
> > 1) maybe a little more insight into your depression/anxiety
>
> I was shy and introverted growing up. I was always anxious in social situations. Last year in grad school I started getting panic attacks and I met my pdoc who started me on klonopin. With 0.5 mg, the panic left, with depression remaining.:::: Seems normal Klonopin will only help social anxiety symptoms::::::
>
> > Would you categorize it as Major Depression (feeling
> > really empty inside, can't experience pleasure at all,
> > think about dying)? Or are you primarily anxious and
> > maybe lacking motivation, interest in life, fearful
> > of social settings etc?
>
> I was primarily anxious and fearful of social settings. With the 0.5 mg klonopin, much of the anxiety is gone. Now with 200mg of neurontin three times a day, it is all gone. Now I am just depressed. Sleep when I get home and on weekends. All my hobbies and interests and friends I have dropped ... no energy or motivation.
::::You poor thing!!! You are taking meds that are sedating and not helping your area of need. That area is motivation drive and desire. Dopamine, NE, or PEA whatever. These are your needs. I would say drop the Neurontin. Increase the Klonopin to 1mg or if that doesn't completely do it gradually go up by .5mg till you find your effective dosage. Separate your doasages as well, i.e. 1mg morning and then 1.5mg night. Dopamine, NE is your area of need. Motivation??? Deprenyl.::::
>
>
> > 2) What were all the medicines you tried in the past
> > and what were the outcomes?
> >
> > Have you tried any of the default SSRIs (Zoloft,Celexa,etc).
> > Failures?
>
> I tried zoloft to 200 mg, feel numb and remained depressed. I also tried lamictal with no benefit and ritalin which increased my anxiety and then crashed after six hours.
>
> >
> > Tried MAOIs (Nardil is often prescribed for social phobiam
> > Parnate, Deprynyl are other options)?
>
> No
>
> > Ever tried an atypical antipsychotic like
> > Zyprexa/Geodon?
>
> No
>
> > What are your main concerns regarding starting a new
> > medication? That it will have bad side effects, it won't
> > effectively address your depression, etc?
> >
> > What kind of pain symptoms are you having?
>
> Pain is pure psychologic. I am so isolated and alone.
::::Just like I thought:::::
>
> > Of all your problems, were are you hurting most?
> >
> I think I have 2 main problems (1) panic/social anxiety:::Klonopin WILL help you just need the right dosage:::
(2) apathic depression. If I increase klonopin/neurontin no more anxiety, but more depression. When I tried ritalin and zoloft less depression, but HUGE anxiety.
::::Wipe out the neurontin. Stay with Klonopin and add selegiline+phenylalanine (the combo is crucial ~ one or the other won't work by itself) and you'll be up and running and anxiety free. Listen I know this is what will help you. I swear by it. This is your cure.
::::The Ritalin works against you in the case of your depression. Just like in my case. Any stimulant like Ritalin, Adderall, or Wellbutrin will only add to your anxiety. The Zoloft worked with your mood somewhat because it elevated your serotonin quite a bit. High serotonin levels can help elevate mood quite a bit, like illegal drugs. But it didn't help all the way did it? NO! Because that is not your primary problem. Read:""Deprenyl's discoverer, Dr. Joseph Knoll, and the uses of selegiline for depression. This explains basically everything you need to know about it's unique selective MAO-B inhibiting properties, catecholamine activity enhancing ability, neuroprotection from various neurotoxins, anti-aging possibilities, and most importantly its effectiveness in teating depression.
I brought it up the last time I met with my doctor but he said that, to his knowledge, it didn't work very well with depression and that he'd never heard of it used for this in quite some time and was mainly used as a medicine for Parkinsons and that it wasn't the best choice, in his opinion. Knowing as much as I know now, I believe he is unaware of some of deprenyl (selegiline HCL - Eldepryl in the US)'s potential benefits and recent findings. Who could blame him? He deals with psychotropic drugs that deal with depression and few doctors use deprenyl for this purpose. All that he knew was that at MAO-B selective doses (above 15mg, it becomes a full MAOI) it was not SOLELY effective at treating depression. My paper describes the studies that were done on atypical depressives, tretment-resistant depressives, and major despressives, and that effective treatment levels required dosages in the 20-30, even 60mg range. Well above MAO-B selective doses. Even though the treatments were effective and had low side-effects, there are risks involved with all-out MAOI's like diet restrictions (such as the "cheese effect"). So I can see where he's coming from in this light. But, there were three studies that suggested effective antidepressant action at selective MAO-B inhibiting doses.
