![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 7 to 31 of 76. Go back in thread:
Posted by ed_uk2010 on July 27, 2010, at 15:46:35
In reply to Re: Nardil is killing me - must find alternative! Help, posted by emmanuel98 on July 26, 2010, at 20:53:40
> If you're going to Boston, I recommend Dr. Carl Salzman at Harvard Med and Beth Israel hospital. He charges A LOT for an initial consultation, but he helped me immeasurably.
Just out of curiousity, approximately how much does he charge?
Posted by emmanuel98 on July 27, 2010, at 19:24:36
In reply to Re: Nardil is killing me - must find alternative! Help » emmanuel98, posted by ed_uk2010 on July 27, 2010, at 15:46:35
He charged me $375 -- doesn't take insurance. Fortunately I have some out of network benefits. As far as linkadge's question, I would say a good p-doc is one with extensive CLINICAL experience -- often these are older docs who have worked with TCAs, old APs, MAOIs as well as the newer generation of drugs. Salzman must be 75. My own p-doc is 71 and does therapy with me -- he still does therapy. A lot of younger p-docs have mostly theoretical knowledge,from med school, residencies, drug reps, journal articles (a fair percentage of them ghostwritten by drug companies). As opposed to actual clinical experience seeing how patients have responded, what type of patient responds to what type of drug, what drugs mix well together and what don't, etc.
Posted by Hombre on July 27, 2010, at 20:58:30
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
I'm sorry to hear that you are having so much trouble with meds and side effects.
The sweating and urinary problems indicate weak kidneys. I have this problem too and take herbs to strengthen the kidneys. I have mostly eliminated the night sweats and have no trouble peeing.
As for not being able to lose weight, that depends a lot on your constitution and what you eat. Diet is highly personal and one-size-fits-all diets tend to be too simplistic or extreme in one way or another.
What body type are you--that is, what body type were you growing up and before illness and meds threw things out of whack? Sort of round and soft? Muscular and lean? Thin and wispy? Are you a high energy type of person, Type-A, loud and run hot? [Edit: ok, you say you overheat a lot] Do you tend to avoid movement and often feel cold, reticent and quiet?
What kind of foods do you regularly eat? Do you have low blood sugar problems? Do you crave carbs? If so, what types of carbs do you eat? Would you say you have a strong or weak appetite? Do you tend to under-eat or over-eat? Do you feel bloated and gassy after eating, or like the food just sits there? Do you get tired after eating? Do you have chronic constipation or diarrhea?
I'm starting to think that meds will not work if the body itself is not balanced and strong. The mind, of course, wherever it lives, depends on the body for energy. Physical energy is #1, then emotional, then mental, then spiritual (more like having strong beliefs and living by them rather than "religion"). When we get physically tired, the first thing to happen is that we start to feel weird or bad. Then our thinking turns negative. Finally, our spirit flags and we lose hope and believe that everything is F-ed. We think we can ignore the foundation of the energetic pyramid, namely physical energy, but without that the other levels have nothing to stand on. Meds can only do so much with what you got. A great manager can only do so much if the employees and the facilities are in bad shape or can't work together.
Not blaming you, just trying to put things in perspective. So many people have these mysterious reactions or non-reactions to meds, and docs are mostly useless when it comes explaining why.
Don't take my word for it, but you sound like you have/the meds cause Yin deficiency. That means you're like an oil lamp with low oil and a wick that's too large. The flame is too big and it burns up all the oil quickly. Insomnia, agitation, night sweats, frequent urination, nocturnal emission (for guys), anxiety, are common symptoms. Psyche meds will often try to make the flame burn higher to create energy, but at the cost of the oil. How to increase the oil? Go to bed very early, maybe before 10pm. Sounds crazy, but it doesn't cost a dime. Stay away from stimulants. If you're a guy, ease up on the sex a bit. Get plenty of rest. Meditate if you can, or take slow walks around plenty of nature. Herbs.
Which herbs? That's a tough one. It also sounds like you have some digestive issues, but that could be indirectly caused by hormonal imbalance. That's getting into some subtle territory. Balancing the kidneys can also regulate endocrine function. Sometimes regulating the thyroid and sex hormones indirectly by strengthening the kidneys (Chinese medicine calls them kidneys, but they encompass so much more than the anatomical kidneys) can have far reaching effects. I also put on weight from my meds, but the kidney tonic I take also helps me to stay leaner by increasing thyroid and/or testosterone, I believe. Who cares why, it works.
But for the kidney problem I would suggest a very famous formula, called Rehmannia Six. In Chinese, It's called "Liu Wei Di Huang Wan", or Six Flavor Rehmannia Pills. It's indicated for those types that tend to "burn the candle at both ends". That fits out metaphor of not enough oil/wax. There are also some other formulas for nourishing blood, calming the spirit, helping with sleep. Take a look at this page for some ideas:
http://www.bestchinesemedicines.com/group.php?gid=0
It's not rocket science, just match your symptoms to those indicated for a particular formula. Watch the contraindications as well. Don't let the "foreign-ness" throw you off. Pretend it's Latin.
