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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 85 to 109 of 201. Go back in thread:
Posted by SLS on September 27, 2011, at 21:37:46
In reply to Re: Viibryd » SLS, posted by Phillipa on September 27, 2011, at 21:05:58
Thanks!
- Scott
Posted by zonked on September 27, 2011, at 23:26:11
In reply to :-) » Everyone, posted by SLS on September 27, 2011, at 21:37:46
There are advocacy group for most conditions, but none that I am aware of for treatment-resistant depression (unipolar or bipolar.)
Depression robs one of energy, so perhaps that's a reason.
I don't think we are so few in number so as to not warrant an advocacy group of our own. No, NAMI doesn't count.
It's something I've been thinking about off and on. Unfortunately, of the many things I do graphic design and website design aren't among them.
I wonder if having such a group would get any attention (press perhaps?) or pressure pharma to consider us a distinct group to study in trials.
As far as I know, the only drugs with FDA *indications* for TRD are Symbyax (Zyprexa with Prozac) and Marplan.
Just an idea. Maybe if I return to full functioning (including occupational) this is a cause I could devote some time to.
I think if big pharma pursued indications for TRD as well as MDD for novel compound they might sell more product. Having said that, the product would have to be effective for TRD. TRD-ers are often excluded from trials for various reasons (previous suicide attempts, I believe, being one of them.)
What do you guys think?
-z
Posted by SLS on September 28, 2011, at 5:55:06
In reply to TRD advocacy, posted by zonked on September 27, 2011, at 23:26:11
Hi Z.
You offer very cogent arguments for greater recognition of TRD.
> There are advocacy group for most conditions, but none that I am aware of for treatment-resistant depression (unipolar or bipolar.)
As you suggest, people with severe depression have trouble getting out of bed and taking a shower. How could such a condition allow for that kind of active advocacy?
> I don't think we are so few in number so as to not warrant an advocacy group of our own. No, NAMI doesn't count.
Why not?
What about DBSA?
http://www.dbsalliance.org/site/PageServer?pagename=home
I didn't know that Marplan was indicated for TRD.
It is wonderful that you now have the resources to consider and act upon such issues.
Stay well.
- Scott
Posted by zonked on September 28, 2011, at 8:31:11
In reply to Re: TRD advocacy » zonked, posted by SLS on September 28, 2011, at 5:55:06
> Hi Z.
>
> You offer very cogent arguments for greater recognition of TRD.
>
> > I don't think we are so few in number so as to not warrant an advocacy group of our own. No, NAMI doesn't count.
>
> Why not?
NAMI *seems* to be focused more on other mental disorders perceived as more chronic and disabling.
Also, I don't have time to look at it now; someone once told me they had accepted donations from pharmaceutical companies. I can't say that's blanket good or bad...> What about DBSA?
>
> http://www.dbsalliance.org/site/PageServer?pagename=homeGood for support groups, but I was thinking more along the lines of, like, how The American Cancer Society is for Cancer.
> I didn't know that Marplan was indicated for TRD.
If you look at the advertising on their website, it's for "treatment resistant depression." US rules only allow advertising for approved indications. I think this supplemental indication is why it was brought back from the dead after Roche didn't seem to care that it pre-dated DESI and never bothered to implement it; and why the third party (Validus?) was interested in it.
> It is wonderful that you now have the resources to consider and act upon such issues.
>
> Stay well.
>
>
> - ScottScott, be patient, and your brain will feel like you remember again. Me, telling you to be patient, that's rich. Some of my own patience has been influenced by watching you over the years. I should say, one day you will feel like yourself - consistently - again. And you have the writing skills to write a novel about your experiences should you ever wish to.
I hope it's Viibryd that does the trick for you. BTW, how easily is the Nardil weight coming off? I am not going to mess with my regime, just curious.
BEST of luck always,
-z
Posted by SLS on September 28, 2011, at 9:10:11
In reply to Re: TRD advocacy » SLS, posted by zonked on September 28, 2011, at 8:31:11
> Scott, be patient, and your brain will feel like you remember again.
From your mouth to God's ears...
Thank you for the words of encouragement and everything else you have to say.
It has been 17 days since I took my last dose of Nardil.
Before: 220 pounds
Now: 207 poundsI have also changed my eating habits, so it is difficult to ascribe discontinuing Nardil for all 13 pounds. However, prior to coming off Nardil, the same eating habits yielded no weight loss.
Thank God for leptin! Burn that white adipose!
- Scott
Posted by SLS on September 28, 2011, at 9:13:28
In reply to Re: TRD advocacy » zonked, posted by SLS on September 28, 2011, at 9:10:11
Hi All.
I am experiencing an unexpected improvement in depression. It would be difficult not to attribute this to Viibryd. The only other thing I can think of is that it might be the result of discontinuing the Nardil with a resultant withdrawal rebound improvement. I believe that it is more likely to be due to Viibryd. You know that I respond to certain drugs for three days, only to relapse afterwards. Today is the third day of improvement. Viibryd differs from the other drugs I have taken in that the improvement began on the very first day. However, this might be the result of having had my 5-HT1a autoreceptors be downregulated by Nardil.
