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Dr. Bob is Robert Hsiung, MD,
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Posted by Ron Hill on November 16, 2007, at 1:08:35
In reply to Re: Anyone tried Deplin?, posted by Fivefires on November 14, 2007, at 16:59:41
5Fires,
> Talk about 'going off like a rocket'!
> Deplin 7.5mg had me laughing and giggling and behaving 'like a silly school girl' within an hour after taking it last eve!
> I thought to myself 'is this what mania feels like?'I'm very happy for you 5F! It feels good to be able laugh and feel well again, doesn't it? Good for you. Get the word out, as best ya can 'cause I suspect Deplin might help several people here in PB land.
I am Bipolar II, so I am very familiar with what hypomania feels like; this is not it. This is just normal. I had forgotten what it feels like to laugh and enjoy the world around me, and enjoy the people around me. Further, Deplin has stopped my dysphoric mood states, which is a blessing to me and my wife.
5f, I can't speak for you, but for me this is NOT hypomania. Instead, it is just a very nice normal.
It's pretty cool when it works, huh?
> It was so much fun and I was so excited, I could hardly settle down to get to bed, but managed to take care of that situation.Yes, I hear ya. I picked up my first script at 9 pm on 10/22, and I was so eager to try it that I did not wait until the next morning. So I took it in the late evening and, like you, I had trouble getting to sleep.
As I stated earlier, I find it best to split my dose and take them morning and early afternoon. You might want to try something similar, as you indicate below.
> I 'SO' 'WAY' hear what you're saying about meds waning Ron, and will keep this in mind.
>
> I've noticed even extended release or slow release meds don't last their official half-times when I'm concerned. Think I'm a megatabolizer!
>
> Prob' should have started on half tab' last eve, b4 I realized how good I could actually feel o_o. Recalled no instructions per pdoc phone conversation. Will try handle appropriately.Same here. The Prescribing Information document makes no reference to splitting the daily dosage. However, splitting the dose works best for me, and it makes sense from the dose response graph.
As you know, Deplin tabs are not scored. When I was taking 7.5 mg/day, I used my teeth to bite the tablet in two. Half of the tablet is outside my mouth and the other half is inside. I set the dry one aside for my early afternoon dose.
I currently take 15 mg/day, but based on what you have written, it sounds to me that 7.5 mg/day will be plenty for you. But, of course, you know what's best.
> As a result of recent labs, was not only told to start folic acid or folate, but also B12 shots monthly, so already got that one covered.
Once the shots get you into the normal B-12 range, I'd bet that you can very easily maintain an optimal level using a sublingual methylcobalamin (methyl-B12) tablet daily.
Sublingual administration works great because the methyl-B12 goes directly into the bloodstream. However, when swallowed down-the-hatch, the intestines transfer only about 1% of the dose to the blood stream.
In my opinion, sublingual administration has a couple advantages over the periodic B-12 shots. First, the B-12 levels in the body stay more constant when the body is supplied the vitamin on daily basis instead of periodic boost followed by a decline over time until the next booster shot.
Second, most people dislike getting poked with needles! Plus, the pt has to drive to the clinic, and pay the copay.
If you think it is important, you might want to take a couple of B-12 blood tests over time in order to determine if you are taking an adequate sublingual dosage.
I posted the following links before, but I'll post them again. The links take you to a site that shows some methylcobalamin products. However, whichever product you buy, make sure it is sublingual and make sure that it is methylcobalamin, absolutely NOT cyanocobalamin.
http://www.iherb.com/Search.aspx?c=1&kw=methylcobalamin
In particular, I like these two the best:
http://www.iherb.com/ProductDetails.aspx?c=1&pid=129&at=0
http://www.iherb.com/ProductDetails.aspx?c=1&pid=117&at=0
The only difference in the two products is the amout of methyl-B12 in the tablets.
> Feelin' a lil guilty about getting down on my pdoc re: lack of commmunication. Think he made a good call here. I'm going to continue down this Deplin path and get every drop of good feeling out of it I can.5f, do me a favor if you have time. Tell me your dx and list all of the meds and dosages that you take.
Thanks. I'm happy for you! Relief at last!!
When you reply, change the subject line of your post to reflect your positive response to Deplin. It might cause more people to read this thread if they see that you also are finding success with Deplin.
Congratulations. Let's hope Deplin continues to work over the long term. To me, it feels like it will, but as always, time will tell.
-- Ron
Currently in full remission.
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
4 pumps of Androgel testosterone on a prn basis.
