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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by David1973 on August 18, 2016, at 16:57:17
Hi All, was hoping for some advice as to my current medication. I have been on Nardil 75mg for a good while now and recently have been prescribed 150mg Trazodone for sleep. I`m happy this combo is relatively safe. Before I started on Trazodone, I was taking 20-50mg of amitriptyline for pain but came off it a few weeks back before I started trazodone as I didnt think it was doing much for the pain, but the pain has unfortunately come back. So I was going to add 20mg of amitriptyline as well, otherwise I may have to up my use of Dihydrocodeine which I dont want to do due to the side effects. I`m thinking such a low dose isn't going to interact much with the nardil and trazodone. Has anyone been on a similar regime? Just wanted some experiences of it before I go to my psychiatrist and tell him plans.
First post so apologies if its not the kind of question to ask, but looking forward to participating in the forum.
Thanks David
Posted by Lou Pilder on August 19, 2016, at 8:36:05
In reply to Nardil, Trazodone and Amitriptyline, posted by David1973 on August 18, 2016, at 16:57:17
> Hi All, was hoping for some advice as to my current medication. I have been on Nardil 75mg for a good while now and recently have been prescribed 150mg Trazodone for sleep. I`m happy this combo is relatively safe. Before I started on Trazodone, I was taking 20-50mg of amitriptyline for pain but came off it a few weeks back before I started trazodone as I didnt think it was doing much for the pain, but the pain has unfortunately come back. So I was going to add 20mg of amitriptyline as well, otherwise I may have to up my use of Dihydrocodeine which I dont want to do due to the side effects. I`m thinking such a low dose isn't going to interact much with the nardil and trazodone. Has anyone been on a similar regime? Just wanted some experiences of it before I go to my psychiatrist and tell him plans.
>
> First post so apologies if its not the kind of question to ask, but looking forward to participating in the forum.
>
> Thanks DavidFriends,
Be not deceived. The psychiatrist here is allowing the promotion of combinations of drugs that could cause death. And worse, he says that by allowing this here, it will be good for him and his community as a whole as he thinks.
This person here asks you for advice. I am now going to forward anyone here that advises this person to take these drugs to the Attorney general of the state that you reside to be investigated for the charge of attempted murder by deceiving the person to take these drugs or promote that these drugs are safer than they really are in any way.
Be advised that these drugs are not medicines for they do not treat a disease or cure. Thousands of people are killed each month by these drugs and by them being promoted here as being safer than they really are, you could be part od a Great Deception that is responsible for the deaths of thousands each month including innocent children reading here being deceived that the drugs are safer than they really are by the psychiatrist here saying that it is supportive as to what stands here by him. Without a repudiation by him here to the taking of the combination of theses drugs that could cause death, Mr. Hsiung allows the tragedy here of innocent children being killed by these drugs. Do you really want to be a part of it?
Lou
Posted by David1973 on August 19, 2016, at 8:41:13
In reply to Lou's urgent warning-Death » David1973, posted by Lou Pilder on August 19, 2016, at 8:36:05
come again?
Posted by Lou Pilder on August 19, 2016, at 8:53:56
In reply to Nardil, Trazodone and Amitriptyline, posted by David1973 on August 18, 2016, at 16:57:17
> Hi All, was hoping for some advice as to my current medication. I have been on Nardil 75mg for a good while now and recently have been prescribed 150mg Trazodone for sleep. I`m happy this combo is relatively safe. Before I started on Trazodone, I was taking 20-50mg of amitriptyline for pain but came off it a few weeks back before I started trazodone as I didnt think it was doing much for the pain, but the pain has unfortunately come back. So I was going to add 20mg of amitriptyline as well, otherwise I may have to up my use of Dihydrocodeine which I dont want to do due to the side effects. I`m thinking such a low dose isn't going to interact much with the nardil and trazodone. Has anyone been on a similar regime? Just wanted some experiences of it before I go to my psychiatrist and tell him plans.
>
> First post so apologies if its not the kind of question to ask, but looking forward to participating in the forum.
>
> Thanks DavidDavid,
The combination of the drugs that you take could cause serotonin syndrome that could be fatal. And if the psychiatrist adds amitriptyline to the combination, then it is a greater risk for death via serotonin syndrome.
But it is much worse than that. For the combination of the drugs if they don't kill you could induce life-ruining conditions and addiction.
