![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by King of Nothing on October 27, 2007, at 19:53:04
I'm excited about this drug/nutrient, any info or news about it would be greatly appreciated!
Posted by Phillipa on October 27, 2007, at 20:07:05
In reply to Is DEPLIN the real deal??, posted by King of Nothing on October 27, 2007, at 19:53:04
King you may have to visit the google site to access all the info that it is indeed a med. By prescription only to boost antidepressants. Phillipa
Deplin® is a novel anti-depressant augmentation therapy with 7.5mg of L-methylfolate.L-methylfolate aids in the synthesis of neurotransmitters associated with mood.
Deplin® tablets contain 7.5mg of L-methylfolate
Deplin® is the first medical food product indicated for the distinct nutritional requirements of persons with low plasma and/or low red blood cell folate with particular emphasis for those individuals who have a major depressive disorder that has not fully responded or may not fully respond to antidepressant therapy.
Deplin® is available by prescription only
Posted by cumulative on October 27, 2007, at 20:50:21
In reply to Is DEPLIN the real deal??, posted by King of Nothing on October 27, 2007, at 19:53:04
Folic acid is incredibly cheap, not sure about deplin. It's very rare to have the metabolism deficiency that prevents one from converting folic acid to the active form, which comprises deplin. I think it would be worth it to try the regular supplement first, maybe even get a serum test if you really want to know. 800mcg of regular folic acid daily boosts my energy.
Posted by Racer on October 27, 2007, at 21:07:22
In reply to Is DEPLIN the real deal??, posted by King of Nothing on October 27, 2007, at 19:53:04
I take something similar, which my pdoc prescribes as an augmenting agent. It's called Metan-X and I don't know if it's doing anything much. I do know that my very brief period of remission correlated in time with starting Metan-X -- and SAMe and Prozac. With all that new stuff, who knows what kicked in.
That's not much, but I hope it helps.
Posted by Ron Hill on October 27, 2007, at 23:49:12
In reply to Re: Is DEPLIN the real deal??, posted by cumulative on October 27, 2007, at 20:50:21
Cumulative,
FYI: One Deplin® 7.5mg tablet is bioequivalent to taking seventy-five 800 mcg folic acid pills. Here is the reference:
http://www.nature.com/bjp/journal/v141/n5/pdf/0705446a.pdf
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin-------------
> Folic acid is incredibly cheap, not sure about deplin. It's very rare to have the metabolism deficiency that prevents one from converting folic acid to the active form, which comprises deplin. I think it would be worth it to try the regular supplement first, maybe even get a serum test if you really want to know. 800mcg of regular folic acid daily boosts my energy.
Posted by King of Nothing on October 28, 2007, at 9:29:12
In reply to Re: Is DEPLIN the real deal?? » cumulative, posted by Ron Hill on October 27, 2007, at 23:49:12
> Cumulative,
>
> FYI: One Deplin® 7.5mg tablet is bioequivalent to taking seventy-five 800 mcg folic acid pills. Here is the reference:
>
> http://www.nature.com/bjp/journal/v141/n5/pdf/0705446a.pdf
>
> -- Ron
>
> Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
>
> 600 mg/day Trileptal
> 200 mg/day Lamictal
> 875 mg/day Keppra
> 90 mg/day Nardil
> 15 mg/day Deplin
>
> -------------
> > Folic acid is incredibly cheap, not sure about deplin. It's very rare to have the metabolism deficiency that prevents one from converting folic acid to the active form, which comprises deplin. I think it would be worth it to try the regular supplement first, maybe even get a serum test if you really want to know. 800mcg of regular folic acid daily boosts my energy.
>
>
Is it helping you Ron?
Posted by Marty on October 28, 2007, at 11:30:28
In reply to Re: Is DEPLIN the real deal?? » Ron Hill, posted by King of Nothing on October 28, 2007, at 9:29:12
If you guys need a guinea pig to test that the proper way, I'm your guy :) .. just send me a bottle lol
Seriously, feel free to pimp my brain with that stuff.
Tried ~25 meds in the last 6 years. I'm a good prospect for that stuff.
Marty
--- Possible bipolar 2
- Social phobia modulated by bipolarity
- Gen. AnxietyCurrently on Omega 3, 0.125mg Clonazepam, 50 mg Lamictal and 150mg x 2 of Lyrica.