Posted by Fivefires on November 16, 2007, at 11:07:53
In reply to Deplin Has Made rHill Well (So Far, As of Day 26 ) » Fivefires, posted by Ron Hill on November 16, 2007, at 1:08:35
Gosh I hate to rain on this parade, and this may just be something else, but ...
Day 2 of Deplin, and I can't go to PCP to get B12 shot today because I had stomach cramping and diarrhea all day yesterday and all night, and then awakened this a.m. w/ very bad head/neck/back pain. I have C2-3, 3-4, 4-5, 5-6 disc extrusions managed w/ Percocet and an NSAID and a muscle relaxant.
Called pdocs office and they said to check net and weren't even going to tell my doc.(?)
Called pcps office and they said to call the pharmacy and weren't going to tell that doc.(?)
I've already had flu and pneumonia shots this year.
Any1 experiencing any such effects w/ the Deplin?
I'm alone and you all are my support I'm afraid. I will do some googling once the Percocet takes the edge off and enables me to sit up and read the screen for any length of time.
This dual diagnosis of mine makes for a real mess sometimes. It's as if some of the psych meds actually zoom in on the extruded discs and exacerbate pain or cause breakthrough pain.
I don't know for sure this is because of Deplin, could be a coincidence or just some viral thing, but felt should post in case any1 is having similar reactions.
Pharmacist said only thing he could see was it might interfere somehow w/ anti-epilectic meds, but I'm not on one of these.
5f
Posted by sparkle on November 16, 2007, at 11:37:57
In reply to Any1 have flu symptoms or back pain w/ Deplin?, posted by Fivefires on November 16, 2007, at 11:07:53
i have been taking deplin for more than 6 weeks and have never had any of the symptoms you are describing. sounds a virus to me. hope you are feeling better
Posted by Fivefires on November 16, 2007, at 15:55:23
In reply to Re: Any1 have flu symptoms or back pain w/ Deplin?, posted by sparkle on November 16, 2007, at 11:37:57
You think so? Because, now, I'm really skiddish to take Deplin today. The cramping had me thinking it might be something serious enough for those damn 6hr ERs! And the back pain had me thinking I'd have to take extra narcotic, which is way 'unliked by pcp'.
I'd planned on getting vite-B shot today, but too ill to drive.
Think I can take it w/o the B for today anyway?
I don't know what to do you guys. I got a glimmer and now I'm scared it's gone or something.
I'm definitely going w/ the sublingual vite-B route so something like this doesn't happen again. Maybe will call about that right now.
I really really hope I'm totally wrong about this being the Deplin. I guess the only way to find out for sure is to take it again.
Guess that's what I'll do.
5f
Posted by stargazer2 on November 16, 2007, at 17:21:54
In reply to Re: Any1 have flu symptoms or back pain w/ Deplin?, posted by sparkle on November 16, 2007, at 11:37:57
What results are you having with Deplin, good enough or significantly better? Want to know whether I should try some myself...Thanks for any feedback and include other meds you are on and your diagnosis if you don't...Stargazer
Posted by Fivefires on November 16, 2007, at 17:44:27
In reply to Results w Deplin/Sparkle, others, posted by stargazer2 on November 16, 2007, at 17:21:54
Hi stargazer2. Just took a tab about 10minutes ago. A test of sorts. Will try and post later if can put my finger on, or identify, results. Some here say needs coinciding AD. My only other psych meds are Xanax and Provigil. (Yeah. I know.)
5f
Posted by sparkle on November 16, 2007, at 18:33:27
In reply to Re: Results w Deplin/Sparkle, others, posted by Fivefires on November 16, 2007, at 17:44:27
since you are having such miserable gastro-intestinal symptoms, i think it would be wise to take as little medicine as possible today until your stomach and cramping improves. Start with clear liquids and work your way up to solid foods and your meds and then try the deplin again. I have been dx with an atypical bipolar 2, which means i have mood swings from major depression to agitation and difficulty sleeping for days. This time of year i typically get really depressed, lethargic have alot of trouble getting going in the am. The deplin seems to have increased my energy level, concentration and kept me from getting really depressed. maybe it is coincidental but i am not ready to stop it. I have also divided the dose as was previously suggested to keep a steadier level of effectiveness. I also take carbatrol, celexa, 7.5mg deplin and rotate sleep meds as necessary lunesta, restoril or ambien. blessings, sparkle
Posted by dreamweever on November 16, 2007, at 18:45:28
In reply to Re: Anyone tried Deplin?, posted by Ron Hill on November 14, 2007, at 6:33:33
I can't seem to find out whether Deplin is available in Canada (perhaps it goes by another name in Canada)? I checked on pharmacy and the pharmacist had not heard of it.
