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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 18 to 42 of 42. Go back in thread:
Posted by morgan miller on January 23, 2012, at 20:37:05
In reply to Re: agitated depression, posted by david blistein on January 23, 2012, at 19:30:14
I just believe that AP's and benzos should be last resort, and we should try to tough it out for a while and see if we can stabilize on better medications before rushing into and getting hooked on medications that have the potential to do more harm down the road. Plus, benzos have a short half live, I just don't see how they ever will fit in to anybody's long term regimen if they are bipolar, with the exception being klonpopin.
Posted by Phillipa on January 23, 2012, at 21:11:41
In reply to Re: agitated depression, posted by morgan miller on January 23, 2012, at 20:37:05
Maybe not bipolar I don't know. I only know that when age 24 had two small children and panic attacks hit and nothing I could do stopped the catastrophic thoughts. Til I was then given valium 5mg three times a day and mepbrobamate. Mep is and was only taken til didn't need it anymore. But this combo saved my life at the time. Yes we are all so different. Phillipa
Posted by david blistein on January 24, 2012, at 7:48:12
In reply to Re: agitated depression, posted by morgan miller on January 23, 2012, at 20:37:05
> I just believe that AP's and benzos should be last resort, and we should try to tough it out for a while and see if we can stabilize on better medications before rushing into and getting hooked on medications that have the potential to do more harm down the road. Plus, benzos have a short half live, I just don't see how they ever will fit in to anybody's long term regimen if they are bipolar, with the exception being klonpopin.
Hey Morganagreed on the benzosClonazepam is a trade name of Klonopin. I now nibble a little piece once in a while (probably equivalent of less than .25), and can go a week without even thinking about it. Whereas the Valium was definitely addictive and Lorazepam I just didn't like (and is also more addictive) As far as the more harm with the anti psychoticsI thought Depakote was of more concern there 'cause of the liver thing? Is that why you suggest the supplements?
As far as Lamictal/Lamotrigine I thought the biggest concern was that odd potentially-fatal rash that occurs rarely, and hasn't with me. I didn't know of long-term concerns. So curious.
Thanks
Posted by SLS on January 24, 2012, at 8:21:40
In reply to Re: agitated depression, posted by david blistein on January 24, 2012, at 7:48:12
I never became addicted to any of the benzodiazepines I used. However, I did become physiologically dependent on them. For this reason, they were difficult to discontinue.
I would be wary of Xanax producing true addiction.
Addiction is not the same as physiological dependence. Addiction includes psychological dependence and cravings.
- Scott
Posted by morgan miller on January 24, 2012, at 12:48:37
In reply to Re: agitated depression, posted by SLS on January 24, 2012, at 8:21:40
> I never became addicted to any of the benzodiazepines I used. However, I did become physiologically dependent on them. For this reason, they were difficult to discontinue.
>
> I would be wary of Xanax producing true addiction.
>
> Addiction is not the same as physiological dependence. Addiction includes psychological dependence and cravings.
>
>
> - ScottPsychological dependence and cravings along with physiological dependence. This is what you are saying right Scott?
Posted by morgan miller on January 24, 2012, at 12:58:23
In reply to Re: agitated depression, posted by david blistein on January 24, 2012, at 7:48:12
Hey david, yeah I thought you said clonazepam, my bad. Did you specify that you just nibble on a little sometimes and go without it for a whole week? If not, that might be very valuable information for someone seeking help to know. Then at least they know that klonopin is not really what is helping to hold you together, and it may be something you want to do without completely at some point.
I do think L-Carnitine can help prevent liver issues. L-Carnitine plays a pretty major role in liver function and is depleted by Depakote. Folate is also depleted by Depakote. I believe we can eat right, supplement right, avoid toxins, and find a fairly low but still effective dose of Depakote and thrive for the rest of our lives-that is most of us at least. There are some that for whatever reason may be very sensitive to liver issues with Depakote. I just think mood stabilizers for the most part have less potential to do harm than antipsychotics.
Lamictal is a very powerful drug, more so than lithium and depakote I believe. It works great for many, and many do not notice much of anything as far as side effects go, but that sh*t is strong, I know it is. I just believe, after doing a little research, that it can have more potential to mess with one's mind over the long run, or the short run, than the other mood stabilizers. It appears that anectodal reports seem to show this-if you check out reviews on drug review websites I think you will find this to be the case.
