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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on August 22, 2006, at 6:25:50
In reply to Re: Sibutramine (Meridia) - Day 15, posted by SLS on August 21, 2006, at 6:18:34
7 days @ 10mg
9 days @ 20mgNo improvement in depression.
I increased the dosage of Topamax from 50mg to 100mg. I think I retain a bit more mental energy at the higher dosage.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg- Scott
Posted by Declan on August 22, 2006, at 15:00:51
In reply to Re: Sibutramine (Meridia) - Day 16, posted by SLS on August 22, 2006, at 6:25:50
Hi Scott
Sometime ago, I think you said, that your meds lift you 15% off baseline. So I wonder:
How do you know what your baseline is by now?
And secondly (if it is only 15%), is it worth the bother?
Your depression is not mainly about mood, but cognitive slowing?
When you say 'dysphoria', do you just mean you feel unwell?
I hope this is OK.
Declan
Posted by SLS on August 22, 2006, at 15:42:57
In reply to Re: Sibutramine (Meridia) - Day 16 » SLS, posted by Declan on August 22, 2006, at 15:00:51
> Hi Scott
Hi Declan.
> Sometime ago, I think you said, that your meds lift you 15% off baseline. So I wonder:
> How do you know what your baseline is by now?It is hard to forget not being able to lift a fork of food from the plate to your mouth because you freeze still for not having the energy to complete the motion.
> And secondly (if it is only 15%), is it worth the bother?
I would not be able to function well enough to live independently otherwise.
> Your depression is not mainly about mood, but cognitive slowing?
I use CBT 24/7 in an effort to reduce depressed mood and anxiety. I am left mainly with loss of interest and motivation, anergia, psychomotor retardation, anhedonia, low libido, incoordination and clumsiness, cognitive slowing, memory impairment, and difficulty concentrating.
> When you say 'dysphoria', do you just mean you feel unwell?
It is a sort of depressed mood with a grayness that you just don't want to be in the middle of.
> I hope this is OK.
No problem.
- Scott
Posted by SLS on August 22, 2006, at 17:04:34
In reply to Re: Sibutramine (Meridia) - Day 16, posted by SLS on August 22, 2006, at 6:25:50
7 days @ 10mg
10 days @ 20mgNo improvement in depression.
The depression has actually worsened. I believe that the sibutramine is contributing to this.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg- Scott
Posted by Phillipa on August 22, 2006, at 19:51:19
In reply to Re: Sibutramine (Meridia) - Day 17, posted by SLS on August 22, 2006, at 17:04:34
Oh Scott I'm so sorry. Two more weeks did you say? Love Phillipa
Posted by SLS on August 23, 2006, at 6:49:15
In reply to Re: Sibutramine (Meridia) - Day 17, posted by SLS on August 22, 2006, at 17:04:34
7 days @ 10mg
11 days @ 20mgNo improvement in depression.
The depression is currently moderately worse than it was prior to beginning sibutramine treatment. However, personal issues continue to contribute to my overall condition. Nevertheless, certain vegetative symptoms do seem to be worse, and are usually a sign that the endogenous depression has been affected negatively. I believe this to indicate an exacerbation of my condition due to the sibutramine.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg- Scott
Posted by Phillipa on August 23, 2006, at 20:48:55
In reply to Re: Sibutramine (Meridia) - Day 18, posted by SLS on August 23, 2006, at 6:49:15
Scott is there someone with you? Love Jan
Posted by SLS on August 24, 2006, at 7:02:37
In reply to Re: Sibutramine (Meridia) - Day 18, posted by SLS on August 23, 2006, at 6:49:15
7 days @ 10mg
12 days @ 20mgDepression continues to worsen.
I am feeling worse in a way that I attribute to a drug-induced exacerbation. There is a worsening of vegetative symptoms and a heaviness of thought that is almost painful. I have decided to suspend taking sibutramine until speaking with my doctor tomorrow.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
sibutramine 20mg- Scott
Posted by JahL on August 24, 2006, at 8:35:15
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
> Depression continues to worsen.
>
> I am feeling worse in a way that I attribute to a drug-induced exacerbation.Hi Scott.
I'm sorry the Sibutramine hasn't worked out for you. That sucks big-time. After all this time - and with all the help you provide on this board - I think you really, finally, deserve some blessed relief (as does everybody else of course).
Sorry to quickly change the subject, but I'd be interested in your thoughts on my Buprenorphine thread further down this page.
You, perhaps more than anyone, know how much pain I've endured, as I do with you. Racer aside (and it's nice to see another oldie return), you're pretty much the only one from 'back in the day' to have stuck with this board.
Again, I'd be interested in your thoughts. You might even have some interest with regard to your own condition.
Wishing you similar success,
Jah.
Posted by SLS on August 24, 2006, at 8:52:56
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by JahL on August 24, 2006, at 8:35:15
Hi Jah.