The psychiatrist that could do this to you could admit that the drugs actions as to how they do what they do are unknown and that throwing mud on a wall could allow some to stick. In your case, death could come before the mud sticks.
But the worse thing here is that the psychiatrist here allows this to stand as being supportive by you taking the combination of the drugs. This could be a promotion of death, for he does not intercede to warn readers of the potential of death. Readers could think that he is validating the use of the combination of drugs that could kill. It becomes a testimonial to some readers which is part of advertising propaganda. The tobacco companies used this tactic for years causing millions to suffer a horrible death by them. When will they ever learn.
Lou
Posted by SLS on August 19, 2016, at 8:54:38
In reply to Nardil, Trazodone and Amitriptyline, posted by David1973 on August 18, 2016, at 16:57:17
Nardil isn't as forgiving as Parnate when it comes to taking tertiary tricyclics like amitriptyline or imipramine. Serotonin syndrome is a possible adverse effect, although your dosage of amitriptyline is low. When I was on Nardil, I had a moderate degree of SS while taking imipramine that I don't get with desipramine or nortriptyline. You could investigate the usage of nortriptyline for pain disorders. I have heard of it being done, but I don't know the statistical rate of success. Nortriptyline probably is not as good as amitriptyline for sleep, but it is much less anticholinergic.
- Scott
Posted by Lou Pilder on August 19, 2016, at 9:17:27
In reply to Re: Nardil, Trazodone and Amitriptyline » David1973, posted by SLS on August 19, 2016, at 8:54:38
> Nardil isn't as forgiving as Parnate when it comes to taking tertiary tricyclics like amitriptyline or imipramine. Serotonin syndrome is a possible adverse effect, although your dosage of amitriptyline is low. When I was on Nardil, I had a moderate degree of SS while taking imipramine that I don't get with desipramine or nortriptyline. You could investigate the usage of nortriptyline for pain disorders. I have heard of it being done, but I don't know the statistical rate of success. Nortriptyline probably is not as good as amitriptyline for sleep, but it is much less anticholinergic.
>
>
> - ScottFriends,
Scott writes,[...Serotonin syndrome is a possible adverse effect, although your dosage of amitriptyline is low...].
Be not deceived. You could think that Scott is approving the combination of these drugs because of the dosage of Amitriptyline. But is there any evidence posted by him that is from scientific studies and not anecdotal remarks from him? You see, you could take these drugs thinking that they will not kill you because the psychiatrist chairing this site is allowing Scott to post what could cause death without him interceding here with the facts that are known in psychiatry. By him withholding his warning here, a validation could be formed in vulnerable people's minds, including children thinking that a doctor can not be a quack. This is the same propaganda used by the tobacco companies to addict children to their deaths, and a horrible death by cancer of the lungs.
And as the deaths from these drugs pile up, sites like this can encourage readers to think that these drugs are safer than they really are. That is a great deception and unfair to humanity for this to be allowed.
Lou
Posted by David1973 on August 19, 2016, at 9:26:54
In reply to Lou's reply-when will they ever learn » David1973, posted by Lou Pilder on August 19, 2016, at 8:53:56
Ok understand your point Lou. The psychiatrist I`m seeing hasn't allowed me to do this, and I`m sure, since I am now on trazodone he wont allow me. I was planning on asking him but wanted some experiences as to whether I should bother. He has been very responsible, I asked him for Nardil, he gave me a full run down of interactions, started me on a low dose and a slow increase in dosage. He as always encouraged me look at non medical alternatives in the long run and introduced me to mindfulness which has been extremely beneficial. Whee he first started me on amitriptyline, I had to spend a week in the hopsital and this was only so they could keep an eye on me while upping to 20mg. He wouldn't let me go any higher than 50mg. He told me trazodone isn't particularly strong on serotonin, and even less so at a dose between 100 and 150, which turned out to be consistent with many studies etc I found on the internet.
Personally I feel that 10mg amitriptlyine, maybe 20mg would present no risk at all.
Thanks, David
Posted by David1973 on August 19, 2016, at 9:46:48
In reply to Lou's urgent warning-unfair to humanity » SLS, posted by Lou Pilder on August 19, 2016, at 9:17:27
You have evidence otherwise ? Have you had issues with any of the combo's posted on here ? I`m not sure you really understand these things well enough and posts like yours on this thread, well, I feel will be completely ignored by most people. If you have sound evidence, post it please.
