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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Elizabeth on December 14, 1998, at 4:37:09
OK, so I am still having some symptoms though doing much better on 20mg Parnate. (I have fairly generic unipolar depression.)
I have these brief depressions, lasting a couple days, where I am very tearful and unpleasant (both to myself and others), lose interest in life, get very irritable, feel intense self-reproach, stop eating, feel excessively tired, etc. I also have mysterious REM rebound (vivid dreaming and RBD) during these periods (Klonopin does not seem to prevent this).
My concentration is still a mess as well.
I am trying to think of things I can add to the Parnate. I have spontaneous hypertensive reactions if I try to go above 20mg. (I have tried most other antidepressants or classes of antidepressants available in this country, Remeron being the main exception. I am uninterested in trying moclobemide because of the consistent reports I have been hearing about its mediocre performance.)
I have already tried:
- Depakote (no effect)
- lithium (no effect)
- Neurontin (excessive sedation even at low doses)
- Lamictal (no effect)
- Zyprexa, Seroquel (excessive sedation, dysphoria)
- Risperdal (agitation)Other things I have thought of are:
- pindolol (might worsen orthostatic hypotension but provide a measure of protection against hypertensive episodes)
- Wellbutrin (might worsen anorexia, insomnia, anxiety)
- naltrexone
- buprenorphine
- T3
- Topamax (might worsen anorexia)
- clonidine or guanfacine
- ginkgo biloba (if I can get confirmation that this has been used safely before)
- stimulants (worried about hypertension though, as well as increased anxiety)
- bromocriptine, pergolide, amantadine
- TCA - although previously I have tolerated these poorly (especially anticholinergic effects, even with desipramine; wondering how amoxapine is in this regard or whether there are ways to reverse the side effects) (I am aware of the possible risks and the need to stop the MAOI, start the TCA, and then reinstate the MAOI)
- a course of ECTPart of my problem is the balancing the need to improve my concentration with the need to avoid excessive spaceyness or sedation.
Anyway, if anyone has other suggestions or ideas, or experience with any of these (especially in combo with an MAOI), I'd like to hear about it. Thanks.
Posted by Seamus McGill on December 28, 1998, at 10:18:17
In reply to need to augment MAOI, not sure what to try next, posted by Elizabeth on December 14, 1998, at 4:37:09
Elizabeth,
I've tried adding Wellbutrin (150 mg, once a day) to Parnate 20 mg bid, but the increased tension was unbearable.
I've lately started Armour Thyroid 30 mg (not much!)once a day and like the results.
Oddly enough, I feel more relaxed; I eat and sleep better. No other side effects.
http://www.dr-bob.org/tips/split/Thyroid-augmentation-of-an.html
used to be a lot longer (Hey, where'd it all go, Dr. Bob?)My 2¢ worth.
Seamus
Posted by Dr. Bob on December 30, 1998, at 21:44:41
In reply to Re: need to augment MAOI, not sure what to try next, posted by Seamus McGill on December 28, 1998, at 10:18:17
> http://www.dr-bob.org/tips/split/Thyroid-augmentation-of-an.html
> used to be a lot longer (Hey, where'd it all go, Dr. Bob?)Maybe you're thinking of </tips/split/Thyroid-replacement.html>?
Bob
Posted by Elizabeth on January 1, 1999, at 16:58:22
In reply to Re: need to augment MAOI, not sure what to try next, posted by Seamus McGill on December 28, 1998, at 10:18:17
> Elizabeth,
> I've tried adding Wellbutrin (150 mg, once a day) to Parnate 20 mg bid, but the increased tension was unbearable.
> I've lately started Armour Thyroid 30 mg (not much!)once a day and like the results.
> Oddly enough, I feel more relaxed; I eat and sleep better. No other side effects.
> http://www.dr-bob.org/tips/split/Thyroid-augmentation-of-an.html
> used to be a lot longer (Hey, where'd it all go, Dr. Bob?)
> My 2¢ worth.
