![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 36 to 60 of 82. Go back in thread:
Posted by PeterMartin on April 1, 2022, at 12:17:28
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 1, 2022, at 12:10:47
> Some blood work might be good, too. I think when meds dont work, it could be because nutrients are lacking.
I've learned that a lot of times when meds don't work (or suddenly stop working), it's due to my pharmacy giving me a different generic manufacturer. It's extremely frustrating since most pharmacists/doctors/patients will doubt that there can be any difference. I saw this post on reddit recently about potential for differences between generics (even batches), and found it reassuring since I've noticed but faced skepticism.
====
Question/Title of thread:
"Do different manufactures for the same medication really make a difference? Or is that just some my patients like to complain about lol""I know some people prefer the size and shape of specific manufacturers because of issues like cutting the medication in half, or swallowing; but pharmacologically, they are exactly the same, no?"
====
====
Top comment reply:
====
"For those whove never worked in manufacturing, I can tell you that regardless of what is being made, the working site / company matters.Drugs would be build to specmeaning they all have the same specs for mixing and chemical composition. But the number of variations in manufacturing are legion: how much tolerance is in equipment used, how frequently do they lubricate bearings, how often do they change dies, how do they get notified of and handle quality errors in production, what humidity and temperature does the mixing happen at, how sensitive is the measuring equipment, where do they get their raw materials from, do they empty their inventory fifo or lifo and what impact does that have on chemical mixing, etc. At one company I worked we even used a pill making machine that we repurposed for a different use because it was designed to handle sensitive powdersand I can tell you there is PLENTY that could vary not only manufacturer to manufacturer, but sure to site within the same manufacturer or even department to department within the same site."
Link for full thread: https://old.reddit.com/r/pharmacy/comments/tpe4nm/do_different_manufactures_for_the_same_medication/
Posted by Lamdage22 on April 1, 2022, at 12:22:45
In reply to Re: combining nardil and parnate ) SLS, posted by PeterMartin on April 1, 2022, at 12:17:28
> I've learned that a lot of times when meds don't work (or suddenly stop working), it's due to my pharmacy giving me a different generic manufacturer.
I think that is because the statutory provisions are lax in the US. No offense.
Posted by SLS on April 1, 2022, at 20:09:36
In reply to Re: combining nardil and parnate ) SLS, posted by rose45 on April 1, 2022, at 12:05:47
Hi, Rose.
> > A "bridge" is meant to be a temporary treatment to mitigate any suffering that occur during a washout period.
> >
> > For me, I think there are 2 drugs that make good candidates tor being a bridges.
> >
> > 1. Zyprexa (olanzapine)
> > 2. Saphris (asenapine)
> >
> > Although Abilify (aripiprazole) might work well to mitigate an antidepressant withdrawal syndrome, discontinuing it is problematic and produces anxiety as its own withdrawal syndrome.
> >
> >
> > - Scott
>
> Isn't Olanzapine also very difficult to come off?
That's a good point. I have not had a problem with olanzapine discontinuation the few time I took it. Maybe I just got lucky. Is anxiety a withdrawal symptom of olanzapine discontinuation?I don't think I ever asked you how you were feeling.
Don't worry, I won't start now...
Silliness aside, are you hanging in there?
- Scott
Posted by SLS on April 1, 2022, at 20:16:40
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 1, 2022, at 12:10:47
> Some blood work might be good, too. I think when meds dont work, it could be because nutrients are lacking.
I totally agree with you. Unfortunately, you and I were born a little too early along the course of history. There is still much work yet to be done in putting all of the pieces of the many puzzles together: the biological, the psychological, and the nutritional.
Which nutrients do you think are most important in maintaining mental health?
- Scott
Posted by Lamdage22 on April 1, 2022, at 20:57:47
In reply to Re: combining nardil and parnate ) SLS » Lamdage22, posted by SLS on April 1, 2022, at 20:16:40
> Which nutrients do you think are most important in maintaining mental health?
> - ScottAll nutrients you are deficient in. There are few if any nutrients that don't play a role in mental health. Some directly, others indirectly. Physical health has more influence on mental health than most people think. I'd say blood test the nutrients that people are most often deficient in.
Posted by Lamdage22 on April 2, 2022, at 0:42:05
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 1, 2022, at 20:57:47
> > Which nutrients do you think are most important in maintaining mental health?
> > - Scott
>
> All nutrients you are deficient in. There are few if any nutrients that don't play a role in mental health. Some directly, others indirectly. Physical health has more influence on mental health than most people think. I'd say blood test the nutrients that people are most often deficient in.