Morgan
Posted by SLS on January 24, 2012, at 13:42:09
In reply to Re: agitated depression, posted by morgan miller on January 24, 2012, at 12:48:37
> > I never became addicted to any of the benzodiazepines I used. However, I did become physiologically dependent on them. For this reason, they were difficult to discontinue.
> >
> > I would be wary of Xanax producing true addiction.
> >
> > Addiction is not the same as physiological dependence. Addiction includes psychological dependence and cravings.
> >
> >
> > - Scott
>
> Psychological dependence and cravings along with physiological dependence. This is what you are saying right Scott?Yes. This is true of exogenous chemical substances. However, there can also be addiction without physiological dependence. Lots of behaviors are addicting. I guess one can make the argument that in these cases, there develops a dependence upon endogenous substances like endorphins and dopamine. I would have to wrestle with that idea for awhile, though.
- Scott
Posted by markwell on January 24, 2012, at 18:29:37
In reply to Re: agitated depression » morgan miller, posted by SLS on January 24, 2012, at 13:42:09
Thanks everyone for your input. I'm seeing a new doctor next week (second opinion). I'm hoping she suggests lithium. I think I have too much depression for depakote.
Mark
Posted by JohnLA on January 24, 2012, at 20:52:20
In reply to Re: agitated depression, posted by morgan miller on January 23, 2012, at 20:30:47
morgan;
what is your opinion of low dose abilify as a add-on to a ad? like 1, 2 or 5mg?
thanks.
john
Posted by JohnLA on January 24, 2012, at 20:54:37
In reply to Re: agitated depression, posted by markwell on January 24, 2012, at 18:29:37
mark-
left you a msg up in your ect thread.
i am glad that you are patient enough to see a 2nd doc.
good job. keep-up the fight.
john
Posted by morgan miller on January 25, 2012, at 0:29:50
In reply to morgan a ?, posted by JohnLA on January 24, 2012, at 20:52:20
> morgan;
>
> what is your opinion of low dose abilify as a add-on to a ad? like 1, 2 or 5mg?
>
> thanks.
>
> johnIt might be worth a shot. I think others here should chime in on their thoughts on Abilify. I personally believe that time and taking an integrative approach will often be enough to get someone over the hump. Are we talking about 75 percent recovery and looking for the remaining 25 percent to be taking care of by Abilify? In this case I say hell no man. This is the very reason why I hate the Abilify commercials. A customer came into the store I work at looking for supplements to treat type II diabetes that she developed due to low dose Abilify adjunctive antidepressant treatment. Abilify for this use is the biggest b*llsh*t scam in the history of psychiatric drugs.
Posted by Christ_empowered on January 25, 2012, at 7:47:51
In reply to Re: morgan a ?, posted by morgan miller on January 25, 2012, at 0:29:50
I read somewhere that you're more likely to experience akathisia off the abilify than you are to experience remission. could be wrong though.
Posted by SLS on January 25, 2012, at 7:51:49
In reply to Re: morgan a ?, posted by morgan miller on January 25, 2012, at 0:29:50
Hi Morgan.
> > what is your opinion of low dose abilify as a add-on to a ad? like 1, 2 or 5mg?
> It might be worth a shot. I think others here should chime in on their thoughts on Abilify. I personally believe that time and taking an integrative approach will often be enough to get someone over the hump. Are we talking about 75 percent recovery and looking for the remaining 25 percent to be taking care of by Abilify? In this case I say hell no man. This is the very reason why I hate the Abilify commercials. A customer came into the store I work at looking for supplements to treat type II diabetes that she developed due to low dose Abilify adjunctive antidepressant treatment. Abilify for this use is the biggest b*llsh*t scam in the history of psychiatric drugs.I appreciate your passions. I am not so sure that it is such a scam, though. Abilify does work well as an adjunct for some people to reduce the severity of their depression when combined with more traditional antidepressants. I doubt we will come to an agreement on the appropriateness of the advertizement campain, but what do these advertizements say that is not factually true?