As for exercise, I would recommend interval training. Short, intense bursts of activity followed by short rest. E.g. All out sprint for 10 seconds, then 30 seconds rest. Rinse and repeat several times. You're done in 10 to 20 minutes, but they will be some tough minutes. Same thing with weights or bodyweight calisthenics. Lift heavy for few reps, short rest, move to the next exercise. Don't ever train to failure. Prolonged low-intensity aerobics do little to help with weight loss. Get in, do the work, get out while still fresh. Your energy and ability to handle stress will benefit greatly from this approach. You won't burn as many calories compared to low-intensity aerobics, but after the workout ends you'll burn a ton more while you go about your day. You'll find plenty of studies to back this point up, but for some reason the treadmill and elliptical are still considered fat burners.
Best of luck.
Posted by Hombre on July 27, 2010, at 21:25:51
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
I should read more clearly before posting. I stand by what I wrote, but you already provided the answers to some of my questions:
I'm going to paraphrase from James Green's "The Male Herbal" because he dose such an elegant job describing constitutional typing without getting into obscure "oriental" ideas:
You have a Warrior type/mesomorph constitution. You used to lift a lot and had a good physique. I'm assuming you also have a personality to match. You have lots of fire and brave spirit. You strive for action and crushing obstables. Unchecked, you can tend to run hot, like a fire out of control. You are strong and disciplined.
You may have a strongly anabolic physiology, your body tends to store and retain things it doesn't need, such as uric acid and excess sodium and cholesterol. When you are irritated, your tissues tend to become inflamed easily. That's your body reacting with an aggressive response, true to your nature. Sometimes too much, however.
Your most serious chronic problem involves the circulatory system. Retaining sodium and cholesterol could, over time, lead to heart disease and high blood pressure.
Your digestion tends to be robust, maybe even excessive in terms of secretion of digestive juices. Alcohol, spices and coffee may tend to aggravate your stomach. You may be able to handle greasy foods better than most.
"To help tame the Warrior's digestive fire and promote harmony and longevity, treatment is aimed at soothing, cooling, and protecting the membranes of the GI tract [soothing and cooling are to enhance Yin to balance overacting Yang].
Herbs include demulcents such as Marshmallow root or Slippery Elm bark, which act to soothe and protect tissues; astringents like Geranium, Blackberry root, and Agrimony, which cool and reduce irritation and inflammation of the GI tract's lining; Chamomile and Yarrow, which are useful for their anti-inflammatory actions; Skullcap or Chamomile, which, as cooling anesthetics, reduce sensitivity to pain, along with the antacid action of Marshmallow and Meadowsweet to relieve painful discomfort.
If a warrior's digestive fire gets too high, spices in general should be avoided, and cooling digestive bitters that can lower the fire and help detoxify the system should be taken; Gentian, Aloe, and Barberry are recommended for this action. Once the digestive fire is normalized, mild harmonizing spices such as Coriander, Turmeric, Cardamom, and Fennel can be taken to maintain balance."
"With respect to the prostate, inflammatory problems often complicate the Warrior-dominant condition. There is a tendency towards infection and irritation of the prostate, with a burning sensation during urination. Stimulating, warming, and anabolic herbs such as American or Chinese Ginseng are contraindicated...in this situation, for we have an individual who already has asn innate tendency to be warm and stimulated and whose anabolic hormones already tend to be excessive...[herbs appropriate for the Warrior:]
o Saw Palmetto and nettle root as general prostate tonics
o Echinacea and Cleavers as anti-inflammatories and protectants against infection
o Marshmallow and Couchgrass as soothing demulcents for tissue irritation"
"Overall, the warrior-dominant body needs cleansing to help balance its inherent accumulation of metabolic wastes. The Warrior wants to hold on but is served much better by letting go. To facilitate this action, toning the organs of elimination and circulation, along with a gentle herbal cleansing program, is efficient and helpful. For kidney maintenance, use herbs such as Burdock root, Cleavers, and Stinging Nettle; clean and nourish the liver with Dandelion root, Globe Artichoke leaf, Barberry, and Yellow Dock. Buffer excessive acidity and adjust blood viscosity with Alfalfa, Gingko, and Feverfew...and protect the CV system from damage by regular use of Hawthorne flower and berry."
"Diet can play a big role in balancing the warrior's anabolic nature. This is best done by minimizing fat and protein intake. warrior-dominant individuals do well with a moderate amount of meat in their diet. Nonetheless, the diet should emphasize fruits and vegetables. Raw foods are suitable, for the Warrior's digestive fire is normally high. Grains and beans are a good choice for providing substance, and, in small quantities, low-fat dairy products are a reasonable choice. In general, when choosing food and herbs for a Warrior-dominant person, think cooling and cleansing, but don't overdo it."
The difficult thing is that the meds mess with your metabolism, but taking your constitution into account while dealing with the med's side-effects may make it a bit easier to work with your body and get it to balance out and return to its normal state.
Hope that helps.
Posted by Enigma on July 28, 2010, at 15:00:33
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by ed_uk2010 on July 24, 2010, at 17:41:34
> >Selegiline worked (for a while) and I want to switch back to it (but poops out rather fast). Emsam worked for my depression but I was allergic to the dermal transfer technology and got awful poison ivy (well worse) rashes.......
