![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 13 to 37 of 37. Go back in thread:
Posted by SLS on May 9, 2021, at 8:01:51
In reply to Re: The magic potion for me., posted by PeterMartin on May 7, 2021, at 20:35:57
Hi, Peter.
> Awesome to read that you're doing well Scott, and thanks for coming back to let us know the cocktail (I think we're all always looking).
>
> Which generic of Lamictal did you settle on? I'm still a bit hung up on that for my own situation.
>
> Also, in case you didn't see a post of mine above, I'd take a look into Rybelsus for Nardil weight gain. It's a GLP-1 agonist. It's not yet approved for weight loss, but the studies have been super positive and I'm almost certain it will be another year or two. I've lost 15lbs in 7weeks which is unheard of for me (on Marplan, Lamictal, and low dose Seroquel).
>
> Now that I'm on Rybelsus I may try to give Nardil another go. The weight gain was an issue for me and I'm not sure if combining it w/ Metformin may have kept it slightly inconsistent for me (as I found it).
>
> Thanks for any info on the Lamictal generic you take.Thanks for the tip on Rybelsus. Do you know anyone taking Nardil who was successful with weight control.
Regarding Lamictal (lamotrigine), I take the GSK name brand. The price is disgusting, but I was able to get an exception on my insurance. I described that I had tried two generic brands, and they didn't work. Lucky.
I have just started looking for the best generic brand myself. I may not get another exception this year.
I found the original Teva (orange) to be the better of the generics I tried. I would go back to it, except it is no longer available. Teva replaced it with the product made by the manufacturer that it acquired - lamotrigine XR.
Have you ever heard of a lamotrigine product called Subvenite by OWP Pharmaceuticals?
This is the phone number they give if your pharmacy is having a problem getting it:
1-800-273-6729
For you so far, which generic is the best and which is the worst?
How was the best different from Lamictal?
I found Mylan to be the worst. I had to go from 300 mg/day to 500 mg/day to get anything close to the desired effect, and it had some uncomfortable psychiatric side effects. I have not tried Dr. Reddys.
Regarding Nardil weight gain, are you eating more or has your metabolism slowed down?I hope you find a brand of lamotrigine that does the trick for you.
- Scott
Posted by SLS on May 9, 2021, at 8:10:48
In reply to Re: The magic potion for me. » SLS, posted by Phillipa on May 7, 2021, at 21:04:32
Hi, Jan.
> Scott are you in remission now? I do so hope you are Phillipa
Not totally. I had been taking Nardil at 90 mg/day for months. It was a daily rollercoaster ride. The magnitude of improvement could change several times a day. I raised the dosage to 105 mg/day a few days ago. The immediate result was to abolish the rollercoaster changes. Now, I have to wait at least 3 weeks before evaluating the trajectory of improvement.
I had experienced a state approaching complete remission on and off at 90 mg/day.
From what I have gathered, the usual effective range for Nardil dosage is between 60-90 mg/day. 120 mg/day seems to be the maximum.
- Scott
Posted by SLS on May 9, 2021, at 8:18:28
In reply to Re: The magic potion for me. » SLS, posted by sigismund on May 7, 2021, at 22:57:06
Hi, Sigi.
> Can I recall you saying that in the past in a desire for improvement you adjusted things in ways you subsequently regretted?
>
> Don't do that, and good luck.
Over the years, I have envied your memory.Yes. I did do that. I was absolutely reckless. I will take your advice this time.
Nardil is a deceptive drug. One can feel an improvement immediately after increasing OR decreasing the dosage. If that initial rush disappears, I have learned that this is not an indicator that further dosage increases will be necessary. I think one must wait at least 3 weeks before evaluating their response. Some people don't experience a robust improvement on Nardil until they have been taking it for 3 months.
Thanks. :-)
- Scott
Posted by SLS on May 9, 2021, at 8:35:20
In reply to Re: The magic potion for me., posted by sigismund on May 7, 2021, at 23:02:11
Hi, again.
> Did Nardil once make you feel a little unstable? No signs of mania? (about which I have zero experience.)
Nardil and Parnate have been involved in all of the few manic episodes (psychotic) that were triggered. I have never experienced anything remotely like that in my baseline untreated depression or with drugs other than MAOIs. Of the two, I found Nardil to be the greater offender. I think the rollercoaster ride I described in the post above represented a destabilization. I think I might have been hypomanic for a few days.
> It is so precious to have some relief.
This is precisely what drove my reckless behavior with Nardil. Once I feel better and then begin to deteriorate again, I will do *anything* to get relief again. The return of depression is like having your hand forced over a flame. You will do anything to pull it out as fast as you can.