I read with great interest your thread regarding your experiment with buprenorphine. I hope it "sticks". :-) I am going to discuss the use of buprenorphine with my doctor today.
I skipped my last night's dose and this morning's dose of sibutramine. I feel somewhat better, but it still comes in waves. The half-life of this stuff (active metabolites) is about 12 hours. I don't know what to do next.
- Scott
> > Depression continues to worsen.
> >
> > I am feeling worse in a way that I attribute to a drug-induced exacerbation.
>
> Hi Scott.
>
> I'm sorry the Sibutramine hasn't worked out for you. That sucks big-time. After all this time - and with all the help you provide on this board - I think you really, finally, deserve some blessed relief (as does everybody else of course).
>
> Sorry to quickly change the subject, but I'd be interested in your thoughts on my Buprenorphine thread further down this page.
>
> You, perhaps more than anyone, know how much pain I've endured, as I do with you. Racer aside (and it's nice to see another oldie return), you're pretty much the only one from 'back in the day' to have stuck with this board.
>
> Again, I'd be interested in your thoughts. You might even have some interest with regard to your own condition.
>
> Wishing you similar success,
>
> Jah.
Posted by Racer on August 24, 2006, at 10:39:53
In reply to Re: Sibutramine (Meridia) - Day 19 » JahL, posted by SLS on August 24, 2006, at 8:52:56
As well as talking to your doctor about buprenorphine, how about asking about tianepine? The other people who've taken here on this board seem to find it helpful, and it's a very different mechanism of action from the other drugs most of us have tried. Despite the difficulties in getting it, it really might be worth it.
It's high on my list, as I think I've told you, and I'll probably bring it up with the fancy doctor I see next month. (Although I won't be trying anything new for a while, as I think we've discussed...)
I'm so sorry the sibutramine hasn't worked out for you. It's partly selfish, but I was really hoping it would.
Posted by Racer on August 24, 2006, at 10:41:44
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by JahL on August 24, 2006, at 8:35:15
> >
> Racer aside (and it's nice to see another oldie return), you're pretty much the only one from 'back in the day' to have stuck with this board.
>Thanks, Jah. It felt really good to read that.
Posted by ed_uk on August 24, 2006, at 13:37:05
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by JahL on August 24, 2006, at 8:35:15
Hi J
Do you know of a doctor who will prescribe buprenorphine for you?
Ed
Posted by JahL on August 24, 2006, at 14:10:59
In reply to Re: Sibutramine (Meridia) - Day 19 » JahL, posted by ed_uk on August 24, 2006, at 13:37:05
Hi Ed.
Long time! How are ya?
> Do you know of a doctor who will prescribe buprenorphine for you?I don't have a pdoc anymore. My last one retired and his replacement was (and still is) an idiot. The smug, ill-mannered 'individual' told me he 'didn't believe in treating Bipolar with drugs' (!!). Seven years wasted at med school then. I had to walk out on him before I did some damage. I wasn't a happy chappy.
My new GP isn't much better ("you're on too many drugs blah, blah") and he can't differentiate between Bipolar and 'Affective Psychoses' (that's what he keeps putting on my notes despite my protestations).
My only hope is my old private pdoc who I paged today. I have no idea what my chances are.
Why, do you have any ideas?
I've lost track of where you are treatment-wise. Is it all under control?
Cheers,
J.
Posted by Maximus on August 24, 2006, at 14:52:23
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
> Depression continues to worsen.
>
> I am feeling worse in a way that I attribute to a drug-induced exacerbation. There is a worsening of vegetative symptoms and a heaviness of thought that is almost painful. I have decided to suspend taking sibutramine until speaking with my doctor tomorrow.
Sincerely sorry dude,Scotty, if i may ask, for how long have you been disabled and been unable to work?
May be it is the time to take the heavy artillery's approach once again. I suggest the hospitalization. Thus you might get ECT + a complete overhaul of your medication. A bit scary, i know, but probably necessary...
Buddy, i do apologize in advance for my personal point of view. I just think you deserve better. Actually i would just stop to tease yourself with experimental medecines. They just don't seem to work.
Be well!
Posted by JahL on August 24, 2006, at 14:57:19
In reply to Re: Sibutramine (Meridia) - Day 19 » ed_uk, posted by JahL on August 24, 2006, at 14:10:59
Sorry, I'm back to my old thread-hijacking ways!
What was the doc's reaction?
J.