That study was just the beginning of the paper's deprenyl-depression studies. What's eye-catching is what followed: "In 1978 Mendelwicz and Youdim treated 14 depressed patients with low-dose deprenyl (< or =10mg) plus 300mg 5-HTP 3 times daily for 32 days. Deprenyl potentiated the antidepressant effect of 5-HTP in 10/14 patients. 5-HTP enhances brain serotonin metabolism, which is frequently a problem in depression, while deprenyl enhances dopamine/noradrenalin activity" (how? - I'll explain in a bit). "Under activity of brain dopamine, noradrenalin (norepinephrine), and serototin neural systems are the most frequently cited biochemical causes of depression. So, deprenyl plus 5-HTP would seem a natural antidepressant combination."
The next one gets even more promising! "In 1984 Birkmayer, Knoll, and colleagues published their successful results in 155 unipolar depressed patients who were extremely treatment-resistant. Patients were given 5-10mg deprenyl plus 250mg phenylalanine daily. Approximately 70% of their patients achieved full remission, typically within 1-3 weeks. Some patients were continued up to 2 years on treatment without loss of antidepressant action. The combination of deprenyl plus phenylalanine enhances brain PEA activity, while both deprenyl and PEA enhance brain catecholamine activity. Thus deprenyl plus phenylalanine is also a natural antidepressant combination."
Almost equally impressive: "In 1991 H. Sabelli reported successful results treating 10 drug-resistant major depressive disorder patients. Sabelli used 5mg deprenyl daily along with 100mg vitamin B6, and 1-3 grams phenylalanine twice daily as treatment. 6 of 10 patients viewed their depressive episodes terminated within 2-3 days! Global Assessment Scale scores confirmed the patients' subjective experiences. Vitamin B6 activates the enzyme that converts phenylalanine to PEA, so the combination of the three is a bio-logical way to enhance both PEA and catecholamine brain function, and thus to diminish depression."
Here is why the catecholamine enhancement is so important in treating depression, especially in those whose depression can be related directly to dopamine under-activity (as in my case). You see, even if deprenyl's oringinally hypothesized mode of action - directly increasing synaptic dopamine levels through MAO-B inhibition - is false, deprenyl's MAO-B inhibition still provides part of its benefit.
It wasn't until the 1990s that Knoll's deprenyl research took a new direction. Working with rat brain stems, rabbit pulmonary and ear arteries, frog hearts and rats in shuttle boxes, Knoll discovered a new mode of action of deprenyl that he believes explains its widespread clinical utility. Knoll discovered that deprenyl [selegiline] (and it's cousin, PEA) are "catecholamine enhancers". Catecholamines refers to the inter-related neurotransmitters dopamine, noradrenaline, and adrenaline. Catecholamines are the transmitters for key activating brain circuits - the mesolimbic-cortical circuit and the locus coeruleus. The neurons from these two brain circuits project from the brain stem, through the mid-brain, to the cerebral cortex. They help to maintain focus, concentration, alertness and effortful attention. One of the reasons the doctor put me on Adderall! - but it seems obvious Adderall is only a temporary fix as it is well documented that the human body develops tolerance (whether it's 6 days or 2 years, everyone's different) to amphetamines, including d-amphetamine, quite quickly. Plus, amphetamines are known to damage dopamine cells but whether or not the damage is done at clincally prescribed doses is not yet known and that scares me especially after long term use AND from what I hear, discontinuing use just sends the person right back into the hole it once lifted them out of). Deprenyl would seem much better (it even protects your dopamine cells from damage/neurotoxicity) :) Dopamine is also the transmitter for a brainstem circuit - the nigrostriatal tract - which connects the the substantia nigra (which deprenyl enhances) and the striatum, a nerve tract that helps control bodily movement.