I know people for whom Abilify made it possible for them to remain employed by treating their residual depression. I do gravitate towards the idea to use psychotherapy to treat less severe residual depressions. However, it depends on the circumstances surrounding the individual, though, whether or not this residual is amenable to psychotherapy. Sometimes, residual depression is not the result of remaining biological pathology, but, rather, of psychological pathology. A good doctor may not be able to predict if Abilify will help, but in an ideal world, they should be able to evaluate the need for psychotherapy. However, I would not want to be denied a biological treatment for depression when no treatable depressive psychopathology exists.
Quite simply, there are some people who don't need psychotherapy to be free of depression - just as there are some people who don't need antidepressants to be equally free.
> Are we talking about 75 percent recovery and looking for the remaining 25 percent to be taking care of by Abilify?
25% can mean the difference between living out one's remaining days in a state of passive contentment, and being able to actively pursue happiness and fulfillment. I don't think every case of residual depression will respond to psychotherpy or the holistic healing arts. If Abilify brings one to remission, it is difficult to argue against using it.
I like Abilify. I hate Abilify.
Abilify reduced the severity of my depression to a degree. It was enough of an improvement to continue taking it, despite gaining 50 pounds and elevating my triglycerides. My choice demonstrates the value I place on the difference Abilify made in my life over the last 10 years.
Since my initiating prazosin treatment and my beginning to respond to it, I have discontinued Abilify using a taper. So far, I have not relapsed. We'll see what happens over the course of the months to come. In a prior attempt to discontinue Abilify, it took 2 months before I relapsed.
- Scott
Posted by morgan miller on January 25, 2012, at 13:53:12
In reply to Re: morgan a ? » morgan miller, posted by SLS on January 25, 2012, at 7:51:49
Hey Scott..I agree Abilify will be good for some people in cases where all else fails and the depression is pretty bad. If the lingering depression is mild to manageably moderate, and you are already having some success with an antidepressant, Abilify should not be a go to as far as I'm concerned. Time, exercise, diet, psychodynamic and cognitive behavioral therapy, introspection, and life changes will likely get someone back to living more the way they want to.
Maybe I should not have used the word "Scam". It is all in the advertising Scott. They simply say something like, "If your symptoms of depression are not totally resolved, then Abilify may help". It is such an aggressive advertising campaign, this is where the injustice lies. People are so vulnerable to and easily impressed by these ads. Ads like this reinforce this idea that we need to medication in order to completely resolve issues with depression. People that are depressed will do anything just to feel better, and the makers of Abilify are totally taking advantage of this.
Morgan
Posted by morgan miller on January 25, 2012, at 13:57:17
In reply to Re: morgan a ? » morgan miller, posted by SLS on January 25, 2012, at 7:51:49
I don't think we need psychotherapy to be free of depression. What I do believe is that psychotherapy is the only way to resolve the inner conflicts that make it harder for us to get what we need in life out of ourselves and relationships. If we cannot reach as close to our full potential from within, loving ourselves as much as possible, and getting the most out of good people in relationships, we cannot have the kind of full lives that provide lasting contentment.
I have obliterated depression with antidepressants before, but in the end, it was what was lingering inside me that always came back to bite me and make it harder for me to maintain what I needed to be happy and avoid stress.
Posted by morgan miller on January 25, 2012, at 14:03:11
In reply to Re: morgan a ?, posted by morgan miller on January 25, 2012, at 13:57:17
Abilify Advertising Campaign=The Devil's Workshop
Seriously, I don't know how anyone can think that these advertisements are not very misleading and motivated solely by making money with no care at all for the possible detriment to the patient. It truly is an evil campaign, nothing anyone can say will change my mind.
Posted by Phillipa on January 25, 2012, at 18:53:47
In reply to Re: morgan a ?, posted by morgan miller on January 25, 2012, at 14:03:11
Morgan I dislike all the advertising campaigns for meds. For money Phillipa
Posted by JohnLA on January 25, 2012, at 22:34:41
In reply to Re: morgan a ?, posted by morgan miller on January 25, 2012, at 0:29:50
thanks morgan and scott (and philipa too ;)).
my new pdoc is pushing very softly to add abilify. he said take 1mg every other day to start and we'll go from there...
i ditched it after the first few times.
my depression is severe. but, taking an anti-psychotic just seems wrong.
thanks again for the replies guys.
john
Posted by SLS on January 26, 2012, at 7:53:14
In reply to Re: morgan a ?, posted by JohnLA on January 25, 2012, at 22:34:41
> my depression is severe. but, taking an anti-psychotic just seems wrong.
