Posted by Janet from Brazil on February 12, 2000, at 4:07:04
In reply to Re: Info on stimulants? to Janet from Brazil, posted by Kim on February 11, 2000, at 22:50:24
> > Sorry Janet things haven't worked better for you. You would think that by now your doctor would 'get it' and realize he's barking up the wrong tree. Antidepressants clearly aren't the answer with you. How much more obvious need it be?
> >
> > You doctor's attitude toward stimulants is absurd. He would rather have you suffer through endless months and years of useless drugs? He does have some valid concerns, but they are easily managed.
> >
> > Concerning possible psychosis, that could happen. Or sometimes an initial good reaction destabilizes into irritibility or something later. In those situations, the simple remedy is a very small dose of an antipsychotic. A stimulant will enhance NE/dopamine function. But it may do so too much in certain parts of the brain. We want to affect some parts, but not all. An antipsychotic is basically a dopamine reducer, and will counteract excessive dopamine in parts of the brain where excess is not desired. A stimulant+antipsychotic takes away the psychosis risk. Doses needed are small. No need for concern of special testing or high dosing or anything like that. You can nullify his argument of psychosis.
> >
> > Concerning addiction, that could happen. But it happens with cigarettes too, and they will likely kill you. Stimulants aren't likely to kill you. They will instead likely do the opposite, allowing you a full productive happy life instead. In my opinion addictive nicotine is much worse than an addictive stimulant. I am a smoker and would much prefer being addicted to a stimulant than nicotine. I don't think your doctor's attitude stands on solid ground.
> >
> > So what to do? Try like heck to debate, argue, defend, beg and whatever for a short 5 day trial of each of three different stimulants. Five days each. I can't see how he could object to that. From these short trials you can find out definitively whether this is the right direction or not. Ritalin, Adderall, and Cyclert would be three top choices to try. Ritalin I think has the most addiction/abuse potential. Adderall less so. And Cyclert is probably near non-addictive non-abusive.
> >
> > If the doc refuses, immediately start calling around for one who is comfortable with stimulants. And as a sidenote, don't overlook thyroid function. Hypothyroid disorder could be involved. It just seems to me that at this point it makes absolutely no sense whatsoever to continue with the antidepressant class. It has become crucial to move on to a completely different class of drugs. Just my opinion. I hope you will find a doctor willing to cooperate in getting you well. Isn't that what they're supposed to do?
>
> Hi Jan,
> I am also on Parnate, with major fatigue problems. My pdoc, who was the head of a large, well-known, well-respected clinic in the state I where I used to live, prescribed dexedrine to augment the Parnate. We had tried Ritalin and Cylert before the dexedrine, but they were not useful.
>
> When I moved, I was taking 45 mg. of dexedrine per day. My new pdoc (selected by my insurance company--don't get me started) is very uncomfortable with prescribing the dexedrine--he first called my old pdoc and that's the only reason he continued to prescribe the dexedrine (in decreasing doses) at all. He wants me off them because they're "addictive."
>
> SO WHAT if they're addictive? All they do is augment my antidepressant and help me be awake enough to function. What is addictive, anyway? Is someone who has to take blood pressure medication for the rest of their life "addicted" to it? They certainly "need" their medication and would be in bad shape if they stopped it abruptly.
>
> I think the reluctance of doctors to prescribe this medication when it is clearly medically indicated is one more example of the discrimination against "mental" illnesses as opposed to "physical" illnesses.
> KimThank you, Kim. Did your doc. try to augment your Parnate with mood stabiliers first or did he go straight on to stimulants? Did Parnate by itself have some effect? With me it's having no effect whatsoever. Thanks Jan
poster:Janet from Brazil
thread:20767
URL: http://www.dr-bob.org/babble/20000209/msgs/21242.html