>
> Have you tried selegiline orally disintegrating tablets (Zelapar)?
>
> Zelapar is only approved for use in Parkinson's disease but it may have other applications. With Zelapar, the selegiline is absorbed across the lining of the mouth. The idea is to reduce MAO inhibition in the gut and to reduce the formation of selegiline metabolites (which may cause adverse effects).
>
> I have no idea what dose of Zelapar would be needed to exert an antidepressant effect. It would be useful to hear from someone who has tried it.
>I tried Selegeline tablets, but not Zelapar. I'll ask my new doctor whenever I get to see him.
The sweating from Nardil is unbearable. This extra sweating made my vacation impossible. I had to go on flume rides and get soaked as a means to cool off!.
Posted by Enigma on July 28, 2010, at 15:28:50
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
Very interesting philosophy, or point of view. I do know of some herbal Chinese medicine stores in the next city over from mine. I'll try any approach at this point, but I think getting off of Nardil is my main goal for now. It causes WAY too many side effects to have to hunt down and eliminate. I don't just get night sweat, my whole body overheats and it now no longer has any idea how to cool itself. That's really what's broken. It doesn't know when to shut off the sweat, so I'm miserable pretty much anywhere I put in "just a little bit" of exertion. Picking up a few boxes and movies, yep, that's enough. When I take a cool shower, no heat, I sweat for 10 mins after the shower, kinda defeating the purpose of the shower.
I was just bedridden for 5 days. I went to the beach and wore myself out, I guess. Swam for hours in a row, walked forever, same thing the next day, then drank one night when some jerk (me) accepted a hard alcohol shot after drinking beer (*always* does me in), I felt that the next day, but went to a water park and amuzement park anyway. Checked the scale when I got home. 191. I must have burned a ridiculous amount of calories, and nada, no weight loss..Thanx nardil. But, I did get to add another "girl to fall in love with", and tossed her in her special compartment in my brain. Getting full up there.
I'm just a mess. I HATE how I look, tried all kinds of different weight loss plans, work-outs, and Nardil (I know it's Nardil) fights me every step of the way). I crying more and more, and I never used to cry 6 months ago, and I'm sad a lonely. I could on and on. when I was on the beach, I was listening to my headphones with my head covered up (since I was fried), and for no reason, started thinking about this soul-mate I found/lost 5.5 years ago, yep, 5 1/2 years. I tried going to a therapist to get her out of my head, and she said that you probably won't be able to get rid of her memory as long as she thinking of her makes you happy and you can't replace her in real life. That's just great. It took me 14 years of marriage just to find her. Finding her, made me lose my marriage (long story), so now I'm emotionally all alone, which hurts like hell. Anyway, I've digressed quite a bit.
I've still got my kids, but they don't replace the love you get/give to a woman.
Bah. I wish I was a dog.
Posted by Ron Hill on July 29, 2010, at 6:34:14
In reply to Nardil is killing me - must find alternative! Help, posted by Enigma on July 24, 2010, at 13:01:13
Enigma,
I'm very sorry for your suffering.
Have you ever added some lithium to minimize or eliminate your suicidal thoughts? Research shows that lithium is one of best meds to tx suicidal thoughts. Here is a paper. Search the document for the word "lithium" and read those sections:
http://ajp.psychiatryonline.org/cgi/content/full/157/12/1925
Start at 300 mg/day of an extended release lithium formulation. The med called Lithobid is a good med.
I would only go as high as is needed to stop the suicidal thoughts. My experience is that at about 900 mg/day I begin to have some bloating. If 300 or 600 mg/day stops the suicidal thoughts, then it would be well worth the addition of the Lithobid.
I take 90 mg/day of Nardil as part of my med combo. My med combo list is provided at the close of this post.
I have gained 70 pounds due to Nardil. I need the med but, like you, I hate the appearance of my pot belly body.
Prior to p-meds, I always weighed 172 during training and by race day (triathlon) I'd always be right at 155 pounds. I'm 5'11". Today I weight 251 pounds, and I do not know how in the h*ll to cut the weight. I eat 1000 calories per day.
You and I never guessed we would ever look like this, did we? Never in a million years!! I always trained hard and my friends used to say I looked buff. The mirror used to be my friend. Now, I avoid mirrors at all costs.
I often want to hang a sign around my neck that says:
"This Massive Weight Gain is Medication Induced. I'm not a Gluttoness Slob."
So you are not alone my friend. Here are a couple of thoughts:
Have you ever tried Parnate? A while back I discontinued my beloved Nardil for a trial of Parnate. I gave 80 mg/day of Parnate four months to kick-in, but it never did provide an antidepressant action for me. But, it might work for you.
During my four months off of Nardil, my potbelly melted away, erectile dysfunction ceased, and my orgasms returned. The side effects of Nardil are dosage dependent. In other words, as the Nardil dosage is increased, the intensity of the side effects typically increases.
Second, as Jan mentioned, some patients consider taking Metformin. But, it has risks and issues:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000974
Find a way to be well my friend.
Problems are solutions waiting to be found. However, having said that, I am well aware of the debilitating h*ll of bipolar depression.
Don't give up, Enigma. There are many things to try.
