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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Anna P. on April 29, 2002, at 16:13:40
Hi there,
I have two weeks left that I can function. my SAD symptoms arrive since the past three years promptly around may 10-13. There is no help. I developed the tolerance to psychiatric medication including ADs, mood stabilizers and antipsychotics. I tried everything available. In january I had ECT. It gave me some energy to function as I was not able to get up from bed, but depression is still there.
I plan to try Dothiepin and Clozapine this time, although they are sedative, just to diminish suffering. I'm not bipolar, but for me the antidepressant doesn't work by itself. I've tried clozapine last year, but I slept after it.
Anyway, I know i will suffer, and there is no help. Anyone can relate?Anna P.
Posted by rainbowlight on April 29, 2002, at 17:48:56
In reply to I have 2 weeks left to SAD, need support please, posted by Anna P. on April 29, 2002, at 16:13:40
I know you have probably tried this, but I thought I would ask you if you have tried sitting in front of one of those special light boxes everyday that are used to treat SAD? I have heard they are very helpful. I am sorry you are suffering so much. I hope the new meds work out for you.
Posted by IsoM on April 29, 2002, at 18:09:38
In reply to I have 2 weeks left to SAD, need support please, posted by Anna P. on April 29, 2002, at 16:13:40
Anna, you must be south of the equator. I had to reread your post before it hit me. I found that a stimulant helped with my winter SAD more than anything else. It woke me up & helped with the other symptoms too. Have you ever tried a stimulant of any type for your SAD?
Posted by Ritch on April 29, 2002, at 23:39:24
In reply to I have 2 weeks left to SAD, need support please, posted by Anna P. on April 29, 2002, at 16:13:40
> Hi there,
>
> I have two weeks left that I can function. my SAD symptoms arrive since the past three years promptly around may 10-13. There is no help. I developed the tolerance to psychiatric medication including ADs, mood stabilizers and antipsychotics. I tried everything available. In january I had ECT. It gave me some energy to function as I was not able to get up from bed, but depression is still there.
> I plan to try Dothiepin and Clozapine this time, although they are sedative, just to diminish suffering. I'm not bipolar, but for me the antidepressant doesn't work by itself. I've tried clozapine last year, but I slept after it.
> Anyway, I know i will suffer, and there is no help. Anyone can relate?
>
> Anna P.
Anna P.,One word for SAD: psychostimulants. I get SAD episodes twice yearly. One from mid-November to mid-January and the other from late-June to late-August. The *only* medication that has thus far worked 100% for them is Adderall (and not much either). My primary symptoms during those episodes strongly resemble narcolepsy and depressive limbic ADD.
hope this helps,
Mitch
Posted by Anna P. on April 30, 2002, at 0:06:58
In reply to Re: I have 2 weeks left to SAD, need support please » Anna P., posted by IsoM on April 29, 2002, at 18:09:38
Yes, unfortunately I've tried stimulants as well, and also I didn't mention I tried dopamine agonists. I have treatment-resistant depression with SAD on top of that. I have SAD twice a year. My major symptoms in may/june episode are those like in severe depression:psychomotor slow down, crying, mild anxiety; it's hard to describe it, the pain is unberable.
Last year I had a family event and had people invited over on May 13. I got my depression and became dysfunctional. I begged my doctor for help. He prescribed Provigil in addition to Reboxetine I was taking at that time. Provigil worked 4 days, but saved my event.
I don't believe much in light boxes. I tried gro-light lamps for plants once. Maybe they don't have enough intensity, but they caused nervousness and crying. On the other hand, Sulpiride worked almost immediately, than it pooped out. Last year I tried for my anergy in the fall: Stelazine and Trilafon. Each worked for about 3 weeks than faded. There are no more options left.
Thank you everyone for support.Anna P.
Posted by Ritch on April 30, 2002, at 9:56:35
In reply to Re: I have 2 weeks left to SAD, need support please, posted by Anna P. on April 30, 2002, at 0:06:58
> Yes, unfortunately I've tried stimulants as well, and also I didn't mention I tried dopamine agonists. I have treatment-resistant depression with SAD on top of that. I have SAD twice a year. My major symptoms in may/june episode are those like in severe depression:psychomotor slow down, crying, mild anxiety; it's hard to describe it, the pain is unberable.
>
> Last year I had a family event and had people invited over on May 13. I got my depression and became dysfunctional. I begged my doctor for help. He prescribed Provigil in addition to Reboxetine I was taking at that time. Provigil worked 4 days, but saved my event.
>
> I don't believe much in light boxes. I tried gro-light lamps for plants once. Maybe they don't have enough intensity, but they caused nervousness and crying. On the other hand, Sulpiride worked almost immediately, than it pooped out. Last year I tried for my anergy in the fall: Stelazine and Trilafon. Each worked for about 3 weeks than faded. There are no more options left.
> Thank you everyone for support.
