![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by ace on April 28, 2003, at 3:29:41
McPac my bro,
Thanks for your Anafranil answer. I have one HUGE qstn for you - how long did the wired sleep thing with Anafranil last (the waking at 4am wide-eyed) I asked my doc and he says this should be gone within a week. I don't like that feeling at all. And by the way, you a right on the mark about the Remeron suggestion. I was thinking either that or Buspirone.
Once again McPac, you are very good to me and I appreciate your kind words to me.
Take Care OCD brother of the night!!!!!
Andrew- AKA ace.
Posted by ace on April 28, 2003, at 21:55:34
In reply to Calling the legend McPAC!!! Serious Qstn..., posted by ace on April 28, 2003, at 3:29:41
Posted by McPac on April 29, 2003, at 18:55:52
In reply to Calling the legend McPAC!!! Serious Qstn..., posted by ace on April 28, 2003, at 3:29:41
McPac my bro,
>>>>I'm here dude!
Thanks for your Anafranil answer. I have one HUGE qstn for you - how long did the wired sleep thing with Anafranil last (the waking at 4am wide-eyed) I asked my doc and he says this should be gone within a week.
>>>>>>>>Here is what I recall (I took Anafranil for about 3 years or so....10+ years ago was when I last took it) So here is what I remember: At first it COMPLETELY knocked me on my butt! But that was FINE because my OCD was BAD and I was glad that it knocked me out while doing its thing! The sedation did ease a lot over time. (Ace, it's always such an individual thing though...for instance, I am a pretty big guy (YET often very med-sensitive; my Aunt, an average-sized woman, was NOT even PHASED by Anafranil (it WORKED but she NEVER even felt the slightest bit tired from it---and she took a HIGHER dose than I did!)....I don't believe I got the "4:00 a.m." wake-ups right at first, because all it did at first was KNOCK ME OUT...it seems that I might have been taking it for awhile before it started giving me sleep awakenings (I vividly remember how I would just suddenly wake up and be wide-eyed all at once...then it was very hard to fall back to sleep for me.....now---here is the GOOD NEWS Ace---I was taking nothing back then for sleep...and I have a terrible insomnia problem....(The Anafranil DID knock me out day AND night, BUT I STILL got that damned "4:00 a.m., wide-eyed wake up crap"...BUT I did NOT have ANYTHING to combat THAT with...I have tried many things for terrible insomnia Ace and NOTHING has worked as well as LOW-DOSE REMERON (7.5 mg...you could use 15 mg, but 7.5 does the job WELL for me and many others)....I really do believe that the Remeron would combat the "4:00 a.m. wake-ups"...."IF" you STILL had ANY problems waking up, get a good form of magnesium (magnesium glycinate) and take about 400-600 mg near bedtime---it doesn't make me/most folks sleep longer, just better ("deeper").....I didn't know as much then as I do now about supplements (I'm still learning too!) and that was before anybody ever heard of Remeron (don't think it was even out back then)....so...just to be clear...I had terrible insomnia, the Anafranil was VERY sedating to me at first, at first I slept a ton on it, then after awhile the Anafranil started causing the 4:00 wake-ups...BUT, I had NOTHING to combat that...some folks may not get those 4:00 wake-ups (my Aunt did NOT)....here's what I'd think about if I were you Ace---get some low-dose Remeron (try 7.5 mg/ at night first, before trying the 15 mg, since you may not need 15mg)...and JUST have it on HAND at first...you may not need to take it...but if you do I will bet that it can counter the "wake-ups" if you start to get them....As for my "wake-ups" Ace, they did NOT last only a week or so....they definitely lasted longer than that...I recall that being a problem for QUITE SOME TIME....but the amazing thing about the Remeron is that, UNLIKE other sleep aids, it has KEPT its effectiveness ever since I've been on it (over a year)...it still works the same (it blocks the 5ht2 receptors, which causes sedation)
I don't like that feeling at all. And by the way, you a right on the mark about the Remeron suggestion. I was thinking either that or Buspirone.
>>>>>>>>>Some people (like my Aunt) get nervous "jitters" and anxiety from Buspar (she said it made her WORSE)...I've heard others have that reaction as well...I never took it...I'd go with the Remeron!
Once again McPac, you are very good to me and I appreciate your kind words to me.
>>>>>No problem at all Ace! Don't feel bad if you don't see responses from me, as I sometimes don't even post here for months at a time....however, I want to keep in touch w/ your progress so I WILL be checking in to see how you're doing.
Take Care OCD brother of the night!!!!!
>>>>>>>>Ace....Take the Anafranil! I REALLY believe that it will kick your ocd's ass! Then, if you get the "wake-ups", take the low-dose Remeron....try that, I think it will serve you very well! Titrate the Anafranil slowly if you need to, paying close attention to how it affects your ocd (but try not to DWELL on it if you can....no need to keep raising the dose once you've found your personal best dose (it varies for different people)...."A very good rule-of-thumb when it comes to OCD meds---"The Dose That Gets You Well, Keeps You Well"....once you find your best dose, I'd stay on it...some folks will try to keep lowering their best dose only to see their symptoms return....once the ocd stops, it's a BEAUTIFUL FEELING! You'll feel great again...laughing, being hilarious, feeling laid-back....you WILL feel very good again Ace...just get the "A-Train" (Anafranil) and let it do it's thing!!!
Posted by jack smith on April 29, 2003, at 19:24:32
In reply to ACE! Re: Calling the legend McPAC!!! Serious Qstn, posted by McPac on April 29, 2003, at 18:55:52
MCPAC,
What are you on now? WHat is you dx?
Posted by ace on April 29, 2003, at 23:39:37
In reply to ACE! Re: Calling the legend McPAC!!! Serious Qstn, posted by McPac on April 29, 2003, at 18:55:52
Talk about making me feel good....Thanyou som much McPac. I actually printed out on e of your responses where you say "better times are ahead on the Anafranil" Over the next 10 day washout that is ALL I will read. No papers about Parnate or Nardil.
BTW, I am doing exactly what you said - going to doc and getting Remeron script tommorow, or probably today. My doc basically gives me anything I want, provided I thoroughluy research it and it fits my symptomatology. I think I will only need 7.5mg.
But, in my heart, I believe the wide awake bullshit will stop after a few days.
