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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 Emme on June 5, 2004, at 12:09:47
Hi Scott,
Just wanted to see how you're doing and if you are having any better luck with your meds.
Emme
Posted by SLS on June 5, 2004, at 15:05:05
In reply to SLS, how are you?, posted by Emme on June 5, 2004, at 12:09:47
Hi Emme.
Thanks for asking.
I am not doing very well. Memantine stopped working completely, but I am continuing with it at 20mg. I stopped taking Zoloft. I am trying to tweak the dosage of Lamictal to reduce the cognitive impairments I suspect that it is causing. It is possible that the effects that I am blaming Lamictal for are actually features of the depression itself. I really am not sure because I have been taking 300mg for so long. I would like to find out for sure before moving on to Cymbalta (duloxetine). My doctor says that he will be getting an advanced supply of Cymbalta from Eli Lilly prior to its final approval, expected later this summer. I should be starting it in about a month.
The other two drugs that I am looking at are riluzole and mifepristone (RU-486). Riluzole is an antiglutamatergic drug (as are Lamictal and memantine). It is currently available for the treatment of ALS (amyotrophic lateral sclerosis). Mifepristone blocks cortisol receptors, and might work in part by resetting the HPA axis. I don't know how easily obtainable it is. It is currently approved by the FDA only as an abortifacient, and is administered as a single dose. However, it is also an effective treatment for Cushing's Syndrome. The NIMH is conducting clinical trials of both drugs as treatments for bipolar depression.
How have you been doing?
It's a gray, rainy day. That's exactly how I feel.
- Scott
Posted by Racer on June 5, 2004, at 16:46:47
In reply to Re: SLS, how are you?, posted by SLS on June 5, 2004, at 15:05:05
Now, my only knowledge about Cushing's is having had a horse who had it, but I know that there were a few drugs being used pretty effectively for it in the land of vets. Since that's related to cortisol, and I imagine cortisol is related to depression, I've wondered myself if those drugs that block the overproduction of cortisol might help with my own depression. You probably already know much more than I do about it all, but I'll offer this anyway.
Cyproheptidine was being used in a lot of horses, because it really seemed to improve things for them. The actual studies done were really inconclusive: one study showed that it helped about 15% of the horses on it, another showed it to be about 60% effective. All this is as of about 1997, so I don't know of any more recent studies. (But it was also showing HUGE results for some other weird 'syndromes' that were popping up all over the country. My favorite was "photic head shaking" -- sure, it may start physical, but it still becomes a behavior issue at some point. The cyproheptidine relieved the head shaking right away for all but a few horses, and for those few dental work usually resolved it.) So, it might be worth a thought.
The other drug used a lot was pergolide. Again, I suspect you already know a lot about it, but all I know is that it's expensive for 1200 pounders. It does seem to work really well in Cushingoid horses, though.
I'm so sorry I can't offer any real help, Scott, but I'm still sending you my best wishes. And my thanks and gratitude for your help with my own issues.
Posted by EERRIICC on June 5, 2004, at 23:14:04
In reply to Re: SLS, how are you?, posted by SLS on June 5, 2004, at 15:05:05
I read an anecdotal report about memantine in the "Entheogen Review". The man who wrote it was not suffering from depression, but simply "reviewing" an interesting new drug for the sake of "consciousness exploration". He found that with oral administration a dose of between 50 and 100 mg was needed for a euphoric effect.
Posted by karen_kay on June 6, 2004, at 0:01:13
In reply to Re: SLS, how are you?, posted by SLS on June 5, 2004, at 15:05:05
((((((scott))))))))
try to remember that the sun does come out again. take care.
Posted by SLS on June 6, 2004, at 7:27:51
In reply to To SLS, posted by EERRIICC on June 5, 2004, at 23:14:04
Posted by Emme on June 6, 2004, at 7:57:47
In reply to Re: SLS, how are you?, posted by SLS on June 5, 2004, at 15:05:05
I'm sorry you're feeling cruddy. Gray and rainy definitely sums it up. I hope you get some relief from the duloxetine when you start it. I didn't realize it could be gotten ahead of final approval. I was hoping Zoloft would help you. Are you on just Lamictal now?