Posted by Zyprexa on October 28, 2007, at 12:25:49
In reply to Re: Is DEPLIN the real deal??, posted by cumulative on October 27, 2007, at 20:50:21
I'm with cumulative on this one. I take a lot of different B vitamins, and get good AD effects from them.
Posted by Zyprexa on October 28, 2007, at 12:33:29
In reply to Re: Is DEPLIN the real deal?? » cumulative, posted by Ron Hill on October 27, 2007, at 23:49:12
I hate to tell you this but its not 75 times higher in the report, but 7 times.
Not sure what it was saying about cardiovascular risk. But looked like folic acid may be safer. i would have to read it more.
Posted by Phillipa on October 28, 2007, at 20:18:52
In reply to Re: Is DEPLIN the real deal?? » Ron Hill, posted by Zyprexa on October 28, 2007, at 12:33:29
You need to take all those water soluable folic acid pills in order to equal 7.5mg of Depline. Phillipa
Posted by Ron Hill on October 29, 2007, at 0:49:36
In reply to Re: Is DEPLIN the real deal?? » Ron Hill, posted by King of Nothing on October 28, 2007, at 9:29:12
> Is it helping you Ron?
King,
Based on the posting times on your e-mails, it looks like you saw my answer in another e-mail of mine after you wrote and sent this. Your subsequent e-mail is posted here:
http://www.dr-bob.org/babble/20071027/msgs/791888.html
Let us know how you do on Deplin if you decide to try it, as you indicated.
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
Posted by King of Nothing on October 29, 2007, at 10:29:41
In reply to Re: Is DEPLIN the real deal?? » King of Nothing, posted by Ron Hill on October 29, 2007, at 0:49:36
> > Is it helping you Ron?
>
> King,
>
> Based on the posting times on your e-mails, it looks like you saw my answer in another e-mail of mine after you wrote and sent this. Your subsequent e-mail is posted here:
>
> http://www.dr-bob.org/babble/20071027/msgs/791888.html
>
> Let us know how you do on Deplin if you decide to try it, as you indicated.
>
> -- Ron
>
> Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
>
> 600 mg/day Trileptal
> 200 mg/day Lamictal
> 875 mg/day Keppra
> 90 mg/day Nardil
> 15 mg/day Deplin
>
>Thanks, and congratulations!!!
Posted by Ron Hill on October 29, 2007, at 16:35:11
In reply to Re: Is DEPLIN the real deal?? » Ron Hill, posted by King of Nothing on October 29, 2007, at 10:29:41
> Thanks, and congratulations!!!
Thank you, King. Time will tell if it lasts, but it feels right.
Do you plan to try Deplin http://www.deplin.com ? Deplin is not unique; there are other similar Rx products on the market. For example, CerefolinNAC http://www.cerefolinnac.com/index.php , and Metanx http://www.metanx.com . All three contain various amounts of Metafolin http://www.metafolin.com .
Further, Cerefolin and Metanx contain, respectively, two and three vitamins, blended with the Metafolin. Deplin, on the other hand, contains only Metafolin.
Metafolin is the trademark name for Merck's patented product. Metafolin is patented for the production process used to produce the food grade L-methylfolate. A company called Eprova, fully owned by Merck, invented the process and manufactures Metafolin. The tricky part of the production process is separating the bioactive 6[S] 5-MTHF (another name for L-methylfolate) isomer from the non-bioactive and highly undesirable 6[R] 5-MTHF isomer.
OTC products contain relatively small amounts of Metafolin (e.g.; 0.8 mg/tablet), whereas one tablet of Deplin, for example, contains 7.5 mg. On a per milligram basis of Metafolin, the OTC products are VERY VERY expensive compared to the Rx product Deplin.
Further, as I understand it, Merck is actively in the process of eliminating the OTC's because Merck wants products that contain Metafolin to be available Rx only. To make this happen, all Merck would need to do is politely refuse to sell Metafolin to OTC manufacturers. Currently, Metafolin is the only game in town when it comes to food grade L-methylfolate.
But, I read recently that Merck has made a special deal with HSfighters http://www.hsfighters.com . However, as you know just because it is written on the web does not guarantee that it is true.
TMI (too much information). Sorry if I rambled. If you try Deplin or one of the other similar products, let us know how your trial goes.
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
Posted by King of Nothing on October 29, 2007, at 17:00:45
In reply to Re: Is DEPLIN the real deal?? » King of Nothing, posted by Ron Hill on October 29, 2007, at 16:35:11
I most certainly will Ron, thanks for all the info.