Viibryd works. It doesn't have to be novel on paper (it actually is novel, though) in order to be effective for people who previously were TRD. Viibryd only has to be different to be worthy of consideration as a treatment. Different is different. As proof of this, there are people who respond to Pristiq whom do not respond to Effexor, regardless of dosage. I like what this drug does on paper and in real life. My doctor has had several TRD patients respond to Viibryd. It is his feeling that it will work as a prophylactic against relapse. You know, I am thinking that Viibryd might act to potentiate the therapeutic effects of standard antidepressants. You can probably add Viibryd to anything except MAOIs. I hope I continue to improve and achieve remission with the addition of Viibryd. Ill keep you informed as to how I do with this drug. Lithium might be an important component to my Viibryd treatment. Both drugs act to release serotonin, albeit via different mechanisms.
I am currently taking:
Viibryd 20mg (target dosage is 40mg)
nortriptyline 150mg
Lamictal 200mg
Abilify 10mg
lithium 300mgI have a good feeling about Viibryd. Wish me luck.
- Scott
Posted by morgan miller on September 28, 2011, at 9:45:41
In reply to Viibrid Treatment, posted by SLS on September 28, 2011, at 9:13:28
Well, it's good to hear you are responding positively so far. I really do hope this continues for you Scott.
Hmm, I wonder what combining a 10 or 20 mg dose of Viibryd with an SSRI like Zoloft would do.
Anyway, good luck and best wishes Scott!
Morgan
Posted by Phillipa on September 28, 2011, at 19:01:07
In reply to Re: Viibrid Treatment, posted by morgan miller on September 28, 2011, at 9:45:41
Scott saying it again this med is the one for you!!!! Phillipa
Posted by Solstice on September 28, 2011, at 19:56:53
In reply to Viibrid Treatment, posted by SLS on September 28, 2011, at 9:13:28
Scott -
You are one of the most courageous people I have ever encountered. I will wait with anticipation for your updates - because I wish for you resounding success with remission on your new treatment. You are so very, Very deserving of remission.
Solstice
Posted by SLS on September 30, 2011, at 7:41:22
In reply to Re: Viibrid Treatment » SLS, posted by Solstice on September 28, 2011, at 19:56:53
Posted by SLS on September 30, 2011, at 7:50:07
In reply to Viibrid Treatment, posted by SLS on September 28, 2011, at 9:13:28
> Hi All.
>
> I am experiencing an unexpected improvement in depression. It would be difficult not to attribute this to Viibryd. The only other thing I can think of is that it might be the result of discontinuing the Nardil with a resultant withdrawal rebound improvement. I believe that it is more likely to be due to Viibryd. You know that I respond to certain drugs for three days, only to relapse afterwards. Today is the third day of improvement. Viibryd differs from the other drugs I have taken in that the improvement began on the very first day. However, this might be the result of having had my 5-HT1a autoreceptors be downregulated by Nardil.
>
> Viibryd works. It doesn't have to be novel on paper (it actually is novel, though) in order to be effective for people who previously were TRD. Viibryd only has to be different to be worthy of consideration as a treatment. Different is different. As proof of this, there are people who respond to Pristiq whom do not respond to Effexor, regardless of dosage. I like what this drug does on paper and in real life. My doctor has had several TRD patients respond to Viibryd. It is his feeling that it will work as a prophylactic against relapse. You know, I am thinking that Viibryd might act to potentiate the therapeutic effects of standard antidepressants. You can probably add Viibryd to anything except MAOIs. I hope I continue to improve and achieve remission with the addition of Viibryd. Ill keep you informed as to how I do with this drug. Lithium might be an important component to my Viibryd treatment. Both drugs act to release serotonin, albeit via different mechanisms.
>
> I am currently taking:
>
> Viibryd 20mg (target dosage is 40mg)
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 10mg
> lithium 300mg
>
> I have a good feeling about Viibryd. Wish me luck.
Today is my fourth day of improvement with this drug. The responsse seems to be growing steadily.Today is my first day at 40mg.
Very cool.
- Scott
Posted by floatingbridge on September 30, 2011, at 8:45:30
In reply to Re: Viibrid Treatment, posted by SLS on September 30, 2011, at 7:50:07
Very cool.
:-)
I like this.
Posted by Phillipa on September 30, 2011, at 12:10:46
In reply to Re: Viibrid Treatment, posted by SLS on September 30, 2011, at 7:50:07
Scott knew it would work it's uphill from here to the very top. Phillipa
Posted by jhj on September 30, 2011, at 23:54:50
In reply to Re: Viibrid Treatment, posted by SLS on September 30, 2011, at 7:50:07
hiSorry to sound pessimistic but it might be a placebo effect.
jhj
Posted by SLS on October 1, 2011, at 6:36:23
In reply to Re: Viibrid Treatment » SLS, posted by jhj on September 30, 2011, at 23:54:50
Hi.
How would one be able to distinguish between a placebo effect and a true antidepressant response?