You have really supported me mate. This been a VERY difficult time for me, and if you ever need advice you MUST post me a line. I am now going to print your great response out!.
BTW, When I took Anafranil before for 2 days, the sedation wasn't too bad, bu there.
God Bless You McPac.
Your Friend,
Andrew.
Posted by ace on April 29, 2003, at 23:40:36
In reply to Some questions ?McPac, posted by jack smith on April 29, 2003, at 19:24:32
Posted by Jack Smith on April 30, 2003, at 12:56:21
In reply to Jack - you on Parnate yet? (nm) » jack smith, posted by ace on April 29, 2003, at 23:40:36
No, my doc talked me into trying Effexor first and I am going to give it a few months because I have heard good things about the drug and I am going to move up to 300 mg and stick that out for a month, if I don't see very positive improvements, I am either going for an MAOI--now I am leaning more towards Nardil or possibly Anafrinil--even though I don't have OCD, I figure anything that is strong enough to wipe out OCD could take care of my GAD/depression.
Oh yeah, Ace, I got some questions for you. DId you have sexual side effects on Zoloft or any other drugs you tried? Because I have had hardly any and I am wondering if maybe that means the sexual side effects of Nardil will be less for me. I don't think my girlfriend would be happy if I couldn't get it up for months!
JACK
Posted by McPac on April 30, 2003, at 17:50:09
In reply to Some questions » McPac, posted by jack smith on April 29, 2003, at 19:24:32
Hi Jack!
I've kept my ocd and depression in check w/ Zoloft for about 11 years now. But I DO get some lousy side effects (I don't care about the minor ones but the ssri's give me anger/temper problems (totally unlike me) and that bothers me.....also, Zoloft really destroys my libido....I've got a good plan up my sleeve though...take care Jack!
Posted by McPac on April 30, 2003, at 18:21:38
In reply to Re: ACE! Re: Calling the legend McPAC!!! Serious Qstn » McPac, posted by ace on April 29, 2003, at 23:39:37
Talk about making me feel good....Thank you so much McPac. I actually printed out on e of your responses where you say "better times are ahead on the Anafranil" Over the next 10 day washout that is ALL I will read. No papers about Parnate or Nardil.
>>>>>>>>No problem Ace, you are too cool!
BTW, I am doing exactly what you said - going to doc and getting Remeron script tommorow, or probably today. My doc basically gives me anything I want, provided I thoroughluy research it and it fits my symptomatology. I think I will only need 7.5mg.
>>>>>>Sounds VERY good! IF you get very jittery, nervous or panicky while waiting for the Anafranil to kick in, you could take the low-dose Remeron to "chill" out also...most folks seem to have little/no problem getting off Remeron, so you don't have to worry about withdrawal. AT FIRST Remeron REALLY knocked me out!! Then my body adjusted and got more used to it...it is STILL a GREAT sleep aid!
But, in my heart, I believe the wide awake bullshit will stop after a few days.
>>>>>>>It might Ace...there's really no way to know until you try it....everybody's body chemistry is truly unique. You'll have the Remeron though if you need it!
You have really supported me mate. This been a VERY difficult time for me, and if you ever need advice you MUST post me a line. I am now going to print your great response out!.
>>>>>>>>>MUCH better days are ahead for you Ace!!! You'll be back here in the not-too-distant future posting away and feeling fine....give the Anafranil time...I think it's going to squash your OCD like a grape!
BTW, When I took Anafranil before for 2 days, the sedation wasn't too bad, bu there.
>>>>>>>>That's a GOOD sign Ace! It never sedated my Aunt AT ALL yet still worked like a charm...but give it time...steady progression!
God Bless You McPac.
>>>>>>>> May God Bless You too Ace! Just get through this crappy wash-out period Ace! I hope it's not too bad for you....do whatever you need to do to get through this period...then let the Anafranil mop up those $@*$^%!-damned ocd symptoms and you'll be able to feel MUCH, MUCH better!!!! Take care my Friend! And keep us all here posted on your progress!!!
Posted by temoigneur on May 1, 2003, at 0:10:08
In reply to Calling the legend McPAC!!! Serious Qstn..., posted by ace on April 28, 2003, at 3:29:41
Hi Ace, I first want to apologize, either here, or through yahoo, I got your addy and mailed you - at the time I was so f^@&*% I wasn't thinking of basic considerance for personal space etc... Anyway, Ace, I'm the one with terrible anxiety, SP, Panic Attacks, GAD, and OCD. Dare I drop the sobering thought that these conditions wax and wane, and for myself especially when under pressure, which you of anyone would know, the symptomsare exacerbated.
When the nebulous free-floating anxiety seems controlled, the OCD cripples me, and vica versa, that's what i was wondering, how are you handling the condition, because I know we have the distinction of sharing the gammit of anxiety problems. I'm on washout to go on Nardil - first time on an MAOI I've been on everything - did nardil work for a time for you, and also, are you using the clomipramine in conjuction with the nardil, I assume not, but I don't know.
I brought one of your posts to my pdoc, and influenced by it, we decided I'd go on Nardil - was it beneficial for a time? - I know you're having terrible OCD now. Sorry for all the Q's but if you're on Nardil and Anafrinil at the same time, do you know of a site, or anybody who knows about the track record of combining the two, as it is thought to be risky, and my neuropsych. refuses to combine them. Right now, my OCD is bad, , but I think it will just manifest as general anxiety if I switch to clomipramine - need something to burn this at both ends.I understand your going through a stressful period right now, I'm sorry if anything I sent you upset, or discouraged you, my intentions DEFINATELY weren't malevolent. Of course logically we stand to gain if we pool our logic and my specialist is one of the most highly regarded pdoc in Vancouver. Any input you could give would be awesome. I'm the one who wrote about aligning with OCFoundation..... there not being enough funding, well, on the bright side, I've never tried Anafrinil, the only drug I haven't, I mean I tried it for two or so days, and my head was spinning, but never given it a proper trial, so don't despair!!!! We both have this to turn to=)
Hanging in there - btw, I want to be a psychiatrist, it sounds like you enjoy sciences too,
Ben
Respond if and when ever is convenient for you, don't feel any pressure or think that I'll think less of you if you don't get back right away - just trying to avoid a fourth, (third - lost count)death door episode hahaha, but I'm okay today
btw if you don't want to post here, and you feel comfortable exchanging emails, [email protected]
Posted by ace on May 1, 2003, at 2:13:28
In reply to Sorry Ace, my pdoc I r taking ur lead, advice? » ace, posted by temoigneur on May 1, 2003, at 0:10:08
> Hi Ace, I first want to apologize, either here, or through yahoo, I got your addy and mailed you -
Sorry, I have no idea waht you mean. You emailed my yahoo email ? You emailed my other email? I reall can't understand. Also, your post titlw, what does it say? You Pdoc and you are taking my lead? What do you mean?
at the time I was so f^@&*% I wasn't thinking of basic considerance for personal space etc... Anyway, Ace, I'm the one with terrible anxiety, SP, Panic Attacks, GAD, and OCD. Dare I drop the sobering thought that these conditions wax and wane, and for myself especially when under pressure, which you of anyone would know, the symptomsare exacerbated.
