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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 Lao Tzu on October 11, 2012, at 12:55:29
Hi. I just wanted to update my nutritional regimen for depression. In the past, I've tried many different nutrients. To date, this is what I have been using and the corresponding dosages. I also have schizophrenia, but it is in remission with medication. The depression however persisted after the psychosis became manageable. Perhaps these vitamins will help you too if you are not getting everything out of your medicine. I've combined medicine with good nutrition and it works if you know how to do it properly. This is my regimen. Hope you like it:
Morning--I take 50mg of B1, 50mg of B6, and 200IU of vitamin E with my morning medication (Zoloft, Risperdal).At 11:00 A.M. I take 500mg of vitamin C, 1,500mg of fish oil, and 1,300mg of borage oil
At 12:00 PM I take 375micrograms of B12 + 200mg of Magnesium Citrate.
Finally, at 8:00 PM (Bedtime) I take my nighttime meds (Risperdal) with the following vitamins: 50mg B2, 100mg B1, 400IU of vitamin E, 500mg GABA, 1mg of melatonin, 100mcg of selenium, and a Centrum multivitamin.
That's it right now!! Could change, but we will see. I'm always evolving. If you have depression, these vitamins may help you, but I'm not a doctor so I don't know for sure that this regimen will benefit everybody. It seems that on this site, everybody has a different regimen unique to his/her own needs. But I thought I would just share what I am doing lately.
Best of luck to all of you out there on Dr. Bob's Homepage.
Lao Tzu
Posted by Christ_empowered on October 12, 2012, at 8:23:58
In reply to Depression supplements Updated, posted by Lao Tzu on October 11, 2012, at 12:55:29
I'm not a doc, but...have you considered a different antipsychotic? I've found Abilify to take the edge off intense depression at lower doses. At higher doses, Abilify at least doesn't seem to make the blues any worse.
Risperdal made me almost instantly dysphoric.
Posted by Lao Tzu on October 17, 2012, at 10:30:24
In reply to Re: Depression supplements Updated, posted by Christ_empowered on October 12, 2012, at 8:23:58
Yes, good point. My doctor suggested Abilify at my last visit to help more with motivation. I am considering trying it, but a lot of people said that Risperdal is a better antipsychotic for schizophrenia than Abilify. They said Abilify is a bit "Weak" for psychosis, but I guess you can't listen to everybody. You have to try it for yourself, which I might bring up with my doctor in November. A couple questions, if you don't mind: What is your dosage of Abilify? Does it keep the voices under control adequately? Have you ever heard of adding Abilify to another antipsychotic (Risperdal in my case)? I am a little cautious not to change anything that is working well. Risperdal has always controlled the voices and made them friendly rather than vicious. I think that if I had Bipolar without psychosis, I would definitely give Abilify a try. I am trying to weigh the pros and cons. Risperdal has an excellent track record for psychosis and a favorable side effect profile compared to the newer AAPs. The only thing I don't like about the Risperdal is the weight gain, but that could also be from the Zoloft I take too. At any rate, I would welcome any information about the Abilify. Does it help with motivation, you know, getting out, looking for a job, etc? My doc said he could also try Wellbutrin, but I think the Zoloft is better for my social phobia. Thanks, as always, for your posting. Take care.
Lao Tzu
Posted by Christ_empowered on October 20, 2012, at 18:48:43
In reply to Re: Depression supplements Updated, posted by Lao Tzu on October 17, 2012, at 10:30:24
Hey man. Sorry it took a bit for me to answer. I don't check this board all that often.
I'm on Abilify primarily because its the only AAP I can tolerate at full dose for any extended period of time. Back in the early days of my psychotic+mood+anxiety "thing," even Abilify gave me a mild tremor. With the whole Orthomolecular line up on board and w/ a lot of psychosocial issues resolved (fewer issues=fewer meds), I tolerate a full 30mgs/day (biggest tablet they make) fairly well. I also take (or am supposed to take...) 900mgs/Neurontin, which I think is a fairly standard (perhaps low?) dose for anxiety+agitation+"crazy."
Anyway, my former shrink explained it to me like this, and experience has proven her correct, at least for me. Lower doses=more stimulating, which could be good or bad. The usual minimum for psychosis is 10mgs/day. The "target" is 15. That's what they used to start everybody on, for pretty much everything.
Above 10-15, it's apparently more "soothing." I personally found that, as long as I can tolerate 20-30, I get more cognitive benefits. I have no idea what that's about. That may not be the case for you.
Everybody's always talking about akathisia with Abilify. Honestly, the other AAPs--particularly Risperdal and Zyprexa--were worse in this regard for me than Abilify. I don't require benzos or propranolol with Abilify to control akathisia, eps, etc. Actually, I think I have some weird dopamine "thing" going on, because full dose AAPs (besides Abilify) make me a bit *more* anxious. Sounds strange, until you realize that sufficiently high doses of D2 blockers induce varying degrees of Parkinson's, and Parkinsons is often accompanied and/or preceded by anxiety.
The whole anti-depressant thing has, in my opinion, been blown out of proportion. I either get some kind of schizophrenic depression (if you believe that diagnosis), or psychotic depression. Either way, because I'm so prone to depression, other AAPs aren't that great for me. I'll mellow out short term, get really sad more long term. Abilify @ 30 at least doesn't make depression worse and doesn't seem to induce any depressive episodes, although I've heard that some people get really dysphoric on Abilify (probably true of any AP or AAP).