Please tell me all of the meds that you currently take.
-- Ron
dx: Bipolar II with ultra rapid cycling, and mild OCPD
600 mg/day Trileptal
200 mg/day Lamictal
500 mg/day Keppra
90 mg/day Nardil
3.75 mg/day Deplin (taken with 2500 mcg/day of sublingual methyl B-12, and 12.5mg/day of sublingual P-5-P)35 ml of Calsons Bottled Fish Oil
100 mg/day phosphatidylserene
Centrum Chewable Multi-vitamins; Only 100% of all the usual vitamins
2000 IU Vitamin E
850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate).
Dark therapy via LowBlueLight glasses (When I remember)
The following are my up and coming add-on trials:25 mg/day agomelatine (Valdoxan)
300 mg/day of lithum carbonate
CoQ10
NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid, + Vitamin C
GTF Chromium
Cromium Picolinate
Cinnamon
Posted by Phillipa on July 29, 2010, at 19:43:08
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by Ron Hill on July 29, 2010, at 6:34:14
Ron what's this about the thyroid as quite frequently type II diabetes and hypothyroidism go hand and hand. My neice is on metformin for above. And she drinks. Jan
Posted by Ron Hill on July 30, 2010, at 4:34:43
In reply to Re: Nardil is killing me - must find alternative! Help » Ron Hill, posted by Phillipa on July 29, 2010, at 19:43:08
> Ron what's this about the thyroid as quite frequently type II diabetes and hypothyroidism go hand and hand. My neice is on metformin for above. And she drinks. Jan
--------------------------------------
Hi Jan,
Sorry, I do not know the answer to your question.
Be well my friend.
-- Ron
Posted by Enigma on August 1, 2010, at 20:22:04
In reply to Re: Nardil is killing me - must find alternative! Help » Phillipa, posted by Ron Hill on July 30, 2010, at 4:34:43
Well, last 2 days (including today), bedridden, suicidal (almost cut myself again), and just endured pure mental and even physical pain. I have some odd illness in my gut where it's too hard to even explain the symptoms for, but gonna call my gastro guy tomorrow if I can or if I'm up to it. Just a couple beautiful days to remind myself how little hope I have, how I have no friends, and my wife just went on a date.
Check this out. We got non-legally separated 10 months ago or such, and I spent that entire time trying to find a women on as many dating sites as I could. She goes on a 3 day free weekend (dating site), and finds a guy she likes in 2 days. If that's not depressing, I don't know what is.
I haven't kissed a girl in years? (an adult woman)
I haven't hugged a woman in years?
Forget about the other thing that starts with S.Look up Vythic on M.C - That's me! Of course, I always go for beauty *1st) and women are too vain to hook up with a lesser guy in looks, even though my personality is generally better (via profiles) (sorry women, I've researched this for 25 years, and I've been dead on, *every time*)
Oh well, I wish I could hypnotize my kids into thinking I never existed, then then saying goodbye to this world would be SO much easier. Those 3 are the ONLY ones keeping me here. Dad's already gone. Karma caught up with him, but not my evil mom and brother yet. I'd love to die just to hurt them. Man, it's all in my book, except I don't know how to publish it. If anyone can help me out there, I'd really appreciate it.
Posted by Phillipa on August 1, 2010, at 20:38:17
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Enigma on August 1, 2010, at 20:22:04
Enigma what the heck is MC? And stop this talk now!!!! You can do it I know you can. Think the stomach is the cause of your mental health problems. It's possible you know? Do you have a gastro diagnosis? Love Phillipa
Posted by Enigma on August 4, 2010, at 17:47:53
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by Phillipa on August 1, 2010, at 20:38:17
> Enigma what the heck is MC? And stop this talk now!!!! You can do it I know you can. Think the stomach is the cause of your mental health problems. It's possible you know? Do you have a gastro diagnosis? Love Phillipa
MC = match dot com, or as I like to call it MenGetRejectedTimesInfinity dot com
Philipa, I've been fighting the "severe" depression for 10 years now, the mania and minor depression for about 7.
I'm getting worse, progressively, each and every month. Willpower doesn't cut it when the chemicals in your brain are as f-ed up as mine are. I tried, gave it a good shot too, and probably outlasted most people I know.
But being realistic, I have about 2 drugs left, one of which I've already tried (Selegeline) and that's failed me already, then there Marplan which I forget if I've tried.
There's VNS (Vagus Nerve Stimulation) and DBS (Deep Brain Stimulation). Same thing?? Both of which I cannot even come close to affording. If my mother thankfully would stop running from her negative Karma, death would take her too, like it took my Dad (and no, I want them both dead - they caused this disorder by living in that "hell-house" with their own disorders they never treated - emotional and physical abuse, and so much more (it's all in my unpublished book - "Imprisoned by a Broken Mind", paying for my surgery, which is STILL no guarantee of a cure. The surgery, after throwing all that money away STILL could be a complete waste. Hell, I could die during surgery.
So, if I can't afford the operation, I'd say the meds will poop out in about 3 months for Selegeline, and who knows about Marplan (do they still make it?). I could have only 6-12 months left to live.