>
> When the nebulous free-floating anxiety seems controlled, the OCD cripples me, and vica versa,This statement I FULLY 100% understand, sometimes I feall happy to have derealization/anxiety and not OC to relieve the oCD at vice versa.
that's what i was wondering, how are you handling the condition, because I know we have the distinction of sharing the gammit of anxiety problems.
I'll tell you - I have a will made of iron, and this awful pain strengthens me. I have been crying at 4am in the more with fear in my gut, scared out of my head, ready to call ambulance to get me to mental ward...But I always go on - I'll use any and every resource that will alleviate a chemical imbalance which exists not because of me, but in spite of me. My will can NEVER be destroyed.
I'm on washout to go on Nardil - first time on an MAOI I've been on everything - did nardil work for a time for you, and also, are you using the clomipramine in conjuction with the nardil, I assume not, but I don't know.OK, Nardil worked VERY well for my anxiety, but at times, esp in phobic situatins, it left a bit to be desired, But overall it was very good for anxiety. It on the whole provided 70% relief. But I am VERY strict with drugs and DEMAND 90%+ relief or a change in drug. SSRIs very rarely give these results. The usual nonses you hear is 40% relief from drug + CBT. Absolute nonsense. I don't by it. BTW, Nardil was unbelievably great for my depression and minor social phobic symptoms. I attribute the former to it's effects on raising (through th inhibition of enzymes) DA, NE, and 5H-T. The later I contibute especially to Nardil's affinity for gABA.
I can not use Clomipramine with Anafranil. But other TCAs can occassionally be used with MAOIs so long as the TCA is initiated first. Nardil, withought doubt also helped my OCD - so much as 60-70%. But that remaining is still painful and intolerable.
> I brought one of your posts to my pdoc, and influenced by it, we decided I'd go on Nardil - was it beneficial for a time? - I know you're having terrible OCD now.Which post did you bring to your doc? Remind him I study psychopharmacology at uni so I'm not ignorant. Absolutely, it WAS benificial. At times, a lot. But remember, my OCD is very severe and atypical. If yours is more typical it could easily destroy it. Actually, suprisingly so, OCD is not to bad at the moment. 2 days into my washout everything seems dandy. But at times on Nardil I had periods of hellish OCD, but MUCH less than when I was on Zoloft (I deem the SSRIs MUCH less effective than TCAs and mAOIs) I will always be on older drugs. A friend of mine father is a psychiatrist - he is on Parnate. Every serious psychiatrist knows the brilliance of TCAs and MAOIs. They are wisely noy bamboozeld by the marketing frenzy of SSRIs. TCAs and MAOIs did not have the same frenzy - they had to prove themselves and they did.
Sorry for all the Q's but if you're on Nardil and Anafrinil at the same time, do you know of a site, or anybody who knows about the track record of combining the two, as it is thought to be risky, and my neuropsych. refuses to combine them.
Your Neuropsych is absolutely correct. Bring this post to him with these augmentative strategies if Nardil falls short of 90-100% relief.
1. Nardil + Pindolol (I'm not a big fan of Pindolol)
2. Nardil + Clonidine (same opinion as Pindolol)
3. Nardil + Bromocriptine
4. Nardil + Elavil (MUST begin Elavil before Nardil)
5. Nardil + Lithium (sceptical this would help, maybe for depression but)
6. Nardil + Olanzapine 2.5-5mg nocte (Many clinical trials show Olanzapine is brilliant (in combo with an AD for OCD/anxiety)
7. Nardil + Risperidone (last line - has more chance of TD than Zyprexa)
I forgot - Nardil + Carbamazepine (officially contraindicated, Pubmed and other sources have conducted trials in which there was no adverse effects)Also, and this is a GREAT combo - Nardil + Klonopin (Klonopin has been shown, in many placebo controlled trials to be great for OCD alone or in combo with an AD. Best yet it is great for anxiety and Panic Disorder)
Right now, my OCD is bad, , but I think it will just manifest as general anxiety if I switch to clomipramine
Disagree - Clomipramine has a atropine-like sedative effect which is the antithesis of 'general anxiety'.
- need something to burn this at both ends.
>
> I understand your going through a stressful period right now, I'm sorry if anything I sent you upset, or discouraged you, my intentions DEFINATELY weren't malevolent.What did you send me?????
To what email????
Of course logically we stand to gain if we pool our logic and my specialist is one of the most highly regarded pdoc in Vancouver. Any input you could give would be awesome. I'm the one who wrote about aligning with OCFoundation..... there not being enough funding, well, on the bright side, I've never tried Anafrinil, the only drug I haven't, I mean I tried it for two or so days, and my head was spinning, but never given it a proper trial, so don't despair!!!! We both have this to turn to=)
>
> Hanging in there - btw, I want to be a psychiatrist, it sounds like you enjoy sciences too,That's great Ben, I am one year away from starting my medical degree. I specificall want to be a psychopharmacologist - I have no interest in trying talk therapy, I dislike it, and find it inappropriate for psychiatric illness. Personality D/O, which, IMO, don't represent a chemical change in the brain, may respond to it, and also those of who are suffering the normal stresses of life. But not those who are having bizzare OCD thoughts which say 'touch this chair, or you'll never be happy, successful, married etc etc.'
I intend to get a thorough understanding of a patients sx and match a psychiatric drug which best suits the alleviation of such systems. Therapy with psychiatry D/O's has a lot to answer for, and in many cases makes the patient worse. They have a chemical imbalance in the brain. Analogous to this we can have a deep cut on the hand. Rubbing or focusing on the cut/biochemical imbalance (with your hands or through talk therapy) irritates things.
