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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by rogdog on January 4, 2001, at 0:00:27
I NEED SOME SUGGESTIONS, I POSTED JUST A COUPLE OF DAYS AGO ABOUT MY PROBLEM BUT I REALLY DIDNT EXPLAIN MY DELEMA. I AM ON ZYPREXA, XANAX AND NARDIL.. THE NARDIL WAS STARTED 2 WEEKS AGO, THE XANAX AND ZYPREXA HAS BEEN A COUPLE OF MONTHS NOW. I DONT THINK THE ZYPREXA IS DOING JACK! BUT I DO KNOW THE XANAX HELPS, AND THE NARDIL HELPS SOMETIMES.. I AM WONDERING IF I SHOULD STAICK WITH IT OR TRY SOMETHING ELSE.. ANY SUGGESTIONS? MY DOC REALLY DOESNT HAVE ANY IDEAS , HE REALLY LETS ME SELECT FROM THE LIST OF DRUGS THAT ARE AVAILABLE AND HE WRITES THE "SCRIPT". THANKS GUYS, ROGDOG
Posted by Cam W. on January 4, 2001, at 6:39:58
In reply to STICK WITH IT, OR QUIT?, posted by rogdog on January 4, 2001, at 0:00:27
rogdog - If I were you I'd get a second opinion from a different doctor. Ask your doc to refer you to someone who might be able to help you. Even doctors or psychiatrists, when ill, should not self-prescribe, as they are not able to make an objective diagnoses that someone removed from the situation could. As for the Nardil, I believe that 2 weeks is far too soon to give up. Antidepressants sometimes take 8 weeks or longer to exert their effects and it is always someone else who will notice the improvement before you will. It is nearly impossible to treat one's self, especially for a mental disorder, where one's judgement could be impaired.
Hope this helps - Cam
Posted by JohnL on January 6, 2001, at 4:43:25
In reply to STICK WITH IT, OR QUIT?, posted by rogdog on January 4, 2001, at 0:00:27
> I NEED SOME SUGGESTIONS, I POSTED JUST A COUPLE OF DAYS AGO ABOUT MY PROBLEM BUT I REALLY DIDNT EXPLAIN MY DELEMA. I AM ON ZYPREXA, XANAX AND NARDIL.. THE NARDIL WAS STARTED 2 WEEKS AGO, THE XANAX AND ZYPREXA HAS BEEN A COUPLE OF MONTHS NOW. I DONT THINK THE ZYPREXA IS DOING JACK! BUT I DO KNOW THE XANAX HELPS, AND THE NARDIL HELPS SOMETIMES.. I AM WONDERING IF I SHOULD STAICK WITH IT OR TRY SOMETHING ELSE.. ANY SUGGESTIONS? MY DOC REALLY DOESNT HAVE ANY IDEAS , HE REALLY LETS ME SELECT FROM THE LIST OF DRUGS THAT ARE AVAILABLE AND HE WRITES THE "SCRIPT". THANKS GUYS, ROGDOG
Rogdog,
If the Zyprexa is not helping then you could consider stopping it. Antipsychotics are fairly heavy duty drugs, and I see no sense in taking one if the benefits don't far outweigh the risks. In your case there don't appear to be any benefits at all.Xanax could be continued since it helps somewhat. There are so many chemical problems that can happen in the brain, and Xanax appears to be helping with one of them, though there is obviously more going on.
Nardil will generally take longer to work, if it is going to work. Since it's been two weeks already, you might want to look at a calendar and mark 6 weeks from now as decision time. Many people here have commented over the years that when an MAOI works, it usually does so abruptly after a long wait. Sometime between now and 6 weeks you might wake up one day and poof, it's working.