Posted by Lou Pilder on August 19, 2016, at 9:48:09
In reply to Re: Lou's reply-when will they ever learn, posted by David1973 on August 19, 2016, at 9:26:54
> Ok understand your point Lou. The psychiatrist I`m seeing hasn't allowed me to do this, and I`m sure, since I am now on trazodone he wont allow me. I was planning on asking him but wanted some experiences as to whether I should bother. He has been very responsible, I asked him for Nardil, he gave me a full run down of interactions, started me on a low dose and a slow increase in dosage. He as always encouraged me look at non medical alternatives in the long run and introduced me to mindfulness which has been extremely beneficial. Whee he first started me on amitriptyline, I had to spend a week in the hopsital and this was only so they could keep an eye on me while upping to 20mg. He wouldn't let me go any higher than 50mg. He told me trazodone isn't particularly strong on serotonin, and even less so at a dose between 100 and 150, which turned out to be consistent with many studies etc I found on the internet.
>
> Personally I feel that 10mg amitriptlyine, maybe 20mg would present no risk at all.
>
> Thanks, DavidDave,
You wrote,[...I feel that taking 20 mg of amitriptyline would present no danger at all..].
In your case, the combination could cause death. And if you felt that the Earth was flat, would it be true that the earth is flat?
If you have some research showing what you claim that you found on the internet, then post it here now. If not, the post a retraction of your advice that innocent children could act on here because the psychiatrist here allows you to post such without a citation when asked. And those children could be killed by the combination . Who will have their blood upon them?
Lou
Posted by David1973 on August 19, 2016, at 9:51:57
In reply to Re: Nardil, Trazodone and Amitriptyline » David1973, posted by SLS on August 19, 2016, at 8:54:38
Thanks Scott. I used to take 200mg of Imprimane before Nardil ! Anyway, from what I understand, Imipramine is far stronger than amitriptline on serotonin.
I'm pretty certain at 20mg, any effect on serotonin will be non existant. My psychiatrist was more concerned about blood pressure form the noradrenaline than SS.
I may leave it for now anyway and see how the pain goes. I'm starting to think I may have to go back on lyrica which I dont want - got too fat!!
Posted by Lou Pilder on August 19, 2016, at 10:12:18
In reply to Re: Lou's urgent warning-unfair to humanity, posted by David1973 on August 19, 2016, at 9:46:48
> You have evidence otherwise ? Have you had issues with any of the combo's posted on here ? I`m not sure you really understand these things well enough and posts like yours on this thread, well, I feel will be completely ignored by most people. If you have sound evidence, post it please.
Dave,
Do you want to trust a quack? Do you want to trust Scott? Do you want to trust Mr. Hsiung? Do you want to trust the Devil?
Here is sound evidence that what I am saying is true. It is common knowledge.
Lou
https://www.drugs.com/interactions-check.php?drug_list=168-0,2228-0,1839-1190
Posted by David1973 on August 19, 2016, at 12:09:58
In reply to Lou's reply-common knowlege » David1973, posted by Lou Pilder on August 19, 2016, at 10:12:18
sorry to sound nasty but you are full of sh*t. Thats not evidence, thats just some website.
Why are these Mums and Dads letting these poor innocent kids f*ck around on an internet forum?
I don't trust doctors, I dont know Mr Hsiung, and the devil isnt' real.
http://www.ncbi.nlm.nih.gov/pubmed/2365668
http://www.ncbi.nlm.nih.gov/pubmed/7037873
Plenty more where they came from.
Anyway,F*ck Off.
Posted by Tabitha on August 19, 2016, at 12:41:47
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by David1973 on August 19, 2016, at 9:51:57
Hi David,
I don't have experience with you combo, but I wondered if you know about duloxetine (cymbalta) for pain. It's approved for fibromyalgia now. I have a lot of joint pain and it works quite well for it. It also decreases appetite for me, so no weight gain. The downside is it messes up my sleep, but YMMV.Also, welcome to the board and I'm sorry you've encountered the resident anti-psychiatry/religious obsessive poster already. There's no moderation on the board at this point, so there's not much we can do about it.
Posted by David1973 on August 19, 2016, at 12:59:57
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by Tabitha on August 19, 2016, at 12:41:47
Thank You Tabitha, no worries about the Lou geezer. It took me 1 or 2 posts to understand what he was on about but it doesn't take long to work out those poor souls like Lou, bless him !!
