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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 60 to 84 of 146. Go back in thread:
Posted by Abby Cunningham on October 16, 2010, at 20:07:00
In reply to Re: Thinking of coming off meds, posted by Maxime on October 16, 2010, at 19:44:58
Maxime, I gained a whole lot of weight (for me) while on Elavil, a cousin to the tricyclic you're on. First time I ever gained weight! I was very skinny before. this was years ago and I had to come off it due to supravenricular tachycardia. Can't take any tricyclic because of that.
Posted by Maxime on October 16, 2010, at 20:34:27
In reply to Re: Thinking of coming off meds » Maxime, posted by Abby Cunningham on October 16, 2010, at 20:07:00
> Maxime, I gained a whole lot of weight (for me) while on Elavil, a cousin to the tricyclic you're on. First time I ever gained weight! I was very skinny before. this was years ago and I had to come off it due to supravenricular tachycardia. Can't take any tricyclic because of that.
Were you able to lose the weight afterwards? I have a feeling that the weight is going to be hard to get rid off.
Posted by Phillipa on October 16, 2010, at 21:25:07
In reply to Re: Thinking of coming off meds » SLS, posted by Maxime on October 16, 2010, at 19:10:35
Maxie just a thought when you mentioned lactation first thing my endo asked me was if I did as had told him of a microadenoma of pituitary that had shown up 6 years ago on MRI. No I didn't lactate but he felt it was time to check the microadenoma again so less than a year ago had another MRI of pituitary and still micros not macro which would cause lactation and not be good would have had to be removed. Just had a brain MRI for the lack of taste and smell and micro still. No changes. But Have you ever had an MRI of pituitary? I seriously am not sure of the symptoms of micro or macro. Phillipa
Posted by floatingbridge on October 17, 2010, at 0:40:32
In reply to Re: Thinking of coming off meds » floatingbridge, posted by Maxime on October 16, 2010, at 18:46:46
Maxime, thanks for the clarification about who said what and how. And I'm glad to hear that you have a friend who really seems to know you.
Do you have the ability to chose a different endo? I have difficulties w/ doctors, and it's hard on me if I don't feel respected. That's my issue.
Could the desire to lighten your med load be coming from a place of feeling a little better? That would be a positive factor. Taking it slow and gathering information is proactive and part of self-care.
Returning to intellectually engaging work after lengthy unemployment will highlight cognitive issues. The brains of even those blessed with good health grow rusty with even a little disuse, hence the benefits of crossword puzzles, etc.
Here's to a decent Sunday.
Posted by SLS on October 17, 2010, at 3:13:16
In reply to Re: Thinking of coming off meds, posted by Maxime on October 16, 2010, at 19:44:58
Maxime,
I forgot to ask you about Topamax. If you start very low and raise the dosage gradually to 100mg-200mg, you might find that it has antidepressant properties. For me, the response to Topamax was mild but obvious. The side effect of interest would be weight-loss instead of weight-gain. I found that 200mg was no better than 100mg. I suffered no cognitive impairments at all.
- Scott
Posted by Maxime on October 17, 2010, at 14:58:56
In reply to Re: Thinking of coming off meds » Maxime, posted by Phillipa on October 16, 2010, at 21:25:07
No MRIs, although I would like to get one to see what is going on. I think she would do one if I wasn't on all these meds which make my prolactin do crazy things.
Posted by Maxime on October 17, 2010, at 15:02:04
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 17, 2010, at 3:13:16
> Maxime,
>
> I forgot to ask you about Topamax. If you start very low and raise the dosage gradually to 100mg-200mg, you might find that it has antidepressant properties. For me, the response to Topamax was mild but obvious. The side effect of interest would be weight-loss instead of weight-gain. I found that 200mg was no better than 100mg. I suffered no cognitive impairments at all.
>
>
> - ScottNo, I have only ever gone as far as 50 mg before I start having visual hallucinations and being put into the hospital. I can't try that med again.
Posted by morgan miller on October 17, 2010, at 17:29:37
In reply to Re: Thinking of coming off meds » Phillipa, posted by Maxime on October 17, 2010, at 14:58:56
> No MRIs, although I would like to get one to see what is going on. I think she would do one if I wasn't on all these meds which make my prolactin do crazy things.
I don't think MRIs will show any effects of medications, so being on medications should not interfere at all with MRI results. Pet and Spect scans are what you want to evaluate brain activity.
Posted by Phillipa on October 17, 2010, at 18:30:13
In reply to Re: Thinking of coming off meds, posted by morgan miller on October 17, 2010, at 17:29:37
I feel what I was trying to say that if an MRI picked up an adenoma that could be the cause of lactation on meds? Phillipa
Posted by Maxime on October 17, 2010, at 20:26:49
In reply to Re: Thinking of coming off meds, posted by morgan miller on October 17, 2010, at 17:29:37
> > No MRIs, although I would like to get one to see what is going on. I think she would do one if I wasn't on all these meds which make my prolactin do crazy things.