>
> Anna P.Anna,
I found DA agonists not to be very helpful. You mention a lot of antipsychotics in your med lists. Were you diagnosed with psychotic depressions during these SAD episodes? Antipsychotics may settle acute agitation for a brief time, but may actually *worsen* depression (perhaps that is the "poop-out" you describe). Have you been seeing the same pdoc all of this time? You might consider a 2nd opinion. As far as light boxes go, you would have to get ones that are made for SAD and are intense enough. Also, they may only be of benefit during the wintertime episode. Have you tried MAOI's like selegiline or Parnate? Also, has your thyroid function been checked? I think you have a lot of options-you may need a different doctor IMO.
Mitch
Posted by Anna P. on April 30, 2002, at 13:15:15
In reply to Re: I have 2 weeks left to SAD, need support please » Anna P., posted by Ritch on April 30, 2002, at 9:56:35
> > Yes, unfortunately I've tried stimulants as well, and also I didn't mention I tried dopamine agonists. I have treatment-resistant depression with SAD on top of that. I have SAD twice a year. My major symptoms in may/june episode are those like in severe depression:psychomotor slow down, crying, mild anxiety; it's hard to describe it, the pain is unberable.
> >
> > Last year I had a family event and had people invited over on May 13. I got my depression and became dysfunctional. I begged my doctor for help. He prescribed Provigil in addition to Reboxetine I was taking at that time. Provigil worked 4 days, but saved my event.
> >
> > I don't believe much in light boxes. I tried gro-light lamps for plants once. Maybe they don't have enough intensity, but they caused nervousness and crying. On the other hand, Sulpiride worked almost immediately, than it pooped out. Last year I tried for my anergy in the fall: Stelazine and Trilafon. Each worked for about 3 weeks than faded. There are no more options left.
> > Thank you everyone for support.
> >
> > Anna P.
>
> Anna,
>
> I found DA agonists not to be very helpful. You mention a lot of antipsychotics in your med lists. Were you diagnosed with psychotic depressions during these SAD episodes? Antipsychotics may settle acute agitation for a brief time, but may actually *worsen* depression (perhaps that is the "poop-out" you describe). Have you been seeing the same pdoc all of this time? You might consider a 2nd opinion. As far as light boxes go, you would have to get ones that are made for SAD and are intense enough. Also, they may only be of benefit during the wintertime episode. Have you tried MAOI's like selegiline or Parnate? Also, has your thyroid function been checked? I think you have a lot of options-you may need a different doctor IMO.
>
> MitchThank you Mitch for your suggestions. I've tried all these options exept the real light boxes.
My depression isn't psychotic, butI used antipsychotics to augment antidepressants when nothing else was left. They did work for anergy for some time for me.
When I tried Parnate and Marplan it was too late, my body has developed immunity to antidepressants.
But I'm glad that I have tried Moclobemide and it's augmentation first before going to real MAOI's. It worked with no side effects for me until I developed the tolerance. And I checked my thyroid also.
I saw the best psychopharmacologists in the country. I went to New York and California. Dr Stahl said: vagus nerve stimulation. but what is the guarantee it will even work? It costs so much money.
Anna P.
Posted by polarbear206 on April 30, 2002, at 15:51:15
In reply to Re: I have 2 weeks left to SAD, Ritch, posted by Anna P. on April 30, 2002, at 13:15:15
> > > Yes, unfortunately I've tried stimulants as well, and also I didn't mention I tried dopamine agonists. I have treatment-resistant depression with SAD on top of that. I have SAD twice a year. My major symptoms in may/june episode are those like in severe depression:psychomotor slow down, crying, mild anxiety; it's hard to describe it, the pain is unberable.
> > >
> > > Last year I had a family event and had people invited over on May 13. I got my depression and became dysfunctional. I begged my doctor for help. He prescribed Provigil in addition to Reboxetine I was taking at that time. Provigil worked 4 days, but saved my event.
> > >
> > > I don't believe much in light boxes. I tried gro-light lamps for plants once. Maybe they don't have enough intensity, but they caused nervousness and crying. On the other hand, Sulpiride worked almost immediately, than it pooped out. Last year I tried for my anergy in the fall: Stelazine and Trilafon. Each worked for about 3 weeks than faded. There are no more options left.
> > > Thank you everyone for support.
> > >
> > > Anna P.
> >
> > Anna,
> >
> > I found DA agonists not to be very helpful. You mention a lot of antipsychotics in your med lists. Were you diagnosed with psychotic depressions during these SAD episodes? Antipsychotics may settle acute agitation for a brief time, but may actually *worsen* depression (perhaps that is the "poop-out" you describe). Have you been seeing the same pdoc all of this time? You might consider a 2nd opinion. As far as light boxes go, you would have to get ones that are made for SAD and are intense enough. Also, they may only be of benefit during the wintertime episode. Have you tried MAOI's like selegiline or Parnate? Also, has your thyroid function been checked? I think you have a lot of options-you may need a different doctor IMO.