Right now, with no love in my life, I'm burning out even faster. I count the days I don't cry now, and there hasn't been one in a while.Chemistry sucks, Genetics Sucks, Biology sucks. I Still, just like when I was 20, am still picky when it comes to women, and nothing I've tried has been able to alter that. I have no friends, since they all abandoned me, literally, and wouldn't even give me the 1 night out a month which is all I asked of them. These are highschool and childhood friends!!! Not the fake co-worker "friends". I still can't believe they just left me here to rot away and die. So, I haven't been to a night club (any type) because when you go alone, *everyone* there (especially where I live) automatically assumes you are a loser. So, been trying all the dating sites, and those have been purely demoralizing rejection. Fun to get rejected by women that you look better than, face, and body, and are 10x as smart as. Now THAT'S a slap in the face.
I'd be so bold as to link my profile so you can see what I look like, but I don't think this forum allows that.So, every corner I turn leads to a dead end. I'm really NOT being melodramatic either. I wind up doing a 360. Fail, Fail, Fail, Fail. 8 months on one dating site and not one date. My wife did it and got a date in 2 days. We're separated, still living together. She's so solace for my pain either, which is a big reason we're separated. It would help if I loved her too, which I don't, and haven't in 20 years of marriage (all of it).
To Sarah, my sole-mate whom I met 5.5 years ago. I still think of you like we met yesterday. I wish I could find her again, even just to see her face...
Posted by Phillipa on August 4, 2010, at 21:31:50
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Enigma on August 4, 2010, at 17:47:53
Enigma that's quite a story of your life. Well as you said you do still have options. And which do you feel you will start with? I can't imagine online dating. Phillipa
Posted by ed_uk2010 on August 5, 2010, at 16:21:41
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Enigma on August 4, 2010, at 17:47:53
Enigma,
Have you considered the possibility of joining a clinical trial? You might have the opportunity to try something that you wouldn't otherwise be able to.
I believe that there are also clinical trials of deep brain stimulation in progress.
http://clinicaltrials.gov/ct2/show/NCT00555698?term=deep+brain+stimulation&rank=20
Posted by Enigma on August 6, 2010, at 19:16:34
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by Phillipa on August 4, 2010, at 21:31:50
> Enigma that's quite a story of your life. Well as you said you do still have options. And which do you feel you will start with? I can't imagine online dating. Phillipa
---
(wicked short version - yeah, we say "wicked" up here in New England, since
we're a British colony, it's a use of slang, even the brit's still use)
Get rid of Nardil ASAP
Get Selegeline or better (unknown drug) ASAPIf I had the money, get more serious about VNS
Read more about DBS
---Well, in the short term, I'm still trying to get into see a new doctor, many miles from the one that quite literally ran out of options for me. He said he had no idea where to go with my treatment because we were out of meds he was familiar with. His only option was to go to a doctor 2 hours away from where I live, opposite Boston, in the boondocks of New Hampshire and get admitted to their general psych ward. Then, after an unknown period of time (in days), the doc on staff there would magically become my new shrink, and then treat me from there - with NO word on when I would get out of the ward. So, seriously, he would not take me as an office patient because he isn't accepting new patients, but WOULD if I stayed in the ward first. (WTF???) I was like, uhm, yeah, that sound REALLY promising with about 100 unknowns. NO THANKS.
Ever stay in a general ward? In other words, one that doesn't segregate by types of illness, level of severity, and age? I'm been in both. I almost ripped my head off to get out of the first ward, which was a "general" psych ward. I found the 2nd to actually feel like a prison, like the first, but at least there were suicidal depressives like me there, and bipolars, non of which talked to themselves, drooled, wore 10 pounds of makeup at 89 years of age, etc. They were all near my age, to a degree and we actually had some good conversations, but still, being without freedom to simply surf the web, watch tv, etc, I was dying to get out of there (and dying to get in there HA HA HA HA).
Man, I gotta post of the right board here to see if someone can help me publish my book. Sure there were people with worse lives out there, but not that many, I'll guarantee you that. It's educational too!!
I unfortunately read today, about VNS, that the patients (the most treatment resistance freaks like me) were the least successful with the procedure. I think it said after 6-12 months after the procedure, in this certain study, the people that failed with 6-12 meds (I failed with a LOT more), had no response to the operation. That, uhm, sucks.
My wife was reading about DBS and they were saying things about it such as it only lasting a YEAR. One year? 30k++ for a YEAR of possible, no-guarantee of success treatment of brain surgery. Read that sentence again. At least VNS said it was meant for a lifetime, -minus changing the batteries in the pulse generator. Sadly with VNS, some people don't notice a positive change for up to 2+ years!!! What am I going to do until them?
(Ren and Stimpy: Ren: Show's over man, let's go home. Stimpy: But what are we going to do till then?!?!?!...)
Posted by Phillipa on August 6, 2010, at 20:26:20
In reply to Re: Nardil is killing me - must find alternative! Help » Phillipa, posted by Enigma on August 6, 2010, at 19:16:34
Also originally from CT so a Yankee. Anyway I don't know what to say. Such a lot of money. There has to be something? I just don't know what? Phillipa
Posted by Leo33 on August 8, 2010, at 17:30:18
In reply to Re: Nardil is killing me - must find alternative! Help » Phillipa, posted by Enigma on August 6, 2010, at 19:16:34
Enigma, your life isn't as bad as you think! Seems like you have your own house, got married and had 3 kids, and have tons of energy to write on this site. Motivation to write a book.