Posted by Ron Hill on October 30, 2007, at 0:48:11
In reply to Re: Is DEPLIN the real deal?? » Ron Hill, posted by Zyprexa on October 28, 2007, at 12:33:29
Hello Zyprexa,
How's it goin'? I hope you're doing well.
> I hate to tell you this but it’s not 75 times higher in the report, but 7 times.
Nope. What I said is completely true:
One Deplin® 7.5mg tablet is bioequivalent to taking seventy-five 800 mcg folic acid pills.Actually, I blocked, copied, and pasted this statement verbatim from the Deplin website. The claim is located on the lower half of this web page:
http://www.deplin.com/DeplinFacts,VsFolicAcid
In my previous e-mail on this subject, I chose to post the reference document, (Ref. 17), instead of the Deplin website page because the reference document contains the actual data backing up the claim.
No offense intended, but one of your errors is in not accounting for the fact that the study medication consisted of a 5 mg oral dose of folic acid, and a 5 mg oral dose of 6[R,S] 5-MTHF. The "7 times" factor that you refer to is specifically and exclusively for these particular dosages (actually dosage ratio) used in the study. However, these dosages in the study are very different from the dosages referred to in the statement; "One Deplin® 7.5mg tablet is bioequivalent to taking seventy-five 800 mcg folic acid."
In this latter case, the oral dosages are 800 mcg folic acid (= 0.8 mg folic acid) and 7.5 mg of 6[S] 5-MTHF (i.e.; L-methylfolate, a.k.a. Deplin). From the data in the study, it is possible to calculate that it takes 75 tablets of 800 mcg folic acid to equal the bioequivalence of one 7.5 mg Deplin tablet.
Further, you did not account for the fact that the study uses a single dose of orally administered 6[R,S] 5-MTHF, a commercially available racemic mixture of the two diastereoisomers of 5-MTHF. However, the administration of Deplin is void of the R isomer. In other words, Deplin is the S isomer, 6[S] 5-MTHF (L-methylfolate), and it does not contain any of the R isomer, 6[R] 5-MTHF.
When I ran the calculations, I came up with 70 tablets of 800 mcg folic acid. I can't find my error, but I've spent too much time already on this trivial issue. Time to move on -- I got bigger fish to fry.
> Not sure what it was saying about cardiovascular risk. But looked like folic acid may be safer. i would have to read it more.
No, the unknown risk, discussed in the last paragraph of the document, is with regard to the accumulation of the R isomer in the human body when 6[R,S] 5-MTHF is administered. However, this is a non-issue for the administration of Deplin because it does not contain any of the R isomer.
Nice talking to you, Zyprexa. Be well, my friend.
-- Ron
Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
Posted by Zyprexa on October 30, 2007, at 13:14:20
In reply to Re: Is DEPLIN the real deal?? » Zyprexa, posted by Phillipa on October 28, 2007, at 20:18:52
Thats what I'm thinking the doctor must have thought. I did take deplin for a month, and no change in Homocystine? Will find out on friday if the 4000mg a day of folic acid works!
Posted by King of Nothing on October 30, 2007, at 15:48:20
In reply to Re: Is DEPLIN the real deal?? » King of Nothing, posted by Phillipa on October 27, 2007, at 20:07:05
> King you may have to visit the google site to access all the info that it is indeed a med. By prescription only to boost antidepressants. Phillipa
>
>
> Deplin® is a novel anti-depressant augmentation therapy with 7.5mg of L-methylfolate.
>
> L-methylfolate aids in the synthesis of neurotransmitters associated with mood.
> Deplin® tablets contain 7.5mg of L-methylfolate
> Deplin® is the first medical food product indicated for the distinct nutritional requirements of persons with low plasma and/or low red blood cell folate with particular emphasis for those individuals who have a major depressive disorder that has not fully responded or may not fully respond to antidepressant therapy.
> Deplin® is available by prescription only
>Thanks Jan. Love,M
Posted by tecknohed on October 30, 2007, at 16:49:05
In reply to One Deplin® 7.5mg tablet is bioequivalent to ... » Zyprexa, posted by Ron Hill on October 30, 2007, at 0:48:11
Hi Ron!
Just wondering, did you have any tests for L-methylfolate blood cencentrations (were they low), or were you found to have difficulty in the conversion from standard folate, before you were put onto Deplin?
