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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Bob on November 15, 1999, at 11:42:24
I promised to keep people filled in, so here goes.
I am starting this week at 1/16th the dose of Zoloft that I was on just a few weeks ago. Up to October 25, it had been 200mg/d since last January or so. On the 25th, I cut to 100mg; Nov 1, 50 mg; Nov 8, 25mg; and now 25mg every other day until I run out of the stuff (at least two more weeks). My pdoc warned me to watch out for withdrawal at the low end, but the only thing I've really experienced that was a caution was some borderline manic tendencies from one to two weeks ago (I got out of it with only $500 of needless, impulse spending or so). Otherwise, I'm now a convert to TCAs since I'm doing so much better on notriptyline and clonazepam alone -- higher baseline mood and more plasticity or range of motion to my moods. The funny thing is that I can see how slight the improvement has been over the last three weeks, so I realize there's lots of room left for improvement. Most noticably is my teflon response to moods. My mood is very situation-dependent and things still level off to a fairly gray area where my social contacts are concerned ... I'm still just as socially detached even tho I feel better inside. So, the next big thing will be figuring out how to get my reactions to be more like velcro than teflon, if you know what I mean.
As for Enada (NADH), it was silly of me to start it in the middle of reducing my dosage of a sedating med. Now, I can't tell if my increased energy level is due to elevated NADH levels or decreased Zoloft levels. I'm guessing my increased energy may be due in large measure to the Enada, tho, as I'm in this kind of mixed-sleepiness-state. The nortriptyline+clonazepam combo is still pretty sedating, but I have a bit more in me to fight the drowsiness successfully, particularly in terms of keeping my brain awake enough to stand up, walk around, go splash water in my face, all those sorts of things instead of just nodding off.
One last thing -- I now have an otolaryngologist (1 word, 7 syllables ... he must get money up the ying-yang for doing this stuff) on my medical team (and I'm just so damned pleased with myself about it, too ;^)! It was a really funny exam ... he had a second doctor there (I guess) training for the specialty. Had me imitate snoring while he used two tongue depressors to push around in my mouth ... third try shut me down completely -- it was so weird to be conscious and recognize that feeling that I usually get while I'm asleep. So, anyway, he bascially threatened to kick my butt if I didn't start working on shedding my Zoloft 40 now that I effectively off of it. He's having me do an at-home sleep study, and then we'll see just what can be done about the too big base of my too big tongue for what he said is already a big mouth (and I had hardly said anything by then -- such a shrewd judge of character!).
That's all, friends, from the medical front. Hope to be able to report back about the workplace discrimination front prior to (US) Thanksgiving next week or, if not then, soon after.
Cheers,
Bob
Posted by Phil on November 15, 1999, at 12:20:28
In reply to A follow-up on my meds for those interested..., posted by Bob on November 15, 1999, at 11:42:24
Hey Bob,
I saw a proctologist years ago, Dr. Crouch!
Sonofabitch! ;-) And I thought seeing a shrink for the first time was stressful.Phil
ps...good luck on your snorage test.
Posted by Sean on November 15, 1999, at 12:38:19
In reply to A follow-up on my meds for those interested..., posted by Bob on November 15, 1999, at 11:42:24
> I promised to keep people filled in, so here goes.
>
> I am starting this week at 1/16th the dose of Zoloft that I was on just a few weeks ago. Up to October 25, it had been 200mg/d since last January or so. On the 25th, I cut to 100mg; Nov 1, 50 mg; Nov 8, 25mg; and now 25mg every other day until I run out of the stuff (at least two more weeks). My pdoc warned me to watch out for withdrawal at the low end, but the only thing I've really experienced that was a caution was some borderline manic tendencies from one to two weeks ago (I got out of it with only $500 of needless, impulse spending or so). Otherwise, I'm now a convert to TCAs since I'm doing so much better on notriptyline and clonazepam alone -- higher baseline mood and more plasticity or range of motion to my moods. The funny thing is that I can see how slight the improvement has been over the last three weeks, so I realize there's lots of room left for improvement. Most noticably is my teflon response to moods. My mood is very situation-dependent and things still level off to a fairly gray area where my social contacts are concerned ... I'm still just as socially detached even tho I feel better inside. So, the next big thing will be figuring out how to get my reactions to be more like velcro than teflon, if you know what I mean.