Not to try and out do ya here, In my forties, never been married, no kids, on welfare which I have now hit my lifetime limit and 4 applications and denials from SSDI, live at home with my elderly and ailing parents, not kissed a woman in 11 years or anything else, have to go to clinic for psych nurse to prescribe meds, had to go to state hospital for inpatient after last psych nurse clinic failure in 2008.
So you are not alone, also I am not a bad looking guy either, and have college degree and a lot of travel. Women want the confident personality types, If you suffer from depression then you are not going to be that, you need that mania.
Anyway, hang in there, you are in a tough spot, but looks like you have enough inside you to fight a bit longer.
Maybe the psych's can put you on heavy anti psychotics to sedate you beyond the point that you care, seems to be the going trend. God forbid no benzo's if they actually work.
Posted by softheprairie on August 9, 2010, at 4:47:04
In reply to Re: Nardil is killing me - must find alternative! Help » Enigma, posted by ed_uk2010 on July 24, 2010, at 17:41:34
> >Selegiline worked (for a while) and I want to switch back to it (but poops out rather fast). Emsam worked for my depression but I was allergic to the dermal transfer technology and got awful poison ivy (well worse) rashes.......
>
> Have you tried selegiline orally disintegrating tablets (Zelapar)?
>
> Zelapar is only approved for use in Parkinson's disease but it may have other applications. With Zelapar, the selegiline is absorbed across the lining of the mouth. The idea is to reduce MAO inhibition in the gut and to reduce the formation of selegiline metabolites (which may cause adverse effects).
>
> I have no idea what dose of Zelapar would be needed to exert an antidepressant effect. It would be useful to hear from someone who has tried it.
>
I took Zelapar in 2007-2008. I found some benefit from Emsam, but did not like the patch form, and asked my pdoc if other forms of selegiline were available. I took the dose of Zelapar where each orally disintegrating tablet was 1.25 mg, and I slowly worked up to 15 mg., or something like that. Although, I guess that doesn't divide evenly. Maybe it was 16 mg. I am pretty sure I got up to 10 or more tablets a day. It gave me a little relief, but I came to think it wasn't enough, and I wanted to move on to try something else. (Also, the hassle of following the MAOI diet when on that high of a dose. Plus, I knew I was costing the insurance a lot, for not much benefit.)Just as a warning, I am kind of surprised my insurance covered it. I think this high of a dose was costing them something like a thousand dollars a month.
Luckily, desipramine has been much better for me, and I don't have to follow those diet and other med restristions of MAOIs any more.
Posted by donald Klein on August 9, 2010, at 8:11:01
In reply to Re: the Zelapar form of selegiline, posted by softheprairie on August 9, 2010, at 4:47:04
I believe the difficulty is the concurrent use of hi doses of bzd
with maoi which renders them sedative to the point of toxicity.
of course very difficult to withdraw from hi dose bzd as outpatient
so detox as inpatient may be necessary. Have seen "refractory"
depressives on this combination relieved by bzd discontinuation
Posted by Enigma on August 9, 2010, at 18:50:14
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Leo33 on August 8, 2010, at 17:30:18
> Enigma, your life isn't as bad as you think! Seems like you have your own house, got married and had 3 kids, and have tons of energy to write on this site. Motivation to write a book.
>Well, I wrote the book now, 1-2 years ago. I couldn't do it now. The kids were easy on my part :). First try, all 3. Must have some serious swimmers.
Energy? No. Anger, hatred, maybe. Depression sucked out all the energy I used to have. I did get a hypo-manic day on Saturday so I went out for the first time in 6 months, all alone. I told myself not to do it, but I did anyway. Had a horrible, depressing time. No one would even come near me. After the first club's bad sucked, I went to another place, that I had, since their all "kiddies" there. I intentionally separated myself from the crowd and went to the balcony so I didn't have to face anyone, or hurt anyone. I carry a knife nowadays, *everywhere* I go. My psychotic side/which is really my defense mechanism to pain and suffering, took on a life of it's own now, even though I still try and suppress it. I got up to leave 15 mins early when some f-ing idiots, thank god I didn't see them, decided to throw lemon wedges at me from below. I thought something was falling out of my pocket and looked down at the ground and saw what they were, normally I'd yell down to *everyone* below me and demand whomever was doing this to make their cowardly face known, but there were cops there, bouncers everywhere, and I would look like the crazy one. I was so depressed, I didn't care, and I just shook my head and left, saying, again, it happened again. Someone had to be mean to me, just cause I was alone (and listening to my headphones at a live band, lol, they sucked).