I've been: wildly anxious and really tired and unmotivated and hopeless and ragingly furious. But, better than 6 months ago I think. Scary. I'm waiting on an answer from a job interview. I want the job badly and I have a sneaky feeling I didn't interview well enough for it. I'm afraid my mood control will slide out of control when I get the rejection.
I'curious now and I'll read up on the Riluzole. For the moment, though, I've really lost faith in prescription meds, except Xanax. I'm debating whether I want to go to my pdoc (or any pdoc) anymore. I haven't thrown out my meds yet, but I'm starting to work my way through the alternatives. I'm curently trying SJW and SAM-e. If they don't work, then at least I'll know.
I'll post on social if by some miracle I get the job. I'll post on alternative if SJW ever kicks in or if I like the outrageously priced SAM-e.
Emme
> Hi Emme.
>
> Thanks for asking.
>
> I am not doing very well. Memantine stopped working completely, but I am continuing with it at 20mg. I stopped taking Zoloft. I am trying to tweak the dosage of Lamictal to reduce the cognitive impairments I suspect that it is causing. It is possible that the effects that I am blaming Lamictal for are actually features of the depression itself. I really am not sure because I have been taking 300mg for so long. I would like to find out for sure before moving on to Cymbalta (duloxetine). My doctor says that he will be getting an advanced supply of Cymbalta from Eli Lilly prior to its final approval, expected later this summer. I should be starting it in about a month.
>
> The other two drugs that I am looking at are riluzole and mifepristone (RU-486). Riluzole is an antiglutamatergic drug (as are Lamictal and memantine). It is currently available for the treatment of ALS (amyotrophic lateral sclerosis). Mifepristone blocks cortisol receptors, and might work in part by resetting the HPA axis. I don't know how easily obtainable it is. It is currently approved by the FDA only as an abortifacient, and is administered as a single dose. However, it is also an effective treatment for Cushing's Syndrome. The NIMH is conducting clinical trials of both drugs as treatments for bipolar depression.
>
> How have you been doing?
>
> It's a gray, rainy day. That's exactly how I feel.
>
>
> - Scott
Posted by Sad Panda on June 6, 2004, at 10:31:56
In reply to Re: SLS, how are you?, posted by SLS on June 5, 2004, at 15:05:05
Hang in there Scott, I hope your Duloxetine trial goes well. :)
Cheers,
Panda.
Posted by Noa on June 6, 2004, at 17:38:05
In reply to Re: SLS, how are you?, posted by SLS on June 5, 2004, at 15:05:05
Scott, sorry to hear things are so down. I hope this next med trial goes well. Hang in there!
Posted by Cecilia on June 11, 2004, at 3:58:39
In reply to Re: SLS, how are you?, posted by Noa on June 6, 2004, at 17:38:05
How did your doctor go about getting an advance supply of duloxetine? Is this something any pdoc could do? Hope it works for you! Cecilia
Posted by SLS on June 11, 2004, at 6:30:13
In reply to Question for SLS, posted by Cecilia on June 11, 2004, at 3:58:39
> How did your doctor go about getting an advance supply of duloxetine? Is this something any pdoc could do? Hope it works for you! Cecilia
Hi Cecilia.
Technically, it isn't so much an advanced supply as it is a continuation of investigational clinical trials. It is sort of like a phase IV trial which is open label (not blinded), and conducted to further assess side effects in the "real world". I have no idea how my doctor arranged to do this. Maybe you could ask your doctor to call Eli Lilly to find out.
In my mind, there is still no guarantee that duloxetine will be approved by the FDA. Hopefully, the conducting of this type of trial is a good sign. For every new drug that becomes available, a certain percentage of people who were previously treatment resistant will go on to respond to it. Keep your fingers crossed.
- Scott
This is the end of the thread.
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