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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sonic_gb on December 10, 2007, at 14:46:30
Hello All,
I hope I can draw on some of the collective wisdom here. Summary: I was admitted last Thursday for inpatient care for severe depression anxiety and insomnia. Meds were Wellbutrin SR 150mg 3x/day, Clonazepam, Oxazepam. The Wellbutrin only made the depression and anxiety worse. I was (and still am) dependant on the benzos, and I think they also made the depression worse.
I finally saw the psychiatrist today for the first time. He agrees that Wellbutrin is totally wrong for me. I've been refusing to take it for 2 days anyways. He too me off it. Because of many, many previous treatment failures on just about every class of AD excpet for one short-lived glowing experience w/ Moclobemide, he has agreed to try me on Nardil dosage TBD. But since I was on Wellbutrin he says I need to wait two weeks to start. Is there any literature to the contrary? I can't find any specific studies.
Also, if I DO have 2 wait 2 weeks, is there any reason I can't use Moclobemide in the meantime? There is no interaction between Moclobemide and Bupropion, but I'm not sure if there is a washout period between Moclobemide AND Nardil.
Also, I'm tapering off the benzos, and tapering up Seroquel. Is this going to help with insomnia and daytime anxiety? What sort of dose range, and timing should I be looking for?
Any overall comments on this treatment plan?
I would really appreciate any help or advice that can be offerred here.
Thanks,
Sonic
Posted by Maxime on December 10, 2007, at 16:47:15
In reply to Update w/ Questions MAOI, Bupropion..., posted by sonic_gb on December 10, 2007, at 14:46:30
I am glad you finally saw the psychiatrist. I think you should do a two week washout and then try the Nardil. If you introduce another med too soon, you won't know how well the Nardil is doing. You've waited this long, wait another two weeks if you can.
As you know, I was taken off 3.5 mg of Clonazepam. The Seroquel is holding me together. It helps my anxiety a great deal. I am on 100 mg. I hope it will do the same for you.
Maxime
Posted by Racer on December 10, 2007, at 17:07:57
In reply to Re: Update w/ Questions MAOI, Bupropion... » sonic_gb, posted by Maxime on December 10, 2007, at 16:47:15
There is some small body of literature out there that says that, in very brittle patients, you can actually cross taper from Wellbutrin to an MAOI -- although never the other way about. I can't remember the guy's name -- maybe something like Schott? Schute? I can't remember, but he's a big name with Emsam, which might ring a bell with someone.
I was tapered off Wellbutrin AFTER starting EMSAM, because my doctor had just attended a workshop with this guy. It has to be done with care, and with close supervision -- something you're getting in the hospital.
If I can find that name, I'll post it. Otherwise, try running a search for EMSAM and Wellbutrin, or maybe brittle patients...
Posted by Phillipa on December 10, 2007, at 18:17:40
In reply to Re: Update w/ Questions MAOI, Bupropion..., posted by Racer on December 10, 2007, at 17:07:57
That's a first don't think many know of this. Phillipa
Posted by jedi on December 12, 2007, at 22:14:57
In reply to Update w/ Questions MAOI, Bupropion..., posted by sonic_gb on December 10, 2007, at 14:46:30
Hi Sonic,
I can't put my hands on the literature right now, but I have taken Nardil at 90mg and bupropion at 300mg simultaneously. Elisabeth, a very intelligent ex-poster on the board, gave me the idea. It is totally contraindicated and I have had PDOCS who said it would kill me, but I'm still here. I'll look for the reference. The negetive references will far outnumber the positive ones.After you get Nardil up to it's affective dosage, you will find it will blow MOC away for both social anxiety and atypical depression. Nardil is the bomb. You may have a period of euphoria when the med first starts to take effect. This will go away, so don't misinterpret it for poop-out. Patients that are in it just to chase the nardil euphoria, won't be in the race very long.
I'm on 2mg of clonazepam for augmentation of social anxiety. I've been off clonazepam a few times and it does not seem to make a difference in my atypical depression. We are all a unique bunch. I take a small dosage of Seroquel(25 to 50mg) for the Nardil induced insomnia. It works great for this and I have had no tolerance issues after at least six months.
Good Luck Sonic,
Jedi
> Hello All,
>
> I hope I can draw on some of the collective wisdom here. Summary: I was admitted last Thursday for inpatient care for severe depression anxiety and insomnia. Meds were Wellbutrin SR 150mg 3x/day, Clonazepam, Oxazepam. The Wellbutrin only made the depression and anxiety worse. I was (and still am) dependant on the benzos, and I think they also made the depression worse.>
> I finally saw the psychiatrist today for the first time. He agrees that Wellbutrin is totally wrong for me. I've been refusing to take it for 2 days anyways. He too me off it. Because of many, many previous treatment failures on just about every class of AD excpet for one short-lived glowing experience w/ Moclobemide, he has agreed to try me on Nardil dosage TBD. But since I was on Wellbutrin he says I need to wait two weeks to start. Is there any literature to the contrary? I can't find any specific studies.
>
> Also, if I DO have 2 wait 2 weeks, is there any reason I can't use Moclobemide in the meantime? There is no interaction between Moclobemide and Bupropion, but I'm not sure if there is a washout period between Moclobemide AND Nardil.
>
> Also, I'm tapering off the benzos, and tapering up Seroquel. Is this going to help with insomnia and daytime anxiety? What sort of dose range, and timing should I be looking for?
>
> Any overall comments on this treatment plan?
>
> I would really appreciate any help or advice that can be offerred here.
>
> Thanks,
>
> Sonic
Posted by sonic_gb on December 13, 2007, at 2:04:38
In reply to Re: Update w/ Questions MAOI, Bupropion... » sonic_gb, posted by jedi on December 12, 2007, at 22:14:57
Thanks Jedi,
That's great info. I appreciate your experience and advice!