>
> I don't think MRIs will show any effects of medications, so being on medications should not interfere at all with MRI results. Pet and Spect scans are what you want to evaluate brain activity.
>
>No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.
Posted by morgan miller on October 17, 2010, at 20:33:11
In reply to Re: Thinking of coming off meds » morgan miller, posted by Maxime on October 17, 2010, at 20:26:49
> > > No MRIs, although I would like to get one to see what is going on. I think she would do one if I wasn't on all these meds which make my prolactin do crazy things.
> >
> > I don't think MRIs will show any effects of medications, so being on medications should not interfere at all with MRI results. Pet and Spect scans are what you want to evaluate brain activity.
> >
> >
>
> No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.Gotchya
Posted by Maxime on October 17, 2010, at 20:34:57
In reply to Re: Thinking of coming off meds, posted by Phillipa on October 17, 2010, at 18:30:13
> I feel what I was trying to say that if an MRI picked up an adenoma that could be the cause of lactation on meds? Phillipa
Yes, that's it!
Posted by Phillipa on October 17, 2010, at 21:02:52
In reply to Re: Thinking of coming off meds » Phillipa, posted by Maxime on October 17, 2010, at 20:34:57
Why do you say that's it did you google I still haven't got to work now. Phillipa
Posted by SLS on October 18, 2010, at 4:51:49
In reply to Re: Thinking of coming off meds » morgan miller, posted by Maxime on October 17, 2010, at 20:26:49
> No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.
Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
- Scott
Posted by floatingbridge on October 18, 2010, at 12:24:58
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 18, 2010, at 4:51:49
I'm really, really sorry Scott.
Did they hold out the possibility of regeneration of structure or function?
Posted by SLS on October 18, 2010, at 13:13:27
In reply to Re: Thinking of coming off meds » SLS, posted by floatingbridge on October 18, 2010, at 12:24:58
> I'm really, really sorry Scott.
>
>
>
>
> Did they hold out the possibility of regeneration of structure or function?This was 1992-1993. I'm not sure what they were thinking behind their veil of objectivity. They did not commit to such predictions. Whatever were their opinions back then were very preliminary as they had not accumulated very much data by then. I have some hope that a great deal of function will reappear once I respond robustly and consistently to treatment. There is some evidence that there is a recovery of brain tissue volume in frontal white matter and the gray matter of the hippocampus as the consequence of attaining remission using antidepressants. Things get more complicated with depression in the elderly, as antidepressant treatment, especially with tricyclics, can actually induce or accelerate the development of white matter hyperintensities (lesions).
This whole thing sucks if you ask me.
- Scott
Posted by floatingbridge on October 18, 2010, at 13:48:41
In reply to Re: Thinking of coming off meds » floatingbridge, posted by SLS on October 18, 2010, at 13:13:27
>Things get more complicated with depression in the elderly, as antidepressant treatment, especially with tricyclics, can actually induce or accelerate the development of white matter hyperintensities (lesions).
Oh. That's sobering.
>
> This whole thing sucks if you ask me.Yes.
Posted by huxley on October 18, 2010, at 17:08:37
In reply to Re: Thinking of coming off meds » huxley, posted by SLS on October 15, 2010, at 5:15:37
>
> In what ways has the advice you received from Bleuberry brought about your remission? How did you change your treatment because of Bleuberry's advice? I would be grateful to learn how and what.
>
>
> - Scottbleuberry was the first person I found that had similar troubles to me coming of Zyprexa and told me what to expect and how to make it easier. This was a great help for me.
I have been stuck on a neuroleptic which is causing me horrible side effects and when I try and withdraw it I get a horrible withdrawal which my doctors told me was my original symptoms returning when it clearly wasn't.
Now stop being hypocritical, you hand out plenty of advice to people on this site on what medications to take etc..
There is plenty of ancedotal evidence around that medications can cause the problems that they are designed to cure and stopping them can be very beneficial for some people.
Not arguing that it is or isnt for maxime.
Posted by huxley on October 18, 2010, at 17:10:12
In reply to Re: Thinking of coming off meds » Maxime, posted by SLS on October 18, 2010, at 4:51:49
> > No,no, I meant a scan of my pituary gland and my thyroid. Not one of my brain (PET Scan), although would be very cool to see.
>
> Or very horrifying. Most of my cerebral cortex was hypofunctional as was indicated by the color blue on repeated PET scans. This compares with healthy individuals whose brains shows up globally yellow and orange except for the ventricles. It was a horrendous finding to see how globally my brain function is affected by depression. It was not so pleasant a revelation that the U.S. NIH considered me to be "very sick".
>
>
> - ScottSerious question. Was this scan before you started taking medication? If it was after, how do you know it wasn't a result of the medication.
Posted by SLS on October 18, 2010, at 17:10:16
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
> Now stop being hypocritical
Yes sir!
- Scott
Posted by SLS on October 18, 2010, at 17:16:36
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
> Serious question. Was this scan before you started taking medication?
