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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by rod on October 14, 2005, at 9:36:45
Hello World :)
Due to financial reasons, I stopped smoking about 2(3) weeks ago. Because 150€ for a month supply for this prescriotion free supplement is just too expensive for me...
First, I just stopped smoking and used a nicotine patch and an inhaler when needed. But despite this measurments, I got severely worse after a few days. The core symptoms got significantly worse. I think it have been 4 days, when I decided to start smoking again instead of using the thik rope on the truss. And after smoking a few, within some minutes I went from suicidal to feeling significantly better..... I thought, ok, lets smoke because it seems to be necessary.
Well, the next day, instead of smoking, I thought I should try some selegiline additional to the nicotine before I really decide to smoke again...
And that really worked!! I now still use a patch and the inhaler when I like to plus "Xilopar" (some kinf of sublingual Selegiline, which bypasses the liver and therefore does not cause amphetamin metabolites, nor a hypertensive crisis if taken to high without dietary restricions). recommended dose is one tab (1,25mg) before breakfast. this really kickstarts my brain in the morning. very very nice :) And now after 2 weeks on this combination I really feel much better than back when I smoked. I even dont feel like crap in the evening anymore and could quit Pentoxyfylline, because I dont get into this state (burned out, stressed out) anymore of which Pent brought my out....I just hope this isnt some kind of transient bipolar swing....
Only "side effect" is anorgasmia, weired (but really interesting, almost psychedelic) dreams, I am sleeping too much also (will quit klonopin)
Anyway. Altough the combination I take is officially Contraindicated, I dont have any problems at all.
I take:
Nortriptyline 75mg
Clomipramine 75mg
Nicergoline 30mg (alpha blocker)
Depakote 300mg
Klonopin 0,25mg
Xilopar (selegiline) 1 tab, 1,25mg
Maybe this is useful for others who try to quit smoking...
ttfnRoli aka Fritz Kraut :D
Posted by ed_uk on October 14, 2005, at 15:42:15
In reply to Smoking - Core Symptoms Depression - Selegiline, posted by rod on October 14, 2005, at 9:36:45
Hi Roli :-)
It's great that you've quit smoking. The selegiline sounds good. I wonder how you'd respond to Parnate? (can't remember whether you've tried it)
MFG
~Ed
Posted by rod on October 14, 2005, at 17:35:25
In reply to Re: Smoking - Core Symptoms Depression - Selegiline » rod, posted by ed_uk on October 14, 2005, at 15:42:15
Hi Ed :)
>I wonder how you'd respond to Parnate? (can't remember whether you've tried it)
I have never tried because its not avaiable here, unfortunately. They took it off the market when Moclobemide came out.... hmm well :D which works good as Parnate mahaha
and Parnate has an abuse potential. these are the 2 reasons a doc once told me.
Anyway, I think my combination is also a very nice one.. Since a few days I am doing really good! almost too good. Its like Nort and Clomi are working much better than before. But I am not manic and dont spend too much money (actually I spend less money if I am feeling better, because I care about my life..) also no insomia. I just feel alife! and my libido is really really much improved. Its like I am rediscovering the *beauty* of gilrs ;) they are making me crazy :D ewwwwww right now I listen to Kt Tunstall.... know her? nice musik and shes a dammn pretty one :) arrrrrhihi
do people actually really say "ta ta for now (ttfn)" which means "byebye" ? or is it just something what only nerds say ?
Regards
Roli
Posted by rod on October 15, 2005, at 9:19:05
In reply to Smoking - Core Symptoms Depression - Selegiline, posted by rod on October 14, 2005, at 9:36:45
well, for those who are interested....
I quit (suspended) university, are officially unemployed right now, am away sick and recieve some kind of social aid.. I really got into financial problems due to my depression, used all my savings and well, now there is nothing left anymore.. But its ok, the system keeps me alive, now. If my condition stabilises on a certain level where I am functioning, I am thinking about going into a day clinic, and make some intensive therapy. art, music etc. etc. and then, get a job if anything goes well, and then I can get back to uni anyway. uni is very flexible where I live, so its not really a problem to combine work and studying. Or I make something else. who knows...
and if you wondered how I look like, here we go.....
http://img380.imageshack.us/my.php?image=thatsme2uk.jpg
Oh, you mean in real life.. :D
well, dont know the diference anymore... :P (joke)bye
Roland
Posted by ed_uk on October 15, 2005, at 13:27:33
In reply to Re: Smoking - Core Symptoms Depression - Selegilin » ed_uk, posted by rod on October 14, 2005, at 17:35:25
Hi Roli,
>Anyway, I think my combination is also a very nice one..