> >
> > Mitch
>
> Thank you Mitch for your suggestions. I've tried all these options exept the real light boxes.
> My depression isn't psychotic, butI used antipsychotics to augment antidepressants when nothing else was left. They did work for anergy for some time for me.
> When I tried Parnate and Marplan it was too late, my body has developed immunity to antidepressants.
> But I'm glad that I have tried Moclobemide and it's augmentation first before going to real MAOI's. It worked with no side effects for me until I developed the tolerance. And I checked my thyroid also.
> I saw the best psychopharmacologists in the country. I went to New York and California. Dr Stahl said: vagus nerve stimulation. but what is the guarantee it will even work? It costs so much money.
>
>
> Anna P.
Anna,The only way to find out if light therapy will help is to purchase one that is specifically made for SAD. No other light will help except this. Your case is clearly very difficult. Some of my depression symptoms are similar to yours. I do think that you have bipolar. SAD is considered a soft bipolar spectrum disorder because both disorders are associated with with disturbances in normal biological rhythms. Have you tried Lamictal?? It has been very promising with treatment resistant depression and bipolar depressions. For the fist time in 13 years I feel better than I ever have on this drug. Go to depression central web site for more info. on this drug. Dr. Goldberg (depression central) may be able to help you out. Send him an e-mail. He specializes in harder cases like yours. Laura.
Posted by Ritch on April 30, 2002, at 23:00:56
In reply to Re: I have 2 weeks left to SAD, Ritch, posted by Anna P. on April 30, 2002, at 13:15:15
> > > Yes, unfortunately I've tried stimulants as well, and also I didn't mention I tried dopamine agonists. I have treatment-resistant depression with SAD on top of that. I have SAD twice a year. My major symptoms in may/june episode are those like in severe depression:psychomotor slow down, crying, mild anxiety; it's hard to describe it, the pain is unberable.
> > >
> > > Last year I had a family event and had people invited over on May 13. I got my depression and became dysfunctional. I begged my doctor for help. He prescribed Provigil in addition to Reboxetine I was taking at that time. Provigil worked 4 days, but saved my event.
> > >
> > > I don't believe much in light boxes. I tried gro-light lamps for plants once. Maybe they don't have enough intensity, but they caused nervousness and crying. On the other hand, Sulpiride worked almost immediately, than it pooped out. Last year I tried for my anergy in the fall: Stelazine and Trilafon. Each worked for about 3 weeks than faded. There are no more options left.
> > > Thank you everyone for support.
> > >
> > > Anna P.
> >
> > Anna,
> >
> > I found DA agonists not to be very helpful. You mention a lot of antipsychotics in your med lists. Were you diagnosed with psychotic depressions during these SAD episodes? Antipsychotics may settle acute agitation for a brief time, but may actually *worsen* depression (perhaps that is the "poop-out" you describe). Have you been seeing the same pdoc all of this time? You might consider a 2nd opinion. As far as light boxes go, you would have to get ones that are made for SAD and are intense enough. Also, they may only be of benefit during the wintertime episode. Have you tried MAOI's like selegiline or Parnate? Also, has your thyroid function been checked? I think you have a lot of options-you may need a different doctor IMO.
> >
> > Mitch
>
> Thank you Mitch for your suggestions. I've tried all these options exept the real light boxes.
> My depression isn't psychotic, butI used antipsychotics to augment antidepressants when nothing else was left. They did work for anergy for some time for me.
> When I tried Parnate and Marplan it was too late, my body has developed immunity to antidepressants.
> But I'm glad that I have tried Moclobemide and it's augmentation first before going to real MAOI's. It worked with no side effects for me until I developed the tolerance. And I checked my thyroid also.
> I saw the best psychopharmacologists in the country. I went to New York and California. Dr Stahl said: vagus nerve stimulation. but what is the guarantee it will even work? It costs so much money.
>
>
> Anna P.
Anna,That is so fascinating how very *quickly* you develop tolerance (or "poop-out") to antidepressant treatment. Have you tried adding mood stabilizers to your antidepressants to see if you can sustain the response? (such as adding lithium, depakote, neurontin, i.e.) I would try those in augmentation with AD's instead of the AP's since they don't have the reputation of being depressogenic like AP's can (also-you mentioned mostly older conventional AP's which are worse for aggravating depression, BTW). Also, an acute AD response to an AP could indicate a primary coexisting anxiety disorder that is potentiating the trouble. Have you tried benzodiazepines as augmentation of your AD's that can help with depression such as Ativan or Xanax? Also hypermetabolic doses of thyroid hormone can snap people out of depressive episodes (bringing your TSH down to somewhere between .5-1.0). I wonder if a combo of Parnate+Ativan+Neurontin+T3/T4 would do for you--have you tried anything like that?
VNS-haven't tried that one! Heard some good things-but I wonder if you haven't tried (or *failed* to take) certain med combos. At least with SAD episodes, they run their course which is helpful.
Mitch
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