Posted by Phillipa on August 24, 2006, at 20:28:55
In reply to Re: Sibutramine (Meridia) - Day 19 » JahL, posted by ed_uk on August 24, 2006, at 13:37:05
Ed that's the med they use in Charlotte for detox. My old group of pdoc's used it all the time. Love PJ O
Posted by Phillipa on August 24, 2006, at 20:31:54
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
Scott can you let us know what you doc said? Love Phillipa
Posted by SLS on August 25, 2006, at 6:15:56
In reply to Re: Sibutramine (Meridia) - Day 19, posted by SLS on August 24, 2006, at 7:02:37
7 days @ 10mg
12 days @ 20mg
1 day @ 0mgThe worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
Currently:
nortriptyline 100mg
Lamictal 150mg
Topamax 100mg
Abilify 10mg
- Scott
Posted by SLS on August 25, 2006, at 6:21:25
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Racer on August 24, 2006, at 10:39:53
> As well as talking to your doctor about buprenorphine, how about asking about tianepine?
Ah. I forgot to plant that seed. I've never mentioned this drug to him. Thanks. Do you have in place a plan to acquire it?
I can't help but to want to go back to taking Nardil for what little it helps me. I just want a break.
- Scott
Posted by SLS on August 25, 2006, at 6:30:32
In reply to So how did it go today Scott?, posted by JahL on August 24, 2006, at 14:57:19
> Sorry, I'm back to my old thread-hijacking ways!
>
> What was the doc's reaction?Basically, I left there with a prescription for pregabalin 75mg with the intent to move up to higher dosages later. There is a chance that it won't be covered by my prescription plan. If it is not, I might not take it.
I discussed with him the use of buprenorphine. He was aware that it was used by some doctors, but didn't seem too keen on it. He said that I should send him some stuff on it. We also discussed adding Nardil to what I am currently taking. He didn't like adding it to nortriptyline, but I think I convinced him to give it a try. I anticipate a mild serotonin syndrome developing, but what the heck. It really represents a dead end, but I would just like to feel better than I am now. I see him in two weeks. I guess I have a lot to think about.
- Scott
Posted by SLS on August 25, 2006, at 7:01:27
In reply to Re: Sibutramine (Meridia) - Day 19 » SLS, posted by Maximus on August 24, 2006, at 14:52:23
Hi Maximus.
> Scotty, if i may ask, for how long have you been disabled and been unable to work?15 years.
Crap.
> May be it is the time to take the heavy artillery's approach once again. I suggest the hospitalization. Thus you might get ECT + a complete overhaul of your medication. A bit scary, i know, but probably necessary...
Thank.
I'm not sure. I've already tried ECT. I can't see myself going through that again. My doctor brought up VNS again. I have already been in a hospital situation a few times. I have allowed them over six months on two occasions to work on me. At the moment, I can't think of anything they could do that hasn't been done already.
> Buddy, i do apologize in advance for my personal point of view.
No apologies necessary!
:-)
> I just think you deserve better.
I would have to agree with you.
> Actually i would just stop to tease yourself with experimental medecines. They just don't seem to work.
This one doctor had it right in 1987. He combined Parnate + desipramine. He just got too smart for his (my) own good and decided at some point that only one drug would be necessary. I naively followed his directions word for word for many months. Then I self-medicated. When I tried going back to the original combination, it no longer worked.
> Be well!Thanks. You do the same.
- Scott
Posted by mayzee on August 25, 2006, at 12:33:53
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued, posted by SLS on August 25, 2006, at 6:15:56
> The worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
>Hi Scott,
I'm only familiar with the newer ADs (SSRIs/SNRIs/etc.) and have always been told that it takes at least 4+ weeks to feel the AD effect. Is Sibutramine different in that you should get the effect much sooner?
I am so sorry that it didn't work for you. I hope that you can find something soon to make you feel better.
Warm regards,
mayzee
Posted by SLS on August 25, 2006, at 17:28:40
In reply to Re: Sibutramine (Meridia) - Day 20 - Discontinued » SLS, posted by mayzee on August 25, 2006, at 12:33:53
> > The worsening of depression continues, but has mitigated towards the end of the day. I have ended my trial of sibutramine.
> I'm only familiar with the newer ADs (SSRIs/SNRIs/etc.) and have always been told that it takes at least 4+ weeks to feel the AD effect. Is Sibutramine different in that you should get the effect much sooner?Hi Mayzee.
You are right. I would not expect sibutramine to be any different from Effexor in this regard. However, I did not expect the drug to make me feel markedly worse. I just don't have the fortitude at this juncture to subject myself to any more of that. I just got done spending weeks feeling worse because of Wellbutrin. I know I can't afford to leave any stone left unturned. However, I think stopping the sibutramine was the right thing to do. I was reacting quite badly to it.
Thanks for your interest.
- Scott
Posted by Maximus on August 25, 2006, at 20:35:11
In reply to Re: Sibutramine (Meridia) - Day 19 » Maximus, posted by SLS on August 25, 2006, at 7:01:27
Thanks for the informations. Now i understand a lot better your situation. You are a gentleman. That is what we call a genuine case of treatment resistant.
Well, you know yourself better than us, so continue to fight this ugly illness.
Last thing, i think the VNS implant would be a good bet.
Bye.
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Dr. Bob is Robert Hsiung, MD,
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