I wouldn't do antipsychotic polypharmacy, personally. If, for whatever reason, I was on risperdal or some other D2 blocker and wanted to switch, I'd just switch over from drug A to Abilify, and just start the Abilify at a higher-than-normal dose, to prevent over-activation. After a while, you could reduce it. Or, your doc could do a more conservative, gradual switch, maybe with some kind of sedative (neurontin, lyrica, vistaril, a benzo...something) on board to smooth things over during the transition phase. A lot of people take benzos for 1-2 weeks when starting Abilify, anyway.
Hope this helps.
Posted by Lao Tzu on October 26, 2012, at 15:11:19
In reply to Re: Depression supplements Updated, posted by Christ_empowered on October 20, 2012, at 18:48:43
Thank you for getting back to me. I think you answered my questions okay. I'm on the fence about trying abilify. I really don't want anything that is too activating, but also, I need help with motivation, so Abilify might be the answer. I'm just hesitant to try anything else when the Risperdal is working well for the hallucinations. I've been on high dose Risperdal now for six years and lower doses years before that. I never really enjoyed taking Risperdal, but nowadays it doesn't bother me much in the way of side effects, as long as I stay with my vitamin regimen. But I will talk it over with my doc. I'm going to see him again next Thursday. He also mentioned trying Wellbutrin. I already take Zoloft and I don't know about tapering off that. Sounds like that could be rough. My point is, if it ain't broke, don't fix it. Thanks again for getting back to me. Have a nice day.
Lao
Posted by Christ_empowered on October 28, 2012, at 10:30:30
In reply to Re: Depression supplements Updated, posted by Lao Tzu on October 26, 2012, at 15:11:19
I would imnagine the TD risk for Abilify would be lower. Also, there's less D2 upregulation than other drugs, so its supposedly "cleaner"--I would imagine there's less tardive psychosis.I recommend you switch. Risperdal can be so dulling, and once you hit a certain dosage (I think its around 6mgs), you might as well be taking Haldol in terms of EPS. Plus, Risperdal causes more weight gain than Abilify and tends to raise prolactin levels. Abilify is less fatty-making (still happens, though) and does not raise prolactin.
I'd recommend that you just try to start at 20-30. Just tell your doc you're scared of over-activation, blah blah blah, he should start higher. Higher can be better, anyway; works faster, less activation, and sometimes, more benefits. You can gradually lower later, if you want.
I would **not** recommend adding Abilify to Risperdal. Just based on the data I've read, you should try to pick 1 antipsychotic and stick with it, unless you're incredibly, unbelievably psychotic. Even then, there are other drugs that could help.
To me, Risperdal+Zoloft seems like it'd be mind-numbing. SRI drugs are numbing; so are all AAPs, especially Risperdal. If you switch to Abilify, you'll have a little more dopamine action going, so you'll be more motivated, more interested in life, etc. Supposedly, it boosts AD drugs, particularly SRI drugs (I read somewhere that it doesn't boost Welbutrin, but that was an animal study), so you might resolve your depression, too.
Just my thoughts. Remember that I hate Risperdal, anyway.
Posted by Lao Tzu on November 19, 2012, at 11:42:08
In reply to Re: Depression supplements Updated, posted by Christ_empowered on October 28, 2012, at 10:30:30
Thanks for the info. Christ! I really appreciate your knowledge of Abilify. I think you are right about the Risperdal + Zoloft being mind-numbing. The only advantage to that is that you don't have to deal with a range of emotional issues. Still, I am able to smile, laugh, feel angry (although less so than so-called normal people). I'm able to keep my emotions from going extreme which they used to do years ago. And my anxiety was off the chart back then. So for me, the Risperdal + Zoloft has really helped in that regard. I don't feel like a zombie b/c I also supplement with a lot of vitamins and they help with the side effects of the meds in that I have more energy and with more stability. I will definitely keep Abilify in mind. I am trying to weigh the pros and cons. My doctor said it has the potential of boosting motivation, and I guess that has been an issue as well. If I want to return to work, I would definitely need more motivation. Until then, I have been feeling okay, not lighting the world on fire, but not in distress either. I don't like the weight gain either. I am overweight about 35 lbs, but I haven't gained any weight recently either, even when I quit cigarettes 5 months ago. I definitely need to exercise for cardiovascular health b/c heart disease runs in my family. I tried Lipitor but it made me so tired that I stopped it. I am a low-energy person, so I am going to have to find another way to take care of my heart. Do you have any metabolic issues with your meds? Yes, I think the Risperdal does increase the prolactin, which might explain the MAN BOOBS! Still, my health is not terrible. Just have to watch what I eat and exercise, stay away from the smokes and alcohol. Other than the heart disease, I seem to have good genes on my mother's side. Again, I appreciate your comments. Will think long and hard about the Abilify. It might just improve my low motivation. Thanks again. Have a nice holiday.
Lao
Posted by Lamdage22 on August 14, 2013, at 13:16:59
In reply to Re: Depression supplements Updated, posted by Christ_empowered on October 28, 2012, at 10:30:30
I remember the Risperdal bitch-t*ts (gyno) and no control of psychosis whatsoever.
I drove back to SoCal from Vegas.. thinking the Government and all the other cars are spying and crap like that.
I needed Risperdal to work and it didnt. Caused quite some damage to my life when i realized it didnt work at all.
This is the end of the thread.
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