> Ben
>
> Respond if and when ever is convenient for you, don't feel any pressure or think that I'll think less of you if you don't get back right away - just trying to avoid a fourth, (third - lost count)death door episode hahaha,I just don't understand what you mean. Please explain.
but I'm okay today
> btw if you don't want to post here, and you feel comfortable exchanging emails, [email protected]
>Sure I will post you. Do you have much interest in chemistry? Physics. I would love to discuss these issues.
Yeah, again, what post did you DR see of mine?
God Bless, and good luck to you.
Feel free to Keep in contact.
Ace.
Posted by McPac on May 1, 2003, at 16:53:03
In reply to Re: Calling the legend McPAC!!! Serious Qstn... » ace, posted by temoigneur on May 1, 2003, at 0:05:48
Hi T!
"Right now, my OCD is bad, , but I think it will just manifest as general anxiety if I switch to clomipramine - need something to burn this at both ends".
Why not try an anti-ocd med PLUS klonopin?
Posted by ace on May 1, 2003, at 19:28:25
In reply to T,Re: Calling the legend McPAC!!! Serious Qstn.., posted by McPac on May 1, 2003, at 16:53:03
Posted by temoigneur on May 2, 2003, at 3:12:19
In reply to Re: Sorry Ace, my pdoc I r taking ur lead, advice? » temoigneur, posted by ace on May 1, 2003, at 2:13:28
Ace, there are no words for the attention you've given me, thanks. I definately want to keep in touch, it seems we have a lot in common, and you eloquently described how using CBT for some types of anxiety is like adding salt to a wound. I went through an intense, four hr/day exposure desensitization program in California. The psychologist had to tell me to take it easy at one time, as I was approaching the therapy so vigorously, but I'm very confused. I seemed to be getting better, until they started talking about me returning home, I'm partially inclined to think that any "progress" that may have been attributed to the therapy was largely the effect of me leaving an environemnt of highly expressed emotion, (home) - which was hard for my situation - and settling into a more stable environment. My symptoms never went away except for one day when I went to berkeley, it was maybe the happiest day I can remember in about five years, I had my faculties about me, I didn't want to leave. But my response was confounding, the next day we went to napa valley, and I was so anxious, I thought I'd collapse and have a full blown seizure if I was approached by someone. When i went home, it was awful - Lending credence to your pt of view, I was worse than ever, I was now confronting situations head on as I had been taught and I found myself among other things, burning myself with an iron to ward off suicidal thoughts, wandering in a downtown parking lot, until my youth paster found me and went out of his way to take me home, then I went to church where I was compelled to reveal my sexual history to some of the kids - thankfuly they were wonderful, but I only on like this in the hope that if you had doubts that perhaps CBT could be helpful for all kinds of OCD, perhaps this could help put some perspective on things, although there are confounding factors I guess.
About me apologizing for using your mail, and feeling like I was an imposition, it's a combo of neurosis, and me having sent you an email, asking a number of questions, without response - but I TOTALLY understand that you were going through a terrible time with your ocd then, as I've kept up on your posts, and anyway, it's your perogative if you want to respond or not
Andrew, I'm stronger with words, I'm guessing that you might have a real aptitude for Chemistry and Physics, I enjoy them, but my gifts lie in verbal communication, the arts, ect.
Also you asked which email persuaded my doctor and I to go on nardil, I'll post it as "Ripples" haha.I know you must be a person of incredible fibre and intelligence to go through what you have, I would very much like to keep in touch.
b.
Take care, and God Bless.
> > Hi Ace, I first want to apologize, either here, or through yahoo, I got your addy and mailed you -
>
> Sorry, I have no idea waht you mean. You emailed my yahoo email ? You emailed my other email? I reall can't understand. Also, your post titlw, what does it say? You Pdoc and you are taking my lead? What do you mean?
>
> at the time I was so f^@&*% I wasn't thinking of basic considerance for personal space etc... Anyway, Ace, I'm the one with terrible anxiety, SP, Panic Attacks, GAD, and OCD. Dare I drop the sobering thought that these conditions wax and wane, and for myself especially when under pressure, which you of anyone would know, the symptomsare exacerbated.
> >
> > When the nebulous free-floating anxiety seems controlled, the OCD cripples me, and vica versa,
>
> This statement I FULLY 100% understand, sometimes I feall happy to have derealization/anxiety and not OC to relieve the oCD at vice versa.
>
> that's what i was wondering, how are you handling the condition, because I know we have the distinction of sharing the gammit of anxiety problems.
>
> I'll tell you - I have a will made of iron, and this awful pain strengthens me. I have been crying at 4am in the more with fear in my gut, scared out of my head, ready to call ambulance to get me to mental ward...But I always go on - I'll use any and every resource that will alleviate a chemical imbalance which exists not because of me, but in spite of me. My will can NEVER be destroyed.
>
>
> I'm on washout to go on Nardil - first time on an MAOI I've been on everything - did nardil work for a time for you, and also, are you using the clomipramine in conjuction with the nardil, I assume not, but I don't know.
>
> OK, Nardil worked VERY well for my anxiety, but at times, esp in phobic situatins, it left a bit to be desired, But overall it was very good for anxiety. It on the whole provided 70% relief. But I am VERY strict with drugs and DEMAND 90%+ relief or a change in drug. SSRIs very rarely give these results. The usual nonses you hear is 40% relief from drug + CBT. Absolute nonsense. I don't by it. BTW, Nardil was unbelievably great for my depression and minor social phobic symptoms. I attribute the former to it's effects on raising (through th inhibition of enzymes) DA, NE, and 5H-T. The later I contibute especially to Nardil's affinity for gABA.
> I can not use Clomipramine with Anafranil. But other TCAs can occassionally be used with MAOIs so long as the TCA is initiated first. Nardil, withought doubt also helped my OCD - so much as 60-70%. But that remaining is still painful and intolerable.
>
>
>
> > I brought one of your posts to my pdoc, and influenced by it, we decided I'd go on Nardil - was it beneficial for a time? - I know you're having terrible OCD now.
