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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by ace on May 19, 2003, at 1:46:17
Here I am again.
The past week or so has been misery for me.
On two occassions I've ended up in hospital.
Once the first night of Anafranil, second last night on Nardil.Briefly, I had a 10 day w/out to CMI (clomipramine-anafranil). Then 4 days on CMI - 2 on 25mg, 2 on 50mg. Severe depression ensued. I stopped. I am in the middle of a semester I needed stability. We only waited 2 days drug free to re-start NARDIL. First dose, felt the NARDIL majic back in my body. Only 15mg that day.
2nd day- 30mg
3rd - 60mg.
During these two days (and the next morning) I had episodic periods of extreme fear and confusion with some somatic complaints (shivering etc) But depression was gone - thanks to Nardil.
After 45mg yesterday I was back to my Nardil euphoria. But 2 hours after my last dose (which made it 60mg for the day) EXTREME confusion came. EXTREME fright, with derealization and anxiety. Took heaps of benzos. Calmed me down.
Went to hospital - saw a DR who knew far less about psych meds than me. Asked for a CMI plasma test. Couldn't do it!
Today I've reduced my Nardil back down to 30mg.I feel OK now but I'm still concerned.
My explanation....
1. Mild serotonin syndrome (remember CMI's half-life is only AVERAGED at 20hrs - it can be as high as 37. So When I started Nardil there still could have been a lot of CMI in my blood.
2. Excaserbation (sp?!) of my derealization/anxiety probs due to excessive 5HT stimulation - but that being so, 5ht levels are not in serotonin syndrome range.
PLAN:
- Stick to 30mg until the episodic confusion/anxiety passes.
- Periactin on hand (but of course CMI's blood concentration is going down day by day)
Please offer any advice/opinions!
What a fool I was to change from such a brilliant drug! In the middle of semester!!!!
I love you all,Andrew.
Posted by ace on May 19, 2003, at 1:49:28
In reply to OUT OF CONTROL...a horrid week, posted by ace on May 19, 2003, at 1:46:17
Posted by Dragonslayer on May 19, 2003, at 7:35:47
In reply to Please answer ASAP !!! Experts or non-experts! (nm), posted by ace on May 19, 2003, at 1:49:28
I'm certainly in the non expert catagory and wanted to post to let you know somebody hears ya.
I'm sorry about your problems. You tried it and, for right now, the new med switch idea didn't work. It happens to us all in varying degrees and for various reasons. The right chemical stews are elusive. Your Nardil experience seemed to be a good one for you. I know you didn't get all you wanted, but it seemed to be a good fit in a lot of regards. I think it will be again. The washout to horrible to restart can be rough (putting it mildly). Just wanted to let you know I'm hoping for your Nardil to work good for you. Hang in.
Posted by Janelle on May 19, 2003, at 13:38:52
In reply to Re: Please answer ASAP !!! Experts or non-experts!, posted by Dragonslayer on May 19, 2003, at 7:35:47
I'm also a non-expert, just wanted to lend some support. I recently *experimented* with going off one of my anti-anxiety meds (Buspar, which it turned out, at least for me, DOES WORK!) because my pdoc feels I'm on "low doses of a lot of meds" and wants to reduce them. Well, just a day or so with no Buspar I began to become a wreck. Called pdoc and insisted on getting it back. Started it right away and feel a lot better. Will work on tapering/getting rid of KLONOPIN, which I've taken for so long I think I'm habituated to it. Actually, I'm not sure it ever did much for me in the first place - never made me the least bit sedated or anything.
In fact, one night months ago in the hospital they gave me like 5 or 6 mg of Klonopin for sleep and it didn't do a thing; I was up at 2:30am with permission from the nurses to watch a video! So I was up till like 4:30-5 in the morning on 6 mg of Klonopin. When I told the pdoc next time I saw him he was shocked and said he'd have been out cold on the floor on that dose! That was when we discovered that Seroquel is my sleep inducer.
I would say to YOU, to do just as you PLAN, stay at 30mg of Nardil for awhile yet and eventually get up to the dose you did well on. I hope it will work again for you. I'm rooting for you!
What's Periactin (spelling)?
Posted by Janelle on May 19, 2003, at 13:40:43
In reply to Re: Please answer ASAP !!! Experts or non-experts!, posted by Dragonslayer on May 19, 2003, at 7:35:47
Posted by maryhelen on May 19, 2003, at 13:52:04
In reply to Re: Please answer ASAP !!! Experts or non-experts!, posted by Dragonslayer on May 19, 2003, at 7:35:47
Dear Ace:
I am not an expert in what you are experiencing, except for the depression. I have treatment resistant depression and have tried more meds and combinations, ECT, hospitalizations, therapy, etc... than I can remember.
I truly cannot imagine going through the OCD and other difficulties you are dealing with. I admire your fighting spirit and tenacity. I admire the fact that you do the research and self educate yourself about medications. I depended on my doctors at the beginning of my depression and had hope and trust that I would get well and that they knew what they were doing. I do not believe that anymore and get more of my information here and on the Web and present it to my pdoc, who is very receptive, most are not, and do not accept looking in a book for the standard treatment, side effects, etc. discounting the human side and differences in all of us.