Hey Roli, you sound really good! I guess it is a good combination :-) You don't need Parnate at the moment. I do think it would be a good med to try in future if your current meds poop out though. You will have to import it!
>do people actually really say "ta ta for now (ttfn)" which means "byebye" ? or is it just something what only nerds say ?
Old women sometimes say it. It's the sort of thing your grandma might say. Men rarely say it, especially young men LOL. It's not a good thing for you to say Roli ;-) People hardly ever say it in this part of the country, I suppose they do say it elsewhere though!
Kind regards
~ed
Posted by SLS on October 16, 2005, at 8:59:50
In reply to Smoking - Core Symptoms Depression - Selegiline, posted by rod on October 14, 2005, at 9:36:45
Hi Roland.
How did you come to take both nortriptyline and clomipramine?
- Scott
Posted by rod on October 16, 2005, at 10:31:58
In reply to Re: Smoking - Core Symptoms Depression - Selegiline » rod, posted by SLS on October 16, 2005, at 8:59:50
> Hi Roland.
>
> How did you come to take both nortriptyline and clomipramine?
>
>
> - ScottHi Scott,
There's no "theory" behind it, actually. I ran out of options. Nortriptyline alone, was not enough. I was on 200mg too, but that was kind of couterproductive, because it was way too sedating and so on. I knew Clomipramine, because I have taken it in the past. It wasnt bad, but wasnt really good either. And since I have problems with falling asleep at night, and Clomipramine is actually one of the very few drugs that really make me sleepy, I thought I combine these two. I see it more like a clomipramine augmentation of nottriptyline. Nortrpyline is activating to me. I take it in the morning. And clomi at evening/night.
And I didnt have a good feeling quiting nort totally, because I feared that I will get worse. So I am just keeping it...
My doc said it wasnt uncommon at all to combine two TCAs in the past. He had many patients on a combination of clomi (morning, because its activating for most) and amitriptyline at night. A different doc also suggested clomi and ami a few years ago...
Also my (actually severe) social anxiety is better on Clomi. Actually the only "SSRI" thats works in that regard.
I know (guess) you think it does not make much sense, and I should quit Nort and raise Clomi, because its (the metabolite) a noradrenergic reuptake inhib. too.But I dont feel like changing anything at the moment, because I am really statring to respond to my drugs... finally... and hopefully .. forever =P hehehe
lets see...
And how are you doing? Still trying your luck with Keppra (sp?)? Hope you are ok! or even well :)
bye
Roland
Posted by SLS on October 16, 2005, at 18:05:13
In reply to Re: Smoking - Core Symptoms Depression - Selegiline » SLS, posted by rod on October 16, 2005, at 10:31:58
> I know (guess) you think it does not make much sense, and I should quit Nort and raise Clomi, because its (the metabolite) a noradrenergic reuptake inhib. too.
Not at all! I am more intrigued by your treatment than judgmental of it. When it comes to these illnesses, I find that many of the treatments that people find success with make no sense "theoretically". This only demonstrates how little we understand about the brain and the drugs we use to treat it.
Actually, in my mind, it is reasonable to combine a derivative of imipramine (clomipramine) with a derivative of amitriptyline (nortriptyline). These two series of drugs are different enough to produce different responses in the same person. Different is different. I might just try adding some imipramine to the nortriptyline I'm currently taking. I need to be cautious, though, as I am also taking Parnate. I am also looking to try a few cortisol drugs first, so I need to wait for an opportunity when I'm between drug trials.
Thanks for the idea!
I hope you remain well for the rest of your days.
- Scott
Posted by zeugma on October 17, 2005, at 18:45:23
In reply to Re: Smoking - Core Symptoms Depression - Selegiline » rod, posted by SLS on October 16, 2005, at 18:05:13
Actually, in my mind, it is reasonable to combine a derivative of imipramine (clomipramine) with a derivative of amitriptyline (nortriptyline). These two series of drugs are different enough to produce different responses in the same person.>>
Hi Scott,
This is a fascinating point to my mind at least. I have had numerous discussions with my pdoc, the upshot of which, as you have heard, is that nortriptyline and desipramine are essentially identical and that clomipramine is equivalent to a combination of nortriptyline plus SSRI.
I don't think he is being unreasionable in this (he said it was not from a theoretical point of view that the two drugs were almost indistinguishable but in terms of clinical effect) but I am very curious as to how you would differentiate the amitriptyline series from the imipramine series experientially. What would adding an imipramine derivative contribute, in terms of desired effect?