> SeamusHi Seamus. I've taken Wellbutrin before and it did make me really anxious. I've never tried the SR, though, with or without Parnate. I've read the various Tips (where do you think I get all these crazy ideas? :-). My doctor had mentioned the possibility of using T3; I think I will ask about it next time I talk to him.
Posted by Seamus on January 3, 1999, at 12:52:43
In reply to Tips on thyroid, posted by Dr. Bob on December 30, 1998, at 21:44:41
> Maybe you're thinking of ?
> BobI swear I couldn't find that ont he day I replied. 'Course it was the day of the crash, maybe that had something to do with it.
Thanks,
S
Posted by Elizabeth on January 19, 1999, at 0:57:57
In reply to Re: Tips on thyroid, posted by Seamus on January 3, 1999, at 12:52:43
> > Maybe you're thinking of ?
> > Bob
> I swear I couldn't find that ont he day I replied. 'Course it was the day of the crash, maybe that had something to do with it.Hi dudes. Thanks for the replies...I ended up starting pemoline (which I've taken before) a couple days ago. I also had a TSH and my doctor is thinking about adding T3 as well (he's also looking into buprenorphine but seems less enthusiastic about it).
Any thoughts on the use of thyroid hormones and stimulants in depression/anxiety? (I have partially remitted major depression and panic disorder.)
Posted by lg on October 24, 1999, at 15:31:40
In reply to Re: Tips on thyroid, posted by Elizabeth on January 19, 1999, at 0:57:57
I take Armour(sp?) thyroid.From pigs,and natural
I think, not synthetic.My Doc says it has T3 and
T4 in one pill.Supposed to replace my cytomel and
synthroid.LG
Posted by Scott L. Schofield on November 7, 1999, at 8:32:04
In reply to Re: Tips on thyroid, posted by lg on October 24, 1999, at 15:31:40
>
> I take Armour(sp?) thyroid.From pigs,and natural
> I think, not synthetic.My Doc says it has T3 and
> T4 in one pill.Supposed to replace my cytomel and
> synthroid.LGT3 (Cytomel) made feel *much* worse. I found T4 (Synthroid) to be somewhat helpful. I think T4 is often overlooked because of the wealth of old literature choosing T3 as the augmenting agent. I wonder if determing an individual's T4/T3 ratio might be helpful in choosing which to try first.
- Scott
Posted by Noa on November 7, 1999, at 9:32:58
In reply to Re: Tips on thyroid, posted by Scott L. Schofield on November 7, 1999, at 8:32:04
I take both T3 and T4, and my doctor told me that with thyroid meds, the brand name makes a difference--not to use the generic, for some reason, not as reliable. A friend of mine has been taking generic T4 with no improvement, and is up to a huge dose with no difference. I suggested she ask the doc about the brand/generic issues.
Posted by andrewb on November 7, 1999, at 23:31:31
In reply to Re: Tips on thyroid, posted by Scott L. Schofield on November 7, 1999, at 8:32:04
In what way did T3 make you feel much worse? Do you suffer from hypothyroidism or are you augmenting your antidepressant?
Posted by Scott L. Schofield on November 8, 1999, at 5:24:20
In reply to Q for Scott, posted by andrewb on November 7, 1999, at 23:31:31
> In what way did T3 make you feel much worse? Do you suffer from hypothyroidism or are you augmenting your antidepressant?
I suffer from treatment-resistant bipolar depression. My major symptoms include a severe lack of energy, inability to concentrate, mild anxiety and some social-phobia. T3 (Cytomel) was introduced as an augmenting agent while I was taking the tricyclic antidepressant imipramine (Tofranil). I experienced a pronounced worsening of all of these symptoms immediately. The Cytomel was discontinued and the worsened state disappeared. When it was reintroduced, I again experienced an exacerbation of the depression.
My thyroid tests in the past have not shown any overt hypothyroidism. However, since nothing else seems to be working well enough for me to get back to work, I don't want to rule out anything.
What are your symptoms?
What, if anything, has helped you in the past?
- Scott
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