I have no intention of trying to irritate you more than what you are going through but I want to ask you something.
You are in the middle of a semester at university, with heavy studying, stuff like chemistry. I sincerely do not know how you are doing this given what you are going through. You mention while coming off the Anafranil you had severe depression with cognitive impairment, terrible derealization and phobic anxiety. You felt great on Nardil, but had the OCD present itself again, if I am correct. Is it not possible to give yourself a break from University until you get this sorted around, and to resume next year, next semester, I don't know how it works because I never went to University. If you were to take a break for yourself is it not possible to go back at another time. With everything you are going through I am afraid you are going to have a complete mental and physical breakdown. I have heard time and again about people resuming their University studies, not necessarily for these reasons, but even simply for dropping out for a while, for no special reason. I think our brain chemistry needs a chance to rebalance and adjust to all the changes we reap upon it. The pressure you have put on yourself is enormous. University is difficult for those who have no problems to contend with. I know when I had to take leave from my job, the first time I thought was the end of the world. My pride, shame, embarassment, feeling of failure were almost too much to bear. I think I was on 3 leaves. I now have been off for over 2 years, just returning again, and the difference in what I have learned about depression from then to now is like night and day. I no longer have those feelings, and **** the stigma. I am going to work as a school secretary in a busy shcool office and instead of lying about the reason I was off, it is now second nature to just tell anyone who asks. It doesn't matter to me what anyone thinks, but I find most are very supportive. Sorry, Ace, I went off topic.
What we think sometimes is the end of our world, sometimes turns out to be a new beginning. I do not know how you can sustain what you are trying to do, although, you sure are a fighter and if anyone can do it, you can, but at what cost.
Ace, just my thoughts. I do wish you only the best in you struggle and after reading all of your posts, I care very much what happens to you.
maryhelen
Posted by McPac on May 19, 2003, at 18:44:38
In reply to OUT OF CONTROL...a horrid week, posted by ace on May 19, 2003, at 1:46:17
I'm still wondering if the biggest problem for you during the last 2-week period or so was simply that you weren't on ANYTHING at any kind of therapeutic level??? i.e., the Nardil was completely gone from your system and the Anafranil was far too little in your system to prevent the lousy feelings that you experienced after stopping the Nardil??? Could it have been a "withdrawal"-type reaction from the Nardil being completely out of your system? Or, perhaps it WAS a bad reaction to the Anafranil? Or a combo of the two? I know that I often have a fitful time when trying new meds (sometimes its due to my body trying to adjust to the new drug...sometimes the "fear" of not knowing what may happen can even spur or exacerbate terrible anxiety).......it is hard to say for sure exactly what created your hellish couple of weeks....I know that the last time I tried to ditch my Zoloft, in an attempt to try another med, there was HELL TO PAY! Seriously NASTY effect...and a "double-whammy" effect at that---the terrible effect of the Zoloft withdrawal COMBINED with my body 'trying' to adjust to the new med....I couldn't complete the mission!...felt VERY, VERY bad...that's the worst thing about the Nardil "washout" period...it wouldn't be AS bad for you IF you could have taken the Anafranil WITH the Nardil, and established a steady, effective Anafranil dose, and THEN started slowly decreasing the Nardil...but by having to clear out ALL of the Nardil from your system and leaving you on NOTHING, while at the same time giving way to withdrawal symptoms, and THEN having to start the Anafranil---it's a time period "ripe" for negative possibilities.....was it the loss of the Nardil in your system, the withdrawal that followed the loss of the Nardil in your system, the Anafranil itself, the fact that there was nothing (neither Nardil OR enough therapeutic Anafranil) in your system, combinations of some or all of these....so hard to say exactly why...I still think it may have been a case of: Nardil withdrawal + unpleasant effects of a new drug...the fact that you said that just ONE 'speck' of Nardil had you magically feeling sooo much better SPEAKS of WITHDRAWAL VERY, VERY STRONGLY! that all being said, I hope that you feel much better if you continue on the Nardil and hopefully you can find something to give you additional "anti-ocd" power...God Bless and Very Best Wishes Ace! OCD bites and bites hard! I've got some add'l ideas you could try to pursue...let me know! Take care ocd brother! You RULE Ace!
Posted by ace on May 19, 2003, at 23:37:13
In reply to Re: Please answer ASAP !!! Experts or non-experts! ?Dragonslayer, posted by Janelle on May 19, 2003, at 13:38:52
> I'm also a non-expert, just wanted to lend some support. I recently *experimented* with going off one of my anti-anxiety meds (Buspar, which it turned out, at least for me, DOES WORK!) because my pdoc feels I'm on "low doses of a lot of meds" and wants to reduce them. Well, just a day or so with no Buspar I began to become a wreck. Called pdoc and insisted on getting it back. Started it right away and feel a lot better. Will work on tapering/getting rid of KLONOPIN, which I've taken for so long I think I'm habituated to it. Actually, I'm not sure it ever did much for me in the first place - never made me the least bit sedated or anything.