If anyone knows if Deplin is available in Canada, could you please let me know.
Thanks.
Posted by Fivefires on November 16, 2007, at 21:31:13
In reply to Re: Results w Deplin/Sparkle, others, posted by sparkle on November 16, 2007, at 18:33:27
> since you are having such miserable gastro-intestinal symptoms, i think it would be wise to take as little medicine as possible today until your stomach and cramping improves. Start with clear liquids and work your way up to solid foods and your meds and then try the deplin again.>
Oh, you make such sense. But, already took a tablet. Over more than a couple weeks, one uncomfortable situation piled on top of another, until I'm pretty emotionally distraught. Then, yes, being so physically ill complicates things further.
>I have been dx with an atypical bipolar 2, which means i have mood swings from major depression to agitation and difficulty sleeping for days. This time of year i typically get really depressed, lethargic have alot of trouble getting going in the am. >
My dx is PTSD w/ soft borderline, but I often wonder if the jury was deadlocked and the judge dismissed the case (ha) too soon.
>The deplin seems to have increased my energy level, >
Did same for me as well upon first tablet.
>concentration and kept me from getting really depressed.>
Me too. But, then this getting physically ill and having breakthrough back pain scared me. It's hard to have chronic pain and an emotional illness. I'm on meds which I sometimes wonder are on a collision course.
I have this theory re: extruded discs in my c-spine and psych meds ... wonder if psych meds (Cymbalta did this.) somehow aggravate my injury via some sort of CNS action.(?) W/ Cymbalta, I actually 'got pain' or 'had exacerbated pain' ... NERVE pain. Enuf' rambling.
Tks for caring sparkle. Sorry can't be of any help here tonight.
>I have also divided the dose as was previously suggested to keep a steadier level of effectiveness. I also take carbatrol, celexa, 7.5mg deplin and rotate sleep meds as necessary lunesta, restoril or ambien.>
Can't remember if I've told u, but on Xanax, Provigil, levothyroxine, was on folic acid, B12 shots (Meant to call doc office earlier and ask about sublingual, but forgot.) for psychiatric tx. For back pain, I have Percocet, Voltaren, and Flexeril. For HRT, w/ oral forms all ineffective, wear estrogen patches. I take Soma for sleep.
It has always worked very well, but, last two nights, first two after taking Deplin, did wake middle of night (unusual) and then too very early next morning (unusual).
Hard to identify what's happening w/ a med when overwhelmed.
I wonder though, w/ as depressed as I am, if I'd even have logged on, to respond here (taken some responsibility), if I'd not just taken the Deplin.(?) Surprised I got out of bed. Plus, experiencing no c-spine pain.
And, I'm actually thinking of what would be good to my stomach. I'd not been hungry at all since this recent onslaught of depressing situations.
sincerely, 5f
ps: Thankful able to share what's going on w/ these meds here and to have this support sparkle, and all.
Live alone and, IRL, not much support. So, big thanks.
Hope everyone here will keep all updated w/ Deplin experiences, and, I apologize if I caused any scare w/ my post early this day re: physical side effects.
Posted by Ron Hill on November 17, 2007, at 0:46:38
In reply to Any1 have flu symptoms or back pain w/ Deplin?, posted by Fivefires on November 16, 2007, at 11:07:53
5f,
Sorry for your flu-like symptoms.
Also, sorry for your disk problems. Do you have pain radiating down your arms? Twenty years ago, I blew out L-5,S-1. That was the worst physical pain that I have ever experinced. Pain down my legs.
How bad is the disk pain for you? Do you have a good orthopedic surgeon? In addition to the orthopedic surgeon, do you also see a chiropractor?
I see nothing in the Deplin prescribing information documents that mention your flu-like symptoms. The one thing I do see is that Deplin interacts with NSAIDs. Check it out:
http://www.drugs.com/cdi/deplin.html
http://www.deplin.com/media/Deplin_PackageInsert.pdf
I'd recommend that you take your Deplin in the mornings when you get up, not in the late evening.
Sublingual B-12 is an over-the-counter product not rx. The hard part is finding a vitamin store that carries the methylcobalamin type of B12. The most common from of B12 is cyanocobalamin. Call around to find a vitamin store in the area you live and see if you can find it.
The easiest way for me to find what I want is to order it online. In particular, I use this on-line store:
Then enter methylcobalamin into the search box. Do a second search for methyl-B12. I showed you the sublingual methylcobalamin that I like the best, but you can pick out one that you like.