>
> As for Enada (NADH), it was silly of me to start it in the middle of reducing my dosage of a sedating med. Now, I can't tell if my increased energy level is due to elevated NADH levels or decreased Zoloft levels. I'm guessing my increased energy may be due in large measure to the Enada, tho, as I'm in this kind of mixed-sleepiness-state. The nortriptyline+clonazepam combo is still pretty sedating, but I have a bit more in me to fight the drowsiness successfully, particularly in terms of keeping my brain awake enough to stand up, walk around, go splash water in my face, all those sorts of things instead of just nodding off.
>
> One last thing -- I now have an otolaryngologist (1 word, 7 syllables ... he must get money up the ying-yang for doing this stuff) on my medical team (and I'm just so damned pleased with myself about it, too ;^)! It was a really funny exam ... he had a second doctor there (I guess) training for the specialty. Had me imitate snoring while he used two tongue depressors to push around in my mouth ... third try shut me down completely -- it was so weird to be conscious and recognize that feeling that I usually get while I'm asleep. So, anyway, he bascially threatened to kick my butt if I didn't start working on shedding my Zoloft 40 now that I effectively off of it. He's having me do an at-home sleep study, and then we'll see just what can be done about the too big base of my too big tongue for what he said is already a big mouth (and I had hardly said anything by then -- such a shrewd judge of character!).
>
> That's all, friends, from the medical front. Hope to be able to report back about the workplace discrimination front prior to (US) Thanksgiving next week or, if not then, soon after.
>
> Cheers,
> BobBob -
Very interesting. I notice the same thing with
amitriptyline. I think the TCA's are for some
people the way to go. I just feel more like
myself and welcome the sedating aspect of them.
Sleep is crucial for me - if I miss a night of
sleep I'm hypomanic by the next day and this
often cascades into a week or two of sleeping
on a few hours a night. Even though TCA's are
supposed to be bad for bipolar symptoms, I think
the sleep disruption of the SSRI's is worse...My 2-cents...
Sean.
Posted by Noa on November 16, 1999, at 2:29:32
In reply to Re: A follow-up on my meds for those interested..., posted by Sean on November 15, 1999, at 12:38:19
Great, Bob. And I think you will feel better without the snoring. Sleep is an important piece of the puzzle.
Posted by dj on November 16, 1999, at 12:16:29
In reply to Re: A follow-up on my meds for those interested..., posted by Noa on November 16, 1999, at 2:29:32
> Great, Bob. And I think you will feel better without the snoring. Sleep is an important piece > of the puzzle.
Though the Prozac, Wellbutrin combo. leaves me feeling pretty good most of the time, I find that I am still fullly on when it time to crash and some mornings like this a.m. feeling empy, discombobulated and exhasted. and not because I'm snoring, though on mornings like this my bedsheets are usually pretty tousled indicating I've had a restless night..And then there is the feeling like a huge empty, pressurized space behind my eyeballs, where my sinal caviities are I believe. May be related to tightening of TMJ musculature or frontal lobe agiation or ????
Hard to know what to make of any of this stuff by-times as this occurs when I'm not on ADs by times. And hence I feel exhausted, dispirited, empty and discombobulated some mornings...
Posted by AA on November 16, 1999, at 22:18:12
In reply to A follow-up on my meds for those interested..., posted by Bob on November 15, 1999, at 11:42:24
I was on Aventyl years ago when SSRI's weren't available. It didn't seem to effect my mood much, but I was more active socially etc.. I don't recall any troubling side-effects. I think I was on 75mg. The next AD I tried was Trazodone, up to 300mg. For the first few days I was sort of giddy and laughed inappropriately. This soon passed. One of the most interesting things I noticed was more vivid symbol laden dreams. These could be quite entertaining sometimes. I have given these dreams some thought and I think they reflect unresolved worrisome issues that perhaps I had suppressed from my conscious mind. I dreamed of tornados quite a bit but what this symbolizes isn't real clear, destructive tendencies, fascination with power, breasts?? There also seemed to be a secret or hidden happy place that reoccurred in my dreams. My brother had similiar experiences with Sinequan. You probably know the down-up side of Trazodone. I have tried most of the SSRI's and didn't tolerate any of them well and didn't stick with any of them. I tolerated Zoloft best and Prozac worst, Prozac was like strychnine to me, that is a very unpleasant stimulation. Wellbutrin wasn't to bad, but I dropped it because of general weirdness. Anafranil was weird too. Lethargy and sexual dysfunction were another down side to SSRI's, Luvox, Paxil. Whats the Klonopin for, anxiety? I tried it once and thought it was too powerful, I was zonked out for a couple days. What does NADH refer to?