>
The nutrients not only people in general but people with your specific condition are most often deficient in.
Posted by undopaminergic on April 2, 2022, at 3:32:15
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 2, 2022, at 0:42:05
> > > Which nutrients do you think are most important in maintaining mental health?
> > > - Scott
> >
> > All nutrients you are deficient in. There are few if any nutrients that don't play a role in mental health. Some directly, others indirectly. Physical health has more influence on mental health than most people think. I'd say blood test the nutrients that people are most often deficient in.
> >
> The nutrients not only people in general but people with your specific condition are most often deficient in.
>What specific nutrients are you thinking of? I have tried vitamins and many other supplements without noticing any change.
-undopaminergic
Posted by Lamdage22 on April 2, 2022, at 3:41:47
In reply to Re: combining nardil and parnate ) SLS, posted by undopaminergic on April 2, 2022, at 3:32:15
> What specific nutrients are you thinking of? I have tried vitamins and many other supplements without noticing any change.
>
> -undopaminergicMy opinion:
Iodine deficiency is common in europe. D3 deficiency. B12 can be low. Iron can be low. Magnesium. Zinc.
Then neorotransmitter precursors Tryptophan, Phenylalanine, Tyrosine. With these caution may be advised with certain psyhmeds.
Take K2 MK7 all trans also if you take D3. Also EPA/DHA is often low.
Posted by Lamdage22 on April 2, 2022, at 3:48:05
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 2, 2022, at 3:41:47
These are the basics in my mind. If you are not an excellent negotiator, testing these will cost. To me it was worth it.
Posted by SLS on April 2, 2022, at 16:52:35
In reply to Re: combining nardil and parnate ) SLS, posted by undopaminergic on April 2, 2022, at 3:32:15
> > > > Which nutrients do you think are most important in maintaining mental health?
> > > > - Scott
> > >
> > > All nutrients you are deficient in. There are few if any nutrients that don't play a role in mental health. Some directly, others indirectly. Physical health has more influence on mental health than most people think. I'd say blood test the nutrients that people are most often deficient in.
> > >
> > The nutrients not only people in general but people with your specific condition are most often deficient in.
> >
>
> What specific nutrients are you thinking of? I have tried vitamins and many other supplements without noticing any change.
>
> -undopaminergic
>
I myself have had only minimal success from using vitamins, supplements, or nutriceuticals. The one substance that I noticed a marked improvement with was L-methylfolate in the form of Deplin. It was significant, but transient. I think it helped for about three months. I guess that's why it never caught on. Since my knowledge of basic nutritional needs and using supra-therapeutic dosages of nutrients, I was looking to learn something from Lamdage.
- Scott
Posted by Lamdage22 on April 2, 2022, at 23:24:25
In reply to Re: combining nardil and parnate ) SLS, posted by SLS on April 2, 2022, at 16:52:35
I recommend getting tested. You can't say supplements don't work because they do, IF you have a deficiency. If you don't there is no point in supplementing. Iodine is best tested in urine. I think I had more deficiencies than average.
Posted by Lamdage22 on April 3, 2022, at 0:20:20
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 2, 2022, at 23:24:25
Some here spend thousands on Transmagnetic whatever, so why not spend 150 on a nutrient test.
Posted by rose45 on April 3, 2022, at 12:19:46
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 1, 2022, at 20:09:36
Im still alive, Scott. Thank you for asking, but totally suicidal, although I dont think I will ever do it. But cant face however many years are left for me to live in this state. My memory is practically non existent,
and I can't do the simplest of things but Im afraid to come off the lamotrigine which I know is the culprit as I tried, and the depression and anxiety got so much worse. NHS want me to add lithium. I already am unable to come off tcp,lamotrigine and olanzapine.Is there any hope for me? I just cannot see any.
Posted by rose45 on April 4, 2022, at 9:54:26
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 1, 2022, at 20:09:36
> Hi, Rose.
>
> > > A "bridge" is meant to be a temporary treatment to mitigate any suffering that occur during a washout period.
> > >
> > > For me, I think there are 2 drugs that make good candidates tor being a bridges.
> > >
> > > 1. Zyprexa (olanzapine)
> > > 2. Saphris (asenapine)
> > >
> > > Although Abilify (aripiprazole) might work well to mitigate an antidepressant withdrawal syndrome, discontinuing it is problematic and produces anxiety as its own withdrawal syndrome.