Again, I would emphasize that, although the lithium might not add to my current robust response, I continue to take 300 mg/day to prevent Alzheimer's. There is a bunch of literature that indicates that lithium can not only prevent, but also reduce the rate of deterioration. Who knows if these reports and speculations are accurate, but at the dosages they claim to see this association, people should generally not be concerned about side effects. There is almost no chance to experience kidney or thyroid damage. These reports describe people taking very small dosages to receive the prophylaxis against Alzheimer's. I think 100 mg is the smallest dose available. Even 150 mg/day is plenty.
I really do appreciate your concern, Sigi. And I thank God for your memory.
- Scott
Posted by SLS on May 9, 2021, at 8:37:41
In reply to Re: The magic potion for me., posted by rjlockhart37 on May 8, 2021, at 22:45:23
Hi, RJ.
> prozac and lamictal seem to help me through the day
Doctors are becoming more comfortable using 60 mg/day of Prozac (fluoxetine). Don't give up on it without exploring this higher dosage.
Good luck, buddy.
- Scott
Posted by Phillipa on May 9, 2021, at 9:39:24
In reply to Re: The magic potion for me. » Phillipa, posted by SLS on May 9, 2021, at 8:10:48
Scott fantastic Phillipa
Posted by rjlockhart37 on May 9, 2021, at 12:16:57
In reply to Re: The magic potion for me. » rjlockhart37, posted by SLS on May 9, 2021, at 8:37:41
Scott
I take 80mg Prozac, i was on 60, my doctor finally said we'll go up to 80. She kept saying 80 would make me flat, or apathic. But...it didnt the dose works for me at keeping depression away. If i don't take it at that doseage is ineffective.
gives... a feeling, somewhat happiness, it makes things seem 'ok'. I'll be going through the day, and ill feel the prozac work, serotonin feeling. When i missed prozac, deep depression. I've been on 16 years, still working. They say it's less effective SSRI, the 'least' selective compared to paxil which the most selective. That's why it's withdrawls are not bad, compared to other SSRI's it has very very long half life. That's all i'll write. Hope things still get better for me
Posted by Lamdage22 on May 12, 2021, at 4:22:27
In reply to The magic potion for me., posted by SLS on May 7, 2021, at 8:48:02
61 isn't that bad. You still got time to enjoy. Maybe pick up exercise if you can. It'll make you feel younger and no one argues about the fact that it helps mood, either.
Posted by beckett2 on May 12, 2021, at 13:41:04
In reply to The magic potion for me., posted by SLS on May 7, 2021, at 8:48:02
This is terrific news, Scott, and I'm happy to hear it. Lamotrigine has made a big difference in my life.
Yay!
Posted by SLS on May 12, 2021, at 23:36:07
In reply to Re: The magic potion for me., posted by beckett2 on May 12, 2021, at 13:41:04
Hi, Beckett22
> This is terrific news, Scott, and I'm happy to hear it. Lamotrigine has made a big difference in my life.
>
> Yay!Yay!
Thanks.
:)
- Scott
Posted by SLS on May 14, 2021, at 15:19:15
In reply to Re: The magic potion for me., posted by beckett2 on May 12, 2021, at 13:41:04
Hi, Beckett
> This is terrific news, Scott, and I'm happy to hear it.
Thanks. :-)
> Lamotrigine has made a big difference in my life.
I'm glad you can move forward now.
What brand of lamotrigine do you take?
- Scott
Posted by beckett2 on May 14, 2021, at 19:05:19
In reply to Re: The magic potion for me. » beckett2, posted by SLS on May 14, 2021, at 15:19:15
> Hi, Beckett
>
> > This is terrific news, Scott, and I'm happy to hear it.
>
> Thanks. :-)
>
> > Lamotrigine has made a big difference in my life.
>
> I'm glad you can move forward now.
>
> What brand of lamotrigine do you take?
>
>
> - ScottUnichem. I haven't had trouble with different manufacturers, although I haven't taken all, and I've only taken generics.
Posted by SLS on May 15, 2021, at 15:09:11
In reply to The magic potion for me., posted by SLS on May 7, 2021, at 8:48:02
> This might be the magic potion for me.
>
> Nardil: 105 mg/day
> Nortriptyline: 100 mg/day
> Lamictal: 300 mg/day
> Lithium: 300 mg/day
Well, I raised the dosage of Nardil from 105 mg/day to 120 mg/day. I felt better by the end of yesterday, but I have learned to not come to any conclusions about Nardil dosage based upon the immediate improvement I receive. Within a few hours of taking more Nardil, I feel better. However, the improvement lasts for only a fraction of a day. Once I begin to lose that initial response, I had assumed that I needed more. However, it seems that the deterioration in my condition is part of the process, but passes within a few days, leaving me with a significant, stable, improvement. I would also suggest that some people must wait for 3 months before Nardil produces a robust response.
