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Dr. Bob is Robert Hsiung, MD,
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Posted by phidippus on February 8, 2012, at 15:55:39
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 5, 2012, at 9:55:02
Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 6 mgI'm sure you could go without nortriptyline and lithium
Eric
Posted by SLS on February 8, 2012, at 16:34:23
In reply to Re: Adding Parnate and prazosin., posted by phidippus on February 8, 2012, at 15:55:39
Hi Eric.
> Parnate 80 mg
> nortriptyline 150 mg
> Lamictal 200 mg
> Abilify 10 mg
> lithium 300 mg
> prazosin 6 mg
>
> I'm sure you could go without nortriptyline and lithium
>
> Eric
Lithium was my doctor's first choice of a drug to eliminate. I chose to continue with it because:1. It encourages hippocampal nerve growth.
2. It produces a perceptible decrease in mood lability for me.
3. It acts as a prophylaxis against Alzheimers Dementia, a disease known to occur more often with people who have MDD or BD.
I was genuinely surprised that I relapsed upon the discontinuation of Abiify.
Nortriptyline? You might be right. However, I would be reluctant to discontinue it at this point in time. The only time that I was brought into remission was when I was treated with a combination of MAOI + TCA; where neither drug alone was sufficient. Of course, I didn't take all of the other drugs in my current treatment regime at that time.
Thank you for providing your input. You might be absolutely right in your conclusions and suggestions. However, I am afraid to "rock the boat" right now.
- Scott
Posted by Beckett on February 9, 2012, at 8:47:51
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 7, 2012, at 16:04:56
I'm glad you're regaining lost ground, Scott.
Posted by SLS on February 19, 2012, at 6:53:48
In reply to Adding Parnate and prazosin., posted by SLS on December 29, 2011, at 6:55:56
I continue to improve.
It took two weeks to make up for the three weeks that I spent without taking Abilify. I had to recover some of the ground that I had lost. Now that I am back on Abilify, things are pretty stable. The only side effects that I experience since the addition of prazosin are some mild dizziness and a reduced sex drive. I'll have to watch my weight to see if prazosin affects it.
Currently:
Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 6 mg
- Scott
Posted by ed_uk2010 on February 19, 2012, at 9:37:59
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 19, 2012, at 6:53:48
>I continue to improve.
That's great news!
>The only side effects that I experience since the addition of prazosin are some mild dizziness and a reduced sex drive.
Excellent. That does not sound too bad at all.
>Lamictal 200 mg
I know you said >200mg causes cognitive impairment. Do you benefit from 150mg? I was wondering whether you'd be slightly more clear headed but still benefit. Of course, it might not work. Just a thought.
Posted by SLS on February 19, 2012, at 10:25:26
In reply to Re: Adding Parnate and prazosin. » SLS, posted by ed_uk2010 on February 19, 2012, at 9:37:59
> >Lamictal 200 mg
> I know you said >200mg causes cognitive impairment. Do you benefit from 150mg? I was wondering whether you'd be slightly more clear headed but still benefit. Of course, it might not work. Just a thought.Yes. I tried on several occasions to reduce my dosage of Lamictal to 150 mg. I deteriorated each time. I really can't complain too much right now.
Thanks for caring.
- Scott
Posted by Beckett on February 19, 2012, at 10:49:57
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 19, 2012, at 6:53:48
:-) yea!
Posted by Phillipa on February 19, 2012, at 18:44:12
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 19, 2012, at 6:53:48
Fabulous!!!! Phillipa
Posted by SLS on February 21, 2012, at 17:41:43
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Beckett on February 19, 2012, at 10:49:57
> :-) yea!
Yes. I must say that this is rather pleasant.
I feel so much lighter.
I am very happy with my recovering an ability to socialize.
I'm gradually recovering an intellectual capacity that I thought might be lost forever.
I have a long way to go, but this is a journey to be enjoyed.
- Scott
Posted by Bob on February 21, 2012, at 17:54:43
In reply to Re: Adding Parnate and prazosin. » Beckett, posted by SLS on February 21, 2012, at 17:41:43
> > :-) yea!
>
> Yes. I must say that this is rather pleasant.
>
> I feel so much lighter.
>
> I am very happy with my recovering an ability to socialize.
>
> I'm gradually recovering an intellectual capacity that I thought might be lost forever.
>
> I have a long way to go, but this is a journey to be enjoyed.
>
>
> - ScottThat is truly awesome bro. Enjoy!