Duloxetine,yes, I know about it. Funnily enough, I worked on one of the sites in England where they were researching it back in the 90's on work experience. The office next to me was a huge building chock full of Prozac ready to be distributed :-).
Anyway, was offered it a few months back actually by a pain consultant, and my psychiatrist reluctantly said I could try it, but I just I didn't want another drug that caused libido issue's. Also felt it was more of a risk
alongside Nardil.Think I`m realising I may have to go back on Lyrica as it worked well before. Otherwise its Dihydrocodeine every day. Just have to put up with side effects of Lyrica.
Thanks, Dave.
Posted by Tabitha on August 19, 2016, at 13:47:31
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by David1973 on August 19, 2016, at 12:59:57
> I didn't want another drug that caused libido issue's.
Yes, I found it to be one of the worst for that.
> Think I`m realising I may have to go back on Lyrica as it worked well before. Otherwise its Dihydrocodeine every day. Just have to put up with side effects of Lyrica.Sounds like the best choice. Personally I can't handle the bowel issues from opiates.
Posted by Lou Pilder on August 19, 2016, at 16:14:00
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by Tabitha on August 19, 2016, at 12:41:47
> Hi David,
> I don't have experience with you combo, but I wondered if you know about duloxetine (cymbalta) for pain. It's approved for fibromyalgia now. I have a lot of joint pain and it works quite well for it. It also decreases appetite for me, so no weight gain. The downside is it messes up my sleep, but YMMV.
>
> Also, welcome to the board and I'm sorry you've encountered the resident anti-psychiatry/religious obsessive poster already. There's no moderation on the board at this point, so there's not much we can do about it.Friends,
Be not deceived. The poster writes that there is no moderation by the psychiatrist here. But could he not be intending to turn his back on the post here for reasons of his own?
You see, Mr. Hsiung has in my understanding a duty and responsibility to save lives here and not let drugs to be promoted without the serious consequences that could befall readers here from that not being disclosed. For readers could be seriously misled to think that these drugs are safer than they really are and receive addiction , life-ruining conditions and death from these drugs.
Now Mr. Hsiung has training to know the adverse consequences associated with these drugs that are not posted with the promotion of these drugs here. This brings up that readers could formulate his intent on their own. Since a doctor has a pledge to do no harm, an ancient oath, then allowing what could kill someone here is out of character for the profession. And those that are killed by reading here can not speak here. I will speak for them.
Lou
Posted by SLS on August 19, 2016, at 16:16:48
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by David1973 on August 19, 2016, at 12:59:57
You absolutely cannot mix duloxetine with Nardil. Serotonin syndrome will surely result with this combination.
- Scott
Posted by David1973 on August 20, 2016, at 4:14:25
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by SLS on August 19, 2016, at 16:16:48
Hi Scott, thats one of the reasons I turned it down but main reason were the side effects and an increase in the possibility of hypertension. I read somewhere that serotonin syndrome is extremely rare with both the main MAOI's, with the acute doses of seroternergic being the culprits. Certainly not willing to see if thats true.
Thanks, Dave.
Posted by Lou Pilder on August 21, 2016, at 6:44:32
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by SLS on August 19, 2016, at 16:16:48
> You absolutely cannot mix duloxetine with Nardil. Serotonin syndrome will surely result with this combination.
>
>
> - ScottScott,
You wrote the above.
This could save lives here, thanks. Now I want for you to go back to the years of your posts advocating the taking of combinations of drugs that could addict, cause life-ruining conditions or death.
Lou
Posted by David1973 on August 21, 2016, at 12:23:16
In reply to Lou's response- » SLS, posted by Lou Pilder on August 21, 2016, at 6:44:32
Could you try this combination for me Lou? Check its ok ?
Posted by Lou Pilder on August 21, 2016, at 19:15:23
In reply to Re: Lou's response-, posted by David1973 on August 21, 2016, at 12:23:16
> Could you try this combination for me Lou? Check its ok ?
Dave,
I have already checked the combination and it could kill you. How long are you going to be led like a lost sheep shepherded by the Shepherd of Death? Would not you really like to be shepherded to life? Who is your shepherd, Scott?, Mr. Hsiung? the devil?
People that do not believe in the devil still can be shepherded by the devil. People can be led astray by doctors and psychiatrists and television commercials. Dave, thousands of people are killed each month by these drugs. What sane person would give these drugs to a human being?