- Scott
Posted by Lamdage22 on May 21, 2021, at 2:23:36
In reply to Re: The magic potion for me., posted by SLS on May 15, 2021, at 15:09:11
I hope you will find your "feel-good-combo". I have experimented with large amounts of Phenelzine and it landed me in the hospital begging for nifedipine. BP= 190+ But yeah, I think that was more than 120mg.
Posted by Lamdage22 on May 21, 2021, at 2:25:44
In reply to Re: The magic potion for me., posted by Lamdage22 on May 21, 2021, at 2:23:36
I think it is not a bad idea to have nifedipine on you.
Posted by undopaminergic on May 21, 2021, at 3:22:55
In reply to Re: The magic potion for me., posted by Lamdage22 on May 21, 2021, at 2:25:44
> I think it is not a bad idea to have nifedipine on you.
I've often wondered why nifedipine, exactly? Wouldn't eg. nitroglycerine act faster?
-undopaminergic
Posted by Lamdage22 on May 21, 2021, at 4:09:52
In reply to Re: The magic potion for me., posted by undopaminergic on May 21, 2021, at 3:22:55
That is just the go-to med. It acted pretty quickly for me. I never could take the content of the whole capsule though, or else I would be bed-ridden because ow low blood pressure. Half seemed just right.
> > I think it is not a bad idea to have nifedipine on you.
>
> I've often wondered why nifedipine, exactly? Wouldn't eg. nitroglycerine act faster?
>
> -undopaminergic
>
Posted by SLS on May 22, 2021, at 9:31:35
In reply to Re: The magic potion for me., posted by Lamdage22 on May 21, 2021, at 2:25:44
Hi, Lamdage22.
> I think it is not a bad idea to have nifedipine on you.
I used to do that. My doctor liked the idea, but for some reason, it never crossed my mind over this past year. Duh.
I recall reading that taking nifedipine might not be a good idea for treating a MAOI hypertensive crisis. This is because it complicates the more aggressive treatments that doctors would want to use in the emergency room. I don't recall the specifics. The standard emergency treatment in the distant past had been phentolamine (Regitine) I.V. I'm not sure about now.
- Scott
Posted by Lamdage22 on May 23, 2021, at 3:55:14
In reply to Re: The magic potion for me. » Lamdage22, posted by SLS on May 22, 2021, at 9:31:35
Most of the time it is best to leave it do a doctor. I just would be scared to be shouted at for getting myself hypertensive.
Posted by Lamdage22 on May 23, 2021, at 4:04:01
In reply to Re: The magic potion for me., posted by Lamdage22 on May 23, 2021, at 3:55:14
Intense fear of people. Makes life really hard.
Posted by alchemy on June 20, 2021, at 11:47:18
In reply to The magic potion for me., posted by SLS on May 7, 2021, at 8:48:02
Congrats Scott! I don't come here much anymore but I do remember a lot of your posts and you were one of those with good advice/wisdom. Gives me hope as the struggle continues :)
Posted by SLS on June 23, 2021, at 22:06:33
In reply to Re: The magic potion for me., posted by alchemy on June 20, 2021, at 11:47:18
> Congrats Scott! I don't come here much anymore but I do remember a lot of your posts and you were one of those with good advice/wisdom. Gives me hope as the struggle continues :)
I am profoundly sorry that you must continue to live your life that way. However, I'm glad that you haven't given up on your pursuit of a normal state of mind / brain. It's worth the struggle. I always knew this because I had a few brief remissions over 40 years of otherwise failed treatments. Most responses lasted for 3 days (not 2 or 4). I call it "tickling" the brain. I also had one longer robust, but incomplete response for six months while being treated with Parnate + desipramine. During these times, I found life to be incredibly easy and rewarding. I held close to me these memories while I agonized with no end in sight. Without these experiences, how could I possibly justify allowing myself to live? I couldn't.
Have you ever thought that depression and other mental illnesses are nothing short of an "altered state of consciousness"? I have begun to use that term with greater frequency. I never heard anyone else describe mental illness that way. Even my doctor didn't want to embrace the term.
- Scott
Posted by Lamdage22 on June 23, 2021, at 22:34:03
In reply to Re: The magic potion for me. » alchemy, posted by SLS on June 23, 2021, at 22:06:33
Same here with the easy and rewarding life. You can allow yourself to live though even if you are not in remission. Who says/said you can't?
> During these times, I found life to be incredibly easy and rewarding. I held close to me these memories while I agonized with no end in sight. Without these experiences, how could I possibly justify allowing myself to live? I couldn't.
Posted by Lamdage22 on June 23, 2021, at 22:49:57
In reply to Re: The magic potion for me., posted by Lamdage22 on June 23, 2021, at 22:34:03
Nobody chooses a mental disorder.
Posted by Lamdage22 on June 23, 2021, at 23:05:43
In reply to Re: The magic potion for me., posted by Lamdage22 on June 23, 2021, at 22:49:57
Self acceptance. Really important. It doesn't come in pills or capsules.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.