Posted by papillon2 on February 21, 2012, at 19:24:11
In reply to Re: Adding Parnate and prazosin. » Beckett, posted by SLS on February 21, 2012, at 17:41:43
> > :-) yea!
>
> Yes. I must say that this is rather pleasant.
>
> I feel so much lighter.
>
> I am very happy with my recovering an ability to socialize.
>
> I'm gradually recovering an intellectual capacity that I thought might be lost forever.
>
> I have a long way to go, but this is a journey to be enjoyed.
>
>
> - ScottI am so pleased for you and heartened by your progress.
I wish dearly to recover my brain.
Posted by sigismund on February 21, 2012, at 20:50:23
In reply to Re: Adding Parnate and prazosin. » Beckett, posted by SLS on February 21, 2012, at 17:41:43
I asked about this down below, but what you say here tells me.
>Yes. I must say that this is rather pleasant.>I feel so much lighter.
>I am very happy with my recovering an ability to socialize.
>I'm gradually recovering an intellectual capacity that I thought might be lost forever.
>I have a long way to go, but this is a journey to be enjoyed.
Posted by SLS on February 21, 2012, at 22:08:39
In reply to Re: Adding Parnate and prazosin., posted by papillon2 on February 21, 2012, at 19:24:11
> I wish dearly to recover my brain.
I understand.
Our brains betray us as our minds leave us.
I hope you recover what has been stolen from you.
- Scott
Posted by sigismund on February 22, 2012, at 0:06:52
In reply to Re: Adding Parnate and prazosin. » papillon2, posted by SLS on February 21, 2012, at 22:08:39
>Our brains betray us as our minds leave us.
Casanova was advised to his memoirs as therapy, feeling as he did that life either sent you mad or made you die of grief.
Posted by SLS on February 22, 2012, at 4:46:48
In reply to Re: Adding Parnate and prazosin. » SLS, posted by sigismund on February 21, 2012, at 20:50:23
Hi Sigi.
I added a few things for you.
I experience only two side effects from prazosin.
1. Mild dizziness
2. Reduced sex drive.
> I asked about this down below, but what you say here tells me.
>
>
> >Yes. I must say that this is rather pleasant.
>
> >I feel so much lighter.
>
> >I am very happy with my recovering an ability to socialize.
>
> >I'm gradually recovering an intellectual capacity that I thought might be lost forever.
>
> >I have a long way to go, but this is a journey to be enjoyed.
The more I improve, the more I realize how sick I am. In the past, I tended to overrate my partial improvements. As best as I can determine, I am now about 25% improved. I am not comfortable rating myself any higher at this point.
Global improvement:25% above baseline relative to remission.
Symptom Improvement:1. More mental and physical energy
2. Increase in the ability to experience pleasure and reward.
3. Increased desire to socialize.
4. Reduced social anxiety.
5. More talkative.
6. Improved ability to read and comprehend.
5. Increase in motivation to initiate activities.
6. Fewer awakenings during the night.
7. Improved short-term memory and long-term recall.
8. Increased intellectual capacity / IQ.
9. Less tendency to feel cold.
10. Less tendency to stare into space.
11. Reduced appetite / food intake.
12. Increased interest.
13. Increased decisiveness.
14. Increased self-esteem.
15. Reduced psychomotor retardation.
- Scott
Posted by sigismund on February 22, 2012, at 12:20:51
In reply to Re: Adding Parnate and prazosin., posted by sigismund on February 22, 2012, at 0:06:52
>6. Fewer awakenings during the night.
Interesting
Posted by ed_uk2010 on February 22, 2012, at 13:07:08
In reply to Re: Adding Parnate and prazosin. » sigismund, posted by SLS on February 22, 2012, at 4:46:48
Hi Scott,
Did you decide to stay at 6mg or are you going to try a higher dose?
Posted by SLS on February 22, 2012, at 13:33:29
In reply to Re: Adding Parnate and prazosin. » SLS, posted by ed_uk2010 on February 22, 2012, at 13:07:08
> Hi Scott,
>
> Did you decide to stay at 6mg or are you going to try a higher dose?Hi Ed.
I have been taking 6 mg for quite a few weeks. I had thought to experiment with higher dosages, but never followed through with it. Perhaps I should try it just to be sure that I am not missing out on anything. What do you think? How do you think I should go about it? I have 1 mg pills to work with. I am currently taking one 2 mg pill t.i.d.