If Nardil doesn't help, then at least you'll know that whatever chemistry problem there is, it isn't much related to low levels of neurotransmitters or downregulation of receptors. It would be something else. You could then focus on drugs that do not have neuro reuptake inhibition or MAO inhibition as mechanisms, because you already would know that raising neuro levels didn't help. Perhaps receptors need to be stimulated or simulated, in which case Ritalin, Adderall, Adrafinil, or Modafinil would do the job. These can work well when neuro levels are fine, but the receptors are not functioning properly for whatever reason (genetic blockage, heavy metal blockage, damage, patchy low blood flow, etc). The receptors just can't fulfill their end of the deal, no matter how much neuros are floating around.
In summary, in your shoes I would drop Zyprexa, keep Xanax, count down 6 more weeks on Nardil, and if needed after that explore the psychostimulant class. Me personal fav is Adrafinil.
I've seen many people get well when they self direct their own care. I think taking an active role in medication choice is an important part of getting well, as long as that is the way the patient wants to do it. I respect doctors very highly who allow patients to take an active decision making role. The doctor is in a perfect position to explain the pros and cons of each choice, to review the risks, to make sure it's safe, and to pose alternatives to think about. I do not think the patient's judgement is clouded. Quite the opposite. Besides which, if judgement was impaired, it would be the doctor's job to steer the patient in the right direction. It should still ultimately be the patient's choice, but at least a doctor can point out anything that appears to be impaired judgement. Taking ownership in one's own care is quite positive as I see it, though some patients would rather just have a doctor make all the decisions. I like to make my own drug choices. Nobody knows my body better than me. Nobody knows my side effects better than me. Or my symptoms. Or my gut instincts. Or my own research focused just on me instead of a universe.
I don't think you need a second opinion. The best another doctor could do is flip a coin or pick a card, any card, at random. Their guess is no better than yours, and rarely better than the odds of flipping a coin. I think where a second opinion is warranted is when you just don't like the doctor, they treat you badly, or they seem stupid, uncaring, whatever. In your case you have a highly cooperative doctor. I like that.
John
Posted by rogdog on January 8, 2001, at 2:00:10
In reply to Re: STICK WITH IT, OR QUIT?, posted by JohnL on January 6, 2001, at 4:43:25
thanks John, I think I will take your advice. What do you think about switching from xanax to clonazpam? or just stick with what works.... I seem to be slowly increasing my dose, I dont really mind "popping more" pills,but mabey it might be better to switch and try Klonopin..
Posted by JohnL on January 8, 2001, at 4:28:56
In reply to Re: Thanks for the advice guys!/ question for john, posted by rogdog on January 8, 2001, at 2:00:10
> thanks John, I think I will take your advice. What do you think about switching from xanax to clonazpam? or just stick with what works.... I seem to be slowly increasing my dose, I dont really mind "popping more" pills,but mabey it might be better to switch and try Klonopin..
Howdy again,
Might Klonopin be better than Xanax? I have no clue. It would vary considerably from person to person. However, I just think that if a med from a particular class of meds works somewhat, it is worth sampling similar meds in that class to see if a superior match exists. You can always return to Xanax if you don't find another one you like better. The cool thing with these comparisons is that you don't need a long trial. One or two weeks would be enough for you to decide. You could even it plan it that way with your doctor. Ask him to prescribe Klonopin for two weeks. Have him renew the prescription or switch you back to Xanax after the trial, or maybe even try a different one like maybe Valium.I like to know for sure that I'm on the best med in a particular class of meds. The only way to know for sure is to try the different ones. In the SSRI category for example, I've tried them all. I know the subtle and not-so-subtle differences between them, which ones make me tired, which ones ruin my sleep, which ones give me which kind of sexual dysfunction, which kinds numb me instead of fix me, etc. It's nice to not have to wonder if another drug might be better. The best way to know for sure is to compare them. Obviously this is not appropriate for someone who is suicidal, psychotic, or unstable. But if someone is relatively functional, it's worth the effort, in my opinion. There's just no other way to know for sure whether Xanax or Klonopin is better for you without actually trying them both for comparison.
John
This is the end of the thread.
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