Or does it simply seem to boost your meds?
What is your own theory as to why YOU have responded so well to Deplin so far?
Posted by Ron Hill on October 31, 2007, at 6:19:32
In reply to Re: One Deplin® 7.5mg tablet is bioequivalent to . » Ron Hill, posted by tecknohed on October 30, 2007, at 16:49:05
Hi Teck,
> Just wondering, did you have any tests for L-methylfolate blood cencentrations
No, I didn't ask my p-doc for any test scripts. On the one hand, it would be fun to pull blood samples before and after Deplin tx, and analyze the samples for folate and homocysteine.
On the other hand, why does it really matter what the pre and post concentrations were and are? The med will either work or not work, regardless of what the test data are. The only times I ask for pre and/or post testing is if there is a health risk associated with the med trial, or if testing is required to monitor blood levels so as to hit a targeted therapeutic blood level.
I'm sure my insurance company is already wishing they could get rid of me. They pay more than $1000 per month just for my meds. So, I try to constrain my testing occasions to those times when it is truly necessary.
Plus, I hate needles and blood draws. ;-)
Finding a p-med that helps in the tx of my disorder is, by and large, a process of educated trial-and-error. My med trial selection process comes down to this: Read a ton of journal articles about the med, search the archives of this site for anecdotal response reports to the med, paying particular attention to the posters with my dx, and/or the posters that typically respond to various meds in the same way that I do.
Then, if I decide the med is worthy of a trial, I take copies of four or five of the best journal articles and show them to my p-doc. During the appointment, I use the articles to explain my rationale for wanting to conduct the trial.
So far, over the years that I have been working with Dr. O, he has never found it necessary to refuse any of my med trial requests. I'm very lucky to have a great working relationship with such an excellent p-doc. We are a very good team.
I've said all of this only to encourage all of us to do our homework, and go to our p-doc appointments with information in hand.
> were you found to have difficulty in the conversion from standard folate, before you were put onto Deplin?
For clarification of your question for subsequent readers of the archives, your question refers to the fact that many psychiatric patients (pts), especially those with depression or schizophrenia, are homozygous for the 677C --> T mutation in the MTHFR enzyme. MTHFR stands for methylenetetrahydrofolate reductase. MTHFR is a regulating enzyme in the folate-dependant remethylation of homocysteine, because it catalyzes the reduction of 5,10 methylenetetrahydrofolate to 5-methylenetetrahydrofolate (5-MTHF, a.k.a.,L-methylfolate).
This will make a lot more sense if you look at the nice pics located on page 5 of this pdf file:
http://www.metafolin.com/pdfs/Scientific_Review_13.12.pdf
The pics are not addressing the subject of genetic impairment of MTHFR. However, just look at the pic and figure out what would happen if MTHFR is functioning poorly, or perhaps not at all.
Now back to your question, Teck. Who knows what it would cost to conduct this kind of testing and analysis. I'd think it would probably involve some type of DNA testing, but I don't know. So, my answer to your question is that it would be nice to know if I have this genetic problem, but it's not all that important since the genetic problem can't be fixed anyway.
So, for me, it comes back to the same old, same old: The med is either going to work or not work. The proof is in the pudding.
I know I have written way too much, but there is one more topic I want to mention and it is VERY VERY important. In fact, I need to start a thread to warn people that it is absolutely essential for all pts that are taking Deplin, or high doses of folic acid, it is vital that the pt also take B12.
Please pull up the document that you opened earlier, and read the text that is in the same section as the pics. The document explains the reason much better than I can. Here is the same link again, Please read it, Teck.
http://www.metafolin.com/pdfs/Scientific_Review_13.12.pdf
One more issue regarding the administration of B12. There are two main types of B12 available. First, there is cyanocobalamin, the more common type. This type of B12 is not "brain ready". What I mean is that it must first go to the liver (I think it's the liver) where the cynanide (yuck) group on cyanocobalamin molecule is replaced by a methyl group to form methylcobalamin (methyl-B12).
Methyl-B12 if the activated form of B12 that the brain cells can use directly. It crosses the blood brain barrier readily and it is ready for use by the brain cells just as it is. Therefore, it makes a lot of good sense to just take methyl-B12 to begin with. It is analogous to taking Deplin instead of folic acid.