- Scott
Posted by jhj on October 1, 2011, at 6:48:01
In reply to Re: Viibrid Treatment » jhj, posted by SLS on October 1, 2011, at 6:36:23
hii am not sure.
I think if the antidepressant effect is sustained for reasonable period of time i.e.few months may be.
jhj
Posted by SLS on October 1, 2011, at 7:40:13
In reply to Re: Viibrid Treatment » SLS, posted by jhj on October 1, 2011, at 6:48:01
>
> hi
>
> i am not sure.
>
> I think if the antidepressant effect is sustained for reasonable period of time i.e.few months may be.
>
> jhj
Frederick Quitkin, MD (RIP) addressed the phenomenology of placebo the effect and its effects on the assessment of clinical antidepressant trials. He and his research team published a few articles about this. One of the things that they reported was that placebo responders "relapsed" rather quickly compared to those taking active antidepressant compounds.As for me, I don't think that I have the potential to feel better on placebo. Recently, I tried a series of nutriceuticals in an effort to improve my chances of responding to my ongoing drug treatment. I was pretty convinced that the vitamins and supplements would make a big difference. Some made me feel worse, while the rest were without effect. I should think that I would have had a placebo "response" to these things because of how optimistic I was that they would work as well for me as they did for the friend of mine who suggested I take them.
There are at least two reasons why I might be less apt than others to feel improved on placebo.
1. I am bipolar.
2. My depression is rated as very severe. I score over 35 on depression scales - Hamilton Rating Scale for Depression (HRSD).
I am glad that you posted your feedback about my medical condition. Thanks you.
- Scott
Posted by Conundrum on October 1, 2011, at 9:33:55
In reply to Re: Viibrid Treatment, posted by SLS on September 30, 2011, at 7:50:07
Awesome Scott. :D
Are you taking advantage of the good feelings? Going out and doing things?
Posted by Phillipa on October 1, 2011, at 19:19:20
In reply to Re: Viibrid Treatment, posted by Conundrum on October 1, 2011, at 9:33:55
Scott how's it going today? Phillipa
Posted by SLS on October 1, 2011, at 19:21:26
In reply to Re: Viibrid Treatment, posted by Conundrum on October 1, 2011, at 9:33:55
> Awesome Scott. :D
>
> Are you taking advantage of the good feelings? Going out and doing things?
YES!I went to an antique car show with a friend today and took pictures. It was nice to feel well enough to WANT to go somewhere and be around people. The Viibryd is still helping, and I am feeling better than I did on Nardil. I expect to feel very well in a few months. Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
Thanks for asking...
- Scott
Posted by zonked on October 1, 2011, at 19:50:06
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
>
> YES!
>
> I went to an antique car show with a friend today and took pictures. It was nice to feel well enough to WANT to go somewhere and be around people. The Viibryd is still helping, and I am feeling better than I did on Nardil. I expect to feel very well in a few months. Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
>
> Thanks for asking...
>
>
> - ScottOh wow. I am really glad for you, and I hereby wish to all relevant deities that the torturous "blip" responses you've gotten are finally over.
I'll be keeping an eye on your progress (I would anyway); I have heard a lot of good about this one... on other boards, as well.
Scott, has low energy or concentration ever been symptoms for you? I know it's early, but how is treatment affecting these symptoms (if you have them).
You know, if Viibryd is as good for old-fashioned MDD as it may be for TRD, Forest could have a blockbuster on its hands. I think the reason we haven't seen much press is because major marketing hasn't started.
(Anyone want to predict the animations they use in the commercials this time?)
I digress. The fact that you are enjoying something that you SHOULD enjoy rather than dragging yourself along and not "feeling" it (boy do I know what that's like) is pretty damned good news.
-z
Posted by Phillipa on October 1, 2011, at 21:04:51
In reply to Re: Viibrid Treatment » SLS, posted by zonked on October 1, 2011, at 19:50:06
Scott congrats knew this med would work!!! Phillipa
Posted by FrustratedMama on October 1, 2011, at 21:21:59
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
So so so happy for you!!!! Your posts always help me - glad you are getting some relief!
Posted by floatingbridge on October 1, 2011, at 21:26:15
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
Yay!
Posted by Conundrum on October 2, 2011, at 1:17:56
In reply to Re: Viibrid Treatment » Conundrum, posted by SLS on October 1, 2011, at 19:21:26
> > Awesome Scott. :D
> >
> > Are you taking advantage of the good feelings? Going out and doing things?
>
>
> YES!
>
> I went to an antique car show with a friend today and took pictures. It was nice to feel well enough to WANT to go somewhere and be around people. The Viibryd is still helping, and I am feeling better than I did on Nardil. I expect to feel very well in a few months. Today represents day 6 of treatment. I have sustained an improvement beyond my usual transient 3-day response pattern. This is very significant. I believe it is an indicator of my being able to achieve remission. Remission is the goal, of course, but I would be grateful for anything above a 50% improvement. I think I can work with that.
>
> Thanks for asking...
>
>
> - ScottThats great! You have a lot of living to catch up on! :)
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Dr. Bob is Robert Hsiung, MD,
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