Sonic
> Hi Sonic,
> I can't put my hands on the literature right now, but I have taken Nardil at 90mg and bupropion at 300mg simultaneously. Elisabeth, a very intelligent ex-poster on the board, gave me the idea. It is totally contraindicated and I have had PDOCS who said it would kill me, but I'm still here. I'll look for the reference. The negetive references will far outnumber the positive ones.
>
> After you get Nardil up to it's affective dosage, you will find it will blow MOC away for both social anxiety and atypical depression. Nardil is the bomb. You may have a period of euphoria when the med first starts to take effect. This will go away, so don't misinterpret it for poop-out. Patients that are in it just to chase the nardil euphoria, won't be in the race very long.
>
> I'm on 2mg of clonazepam for augmentation of social anxiety. I've been off clonazepam a few times and it does not seem to make a difference in my atypical depression. We are all a unique bunch. I take a small dosage of Seroquel(25 to 50mg) for the Nardil induced insomnia. It works great for this and I have had no tolerance issues after at least six months.
>
> Good Luck Sonic,
> Jedi
>
>
> > Hello All,
> >
> > I hope I can draw on some of the collective wisdom here. Summary: I was admitted last Thursday for inpatient care for severe depression anxiety and insomnia. Meds were Wellbutrin SR 150mg 3x/day, Clonazepam, Oxazepam. The Wellbutrin only made the depression and anxiety worse. I was (and still am) dependant on the benzos, and I think they also made the depression worse.
>
> >
> > I finally saw the psychiatrist today for the first time. He agrees that Wellbutrin is totally wrong for me. I've been refusing to take it for 2 days anyways. He too me off it. Because of many, many previous treatment failures on just about every class of AD excpet for one short-lived glowing experience w/ Moclobemide, he has agreed to try me on Nardil dosage TBD. But since I was on Wellbutrin he says I need to wait two weeks to start. Is there any literature to the contrary? I can't find any specific studies.
> >
> > Also, if I DO have 2 wait 2 weeks, is there any reason I can't use Moclobemide in the meantime? There is no interaction between Moclobemide and Bupropion, but I'm not sure if there is a washout period between Moclobemide AND Nardil.
> >
> > Also, I'm tapering off the benzos, and tapering up Seroquel. Is this going to help with insomnia and daytime anxiety? What sort of dose range, and timing should I be looking for?
> >
> > Any overall comments on this treatment plan?
> >
> > I would really appreciate any help or advice that can be offerred here.
> >
> > Thanks,
> >
> > Sonic
>
>
Posted by sonic_gb on December 13, 2007, at 2:11:23
In reply to Update w/ Questions MAOI, Bupropion..., posted by sonic_gb on December 10, 2007, at 14:46:30
Unfortunately, it looks like this forum is a little too public, and my anonymity has been compromised. And this isn't just unfounded paranoia, but fairly concrete. I won't post again unfortunately.
It's too bad to lose such a great resource with so many knowledgeable people for support. I will keep reading threads, but just won't be able to post again. Maybe I'll come back soon under a different name with slightly different information. In the mean time I will fade into the background.
Thanks everyone for all your help and support over the last few months.
Sonic
Posted by ny2bk on December 14, 2007, at 7:42:31
In reply to Last post on PB unfortunately..., posted by sonic_gb on December 13, 2007, at 2:11:23
> Unfortunately, it looks like this forum is a little too public, and my anonymity has been compromised. And this isn't just unfounded paranoia, but fairly concrete. I won't post again unfortunately.
>
> It's too bad to lose such a great resource with so many knowledgeable people for support. I will keep reading threads, but just won't be able to post again. Maybe I'll come back soon under a different name with slightly different information. In the mean time I will fade into the background.
>
> Thanks everyone for all your help and support over the last few months.
>
> SonicYess,and aside from what you might mean in regard to this group,google itself mirrors everything,i actualy found postings of mine put into other sites,via cached,(locked in,framed)threads,so its crucial one knows this and uses a good handle because google keeps it all!
Posted by Phillipa on December 14, 2007, at 19:23:53
In reply to Re: Last post on PB unfortunately..., posted by ny2bk on December 14, 2007, at 7:42:31
Same here many times I was on google. Phillipa
Posted by tgo on December 16, 2007, at 9:25:09
In reply to Re: Update w/ Questions MAOI, Bupropion... » sonic_gb, posted by jedi on December 12, 2007, at 22:14:57
Jedi, how long have you been on Nardil and how much weight have you gained. Are there any options to combat weight gain while on Nardil?
tgo
Posted by jedi on December 16, 2007, at 12:14:08
In reply to Re: Update w/ Questions MAOI, Bupropion... » jedi, posted by tgo on December 16, 2007, at 9:25:09
> Jedi, how long have you been on Nardil and how much weight have you gained. Are there any options to combat weight gain while on Nardil?
>
> tgoHi,
I've been on Nardil for most of the past 11 years. I have tried to quit for other med trials about four times. Each time my major depression returned.At one point I had gained more than 100 pounds from the atypical depression and Nardil. One year with intense exercise (two hours a day) and a low carb diet I was able to take off 80 pounds. 30 of that has slowly come back.
It is very easy to gain huge amounts of weight in a short time on Nardil. It really increases my cravings for sweet carbohydrates and I believe lowers my metabolism also.
Not funny, but weird how a medication used to treat bulimia can cause such cravings for food.
I consider Nardil to be "The Bomb" in the treatment of atypical depression. Ironically, one of the symptoms of atypical depression is weight gain, while one of the side effects of the med used to treat it is weight gain.
Be well,
Jedi
This is the end of the thread.
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