>
> Which post did you bring to your doc? Remind him I study psychopharmacology at uni so I'm not ignorant. Absolutely, it WAS benificial. At times, a lot. But remember, my OCD is very severe and atypical. If yours is more typical it could easily destroy it. Actually, suprisingly so, OCD is not to bad at the moment. 2 days into my washout everything seems dandy. But at times on Nardil I had periods of hellish OCD, but MUCH less than when I was on Zoloft (I deem the SSRIs MUCH less effective than TCAs and mAOIs) I will always be on older drugs. A friend of mine father is a psychiatrist - he is on Parnate. Every serious psychiatrist knows the brilliance of TCAs and MAOIs. They are wisely noy bamboozeld by the marketing frenzy of SSRIs. TCAs and MAOIs did not have the same frenzy - they had to prove themselves and they did.
>
> Sorry for all the Q's but if you're on Nardil and Anafrinil at the same time, do you know of a site, or anybody who knows about the track record of combining the two, as it is thought to be risky, and my neuropsych. refuses to combine them.
>
> Your Neuropsych is absolutely correct. Bring this post to him with these augmentative strategies if Nardil falls short of 90-100% relief.
>
> 1. Nardil + Pindolol (I'm not a big fan of Pindolol)
>
> 2. Nardil + Clonidine (same opinion as Pindolol)
>
> 3. Nardil + Bromocriptine
>
> 4. Nardil + Elavil (MUST begin Elavil before Nardil)
>
> 5. Nardil + Lithium (sceptical this would help, maybe for depression but)
>
> 6. Nardil + Olanzapine 2.5-5mg nocte (Many clinical trials show Olanzapine is brilliant (in combo with an AD for OCD/anxiety)
>
> 7. Nardil + Risperidone (last line - has more chance of TD than Zyprexa)
>
>
> I forgot - Nardil + Carbamazepine (officially contraindicated, Pubmed and other sources have conducted trials in which there was no adverse effects)
>
> Also, and this is a GREAT combo - Nardil + Klonopin (Klonopin has been shown, in many placebo controlled trials to be great for OCD alone or in combo with an AD. Best yet it is great for anxiety and Panic Disorder)
>
> Right now, my OCD is bad, , but I think it will just manifest as general anxiety if I switch to clomipramine
>
> Disagree - Clomipramine has a atropine-like sedative effect which is the antithesis of 'general anxiety'.
>
>
>
>
>
>
>
>
> - need something to burn this at both ends.
> >
> > I understand your going through a stressful period right now, I'm sorry if anything I sent you upset, or discouraged you, my intentions DEFINATELY weren't malevolent.
>
> What did you send me?????
> To what email????
>
> Of course logically we stand to gain if we pool our logic and my specialist is one of the most highly regarded pdoc in Vancouver. Any input you could give would be awesome. I'm the one who wrote about aligning with OCFoundation..... there not being enough funding, well, on the bright side, I've never tried Anafrinil, the only drug I haven't, I mean I tried it for two or so days, and my head was spinning, but never given it a proper trial, so don't despair!!!! We both have this to turn to=)
> >
> > Hanging in there - btw, I want to be a psychiatrist, it sounds like you enjoy sciences too,
>
> That's great Ben, I am one year away from starting my medical degree. I specificall want to be a psychopharmacologist - I have no interest in trying talk therapy, I dislike it, and find it inappropriate for psychiatric illness. Personality D/O, which, IMO, don't represent a chemical change in the brain, may respond to it, and also those of who are suffering the normal stresses of life. But not those who are having bizzare OCD thoughts which say 'touch this chair, or you'll never be happy, successful, married etc etc.'
>
> I intend to get a thorough understanding of a patients sx and match a psychiatric drug which best suits the alleviation of such systems. Therapy with psychiatry D/O's has a lot to answer for, and in many cases makes the patient worse. They have a chemical imbalance in the brain. Analogous to this we can have a deep cut on the hand. Rubbing or focusing on the cut/biochemical imbalance (with your hands or through talk therapy) irritates things.
>
>
>
> > Ben
> >
> > Respond if and when ever is convenient for you, don't feel any pressure or think that I'll think less of you if you don't get back right away - just trying to avoid a fourth, (third - lost count)death door episode hahaha,
>
> I just don't understand what you mean. Please explain.
>
>
> but I'm okay today
> > btw if you don't want to post here, and you feel comfortable exchanging emails, [email protected]
> >
>
> Sure I will post you. Do you have much interest in chemistry? Physics. I would love to discuss these issues.
>
> Yeah, again, what post did you DR see of mine?
>
> God Bless, and good luck to you.
>
> Feel free to Keep in contact.
>
>
> Ace.
Posted by temoigneur on May 2, 2003, at 3:37:57
In reply to Re: Sorry Ace, my pdoc I r taking ur lead, advice? » temoigneur, posted by ace on May 1, 2003, at 2:13:28
Hi Ace, here's the email you posted
Re: Ace, nardil and anxiety? » temoigneur
Posted by ace on March 23, 2003, at 19:48:53In reply to Ace, nardil and anxiety?, posted by temoigneur on March 22, 2003, at 13:49:32
> Hi Ace, - you say you took the Nardil for a whole range of anxiety problems,
Yes, these include OCD, GAD, SP, phobic Anxiety, Derealization (Depersonalization Syndrome), episodic depression and subclinical ADHD. All of these conditions, some immensly so, have been helped by Nardil.
I have severe GAD, SP, and moderate OCD, I've been through the full range of pharmaceuticals, presently on high dosages of effexor, paxil, 2.5mg zyprexa + sleep meds, It leaves me tired 65% of the day, and I sleep 12 hrs/day in addition to that
This doesn't sound too good!
- I remain hopeful because there was a four month period when I first started prozac that I felt motivated, no anxiety, did very well in school, social life is great, do you think Nardil is worth a try
What you wrote above there is how I feel 100% of the time. Only a minute bit of anxiety, and a fair bit of OCD. BUT Nardil has made me SOoooo happy and confident that the anxiety hardly ever phases me. It has turned my social life from nil to going out/getting gals phone numbers all the time! I mean, with Nardil I will approach any girl, no matter how beautiful!
Also with motivation, I am LOVING my university work, studying hard and enjoying every second of it. NO DEPRESSION AT ALL. Last year, on Zoloft, I had very bad periods of the above probs.
-MAOi's are only class I haven't tried.