Another issue is that if B12 is swallowed, as is usually the case, only about 1% of the oral dose is passed through the intestinal wall and into the blood stream. The rest of it goes out with your, ah, well you know what I mean. This why you hear of people getting B12 shots.
However, if the B12 is a sublingual tablet, when the tablet is placed under the tongue, the B12 goes directly to the blood stream via the thin membrane in the bottom of the mouth under the tongue. Any portion of the B12 sublingual dose that is inadvertently swallowed with the build up of the saliva which accumulates in the mouth while the tablet is being administered sublingually, is lost via passing through the digestive system virtually unabsorbed.
Here's a link to some methyl-B12 sublingual products. Click on each product, read the Product Details tab and the Product Reviews tab. Then pick one ya like. If this is all you are buying, you are obviously better off to buy it at a local vitamin store because the shipping costs more that the cost of the product. On the other hand, however, if you have a large order, the shipping is free.
If this link automatically switches you to the home page when you click it, then just do a search for methylcobalamin.
http://www.iherb.com/Search.aspx?c=1&kw=Methylcobalamin
I also plead with psychiatric pts to take P-5-P, the biologically active form of B6.
Geeze, why don't I just give short concise answers to short questions. Sorry if I rambled too long.
Be well my friend.
-- Ron
Currently In Full Remission Since Addition of Deplin on 10/22/07.
Bipolar II, with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
Posted by tecknohed on October 31, 2007, at 6:48:18
In reply to Re: One Deplin® 7.5mg tablet is bioequivalent to . » tecknohed, posted by Ron Hill on October 31, 2007, at 6:19:32
You didn't ramble, you were VERY informative!
Thanks for all the info.I too believe the 'active' forms of vitamins are preferable. In fact I think ALL supplement manufacturers should replace the non-active forms with the active forms. For example, I want to add P-5-P to my supplement regime, but my multi alraedy contains 75mg Pyridoxine hydrochloride - I dont want to over-do B6, especially as there is (conflicting) evidence that too much B6 can cause peripheral neuropathy even at moderate doses (50mg).
Thanx again!
teck
Posted by Larry Hoover on October 31, 2007, at 9:23:54
In reply to Re: One Deplin® 7.5mg tablet is bioequivalent to . » tecknohed, posted by Ron Hill on October 31, 2007, at 6:19:32
> Geeze, why don't I just give short concise answers to short questions. Sorry if I rambled too long.
>
> Be well my friend.
>
> -- RonThat's just one of the reasons you've been missed, buddy. You 'splain everything.
Lar
Posted by Ron Hill on October 31, 2007, at 13:03:34
In reply to Re: One Deplin® 7.5mg tablet is bioequivalent to . » Ron Hill, posted by Larry Hoover on October 31, 2007, at 9:23:54
> That's just one of the reasons you've been missed, buddy. You 'splain everything.
> LarThanks, Lar.
It's great that you've stuck around here. I need you here to catch my errors and correct me when I say something blatantly false. And second, when I have questions, I can knock on your door.
You're one of the elite "go to guys" 'round these parts. You da man, Lar. You da man.
Lar, is your neuropathy pain as bad as it has been in the past? Are you still taking neurontin? And, weren't you taking tramadol at one point? Oxy for the pain?
Do you still have good movement in your elbow and arm?
If I recall correctly, you made your way through the health care system to the stage where you were allowed to see the specialist, right or wrong? If so, are you allowed to see the specialist on an ongoing basis?
Bring me up to speed with regard to your current condition and your current med cocktail.
Maybe we should redirect to a fresh thread on the med page so we can get outta the way here. What say?
-- Ron
Currently in Full Remission since the Addition of Deplin on 10/22/07. Time will tell if it lasts.
dx: Bipolar II, with ultra rapid cycling (15 days for one complete cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)
600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil
15 mg/day Deplin
Posted by Phillipa on October 31, 2007, at 19:49:03
In reply to Brief Interuption in Thread. Deplin Back on Soon. » Larry Hoover, posted by Ron Hill on October 31, 2007, at 13:03:34
Ron what if testing of the blood reveals higher than normal B12? And you're not anemic what will Deplin do then. I know I'm not the smartest cookie in the world. Phillipa
Posted by Ron Hill on October 31, 2007, at 23:32:04
In reply to Re: Brief Interuption in Thread. Deplin Back on Soon. » Ron Hill, posted by Phillipa on October 31, 2007, at 19:49:03
> Ron what if testing of the blood reveals higher than normal B12? And you're not anemic what will Deplin do then. I know I'm not the smartest cookie in the world. Phillipa
Jan,
You are bright; never believe otherwise!!