Here's how it works: when an electrical impulse travels down the length of a neuron - from the recieving dendrite, through the cell body, and down the transmitting axon - it triggers the release of packets of nerotransmitters into the synaptic gap. These transmitters hook onto receptors of the next neuron, triggering an electrical impulse which then travels down that neuron , causing yet another transmitter release. What Knoll and colleagues discovered through their highly technical experiments is that deprenyl and PEA act to more efficiently couple the release of neurotransmitters to the electrical impulse that triggers their release. In other words, deprenyl (and PEA) cause a larger release of transmitters in response to a given electrical impulse. It's like "turning up the volume" on catecholamine nerve cell activity. And this may be clinically very useful in depression where there may be under-activity of both dopamine and noradrenalin neurons. And the key here is the addition of the supplement phenylalanine to the deprenyl to help significantly increase PEA levels (one need only look to the results of the above studies to come to that conclusion). Even deprenyl in itself has shown in autopsy studies to not only increase dopamine levels by 40-70% in Parkinson patients but increase PEA levels 1300-3500%! You see, PEA is the preferred substrate for MAO-B, the MAO that deprenyl inhibits. PEA has an extremely rapid turnover due to its rapid and continuous breakdown by MAO-B. Thus deprenyl's catecholamine activity enhancer has a dual mode of action. At MAO-B inhibiting doses, deprenyl has a huge catecholamine enhancing effects due to the major increases in PEA levels. Many authors have pointed out the probable dopamine neuron activity enhancing effect of PEA in Parkinson patients taking deprenyl. Knoll's discovery of PEA's catecholamine activity enhancer effect now explains this PEA dopamine-enhancing effect.
So my proposal on Wednesday will be to take 10mg a day of selegiline, 600mg of phenylalanine supplement, as well as a good amount of vitamin's C and E, and 1000mg of NAC. The reason for the latter is that deprenyl increases only 2 of the 3 main antioxidants made in the brain. SOD, and catalase to a lesser extent. But the third, glutathione isn't raised at all so it is recommended by Knoll that one take around 1000mg NAC (which increases glutathione levels) to normalize these levels. Good amounts of vitamin C and E help very much as antioxidants themselves. I will ask to discontinue Adderall and taper off the Wellbutrin as well. Wellbutrin is now said to be mainly a noradrenalin reputake inhibitor while only mildly binding to the dopamine uptake sites and actually decreasing the amount of dopamine that is manufactured! I believe that Eldepryl and around 600mg/day of phenylalaine will take care of the noradrenalin AND dopamine especially."
This is why I preach so much about selegiline AND phenylalanine as the cure for depression that so many people don't know about and are missing out on. Just look at the people who have posted on the forum with positive results. I don't see how it could do anything bad other than "over-activate" those who's problems lie else where. Those that don't have MAJOR DEPRESSION I think will almost definately benefit, especially with Klonopin for those who can't get to sleep."::::
>
> > Sorry for all the questions. But I think they
> > really would help us to give you better support.
> >
>
> No Problem. I love the fact that someone is helping me. If anyone can help me, I will owe then my life, because I haven't had a life for so many years.
>
> Your Friend,
>
> Jill
Posted by christophrejmc on March 4, 2002, at 23:31:10
In reply to Here are the answers » JohnX2, posted by Jill K. on March 4, 2002, at 19:20:29
Do you think that you are more depressed now than before taking Klonopin? Klonopin can potentially cause or exacerbate depression, perhaps moreso than some of the other benzos. One benzo that often seems to help depression is Xanax.
-christophre
P.S.- Considering your previous response to Zoloft and Ritalin and because of your anxiety, I don't think it would be wise to try selegiline (atleast not before trying more effective & better suited meds).
Posted by Ron Hill on March 7, 2002, at 2:11:30
In reply to Here are the answers » JohnX2, posted by Jill K. on March 4, 2002, at 19:20:29
Jill,
I am very sorry that you are stuck in a depression. Been there, done that, no fun! I wish I could wave a magic wand to make it all better.
I will not be presumptuous and pretend that I know the solution to your specific brain chemistry problems. On the contrary, I will merely pass along that which gave me back my life in hopes that it might benefit you as well. (I just have a hunch that this could help you).
I'm Bipolar II. Lithobid adequately controls my hypomania but does nothing for my depression. Any of the SSRI's will take away my "I want to die" mood but leaves me with side effects (loss of ambition, loss of energy, lack of motivation, blunted emotions, etc). I have tried a ton of other ADs over the years, but I will not bore you with the details.
Four months ago I went to my regularly scheduled visit with my pdoc. At the time, I was only taking Li because of the AD side effects. Depression was a problem for me at the time. My pdoc had recently reviewed several studies showing success in treating depression using SAM-e in conjunction with an AD and success using SAM-e alone. He suggested that I take two 200 mg SAM-e tablets daily in conjunction with 25 mg of Zoloft. (I am hypersensitive to most medication so I take small doses). Initially, I was skeptical because over the years I have taken a lot of over-the-counter supplements, most of which did very little to ease my depression. But I told my pdoc that I would give it a try.
