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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by zonked on May 25, 2011, at 20:05:34
Hi all:
Haven't posted or even lurked in awhile... I joined a HMO for awhile, and have decided they aren't for me, so I'll be seeing the old pdoc again.
Presenting problems: Parnate no longer works for me except in mega-doses (~130-150mg/day). When it does kick in, I develop hypomania. What a damned curse. I have low tolerance for mood stabilizers, and a strong aversion to the use of antipsychotics for anything but psychosis (which I don't have), so I am not quite sure what to do.
Have taken myself off EVERYTHING except Klonopin, which I have enough of until I see my doctor. I hate Klonopin, because makes my depression worse, and gives me a terrible "hangover" no matter what time of day I take it, but it is keeping me from being hospital material with depression and anxiety.
A long story short - I joined an HMO, and didn't get very good care. Will be returning to my old coverage as of the first of the month, and seeing my old pdoc again.
I don't know what to do, or ask for, anymore. The Klonopin keeps me from freaking out, but I just don't have much enthusiasm for anything (except eating!), don't check e-mail, don't persue hobbies - you guys know the drill.
I am scared of taking high-dose Parnate because of some of the really scary manicy things I did while on it.
Some people have said Remeron is a pretty powerful anti-depressant. Honestly, it is something I haven't tried.
Nardil has worked for me in the past, but the second time it worked, it quit working quickly; and the third time it didn't work at all. Haven't tried it since over a year ago.
SSRIs: Zoloft worked wonders for me in the early 2000s (my first anti-D) and, after that quit working, no SSRI worked very well again. I am just wondering, since it's been 6 years since I've even TRIED an SSRI, if they could ever work again. Anyone?
Mostly venting. Hoping to feel well sooner rather than later...and hoping I can convince my doctor to switch my benzo to Xanax XR (or even IR).
Don't you hate having to go back to the drawing board?
-z
Posted by Phillipa on May 25, 2011, at 23:36:15
In reply to Back to drawing board: SSRIs, Nardil or Remeron?, posted by zonked on May 25, 2011, at 20:05:34
Seems like you respond to stronger meds ever try Prozac? I don't know if SSRI's will work again worth a try though right? Phillipa
Posted by zonked on May 26, 2011, at 13:04:12
In reply to Re: Back to drawing board: SSRIs, Nardil or Remeron? » zonked, posted by Phillipa on May 25, 2011, at 23:36:15
> Seems like you respond to stronger meds ever try Prozac? I don't know if SSRI's will work again worth a try though right? Phillipa
Prozac made me amped up, but in all the wrong ways! Like I'd drank 15 cups of coffee (Effexor had the same effect. Made me a nervous wreck.)
Thinking back, it could have been that Lexapro had a mild effect (this was the last SSRI I tried) but I had so much psychosocial stress it may have been blunted.
I'm entering one of those phases where I start to seriously consider ECT. So ambivalent about it though--I've talked personally to people who swear by it (and don't *seem* cognitively abnormal) but read numerous accounts on the net about lives destroyed. Too bad it's not more clear cut.
As for TMS and other alternative therapies, I've more or less been told there's no way the coverage I have will pay for it at this point.
Wish me luck. Surviving the best I can until the doctor's appointment.
-z
Posted by jono_in_adelaide on May 26, 2011, at 17:36:54
In reply to Back to drawing board: SSRIs, Nardil or Remeron?, posted by zonked on May 25, 2011, at 20:05:34
Two "boosted" options come to mind,
Remeron 30mg at night plus Effexor 150mg in the morning
or
Welbutrin 300mg plus Sertraline 100mg, both in the morning
Both are potent antidepressant combos. You cant take Klonopin or a mood stabaliser with them if needed. I have had great sucsess using reisperdone 1mg at night, it has a calming effect and boosts my antidepressant response, and at that dose it isnt an antipsychotic, just a mild tranquiliser.
Posted by zonked on May 26, 2011, at 19:20:26
In reply to Re: Back to drawing board: SSRIs, Nardil or Remeron?, posted by jono_in_adelaide on May 26, 2011, at 17:36:54
>
> Remeron 30mg at night plus Effexor 150mg in the morningI have known (in real life actually!) three people for whom Effexor has been a lifesaver. Unfortunately for me, it turns me into even more of a batcase (can't stop pacing the floors, flooded with anxiety... in fact, nortriptyline has a similar effect. Hence my theory that increased NE levels make me bonkers!)
I don't think I ever gave Remeron a fair trial.
>
> Welbutrin 300mg plus Sertraline 100mg, both in the morningIf I could regain what Zoloft used to do to me, and avoid the panic attacks and anger Wellbutrin caused in me this might work.
>> I have had great sucsess using reisperdone 1mg at night, it has a calming effect and boosts my antidepressant response, and at that dose it isnt an antipsychotic, just a mild tranquiliser.
Here's what I don't get about low dose antipsychotics -- someone on this board will know enough to answer this I'm sure =)
Wouldn't one get the same benefits (mild sedation) from Benadryl without the risks and expense of APs? Isn't that what they do in low doses anyway - act primarily as antihistamines?
Posted by floatingbridge on May 30, 2011, at 2:29:30
In reply to Re: Back to drawing board: SSRIs, Nardil or Remeron?, posted by zonked on May 26, 2011, at 19:20:26
Xanax xr. My old buddy. Hardly anyone uses it. I 'graduated' from klonopin to Xanax xr when anxiety was finally more background. Regular xanax was/is my go-to med. Until emsam--or maybe hyper thyroid :)
You have some options and and a lot of self knowledge. But the decision making process itself can be dizzying. Hang in there.
This is the end of the thread.
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