Abilify, like other drugs, is nothing more than a chemical substance with certain biological properties. It is us who attempt to categorize a drug by pigeon-holing it into a very narrow characterization by using a label.
Does it seem wrong to use valproate, an antiepileptic drug (AED) to treat bipolar disorder? Same thing.
Judge Abilify by its therapeutic potential and side-effect profile, not by its name.
I don't know that Abilify is a good drug for you. I am not recommending that you try it. However, I am not recommending that you don't.
- Scott
Posted by david blistein on January 26, 2012, at 8:14:01
In reply to Re: morgan a ? » JohnLA, posted by SLS on January 26, 2012, at 7:53:14
Hi John: I'm glad you pointed this out. I understand peoples' reluctance to be "labelled" psychotic, but those of us with these issues have enough to worry about without caring what other people think about how we're trying get better! (Or, as Sheryl Crow sang, "if it makes you happy, it can't be that bad...")
Besides, these drugs keep getting approved for different purposes. Seems to me the lines between anti-depressant, anti-anxiety, anti-psychotic, anti-seizure, and mood stabilizer can get pretty fuzzy.
Most importantly, best of luck to you, Morgan.
Posted by Morgan Miller on January 26, 2012, at 14:44:25
In reply to Re: morgan a ?, posted by JohnLA on January 25, 2012, at 22:34:41
If your depression is that bad, and you feel you have exhausted all options, Abilify may be worth a try.
Did you tell us all that you have tried? How about low dose lithium, nortriptyline with Zoloft, or an maoi?
Posted by SLS on January 26, 2012, at 15:17:12
In reply to Re: morgan a ?, posted by Morgan Miller on January 26, 2012, at 14:44:25
> If your depression is that bad, and you feel you have exhausted all options, Abilify may be worth a try.
>
> Did you tell us all that you have tried? How about low dose lithium, nortriptyline with Zoloft, or an maoi?I can't be sure, but I think Abilify becomes more effective when it is combined with other agents. Someone I know who has severe depression takes only Lamictal and Abilify, and has had some success. My treatment also combined Lamictal and Abilify. Both Lamictal and Abilify can energize dopaminergic neurons in the nucleus accumbens, albeit via different mechanisms.
- Scott
Posted by JohnLA on January 27, 2012, at 0:53:48
In reply to Re: morgan a ?, posted by Morgan Miller on January 26, 2012, at 14:44:25
wish you guys lived near by; i'd buy you all some beers and burgers...
thanks for the responses about abilify.
i have tried zoloft, celexa, lexapro, welbbutrin, ect, remeron and klonopin.
the remeron and klonopin have brought some relief; good sleep and less anxiety. no real help in my depression.
but! something seems to be happening these past few weeks. nothing to do with meds. i am getting-up and out of bed on a consistent basis for the first time since my depression started 22 months ago. (this is my first depressive episode.)
i have exercised as well for the first time in over a year and bumped-up my talk therapy to 2 times a week.
they say most depressive episodes due come to an end with time. i mentioned that when i first got here a few months ago. (remember scott? 'time and patience are the greatest warriors.' tolstoy)
i know it may not seem like much, and i am still miles away from what i would consider remission, but i am forcing myself to get up and out of the house each day. this has not happened since this nightmare started.
i'd rather wait on the abilify and see how this new change plays out.
i have also been reducing my klonopin. wondering if this has anything to do with the recent change?
thanks again guys. you are all kind to throw your opinions my way.
john
Posted by JohnLA on January 27, 2012, at 0:55:54
In reply to Re: morgan a ?, posted by Morgan Miller on January 26, 2012, at 14:44:25
forgot to mention; i also tried cymbalta.
Posted by Phillipa on January 27, 2012, at 18:57:45
In reply to Re: morgan a ?, posted by JohnLA on January 27, 2012, at 0:55:54
Fabulous you may be one who has but on depressive episode. I'd discuss meds with doc. Phillipa
This is the end of the thread.
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