>
> In fact, one night months ago in the hospital they gave me like 5 or 6 mg of Klonopin for sleep and it didn't do a thing; I was up at 2:30am with permission from the nurses to watch a video! So I was up till like 4:30-5 in the morning on 6 mg of Klonopin. When I told the pdoc next time I saw him he was shocked and said he'd have been out cold on the floor on that dose! That was when we discovered that Seroquel is my sleep inducer.
>
> I would say to YOU, to do just as you PLAN, stay at 30mg of Nardil for awhile yet and eventually get up to the dose you did well on. I hope it will work again for you. I'm rooting for you!Thankyou so much. My world has really turned black...
> What's Periactin (spelling)?
Periactin is an antihistamine. It has potent serotonin antagonistic properties ie- it brings down the levels of serotonin in your brain. Serotonin syndrome happens when there is too much serotonin up their - using Periactin quickly and efficiently brings down levels. BUT - it can also cause depression, or anxiety, or insomnia. It can cause (and does a lot of the time) sedation.
I used it once due to my Nardil anorgasmia (it is also used for sexual probs) - it caused insomnia and terrible anxiety.
Thankyou for your support!
Ace.
Posted by ace on May 19, 2003, at 23:51:15
In reply to Re: Please answer ASAP !!! Experts or non-experts!, posted by maryhelen on May 19, 2003, at 13:52:04
> Dear Ace:
>
> I am not an expert in what you are experiencing, except for the depression. I have treatment resistant depression and have tried more meds and combinations, ECT, hospitalizations, therapy, etc... than I can remember.
>
> I truly cannot imagine going through the OCD and other difficulties you are dealing with. I admire your fighting spirit and tenacity.I really appreciate that comment. I'm in a bad way now, but this is the time to hold my head up.
I admire the fact that you do the research and self educate yourself about medications. I depended on my doctors at the beginning of my depression and had hope and trust that I would get well and that they knew what they were doing. I do not believe that anymore and get more of my information here and on the Web and present it to my pdoc, who is very receptive, most are not, and do not accept looking in a book for the standard treatment, side effects, etc. discounting the human side and differences in all of us.
>
> I have no intention of trying to irritate you more than what you are going through but I want to ask you something.
>
> You are in the middle of a semester at university, with heavy studying, stuff like chemistry. I sincerely do not know how you are doing this given what you are going through. You mention while coming off the Anafranil you had severe depression with cognitive impairment, terrible derealization and phobic anxiety. You felt great on Nardil, but had the OCD present itself again, if I am correct. Is it not possible to give yourself a break from University until you get this sorted around, and to resume next year, next semester, I don't know how it works because I never went to University. If you were to take a break for yourself is it not possible to go back at another time. With everything you are going through I am afraid you are going to have a complete mental and physical breakdown. I have heard time and again about people resuming their University studies, not necessarily for these reasons, but even simply for dropping out for a while, for no special reason. I think our brain chemistry needs a chance to rebalance and adjust to all the changes we reap upon it. The pressure you have put on yourself is enormous. University is difficult for those who have no problems to contend with. I know when I had to take leave from my job, the first time I thought was the end of the world. My pride, shame, embarassment, feeling of failure were almost too much to bear. I think I was on 3 leaves. I now have been off for over 2 years, just returning again, and the difference in what I have learned about depression from then to now is like night and day. I no longer have those feelings, and **** the stigma. I am going to work as a school secretary in a busy shcool office and instead of lying about the reason I was off, it is now second nature to just tell anyone who asks. It doesn't matter to me what anyone thinks, but I find most are very supportive. Sorry, Ace, I went off topic.You are right on. First of all, words cannot express how much I appreciate your concern - people like you really give me faith in human beings.
I am so stressed out about the uni situation because after this year I sit a test to enter medicine - as a post graduate. But things are looking bleak - so far behind in my work, so much anguish, so much stress...I'm just sick of this. I am seeing my uni's admin. today or tommorow - I am probably going to drop all but one subject. I am now 24, so I want to hurry and get my medical degree. But you are right - I can feel a complete breakdown on the way...I'm going to have to worry about my health first.
> What we think sometimes is the end of our world, sometimes turns out to be a new beginning. I do not know how you can sustain what you are trying to do, although, you sure are a fighter and if anyone can do it, you can, but at what cost.
>
> Ace, just my thoughts. I do wish you only the best in you struggle and after reading all of your posts, I care very much what happens to you.
>
> maryhelenThankyou so much - I really, really want to wright more to you but, at the moment, I still feel somewhat confused and it is a strain to think. When I'm stabalized I will wright more.
God Bless you, and I wish you much happiness,
Ace.
PS - People like you really do help so much - I am going to print your note out, because it really did help me.
Posted by ace on May 20, 2003, at 1:49:39
In reply to Ace, Re: OUT OF CONTROL...a horrid week, posted by McPac on May 19, 2003, at 18:44:38
Posted by ace on May 20, 2003, at 3:00:44
In reply to Re: Please answer ASAP !!! Experts or non-experts!, posted by Dragonslayer on May 19, 2003, at 7:35:47
This is the end of the thread.
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