So that marks every time I've gone out alone, I was either insulted in some way, mistreated, and so on. Sad, cause I'm 190 pounds, and it's mostly muscle except for the gut from f-ing Nardil, and I have a very mean looking face. You would have to be pretty stupid to mess with me, but just add alcohol, and there were probably a few of them doing it, so, there ya go. I fear nothing. Even multiple attackers, as long my trusty blade is with me. Assholes. Immature assholes.Going out at night was one of the few activities I still enjoyed, even with the depression, but I always needed one friend to go with me. They're all gone now. Abandoned me for a million different reasons. Sad thing is, I'm STILL the life of the party when I'm out and don't act depressed (unless alone), but just about everyone I know thinks that part of their life is over, so guess who suffers. Me. Never got lucky and found any younger people to hang with.
> Not to try and out do ya here, In my forties, never been married, no kids, on welfare which I have now hit my lifetime limit and 4 applications and denials from SSDI, live at home with my elderly and ailing parents, not kissed a woman in 11 years or anything else, have to go to clinic for psych nurse to prescribe meds, had to go to state hospital for inpatient after last psych nurse clinic failure in 2008.
41 here. My life, women, and social outings-wise, went to hell at 40. I have NO idea why. It's like everyone knew I was single and 40 and stayed far away from me or was just offended that I would even speak to them, like I would make them look uncool or something.
Well, I wish I never got married, don't regret the kids though, but the marriage killed 20 years of my life and I should have got out at 30 and still had a chance to meet a pretty girl. You must be lonely as hell. I know I am. Wow, I got lucky and when I went on long term disability and failed to come back, I got accepted to disability right away. I feel so bad for you. 4 denials??? You know, they wrote this letter about me at work than ended my career and I thought it was WAY over the top and hurt my feeling like you wouldn't believe, because they basically made me sound like I couldn't do ANY part of my job in ANY way. I HATED my boss (ex-friend!!) and always wondered why he went so god damn far with it. Maybe he was trying to help me get disability? I NEVER thought of that until just now (it's been 10 years I think, or is it 6?).. maybe that's why they made me sound so useless... I should ask him someday..inpatient is hell, IMHO. Are you there now or out? I couldn't use a computer or cell phone or almost anything like that at the place I was at for a few days. Good thing I checked myself in and was able to check myself out. It's a jail. They even monitored what we talked about at the dinner table, I actually had a few girls into me.. it was strange! Too bad none were lookers or I would have married them.
Kissing, hugging, intimacy.. haven't had any of that, though I'm technically married, but separated now. Sadly, I got very lonely at 19, my gf/wife, was an idiot leech and wouldn't let me go no matter how mean I was to her. We became friends with benefits which is something, if she had a backbone or confidence would/should have NEVER allowed, and she should have NEVER accepted when I asked her out. All she had to do was ask me one question. "Are you in love with me". I would have said "no", and ya know, I bet she wouldn't have even cared. My depression was always chemical, and still is, but now I'm depressed "situationally" too. I met my soul-mate 6 years ago - we got split up without getting contact info, and I lost her, just like that. Someone that took me 14 years to find, love at first sight, and I was so happy, and confident we'd meet later (we tried, long story) that we didn't exchange #'s first. I will NEVER forgive myself for that night. I fell in love with her 2-3 days later and have been in love "with her ghost", ever since. I remember ever second of our short, patheticly fun time together.
She helped kill my marriage, just because (I) compared her to my wife. When I did that, I started to have real disgust for my wife.. when that happened, I knew there was no going back. I don't even know what "sex" is anymore, and I'd actually pay an escort (if I had the money) just to let me be affectionate with her, no sex!!! Intimacy is what I missed, through the entire marriage. It degraded over time after the first 5-10 years of our 20 year relationship.
I tried match.joke and it was an epic failure, and oh, I went out with a bang, today actually. I changed my profile and trashed all the users there (targeted pretty women) and listed my DISMAL experience with the site in my profile. I'll leave that up for 2 months. Funny thing, they can't even flame me because all I stated was facts. Some lady emailed me and said non-attractive women have the exact same problem there and told me that pretty women on there get 200 emails a week. So, these chicks do the most selfish and vain thing possible and pick (ONE) of the best looking of all the respondents, and literally blow off the rest without even a response. They act like they are ordering from a dinner menu or picking the nicest looking car out of the lot.
Me, if I miraculously for 5 emails of interest, I would be fair and DATE all 5.Dating is officially death BTW. At least where I live. The women on the site think they can pick a sole-mate, from a god-damned menu!!!! You don't know ANYONE unless you've spent real time dating them several times. But these women are so lazy, it's unreal. They even write in their profiles that they don't want to date a lot of men, just want one "winner". The lucky man who's a a 9 or a 10. I said from the first month of there, that's it's just one huge beauty contest. I'm about 6-8, in most women's eyes, and even 5's were blowing me off. How depressing.
>
> So you are not alone, also I am not a bad looking guy either, and have college degree and a lot of travel. Women want the confident personality types, If you suffer from depression then you are not going to be that, you need that mania.
>
> Anyway, hang in there, you are in a tough spot, but looks like you have enough inside you to fight a bit longer.
>
> Maybe the psych's can put you on heavy anti psychotics to sedate you beyond the point that you care, seems to be the going trend. God forbid no benzo's if they actually work.I think my age nips it in the bud. I'm just too old to get the pretty girl I want. I don't like girls my own age.. they really look it.. (no offense), but somehow, I aged very well, and don't look old, wrinkled, bald, etc.