Just to reiterate what I posted before, here are the sublingual methylcobalamin that I like best:
http://www.iherb.com/ProductDetails.aspx?c=1&pid=129&at=0
http://www.iherb.com/ProductDetails.aspx?c=1&pid=117&at=0
I care what happens to you, 5f, and I wish you the very best.
-- Ron
Currently in full remission.
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
4 pumps of Androgel testosterone on a prn basis during ultra rapid cycling depressive phases.
Posted by Ron Hill on November 17, 2007, at 0:51:11
In reply to Re: Results w Deplin/Sparkle, others, posted by Fivefires on November 16, 2007, at 21:31:13
5f,
When you feel well enough to read, scan through this document on Deplin:
http://www.cnsspectrums.com/aspx/article_pf.aspx?articleid=1267
--Ron
Posted by sparkle on November 17, 2007, at 10:37:15
In reply to Re: Any1 have flu symptoms or back pain w/ Deplin? » Fivefires, posted by Ron Hill on November 17, 2007, at 0:46:38
ron thanks for the info about the interaction with nsaids. I had not read that and i have taken nsaids for various things. sparkle
Posted by Fivefires on November 17, 2007, at 15:49:04
In reply to Re: Any1 have flu symptoms or back pain w/ Deplin? » Fivefires, posted by Ron Hill on November 17, 2007, at 0:46:38
I can state with pretty much complete certainty Deplin was NOT the cause of the 'flu-like thing' I coincidentally got when began it, as I went ahead and took Deplin yesterday and then again this a.m. and the physical ailment is abating.
Things went too far for me here though. I unsuccessfully tried to reach pdoc and others re: depression weeks ago.
I just posted on social, Major depression. Feel like need hospitalization, but won't lie to get it. Think you know what I mean. It is probably situational in causation, but nonetheless very strong.
When get out of house .. will look for the B-12 as specified and will take a look at d.c. or alter Voltaren, yet I've tried a couple times and gotten damn break-through pain.
Since I didn't have a documented 'accident', I'm not a candidate for surgery, not yet anyway, and have been passed on and on by pain docs. So, my PCP helps me w/ this. There are very few pain docs here. It's never been suggested I see an ortho. I've been told to stay away from chiros. I've only been referred to neurologists, neurosurgeon or pain specialists.
I'm so happy you're in remission.
Tks for staying here and helping out when you could instead be out enjoying life; this is cool of you to do.
I'll try to remember to do the same if ever I'm able.
thanks, 5f
Posted by clipper40 on November 17, 2007, at 18:33:11
In reply to Deplin, posted by Fivefires on November 17, 2007, at 15:49:04
Here's a description of it:
Source Naturals Mega Folinic is a highly bioavailable source of folic acid that helps the body build healthy red blood cells. It supports healthy brain and neurological development along with healthy cell division. Folinic acid does not require the enzymatic conversion that folic acid does so there is enhanced effectiveness for many people. Research suggests that folinic acid is more bioavailable than folic acid because it is more rapidly converted into L-methylfolate, the form of folate in circulation that can cross the blood-brain barrier.*
Here's the link at iherb.com:
http://www.iherb.com/ProductDetails.aspx?c=1&pid=7735&at=0
Note the very low price! (Even if you had to take a lot of it to get same result as Deplin, you'd still be way ahed of the game financially.)
Posted by Iansf on November 18, 2007, at 18:59:55
In reply to Do you think MegaFolinic could work as well?, posted by clipper40 on November 17, 2007, at 18:33:11
Megafolinic is not in fact substantially cheaper than Deplin because Megafolinic tablets are only 800 mcg, while Deplin tablets are 7.5 mg. It would take nine tablets of Megafolinic to equal slightly less than one tab of Deplin.
> Here's a description of it:
>
> Source Naturals Mega Folinic is a highly bioavailable source of folic acid that helps the body build healthy red blood cells. It supports healthy brain and neurological development along with healthy cell division. Folinic acid does not require the enzymatic conversion that folic acid does so there is enhanced effectiveness for many people. Research suggests that folinic acid is more bioavailable than folic acid because it is more rapidly converted into L-methylfolate, the form of folate in circulation that can cross the blood-brain barrier.*
>
> Here's the link at iherb.com:
>
> http://www.iherb.com/ProductDetails.aspx?c=1&pid=7735&at=0
>
> Note the very low price! (Even if you had to take a lot of it to get same result as Deplin, you'd still be way ahed of the game financially.)
>
Posted by clipper40 on November 18, 2007, at 22:06:20
In reply to Re: Do you think MegaFolinic could work as well?, posted by Iansf on November 18, 2007, at 18:59:55
True, the difference in price is not nearly as large as it appears at first glance.