An increase in the amount of L-methylfolate (Deplin) in the brain cell requires an increase of B12 in order to avoid methyl trap hypothysis. Further, if B12 deficiency does occur, a condition of megaloblastic anemia would not become obvious and the vitamin B12 deficiency would be masked.
For a fuller discussion of this issue, read page 5 of the following link. The text is complicated, so read, re-read, and read again. Just skip the words you do not know, or look them up in an online medical dictionary. The diagrams are your friends. Use the diagrams to follow along as you read the text.
Here's the link: http://www.metafolin.com/pdfs/Scientific_Review_13.12.pdf
-- Ron
Posted by Larry Hoover on November 1, 2007, at 14:52:18
In reply to Brief Interuption in Thread. Deplin Back on Soon. » Larry Hoover, posted by Ron Hill on October 31, 2007, at 13:03:34
> > That's just one of the reasons you've been missed, buddy. You 'splain everything.
>
> > Lar
>
> Thanks, Lar.
>
> It's great that you've stuck around here. I need you here to catch my errors and correct me when I say something blatantly false. And second, when I have questions, I can knock on your door.Well, I hope I can live up to your praise.
> You're one of the elite "go to guys" 'round these parts. You da man, Lar. You da man.
Thanks.
> Lar, is your neuropathy pain as bad as it has been in the past?No, but....
I've seen some modest improvement, but the last time I took the McGill Pain Questionnaire, I'm still scoring at the 91st percentile.
> Are you still taking neurontin?
I simply can't tolerate the side effects. They didn't moderate with time, they increased.
> And, weren't you taking tramadol at one point?
Long long time ago, and not for this issue. It pooped out real quickly, in any case, so I used it as a booster, transiently.
> Oxy for the pain?
Well, now there's a story. I developed a serious adverse reaction to the drug. Despite stable dosing of continual release oxycodone, I was suffering from symptoms of withdrawal. I lost ~60 lbs., drenching night sweats, panic attacks, abdominal pain. I had to do a full withdrawal, without any medical support. Long story.
My only true pain treatment, just now, is stellate ganglion nerve blocks, every four weeks or so. They may be responsible for some modest improvement in my symptoms of complex regional pain syndrome.
>
> Do you still have good movement in your elbow and arm?Ya, but.....As everything I do with it hurts, I'm losing muscle mass. I've got $6,000 in guitars, getting dusty. :-/
> If I recall correctly, you made your way through the health care system to the stage where you were allowed to see the specialist, right or wrong?Well, ya, but....Worker's Comp is refusing to pay for ongoing treatment with the nerve blocks, despite my not yet being discharged from treatment. It costs me $300 round trip each treatment for a taxi, but my lawyer says I should be able to get that back, at some point. Considering there's a year wait list to get into this pain clinic, and they're still treating me, I'd expect that the treatments are medically necessary. Worker's Comp is thinking about it.
> If so, are you allowed to see the specialist on an ongoing basis?
I'm still going, but the red tape is a full time job.
> Bring me up to speed with regard to your current condition and your current med cocktail.
Just prior to the opiate withdrawal (and significantly coinciding with it), I was suicidal. Two days before my last opiate dose (self tapered), my dad died. 3 1/2 weeks later, my mom died. I entered a period of significant challenges, with mood problems, cognitive problems, memory problems. I had three serious kitchen incidents, turning on the stove and forgetting all about it. I invented a new way to make tear gas: put a dozen eggs (and water) in a teflon pot, turn on high, and forget about them. After an hour or so, you get teflon degradation products, combined with sulphur compounds and amine derivatives from the carbonizing eggs.
Prozac, 20 mg
Restoril, 30 mg
Surmontil, 25 mgIt's a long story, but I also concluded that my thyroid function was suppressed (opiates and stress can each do this). I got hold of some Armour thyroid, and I've been self-treating. I think, based on how things are going, that I was absolutely correct. I *was* feeling totally burned out. Now, I'm getting some resiliency back. I'm doing a little better, but I have to emphasize, this is relative.
> Maybe we should redirect to a fresh thread on the med page so we can get outta the way here. What say?
>
> -- RonWell, we'll be the Brief Interruption.
Lar
Go forward in 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
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