I had already tried a bunch of drugs.
> If it was after, how do you know it wasn't a result of the medication.
You would have to do some research of your own if you really want to have that question answered. I would rather not postulate to you. See what the search engines come up with. I am all but sure you can find some commentary on the use of PET scans on drug-naive individuals.
- Scot
Posted by Lou Pilder on October 18, 2010, at 17:22:00
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:08:37
huxly,
You wrote,[...plenty of...can cause the problems...stopping them could...]
Lou
http://www.dr-bob.org/babble/health/20100104/msgs/944131.html
Posted by SLS on October 18, 2010, at 17:28:40
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
Here's one.
- Scott*************************************
http://www.ncbi.nlm.nih.gov/pubmed/15094258
J Affect Disord. 2004 May;80(1):55-63.
Correlation between cerebral blood flow and items of the Hamilton Rating Scale for Depression in antidepressant-naive patients.Graff-Guerrero A, González-Olvera J, Mendoza-Espinosa Y, Vaugier V, García-Reyna JC.
Instituto Nacional de Psiquiatría Ramón de la Fuente, Dirección de Servicios Clínicos, Calz. México-Xochimilco 101, Col. San Lorenzo Huipulco, Del. Tlalpan 14370, México D.F., Mexico. [email protected]
AbstractBACKGROUND: The purpose of this study was to correlate the basal cerebral blood flow (CBF) in patients with major depressive disorder (MDD) with the score for each of the 21 questions in the Hamilton Rating Scale for Depression (HRSD), in order to determine the cerebral regions associated with each item.
METHODS: Fourteen antidepressant-naive patients with unipolar depression (DSM-IV criteria for MDD) participated in this study with a HRSD score of >/=20 points. CBF images obtained by SPECT were analyzed by SPM99 software. The significant correlation threshold for a priori regions (frontocortical and limbic regions) was a Z value of at least 2.25 and clusters formed by more than 10 voxels.
RESULTS: Items 1, 6, 11 and 20 were positively correlated with right medial frontal gyrus; item 7 was negatively correlated with bilateral medial frontal gyrus. Items 2 and 10 were positively correlated with right anterior and medial cingulate, respectively. Item 5 was negatively correlated with the left amygdala. Item 9 was negatively correlated with bilateral insula, and item 16 with right insula. Items 12 and 14 were positively correlated with right and left precentral frontal gyrus, respectively. Limitations: The small sample size and only out-patients included in the study.
CONCLUSIONS: The frontal cortex plays an important role in the expression of MDD symptoms. Not all the symptoms evaluated correlated with one single structure, which may explain the diverse results reported in the literature. These preliminary results support the necessity of further analyses by symptoms that could provide more specific information on the pathophysiology of MDD.
PMID: 15094258 [PubMed - indexed for MEDLINE]
Posted by SLS on October 18, 2010, at 17:36:42
In reply to Re: Thinking of coming off meds » SLS, posted by huxley on October 18, 2010, at 17:10:12
Here is another one. This particular study gives some supportive evidence to the explanations that Linkadge gives regarding possible dopaminergic hyperfunction in various limbic circuits in major depressive (MDD) order.
- Scott
Posted by SLS on October 18, 2010, at 17:46:35
In reply to Re: Thinking of coming off meds » huxley, posted by SLS on October 18, 2010, at 17:36:42
Sorry...
Psychopharmacology (Berl). 1999 Jun;144(3):282-5.
Striatal dopamine transporter density in major depression.Laasonen-Balk T, Kuikka J, Viinamäki H, Husso-Saastamoinen M, Lehtonen J, Tiihonen J.
Department of Psychiatry, Kuopio University Hospital, Finland.
AbstractRATIONALE: There are no previous data available regarding [123I]beta-CIT binding to the dopamine transporter sites in the basal ganglia in depressed patients.
OBJECTIVE: The present study tested the hypothesis that the brain DAT density in depressed patients is lower than that in matched healthy controls.
METHODS: Fifteen drug-naive outpatients with major depression and 18 healthy controls were investigated using single photon emission computerized tomography (SPECT) with a high-affinity dopamine transporter specific radioligand. 123I-labeled beta-CIT (2beta-carbomethoxy-3beta-(4-iodophenyl-tropane).
RESULTS: We found a significantly higher [123I]beta-CIT uptake in both sides of the basal ganglia in patients with major depression than in the controls (Mann-Whitney U-test, P = 0.002 on the right and P = 0.003 on the left).
CONCLUSIONS: The radioligand uptake reflecting the DAT density was significantly higher among the patients than in the controls. This finding is unexpected, since it is generally believed that monoaminergic neurotransmission is lower in depression, and therefore it could be assumed that a reduction in dopamine transmission would lead to secondary down-regulation of DAT density. However, it is possible that up-regulation of the DAT may be the primary alteration, which leads to lower intrasynaptic dopamine concentration and to lower dopamine neural transmission.
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Dr. Bob is Robert Hsiung, MD,
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