>
>
You want peace? Peace=Nardil
Ace,
The Australian Heavyweight Champion of Nardil!!!!Nardil, 90mg, Lithium, 500mg.
Posted by ace on May 3, 2003, at 0:52:56
In reply to Re: Sorry Ace, my pdoc I r taking ur lead, advice?, posted by temoigneur on May 2, 2003, at 3:12:19
> Ace, there are no words for the attention you've given me, thanks.
No problems mate. I feel very happy I can help you/
I definately want to keep in touch, it seems we have a lot in common, and you eloquently described how using CBT for some types of anxiety is like adding salt to a wound.Yeah, I mean, I've done intense research on CBT and it is true it is very popular. This popularity, i believe, stems from it's congruence with application to those who have no psychopathology. In other words, when a healthy person, feels down because he lost a race or something like that, CBT can be useful. But for someone with clinical (ie psychiatric depression) it is ineffective, inappropriate and bordering on gross negligence on the part of the practicer. I actually tried CBT for 2 years to alleviate my (episodic) depression. I was extremely persistent and thorough. It fell short miserably. This CBT nonsense, is trying aimlessly push against the pull of a person. If a person who has severe depression is down CBT causes a dynamic of frustration. Of a person trying to push against nature (ie their depression in the form of a chemical imbalance). We reajust this problem by changing the nature (the depressed brain) through realigning the neurotransmitter imbalance. I have read and wrote to David D. Burns, a prominent CBT clinician. Albeit, he seems very amicable, he is so ridiculously naive in his views. Hmmmm... I really would like to see the statistical design of his studies! Same goes for Albert Ellis, and Tim Beck. These clinicians seem to be grossly confusing normal unhappiness and clinical depression, the latter of which never substatially responds to CBT, or for any length of time. BUT, the above being so, CBT is very health for those sans real chemical imbalances, but rather are having normal problems of life.
I went through an intense, four hr/day exposure desensitization program in California. The psychologist had to tell me to take it easy at one time, as I was approaching the therapy so vigorously, but I'm very confused. I seemed to be getting better, until they started talking about me returning home, I'm partially inclined to think that any "progress" that may have been attributed to the therapy was largely the effect of me leaving an environemnt of highly expressed emotion, (home) - which was hard for my situation - and settling into a more stable environment.
Very insightful idea. I would tend to agree. Don't forget their is a placebo effect in CBT.
My symptoms never went away except for one day when I went to berkeley, it was maybe the happiest day I can remember in about five years, I had my faculties about me, I didn't want to leave. But my response was confounding, the next day we went to napa valley, and I was so anxious, I thought I'd collapse and have a full blown seizure if I was approached by someone.I'm very sad this happened, but It doesn't suprise me. I would personally stay clear of psychologists (believe me, I study physics, chem and other sciences). Psychology is NOT a science. I really do ponder how these psychologists really think they help. Once again, for personality D/Os they might but for people like you and me and most of the other brave spirits on this board (with chemical probs, Personality D/O is NOT such, BTW) they will likely rub salt in the wound, witheir 'affirmations', 'visualisation', and 'implosive' techniques. And BTW, I strongly disagree that they should have ANY right in prescribing medicines, they are pushing for this now, trying to be real scientists! Actually do me a favour, prent this to you pdoc, and tell me if he agrees or not.
When i went home, it was awful - Lending credence to your pt of view, I was worse than ever, I was now confronting situations head on as I had been taught and I found myself among other things, burning myself with an iron to ward off suicidal thoughts, wandering in a downtown parking lot, until my youth paster found me and went out of his way to take me home, then I went to church where I was compelled to reveal my sexual history to some of the kids - thankfuly they were wonderful, but I only on like this in the hope that if you had doubts that perhaps CBT could be helpful for all kinds of OCD, perhaps this could help put some perspective on things, although there are confounding factors I guess.This sounds awful, and we now need some agressive medical strategies to assuage your sx. First of all, you sound like you have a good doctor - ie, he is willing to precribe an MAOI. Tell him I applaud him!
I would forget about facing your sx head on. Don't aggravate them by such tactics. Just do your best to ignore them for the moment, until YOUR special magic pill(s) is found. I will tell you the opposite of any non-psychiatric therapist: HIDE from your sx, try to stay clear however you can. Now, we have tried some drugs, so lets try some more.
1.Nardil - up to 90mg
2.Nardil + Zyprexa or Risperidone (low dose)
3.Elavil + Nardil (imperative you start Elavil before)
4. Nardil + Klonopin (this should be a real kick in the pants to your OCD and anxiety D/O's -- sitting in my room I have extensive clinical trials of Klonopin combined, or even alone, with an AD does amazing things. I would try this first line)Experimentals
1. Nardil + Clonidine (esp for ADHD)
2. Nardil + Pindolol
3. Nardil + BromocriptineBe careful with the first two. They can easil precipitate depression or wierd things. After reading the pharmacology of Clonidine I didn't try it - it can do all sorts of things.
After the above I'd move onto Parnate, but let's take one thing at a time.
BTW, these are only suggestions, which you can pass by your doctor. I'm sure he is batting for you 100%. I personally think one of the above will bring %90+ relief, which is what you want.
> About me apologizing for using your mail, and feeling like I was an imposition, it's a combo of neurosis, and me having sent you an email, asking a number of questions, without response - but I TOTALLY understand that you were going through a terrible time with your ocd then, as I've kept up on your posts, and anyway, it's your perogative if you want to respond or not
That's cool! My biggest prob at the moment is my intensive studies of physics, chemistry, and psychopharmacology. I also do Philosophy at uni, but I naturally think philosophically, so I never really study as such for that topic.
> Andrew, I'm stronger with words, I'm guessing that you might have a real aptitude for Chemistry and Physics, I enjoy them, but my gifts lie in verbal communication, the arts, ect.
Great!! I love the arts! Try reading some David Hume, Arthur Schopenhauer, Ludwig Wittgenstein. These philosophers blow my mind! Fundamentally everything is philosophy - chemistry and physics are just a man-made 'reality' we transpose on this thing we percieve as life. But they are helpful! Without them means no psyciatric meds!
>
> Also you asked which email persuaded my doctor and I to go on nardil, I'll post it as "Ripples" haha.