However, if you do the math (assuming 9.5 tabs of MegaFolinic per dosage and $119.69 as price of Deplin from manufacturer's website), you get $57.60 per 90 doses MegaFolinic vs. the $119.69 of 90 doses of Deplin. That's still quite a significant savings - not to mention that you don't need a prescription for the Megafolinic.
Posted by Iansf on November 21, 2007, at 13:13:24
In reply to Re: Do you think MegaFolinic could work as well? » Iansf, posted by clipper40 on November 18, 2007, at 22:06:20
> However, if you do the math (assuming 9.5 tabs of MegaFolinic per dosage and $119.69 as price of Deplin from manufacturer's website), you get $57.60 per 90 doses MegaFolinic vs. the $119.69 of 90 doses of Deplin. That's still quite a significant savings - not to mention that you don't need a prescription for the Megafolinic.
>
>
>
Except I found one source that has Deplin for $45 for 30 tablets and $107 for 90 (equivalent to about $36 for 30). So it can still end up being cheaper.
Posted by clipper40 on November 21, 2007, at 16:43:39
In reply to Re: Do you think MegaFolinic could work as well? » clipper40, posted by Iansf on November 21, 2007, at 13:13:24
> > However, if you do the math (assuming 9.5 tabs of MegaFolinic per dosage and $119.69 as price of Deplin from manufacturer's website), you get $57.60 per 90 doses MegaFolinic vs. the $119.69 of 90 doses of Deplin. That's still quite a significant savings - not to mention that you don't need a prescription for the Megafolinic.
> >
> >
> >
> Except I found one source that has Deplin for $45 for 30 tablets and $107 for 90 (equivalent to about $36 for 30). So it can still end up being cheaper.
How is $107 for 90 doses cheaper than $57.60 for 90 equivalent doses?The only way I can see the Deplin being a better deal is if the Megafolinic doesn't work as well - which is entirely possible, if not probable.
Posted by KayeBaby on November 22, 2007, at 0:52:33
In reply to Re: Do you think MegaFolinic could work as well? » Iansf, posted by clipper40 on November 21, 2007, at 16:43:39
No. It is the same. The drug co., Pan American, owns the raw material and for a time sold it to supplement companys. It stopped providing l-methylfolate when it was ready to market Deplin.
This is the info I have read. My Dr. told me the same thing.
Peace,
Kaye
Posted by Ron Hill on November 22, 2007, at 1:21:24
In reply to Re: Any1 have flu symptoms or back pain w/ Deplin?, posted by sparkle on November 17, 2007, at 10:37:15
This study shows why folate supplementation does not help all depressed patients. This has direct application to Deplin efficacy. But more than that, it gives a good rationale for why folate tx does work well in patients with low folate as measured by homocysteine levels.
http://jnnp.bmj.com/cgi/content/full/69/2/228?ijkey=894fd0cb1ea17d8ec0e2ef52e5b7f0ab7739e709
- Ron
Posted by Iansf on November 22, 2007, at 11:43:26
In reply to Re: Do you think MegaFolinic could work as well? » Iansf, posted by clipper40 on November 21, 2007, at 16:43:39
> How is $107 for 90 doses cheaper than $57.60 for 90 equivalent doses?
>This is why you should never hire me to do your income tax forms - unless, of course, you WANT to pay the IRS more than you owe.
Posted by KayeBaby on November 22, 2007, at 11:59:28
In reply to Re: Do you think MegaFolinic could work as well?, posted by Iansf on November 22, 2007, at 11:43:26
I figured out what happened. I sent the wrong link or they switched products. The product I was taking is Metafolin by Source Naturals.
Oh-Merck is the patent holder not Pan Am. I think I was up too late when I posted this.
Sorry for any confusion.
Kaye
Posted by clipper40 on November 22, 2007, at 14:05:44
In reply to Re: Do you think MegaFolinic could work as well?, posted by Iansf on November 22, 2007, at 11:43:26
Posted by Ron Hill on November 22, 2007, at 14:19:20
In reply to Do you think MegaFolinic could work as well?, posted by clipper40 on November 17, 2007, at 18:33:11
Posted by sparkle on November 22, 2007, at 14:34:08
In reply to Please see my post below regarding Metafolin » Ian » clipper40, posted by Ron Hill on November 22, 2007, at 14:19:20
i am really confused now. so is there a drug comparable to deplin out there and substantially cheaper. if so where do you access it? thanks sparkle ps happy thanksgiving
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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