I also tend to think that medications produce some of their effect from our using the perturbations they make in our CNS to productive results. I am watchful for signs of perturbations during med trials, because there are some perturbations (e.g., the slight slowing effect of Provigil) that can be used productively, and others which are not useful at all.
Interestingly, the medications that I tolerate best emotionally and cognitively (not necessarily physically) are those that produce a slowing effect. The first glimmer of therapeutic response I got from nortriptyline was that my mind was slowing down slightly, allowing me to perceive things as less of a blur than usual. I wonder if this is a trait of the amitriptyline series generally, or is an idiosyncratic response.
-z
Posted by rod on October 17, 2005, at 19:22:29
In reply to Re: Smoking - Core Symptoms Depression - Selegiline » rod, posted by SLS on October 16, 2005, at 18:05:13
> I am more intrigued by your treatment
ahh I am glad I could "inspire" some minds, at least one.. :-)
> This only demonstrates how little we understand about the brain and the drugs we use to treat it.
Exactly!
Another little general note: 1 tab Xilopar (1,25 mg) equals an regular oral dose of 10mg. Because the "first pass" metabolism doesnt "eat" 7/8 away.... and no amphetamines, so no sleep troubles... I guesssand from : http://www.selegiline.com/
"At dosages up to around 10 mg or so daily, selegiline retains its selectivity for the type-B MAO iso-enzyme; but it is also a weak reversible inhibitor of the type-A MAO iso-enzyme."
Might also play a role.... but you can read on the link above that selegiline, does a LOT of stuff in your body...... or know about most already, I guess :-)
bye
Roland
Posted by Declan on October 18, 2005, at 16:40:05
In reply to Re: Smoking - Core Symptoms Depression - Selegilin » SLS, posted by rod on October 17, 2005, at 19:22:29
Hi Roland
You were saying that with sublingual admin there were't any sleep problems or amphetamine metabolites.
IYou mean because less deprenyl/selegeline is taken?
I've always taken it sublingual, for no particular reason, in the 1-3mg/d range.
Sometimes I notice sleep disturbance, especially if I've taken any phenylalanine, in protein shakes for example.
Declan
Posted by rod on October 18, 2005, at 17:53:22
In reply to Re: Smoking - Core Symptoms Depression - Selegilin » rod, posted by Declan on October 18, 2005, at 16:40:05
> You were saying that with sublingual admin there were't any sleep problems or amphetamine metabolites.
> IYou mean because less deprenyl/selegeline is taken?
Hi Declan,Its not because the dosage is smaller, its just because it bypasses first pass metabolism in the liver.
Either 1,25 mg Xilopar or 10mg regular Selegiline (swallowed) results in the same plasma level of Selegiline. You are just bypassing the liver and therefore vitually no selegiline gets transformed into amphetamine metabolites. If you take Xilopar "nothing gets wasted" (well depending on your view. some might like the amphetamine stuff). Only 1/8 of the 10mg oral selegiline will reach your bloodtream, if swallowed, regulary.And actually its not called "sublingual". Oficially it called a "Lyo-tablet" (Lyo (Greek) meaning loose or free). If you put it on your tounge, it melts within a few seconds. The prescription info doesnt tell more on how to take it, other than you should not eat anything for 5 minutes afterwards.
I always try to dispense it on the oral mucosa and wait a minute before I swallow it. But I dont see any difference to a sublingual tab.. (note the I :) )And I am really not sure (I simply dont know) if you can absorb a regular selegiline tab (chip of a tab) under your tounge. I can imagine there might be some "helper substances" necessay or it has to dissolve really "fine" (like Xilopar)
hope I could clarify any obscurities :)
sleep well, world :)
bye
Roland
Posted by rod on October 27, 2005, at 12:36:30
In reply to Re: Smoking - Core Symptoms Depression - Selegilin » Declan, posted by rod on October 18, 2005, at 17:53:22
Hello World :)
Just wanted to say that I am still a non smoker. I alsolutely have NO Desire to smoke anymore. I even begin to use my nicotine inhaler a lot less often. But I still use the patch also. If I forget to apply one, I notice that I get worse within a few hours...
Anyway, I'm fine :))
Regards
Roland
Posted by ed_uk on October 28, 2005, at 14:28:50
In reply to Re: Smoking - Core Symptoms Depression - Selegilin, posted by rod on October 27, 2005, at 12:36:30
Hello Roli :-)
Quitting smoking will be excellent for your health! The Xelapar sounds very good :-)
~ed
This is the end of the thread.
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