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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Ilene on February 26, 2004, at 17:19:08
I just saw a new doctor for my cfs and he told me that antidepressants don't work the same in people who have cfs. He says many cfs patients are depressed. He prescribes ADs for them because he says most psychiatrists don't understand cfs. He regards cfs and its associated disorders as a problem of the autonomic nervous system. At first he said "standard antidepressants don't work" but I think he mis-spoke because he said his patients do well on combinations of ADs or high doses of Effexor. He thinks MAOIs should be effective, but he's never prescribed them to his patients because of the food and drug cautions.
I'm still shook up over this, even though I should be feeling optimistic, because I am now taking an MAOI.
Socialdeviantjeff, are you reading this?
I.
Posted by jlbl2l on February 26, 2004, at 18:31:00
In reply to Chronic fatigue syndrome ADs, posted by Ilene on February 26, 2004, at 17:19:08
depends on what maoi. nardil did have a single study indicated it helped CFS patients. also, effexor and norep-sero reuptake inhibitors do help CFS/FMS pain generally, so he was being quite truthful. until the drug ampligen comes out (just finished FDA phase 3 trials this past year for cfs) stick to conservative treatments such as ADS. look up ampligen.
Posted by Ilene on February 27, 2004, at 20:02:29
In reply to Re: Chronic fatigue syndrome ADs, posted by jlbl2l on February 26, 2004, at 18:31:00
> depends on what maoi. nardil did have a single study indicated it helped CFS patients. also, effexor and norep-sero reuptake inhibitors do help CFS/FMS pain generally, so he was being quite truthful. until the drug ampligen comes out (just finished FDA phase 3 trials this past year for cfs) stick to conservative treatments such as ADS. look up ampligen.
I thought I replied to this already, but my reply isn't showing up.
I think I might have been unclear. What I meant was that ADs don't work as well against depression in people who have CFS. My concern is not whether ADs help CFS.
I.
Posted by socialdeviantjeff on February 27, 2004, at 23:28:07
In reply to Re: Chronic fatigue syndrome ADs, posted by Ilene on February 27, 2004, at 20:02:29
Well, I wish I had something constructive to add. I haven't had an MAOI yet. My experience has basically been bad side effects and swinging from major fatigue and pain to major stimulation and agitation depending on whether the AD was sedating or stimulating.
IMHO, it seems that CFS can be divided into two subtypes: a dysautonomia or an autoimmune problem. Of course, I'm probably overgeneralizing. I do think that the dysautonomic type of CFS could cause AD's to work in odd ways. I can't find any real research on this, though.
Abilify has helped with the fatigue to some degree. which is more than anything. May be worth discussing with your doc.
Best of luck
SDJ
Posted by Ilene on February 28, 2004, at 12:23:22
In reply to Re: Chronic fatigue syndrome ADs, posted by socialdeviantjeff on February 27, 2004, at 23:28:07
> Well, I wish I had something constructive to add. I haven't had an MAOI yet. My experience has basically been bad side effects and swinging from major fatigue and pain to major stimulation and agitation depending on whether the AD was sedating or stimulating.
>
> IMHO, it seems that CFS can be divided into two subtypes: a dysautonomia or an autoimmune problem. Of course, I'm probably overgeneralizing. I do think that the dysautonomic type of CFS could cause AD's to work in odd ways. I can't find any real research on this, though.
>
I believe you're right about CFS having subtypes. At least two. Mine is recurrent and triggered by specific things--heat, exertion, and emotional stress--and I have dysautonomic symptoms. When it flares up I feel like I have the flu, plus I can't think.I can't find any research about this either. My doc seems to enjoy reasoning things out, he has some background in epidemiology, and he has a large CFS practice. He's not a researcher. I think he's developed some theories but doesn't have the resources (or maybe the interest ) to follow them up with research. He said something about writing up a series of case studies. He thinks people with CFS just don't have a lot of neurotransmitters to begin with, so it's hard to manipulate. The MAOI should do the trick, in theory, because it prevents neurotransmitter breakdown.
> Abilify has helped with the fatigue to some degree. which is more than anything. May be worth discussing with your doc.
>
I'm taking minimal doses of Risperdal. We might increase it.I think my ordinary, day-to-day fatigue is caused by the depression rather than the CFS, because the CFS is clearly intermittant.
Glad you're feeling better.
I.
This is the end of the thread.
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