Come, let us reason together. If you could go back to where you started before you took the drugs, would you do it?
Lou
Posted by Robert_Burton_1621 on August 22, 2016, at 5:08:12
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by David1973 on August 20, 2016, at 4:14:25
> Hi Scott, thats one of the reasons I turned it down but main reason were the side effects and an increase in the possibility of hypertension. I read somewhere that serotonin syndrome is extremely rare with both the main MAOI's, with the acute doses of seroternergic being the culprits. Certainly not willing to see if thats true.
>
> Thanks, Dave.Hello Dave. I'd like to echo Scott's opinion about duloxetine co-administration with either Nardil or Parnate; indeed, you ought not go near an agent with substantial serotonergic potency for at least 10 days after stopping an MAOI. Such agents include all of the SSRIs, the new "SNRIs" venlafaxine and duloxetine, and the tricyclics imipramine and clomipramine. I'm not sure about the veracity of the proposition that serotonin syndrome is extremely rare with MAOIs. Does this proposition only apply to overdosing on MAOIs? Or does it apply to the co-administration of an MAOI with a serotonergic agent with a different mode of action? And if the later, is the proposition absolute or relative; i.e., in comparision to what other combination carrying the potential risk of serotonin toxicity is the MAOI + sert combination purportedly "extremely rare"?
The *rate* of serotonin toxicity induced by the combination of an MAOI with a sert drug may be, in relative terms, low owing to the lower rate of MAOI prescibing. But the absolute risk of serotonin syndrome occuring as a result of MAOI + sert combination is substantial.
Remember, though, that the clinical expression of serotonin toxicity falls on a spectrum of symptoms, is dose and timing dependent, and in minor cases may simply require close monitoring. But the combining (e.g.) clomipramine or duloxetine with an MAOI is absolutely contra-indicated.
There is excellent information at Dr Gillman's site on serotonin toxicity: http://www.psychotropical.com/serotonin-toxicity
Amitriptyline is not significantly serotonergic, so should be safe to combine with an MAOI, with close monitoring. The active metabolite of amitriptyline - viz., nortriptyline - is an NRI and thus, from what I have read, safe to co-administer with an MAOI. The addition of NORT can also attenuate any pressor response from excessive tyramine consumption.
Sorry to hear of your continuing pain syndrome. If the pain is neuropathic, have you considered gabapentin?
Posted by David1973 on August 22, 2016, at 10:02:40
In reply to Re: Nardil, Trazodone and Amitriptyline, posted by Robert_Burton_1621 on August 22, 2016, at 5:08:12
Thanks Robert, maybe I should scrub that proposition altogether, I did read but I`ll let the experts offer advice like that !! I certainly agree with Scott and yourself, and like I said, it was one of the reasons why I didn't want to try it.
As for gabapentin, isn't that similar to pregab ? I was on 600mg Lyrica for a good while for anxiety but it did a great job for the pain as well. I just wanted some kind of sex life !! Does gabapentin have similar libido killing properties ?
I'm seriously thinking about dropping everything except for Nardil. Painkillers, supplements, the lot and then starting again to see what works. Fed up of taking pills now.
Thanks, Dave.
Posted by Robert_Burton_1621 on August 22, 2016, at 10:37:10
In reply to Lou's response-the shepherd of death, posted by Lou Pilder on August 21, 2016, at 19:15:23
> > Could you try this combination for me Lou? Check its ok ?
> Dave,
> I have already checked the combination and it could kill you. How long are you going to be led like a lost sheep shepherded by the Shepherd of Death? Would not you really like to be shepherded to life? Who is your shepherd, Scott?, Mr. Hsiung? the devil?
> People that do not believe in the devil still can be shepherded by the devil. People can be led astray by doctors and psychiatrists and television commercials. Dave, thousands of people are killed each month by these drugs. What sane person would give these drugs to a human being?
> Come, let us reason together. If you could go back to where you started before you took the drugs, would you do it?
> Lou
>Dave. Do not pay an iota of interest to Lou's posts.
Posted by David1973 on August 22, 2016, at 10:42:32
In reply to Re: Lou's response-the shepherd of death, posted by Robert_Burton_1621 on August 22, 2016, at 10:37:10
:-) worked him out pretty quickly Robert. Just wanted him to try the extremely poisonous duloxetine - Nardil combo for me :-). I'll ignore him now.
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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