- Scott
Posted by ed_uk2010 on February 22, 2012, at 14:05:00
In reply to Re: Adding Parnate and prazosin. » ed_uk2010, posted by SLS on February 22, 2012, at 13:33:29
>How do you think I should go about it? I have 1 mg pills to work with. I am currently taking one 2 mg pill t.i.d.
Perhaps you could start out by increasing your night time dose. You might sleep better and hopefully 'sleep through' any dizziness (assuming you don't get up for a pee!)
Posted by sigismund on February 22, 2012, at 16:36:16
In reply to Re: Adding Parnate and prazosin. » SLS, posted by ed_uk2010 on February 22, 2012, at 14:05:00
Eddy, does Scott's response to prazosin surprise you?
Posted by SLS on February 23, 2012, at 6:37:39
In reply to Re: Adding Parnate and prazosin. » ed_uk2010, posted by sigismund on February 22, 2012, at 16:36:16
> Eddy, does Scott's response to prazosin surprise you?
I don't know if Ed is surprised, but I certainly am. However, there is a reason for everything - we just don't know it yet. I can't be unique. I'm sure others will respond to prazosin as well. I haven't recommended it to anyone yet, though. I am hoping that some people will try prazosin on their own initiative based upon my reporting.
It may be that the antagonism by prazosin of NE alpha-1b receptors reduces neuronal activity in circumscribed areas known to be hyperactive in depression, including subgenual cingulate and nucleus accumbens. These areas just so happen to have populations of these receptors.
Interestingly, prazosin antagonism of NE alpha-1b receptors reduces activity in areas known to be stimulated by amphetamine and cocaine. I bet prazosin can aid in treating addiction to these to stimulants. It is hypothesized that global reduction in 1b receptor activity is partly responsible for producing depression. However, the interactions between circuits is complex. I don't think prazosin will be a successful treatment for everyone. I am interested in characterizing the subtypes or symptomatological profile of people who will respond to prazosin.
For now, I would like to propose the idea that prazosin, in combination with antidepressant medication, will help resolve depressions that evolve due to developmental PTSD wherein the PTSD is occult, operating in the background and driving the depression. This would indicate that people who suffered physical abuse, emotional abuse, or neglect early in life would have a good chance to respond to prazosin.
I am really not terribly interested in performing intense research regarding prazosin and its neurobiology right now. I am too involved in enjoying its results.
- Scott
Posted by SLS on February 23, 2012, at 7:09:03
In reply to Re: Adding Parnate and prazosin. » SLS, posted by ed_uk2010 on February 22, 2012, at 14:05:00
> >How do you think I should go about it? I have 1 mg pills to work with. I am currently taking one 2 mg pill t.i.d.
>
> Perhaps you could start out by increasing your night time dose. You might sleep better and hopefully 'sleep through' any dizziness (assuming you don't get up for a pee!)
Okay. That's a good plan. Thanks.I am all but convinced that 6 mg is the optimal dosage for me, but I don't want to miss out on a more robust therapeutic effect and the achievement of remission. Actually, I began to respond to 3 mg, but found that my mood was somewhat variable. I raised the dosage by 100% to 6 mg just to have some headroom. I immediately gleaned an antidepressant response of greater magnitude without mood lability. I might increase the dosage by another 50% to 9 mg. The worst thing that happens is that I get dizzy.
- Scott
Posted by sigismund on February 23, 2012, at 13:24:45
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 23, 2012, at 6:37:39
I will try it at some point.
When it was used as a blood pressure med there must have been some somewhat depressed people who benefited from it?
Posted by SLS on February 23, 2012, at 15:42:42
In reply to Re: Adding Parnate and prazosin. » SLS, posted by sigismund on February 23, 2012, at 13:24:45
> I will try it at some point.
>
> When it was used as a blood pressure med there must have been some somewhat depressed people who benefited from it?
I wouldn't know. I guess the effect couldn't have been that robust, or it would have been noticed. Prazosin was found to be effective for PTSD by accident at a VA hospital. It probably does not help with MDD or BD as monotherapy.
- Scott
Posted by phidippus on February 23, 2012, at 17:37:07
In reply to Re: Adding Parnate and prazosin., posted by SLS on February 19, 2012, at 6:53:48
Prazosin works by raising dopamine (DA) levels in the synaptic cleft in the prefrontal cortex and inhibiting extracellular DA concentrations in the nucleus accumbens
Eric
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Dr. Bob is Robert Hsiung, MD,
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