>
> I know you must be a person of incredible fibre and intelligence to go through what you have, I would very much like to keep in touch.I really appreciate those statements. Not soliciting sympathy, but from the age of 14 (I am now 24) i have endured tremendous mental pain, at times varying in degree. I have never had a 'spontaneous recovery', except with meds. Every day, except when I have the appropriate drug, there is much turmoil in my brain. But this makes me a much stronger being. I smile when I suffer. Or I try!
Like NIETZSCHE said :"to those human beings who are of any concern to me, I wish suffering, desolation, sickness, ill-treatment, indignities - I should wish that they should not remain unfamiliar with profound self-contempt, the torture of self-mistrust, the wretchedness of the vanquished: I have no pity for them, because I wish them the only thing that can prove today whether one is worth anything or not-- that one endures"
Contrary to what a lot of people say Nietzsche was a very kind-hearted, friendly man. This above paragraph exemplifies his own attidude to HIS suffering. And I use it on myself many a time. I always will AFFIRM life, even when I am in the throes of terrible suffering. There is a beauty about a spirit who suffers but never gives in (Suicides). Of course I want happiness, just like you and every being, but this is the most noble and productive way of looking at your pain while it's there - draw ANY strength you can from it.
A person who persevers in spite of all is a person who is God-like.
> b.
>
> Take care, and God Bless.
You take care and feel free to post me whenever. Tell me if you want my email.Keep your head up, brave person.
God Bless,
Andrew.
>
>
>
>
>
>
Posted by ace on May 3, 2003, at 1:51:45
In reply to Re: Jack - you on Parnate yet? » ace , posted by Jack Smith on April 30, 2003, at 12:56:21
Posted by temoigneur on May 3, 2003, at 2:45:00
In reply to Re: Sorry Ace, my pdoc I r taking ur lead, advice? » temoigneur, posted by ace on May 3, 2003, at 0:52:56
Ace, it's late now and I should be in bed, but wow, do we have commonalities, I started to suffer almost unbearably when I was 14 as well, now 24 also. I think for myself, the CBT was hope, and when it didn't materialize, I relate to Neitschze, if I'm reading it correctly that people in the throngs of mental illness tend to dislike themselves, as was certainly the case with me, but at the risk of offending you're seemingly definitive sensibilities about psychology vs drugs - and I don't say this to offend, just to tell you that there is a motivational speaker talks about there being of course a wide range of negative emotions, but in the end, they all boil down to anger. His take on anger is that it's not helpful to express to others, or learn to live with or dwell on, but rather to accept that we are responsible for our emotions. He says this in the context that the more control one thinks one has over their life, the greater degree of mental health they'll enjoy. Now when I first heard this, I thought "well yes that's a convienent way for the healthy executive living in a posh gated community, to disregard the millions who have now control over their suffering, and feel more secure because they have full control over their lives. Obviously this man has gone to far, and I hope he's ignorant rather than someone perpetuating capitalist genocide, But then I began to think of how in my own life, I can blame things on meds, that can infact be controlled IN SPITE of the meds. For instance weight gain, I have the OCD thought that if I don't eat or do whatever my head is telling me I'll loose control, but when I stand up to that thought, after time I have found that I do definately have more control than I orginally thought. How does one go about discovering this, how did I discover this, I think it was unconscious, I just made a decision to confront things head on, and like you said, many times it made things messy, but from that I learnt that those were OCD thoughts, and other things I confronted which I thought were OCD, I learned were more matters of self control, so what I'm saying is I think there may be some truth in the thought that even very mentally ill people can have some control over their health by and therby enjoy better mental health, without medication. What I'm hearing now is that anger is unproductive, and I just tell myself that "yes, you can be bitter at people, be bitter that your mentally ill, be bitter that your gay, and your family has a hard time with it, but when you're angry it only clouds your thinking, and alienates you, nothing good comes from anger - at least what I'm thinking now. So when I get angry I try stepping back and telling myself that I could be angry, but what will it accomplish. This speaker contends that all -ve emotions boil down to anger through his exhaustive research, and if I can realize that there's nothing productive, noble, or good about anger, I can diffisue some of it, and it must say it has made a difference in my life recently. I don't mean to upset, just share my experience.
Bon Courage, God Bless
Ben, (also andrew I have access to a book on the latest advances made in anxiolytics edited by Dr. Nutt, and Dr. Briley in the UK, I think it is a fairly authoritative source in terms of currency and scientific soundness, (from what little I know) email me if you are interested in this [email protected] Also Andrew, when I listen to the motivation spkr, at first my obsessions get worse, but like meditation it's a discipline to follow through, and test your limits to see what you can incorporate and, what falls short of your experience. I would send you the series if you like, anything to help.
God Bless ( Even though as in the vien of Neitschze's thinking he doesn't intervien like we'd like him to, I feel like we're here on our own in the important times frankly, and we have to be God's light to eachother, because he doesn't intervien - many theories why, but to leave my environment brighter than when I entered, I choose to believe God is good, although I have no proof whatsoever, but I choose to be a positive person, live in optimism, and await the day we'll know.
God bless
Ben
> > Ace, there are no words for the attention you've given me, thanks.
>
> No problems mate. I feel very happy I can help you/
>
>
> I definately want to keep in touch, it seems we have a lot in common, and you eloquently described how using CBT for some types of anxiety is like adding salt to a wound.
>
> Yeah, I mean, I've done intense research on CBT and it is true it is very popular. This popularity, i believe, stems from it's congruence with application to those who have no psychopathology. In other words, when a healthy person, feels down because he lost a race or something like that, CBT can be useful. But for someone with clinical (ie psychiatric depression) it is ineffective, inappropriate and bordering on gross negligence on the part of the practicer. I actually tried CBT for 2 years to alleviate my (episodic) depression. I was extremely persistent and thorough. It fell short miserably. This CBT nonsense, is trying aimlessly push against the pull of a person. If a person who has severe depression is down CBT causes a dynamic of frustration. Of a person trying to push against nature (ie their depression in the form of a chemical imbalance). We reajust this problem by changing the nature (the depressed brain) through realigning the neurotransmitter imbalance. I have read and wrote to David D. Burns, a prominent CBT clinician. Albeit, he seems very amicable, he is so ridiculously naive in his views. Hmmmm... I really would like to see the statistical design of his studies! Same goes for Albert Ellis, and Tim Beck. These clinicians seem to be grossly confusing normal unhappiness and clinical depression, the latter of which never substatially responds to CBT, or for any length of time. BUT, the above being so, CBT is very health for those sans real chemical imbalances, but rather are having normal problems of life.