Posted by Bob on November 16, 1999, at 23:42:38
In reply to Re: A follow-up on my meds for those interested..., posted by AA on November 16, 1999, at 22:18:12
Man, Phil, don't say that word! All apologies to any rap fans out there, but among my friends here we have a new way to describe something nastier than nasty -- "That is so dre!" (Yes, prounced "dray" and if you can't figure that TLA -- DRE -- out, just think of the exam a proctologist (ooh! Now I've sait it!) does with his finger...).
As for the TCAs seeming to be forgotten -- it seems like there's such a rush to SSRIs as the first line fo treatment because they're supposed to be so clean and gentle, I guess ... sure as heck not for me.
...although I *do* remember the very first day I took my very first pill -- 50mg of Zoloft...I dunno, maybe I told this story before, but its too funny. An hour later, I was off doing some consulting in the elementary school in Yonkers, NY ... I knew something was up because I was just so giddy on the train up ... walked into the science center where the two specialists (with whom I worked), five or so teachers, and NO KIDS (thank God!) were sitting, having a meeting, and I just burst out with "Guess who I took a shower with this morning?!" Not a single smidgen of social inhibition in this boy! Well, anyway, it was my 6 month old German Shepard pup....
>Whats the Klonopin for, anxiety? I tried it once and thought it was too powerful, I was zonked out for a couple days.
AA--yes, the K's for anxiety. Just i mg/day for me.
>What does NADH refer to?
You may want to check out www.nadh.com. Lots of info, if you can manage the hideous site navigation. Too Much Info, not enough site management. They have some interesting "guided tours" to explain what it does. Here's a quote:
"NADH or nicotinamide adenine dinucleotide is a natural coenzyme with the ‘H’ standing for hydrogen."
As a coenzyme, its the trigger that causes ATP to shed one of those P's in cellular respiration, releasing energy as a result. It's another one of those "antioxidant" "enzymes" that we seem to have in abundance when we're young but produce less and less of as we get older, like SOD (super oxide dismutase).
And as CC would have me say, while I may not have any sound scientific evidence of my own (since I tainted the experiment with too many variables) to go on, I do have some faith (there's that F word again!) that it is having some effect. We'll see in a month.
Bob
Posted by AA on November 17, 1999, at 3:34:19
In reply to Ouch!, posted by Bob on November 16, 1999, at 23:42:38
I thought it might be noradrenalin something something, how can you tell what the levels are, blood work? There's NADPH too, right? Krebs cycle and all that. Is c-AMP a big deal? It was years back it seemed. Why not Xanax, to addictive? I wonder what would happen if you mixed Trazodone with Viagra. I suppose it would keep you up all night, and then some.
Posted by Bob on November 17, 1999, at 15:06:32
In reply to Re: Ouch!, posted by AA on November 17, 1999, at 3:34:19
> It was years back it seemed...
Years? Is that all? Decades (2) for me. Maybe someone else can answer all that Krebs cycle stuff, but yes it does have something to do with that (I remember THAT much from what I read at their site).
>Why not Xanax, too addictive?
My pdoc like to stick to "safer" options rather than following fashions. From all I've heard, I'm glad he didn't pick xanax!
>I wonder what would happen if you mixed Trazodone with Viagra. I suppose it would keep you up all night, and then some.
Now THAT really hurts, too!!
Bob
Posted by AA on November 18, 1999, at 18:46:55
In reply to Re: Ouch! again!!, posted by Bob on November 17, 1999, at 15:06:32
Have you ever heard of pyroglutamic acid. Its a nootropic. It also occurs in the body naturally in fairly large quantities. It is supposed to enhance memory and even the "consolidation of memory". It might be worth a try.
This is the end of the thread.
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