See, I don't want to be on heavy drugs so I don't care. That's not me anymore. I'd rather die with my personality the same as it's always been. I'm not going to die drooling and comatose, or end up that way. I'm taking my life into my own hands. I tried all the atyp. Antip., and suffered from way too many side effects. No thanks. Pretty sure I've tried benzo's too. Nothing works on me.
Looking into DBS studies now. I want my selegeline and this Nardil crap OUT of my system. Selly won't last me long, but it's better than failing Nardil with 3-4 MAJOR side effects I've had for 3 years. I can't even go outside if it's humid. I'm covered head to toe with sweat in about 3 mins.
Enough complaining.. done so much the last few days.. ack..
Nice talking to ya, and it's "nice", but horrible to hear you're in the same boat, at least with women. God I hate them. If I didn't find them so damn attractive.. I thought about going to Europe for a while. No cash though.
I hear dating EXISTS there, so does casual dating/sex/loving/sharing/intimacy.Women here.. I wish I knew what happened to them. I wish I was alive during "free love". So many women in the world and people are so selective. What happened to casual dating/one night-ers, flings, short relationships. There is safety with condoms!!! I'm not a hedonist but I think it's ridiculous that more people don't enjoy each other mentally and physically without SO MANY SUPID RULES, BS RESTRICTIONS, SUPERFICIAL TRIVIAL GARBAGE, ETC!!!!!!! Just imagine.. dating a different pretty girl every 4-6 weeks. Heaven on Earth for me. So many experiences to be had with the opposite sex, but so many rules so no one is "getting any". So, you grow old and die, missing out on a giant CHUNK of living. I'll die by those words.
Posted by Dr. Bob on August 10, 2010, at 14:47:58
In reply to Re: the Zelapar form of selegiline, posted by donald Klein on August 9, 2010, at 8:11:01
> I believe the difficulty is the concurrent use of hi doses of bzd
> with maoi which renders them sedative to the point of toxicity.
> of course very difficult to withdraw from hi dose bzd as outpatient
> so detox as inpatient may be necessary. Have seen "refractory"
> depressives on this combination relieved by bzd discontinuationDon,
Welcome! It's always great to see one of The Best Psychiatrists in the U.S.A. and Canada Specializing in the Treatment of People with Mood Disorders here. :-)
http://www.psycom.net/depression.central.psychiatrists.html
Bob
Posted by violette on August 10, 2010, at 19:10:30
In reply to Re: welcome! » donald Klein, posted by Dr. Bob on August 10, 2010, at 14:47:58
http://www.psycom.net/depression.central.psychiatrists.html
Bob
Just a note about the list of 'best psychiatrists" posted here: the ones listed in my area run the worst mental hospital in my city. It's well-regarded and well-known for its research, but the patient care is very poor. That can be verified by the view of just about any experienced psychiatrist, social worker, therapist, family practitioner, or mental patient in my city. It's well know for being the 'worst'.
Just a word of caution to anyone looking at that list - best does not necessarily = best in practice.
Posted by donald Klein on August 10, 2010, at 19:26:04
In reply to 'Best Psychiatrist' list, posted by violette on August 10, 2010, at 19:10:30
> http://www.psycom.net/depression.central.psychiatrists.html
>
> Bob
>
> Just a note about the list of 'best psychiatrists" posted here: the ones listed in my area run the worst mental hospital in my city. It's well-regarded and well-known for its research, but the patient care is very poor. That can be verified by the view of just about any experienced psychiatrist, social worker, therapist, family practitioner, or mental patient in my city. It's well know for being the 'worst'.
>
> Just a word of caution to anyone looking at that list - best does not necessarily = best in practice.It is very difficult to evaluate just how good any doctor is at a distance. Obviously such lists provide only moderate guidance and reasoned skepticism is always advisable.
Just as the professional's difficult job is to objectively evaluate and monitor treatment , the patient has the same task. Both are not easy.
Posted by violette on August 10, 2010, at 19:47:42
In reply to Re: 'Best Psychiatrist' list, posted by donald Klein on August 10, 2010, at 19:26:04
I don't disagree with you. I came across that list before; checked up on the psychiatrists listed in my area-one had a curriculum vitae over 25 pages long...the other I don't even want to mention.
The best psychiatrist I found in my city? Not one published article. (Maybe he did some research in the 60s or 70s but nothing online).
I found the psychiatric community in my city seem to know of one another's competency, reputation, assets through word of mouth...through both colleagues and patients, and that referrals are the Best way to find the Best of the Best...as opposed to lists, which may (or may not) have political connotations involved. There may be less subjectiveness involved when referrals represent a consensus of reputation within the local community.
Posted by former poster on August 10, 2010, at 22:46:01
In reply to Re: Nardil is killing me - must find alternative! Help, posted by Leo33 on August 8, 2010, at 17:30:18
I was on Nardil for 15 years. I switched to Cymbalta 60mg a day and a low dose of Dextroamphetamine- about 10mg a day. I think this combo is close to being effective as Nardil without a lot of the side effects and dietary restrictions. It's been 3 years now and I'm looking for an alternative to Cymbalta because of the sexual side effects. So I think there are other options to consider. Hope you feel better soon.
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