>
> I went through an intense, four hr/day exposure desensitization program in California. The psychologist had to tell me to take it easy at one time, as I was approaching the therapy so vigorously, but I'm very confused. I seemed to be getting better, until they started talking about me returning home, I'm partially inclined to think that any "progress" that may have been attributed to the therapy was largely the effect of me leaving an environemnt of highly expressed emotion, (home) - which was hard for my situation - and settling into a more stable environment.
>
> Very insightful idea. I would tend to agree. Don't forget their is a placebo effect in CBT.
>
>
> My symptoms never went away except for one day when I went to berkeley, it was maybe the happiest day I can remember in about five years, I had my faculties about me, I didn't want to leave. But my response was confounding, the next day we went to napa valley, and I was so anxious, I thought I'd collapse and have a full blown seizure if I was approached by someone.
>
> I'm very sad this happened, but It doesn't suprise me. I would personally stay clear of psychologists (believe me, I study physics, chem and other sciences). Psychology is NOT a science. I really do ponder how these psychologists really think they help. Once again, for personality D/Os they might but for people like you and me and most of the other brave spirits on this board (with chemical probs, Personality D/O is NOT such, BTW) they will likely rub salt in the wound, witheir 'affirmations', 'visualisation', and 'implosive' techniques. And BTW, I strongly disagree that they should have ANY right in prescribing medicines, they are pushing for this now, trying to be real scientists! Actually do me a favour, prent this to you pdoc, and tell me if he agrees or not.
>
>
> When i went home, it was awful - Lending credence to your pt of view, I was worse than ever, I was now confronting situations head on as I had been taught and I found myself among other things, burning myself with an iron to ward off suicidal thoughts, wandering in a downtown parking lot, until my youth paster found me and went out of his way to take me home, then I went to church where I was compelled to reveal my sexual history to some of the kids - thankfuly they were wonderful, but I only on like this in the hope that if you had doubts that perhaps CBT could be helpful for all kinds of OCD, perhaps this could help put some perspective on things, although there are confounding factors I guess.
>
> This sounds awful, and we now need some agressive medical strategies to assuage your sx. First of all, you sound like you have a good doctor - ie, he is willing to precribe an MAOI. Tell him I applaud him!
>
> I would forget about facing your sx head on. Don't aggravate them by such tactics. Just do your best to ignore them for the moment, until YOUR special magic pill(s) is found. I will tell you the opposite of any non-psychiatric therapist: HIDE from your sx, try to stay clear however you can. Now, we have tried some drugs, so lets try some more.
>
> 1.Nardil - up to 90mg
> 2.Nardil + Zyprexa or Risperidone (low dose)
> 3.Elavil + Nardil (imperative you start Elavil before)
> 4. Nardil + Klonopin (this should be a real kick in the pants to your OCD and anxiety D/O's -- sitting in my room I have extensive clinical trials of Klonopin combined, or even alone, with an AD does amazing things. I would try this first line)
>
> Experimentals
> 1. Nardil + Clonidine (esp for ADHD)
> 2. Nardil + Pindolol
> 3. Nardil + Bromocriptine
>
> Be careful with the first two. They can easil precipitate depression or wierd things. After reading the pharmacology of Clonidine I didn't try it - it can do all sorts of things.
>
> After the above I'd move onto Parnate, but let's take one thing at a time.
>
> BTW, these are only suggestions, which you can pass by your doctor. I'm sure he is batting for you 100%. I personally think one of the above will bring %90+ relief, which is what you want.
>
> > About me apologizing for using your mail, and feeling like I was an imposition, it's a combo of neurosis, and me having sent you an email, asking a number of questions, without response - but I TOTALLY understand that you were going through a terrible time with your ocd then, as I've kept up on your posts, and anyway, it's your perogative if you want to respond or not
>
>
> That's cool! My biggest prob at the moment is my intensive studies of physics, chemistry, and psychopharmacology. I also do Philosophy at uni, but I naturally think philosophically, so I never really study as such for that topic.
>
> > Andrew, I'm stronger with words, I'm guessing that you might have a real aptitude for Chemistry and Physics, I enjoy them, but my gifts lie in verbal communication, the arts, ect.
>
>
> Great!! I love the arts! Try reading some David Hume, Arthur Schopenhauer, Ludwig Wittgenstein. These philosophers blow my mind! Fundamentally everything is philosophy - chemistry and physics are just a man-made 'reality' we transpose on this thing we percieve as life. But they are helpful! Without them means no psyciatric meds!
> >
> > Also you asked which email persuaded my doctor and I to go on nardil, I'll post it as "Ripples" haha.
> >
> > I know you must be a person of incredible fibre and intelligence to go through what you have, I would very much like to keep in touch.
>
> I really appreciate those statements. Not soliciting sympathy, but from the age of 14 (I am now 24) i have endured tremendous mental pain, at times varying in degree. I have never had a 'spontaneous recovery', except with meds. Every day, except when I have the appropriate drug, there is much turmoil in my brain. But this makes me a much stronger being. I smile when I suffer. Or I try!
>
> Like NIETZSCHE said :"to those human beings who are of any concern to me, I wish suffering, desolation, sickness, ill-treatment, indignities - I should wish that they should not remain unfamiliar with profound self-contempt, the torture of self-mistrust, the wretchedness of the vanquished: I have no pity for them, because I wish them the only thing that can prove today whether one is worth anything or not-- that one endures"
>
> Contrary to what a lot of people say Nietzsche was a very kind-hearted, friendly man. This above paragraph exemplifies his own attidude to HIS suffering. And I use it on myself many a time. I always will AFFIRM life, even when I am in the throes of terrible suffering. There is a beauty about a spirit who suffers but never gives in (Suicides). Of course I want happiness, just like you and every being, but this is the most noble and productive way of looking at your pain while it's there - draw ANY strength you can from it.
>
> A person who persevers in spite of all is a person who is God-like.
>
>
>
> > b.
> >
> > Take care, and God Bless.
>
>
> You take care and feel free to post me whenever. Tell me if you want my email.
>
> Keep your head up, brave person.
>
> God Bless,
> Andrew.
> >
> >
> >
> >
> >
> >
>
This is the end of the 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.