Initially I could only take one 200 mg tablet of SAM-e every other day. If I took more, I would experience side effects (flush, nausea, confused thinking, general ill feeling, "skin crawling"). However,within about five days, my depression began to lift and I now have my life back. Yeah!!! Currently, I take one 200 mg tablet daily without any adverse side effects. In total I daily take 600 mg Lithobid, 12.5 mg Zoloft, and 200 mg SAM-e. Eventually, I plan to discontinue the small amount of Zoloft.
Bottom line: 200 mg SAM-e daily has helped me more than any of the many ADs I've tried over the years.
It is very important to take plenty of B-6, B-12 (sublingual form) and folate with the SAM-e. Also take SAM-e on an empty stomach. SAM-e, like many perscription ADs, can induce mania in bipolar patients if the patient is not taking an adequate amount of a mood stablizer.
SAM-e is a naturally occurring compound and is manufactured by the human body. However, some people do not produce enough of it and supplementation may be beneficial.
SAM-e is involved in a plethora of various biochemical reactions in the human body. It functions as a very important methyl group donor. With regard to mood and related brain chemistry, SAM-e serves as the methylating agent in the biochemical reaction mechanism whereby various neurotransmitters (serotonin and dopamine in particular) are synthesized from amino acids in dietary protein.
For me personally, SAM-e has turned out to be a lifesaver! I have waited to post on this topic until I gave it some time to make sure it did not poop out right away. So far I have four months of excellent results and absolutely no hint of poop out.
Here are some links to articles on the topic. Do some research (use "SAM-e" in search engine). Buy a good name brand to ensure product quality.
http://www.biopsychiatry.com/sameart.html
http://more.abcnews.go.com/sections/living/inyourhead/allinyourhead_36.html
http://www.psycom.net/depression.central.same.html
http://www.mhsource.com/expert/exp1041299b.html
http://www.arthritissupport.com/track/goto/rtgoto30l.cfm
-- Ron
--------------------------------------------------
>
> > Now were missing some pieces of the Jill K
> > puzzle in these areas:
> >
> > 1) maybe a little more insight into your depression/anxiety
>
> I was shy and introverted growing up. I was always anxious in social situations. Last year in grad school I started getting panic attacks and I met my pdoc who started me on klonopin. With 0.5 mg, the panic left, with depression remaining.
>
> > Would you categorize it as Major Depression (feeling
> > really empty inside, can't experience pleasure at all,
> > think about dying)? Or are you primarily anxious and
> > maybe lacking motivation, interest in life, fearful
> > of social settings etc?
>
> I was primarily anxious and fearful of social settings. With the 0.5 mg klonopin, much of the anxiety is gone. Now with 200mg of neurontin three times a day, it is all gone. Now I am just depressed. Sleep when I get home and on weekends. All my hobbies and interests and friends I have dropped ... no energy or motivation.
>
>
> > 2) What were all the medicines you tried in the past
> > and what were the outcomes?
> >
> > Have you tried any of the default SSRIs (Zoloft,Celexa,etc).
> > Failures?
>
> I tried zoloft to 200 mg, feel numb and remained depressed. I also tried lamictal with no benefit and ritalin which increased my anxiety and then crashed after six hours.
>
> >
> > Tried MAOIs (Nardil is often prescribed for social phobiam
> > Parnate, Deprynyl are other options)?
>
> No
>
> > Ever tried an atypical antipsychotic like
> > Zyprexa/Geodon?
>
> No
>
> > What are your main concerns regarding starting a new
> > medication? That it will have bad side effects, it won't
> > effectively address your depression, etc?
> >
> > What kind of pain symptoms are you having?
>
> Pain is pure psychologic. I am so isolated and alone.
>
> > Of all your problems, were are you hurting most?
> >
> I think I have 2 main problems (1) panic/social anxiety (2) apathic depression. If I increase klonopin/neurontin no more anxiety, but more depression. When I tried ritalin and zoloft less depression, but HUGE anxiety.
>
> > Sorry for all the questions. But I think they
> > really would help us to give you better support.
> >
>
> No Problem. I love the fact that someone is helping me. If anyone can help me, I will owe then my life, because I haven't had a life for so many years.
>
> Your Friend,
>
> Jill
Posted by Jill K. on March 7, 2002, at 6:39:59
In reply to Re: Let's Try to Help Jill K » Jill K., posted by Ron Hill on March 7, 2002, at 2:11:30
This is the end of the thread.
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