> > >
> > >
> > > - Scott
> >
> > Isn't Olanzapine also very difficult to come off?
>
>
> That's a good point. I have not had a problem with olanzapine discontinuation the few time I took it. Maybe I just got lucky. Is anxiety a withdrawal symptom of olanzapine discontinuation?
>
> I don't think I ever asked you how you were feeling.
>
> Don't worry, I won't start now...
>
> Silliness aside, are you hanging in there?
>
>
> - ScottIm hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
Posted by undopaminergic on April 4, 2022, at 10:24:05
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
> Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
>
>It sounds like it can't get much worse, or I wouldn't ask, but have you ever tried psychedelics?
-undopaminergic
Posted by Lamdage22 on April 4, 2022, at 11:33:25
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
Rose, Lithium can calm your suicidal thoughts down quite a bit. Can you get low dose? I am on 225. I recall SLS thinks it is essential for him too. Few side effects at low dose. Hope this helps.
Posted by Lamdage22 on April 4, 2022, at 11:36:37
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
What is tcp?
Posted by rose45 on April 4, 2022, at 11:49:47
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 11:33:25
> Rose, Lithium can calm your suicidal thoughts down quite a bit. Can you get low dose? I am on 225. I recall SLS thinks it is essential for him too. Few side effects at low dose. Hope this helps.
I will try to limit it to low dose, even if they dont agree..... Why are you taking it ?
But my main problem is this dreadful anxiety, which used to be covered up by the tcp when it was working. Not sure if lithium can help with anxiety?
Posted by Lamdage22 on April 4, 2022, at 12:27:49
In reply to Re: combining nardil and parnate ) SLS » Lamdage22, posted by rose45 on April 4, 2022, at 11:49:47
Specifically against suicidal thoughts. And for neuroprotection. It is basically a mineral. You'll find it in water in varying conncentrations. Not sure about anxiety, maybe not as much. But suicidal thoughts hurt. At least me.
> I will try to limit it to low dose, even if they dont agree..... Why are you taking it ?
> But my main problem is this dreadful anxiety, which used to be covered up by the tcp when it was working. Not sure if lithium can help with anxiety?
Posted by Lamdage22 on April 4, 2022, at 12:32:43
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 12:27:49
I like liposomal GABA for anxiety. It is a version of GABA that crosses the blood brain barrier. There is a product that also has Theanine in it. It doesn't hurt. I can't sleep without it.
https://www.quicksilverscientific.com/all-products/gaba-l-theanine/Not getting any money from them. You guys know I'm real.
Posted by undopaminergic on April 4, 2022, at 12:33:50
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 11:36:37
> What is tcp?
TranylCyPromine. Or Transmission Control Protocol (which gets used every time you access a web site).
-undopaminergic
Posted by Lamdage22 on April 4, 2022, at 12:35:49
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 12:32:43
Is there any history of psychosis or mania? If so, caution with psychedelics or stimulants. Thats just my cents.
Posted by Lamdage22 on April 4, 2022, at 12:42:04
In reply to Re: combining nardil and parnate ) SLS, posted by undopaminergic on April 4, 2022, at 12:33:50
> > What is tcp?
>
> TranylCyPromine. Or Transmission Control Protocol (which gets used every time you access a web site).
>
> -undopaminergicProbably the former in this context.
Posted by SLS on April 4, 2022, at 13:22:53
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
Hi, Rose.
> >
> > I don't think I ever asked you how you were feeling.
> >
> > Don't worry, I won't start now...
> >
> > Silliness aside, are you hanging in there?
> >
> >
> > - Scott> Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
.
No!
Lithium *is* essential for me!
However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
> Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
I have responded best to Parnate when it was combined with either desipramine or nortriptyline.- Scott
Posted by SLS on April 4, 2022, at 13:27:01
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
Hi, Rose.
> >
> > I don't think I ever asked you how you were feeling.
> >
> > Don't worry, I won't start now...
> >
> > Silliness aside, are you hanging in there?
> >
> >
> > - Scott> Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
.
No!
Lithium *is* essential for me!
However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
> Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
I have responded best to Parnate when it was combined with either desipramine or nortriptyline.If you have never tried Nardil, I strongly encourage you to do so. It is much better for anxiety than is Parnate. For me, Nardil makes me feel much "brighter" than Parnate. Nardil is also "pro-social". I did not find Parnate capable of doing this, even when it produced a remission of depression.
- Scott
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.