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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 1 of 1. This is the beginning of the thread.
Posted by rose45 on March 14, 2023, at 8:14:29
Hi SLS,
I am so grateful for your post. I went to bed last night with plans on how to end my life and awoke to your long message. It means a lot.
I have written a long message back. Thank you for reading it and I hope it makes sense.
<What is a little manic for you?> I had been to a meditation retreat and felt happier than i had ever been.
This has happened to me before, meditation retreats have their own energy, and you can feel on top of the world. However I then intended to give all my money to this meditation teacher, and caught myself in time, realising this was mania. I was in India with no doctor in sight, so i basically reduced my medication from 30mg to 20 mg. I had been perfectly happy for 6 years on 30 mg. I was not taking any other drug.After about one month, I began to feel anxious and should have increased the amount back up to 30, but was deceived by my mania, and thought i could survive at the lower dose. Total self-deception and when I finally realised what was happening, I increased the dose back up and even up to 40 mg but it made no difference. I simply cannot tolerate higher than 40 mg.
The anxiety got worse and worse, and this has happened to me in the past when on nardil, when i reduced it, all the anxiety which had been suppressed by the med envelops me and I cannot think clearly cannot make decisions,and am in terrible psychiatric pain. its hard to describe.
You are right I should have stayed with the hypomania and it would have calmed down, but I was so set on giving all my money away, that I felt i had to do something to stop myself acting irrationally. I was not in control of my own mind . If there had been a doctor around, i would not have decreased the medication which had been so good to me, but here in UK you do not get supervision, they discharge you when you are Ok.. I made a terrible mistake and am paying for it. I simply cannot go higher on the parnate. Am taking 40 mg now but you have to believe me, cannot tolerate any higher. The anxiety is so crushing, I cannot bear it, and have become an invalid.... As I write to you, my hand is shaking with fear, and I can barely think clearly. I have had to take a tranquiliser to write this. I cannot endure the psychic pain of the parnate not working.
Both Nardil and Parnate were wonder drugs for me and I took them on their own. Nardil at 45 mg for 20 years, until it stopped working. And Parnate at 30 mg until I stupidly reduced it.
It is my own stupidity to have lowered the dose. But now I am incapable to increasing the dose above 40 mg, as it is unbearable and in any case, makes no difference.
When all this hahppened, I added 25mg olanzapine and it magically made the parnate work again. I should have left it at that. But stupidly asked Dr. Gillman if it would be safe to decrease the olanzapine, and he said yes, do it slowly....... That was a big mistake, because the whole combination stopped working gradually, and even though I upped the olanzapine, it made no difference, and the unbearable anxiety came back.Other people are able to increase and decrease their doses of meds. In my experience, when I decreased the parnate, or the olanzapine , however much i increase the dose afterwards it makes no difference.I dont understand it,
<What is the top dosage of parnate you reached?>
I was happy on 30 mg for 6 yrs. When it stopped working after I reduced it. I went up to 40mg. That was the highest i could tolerate. I tried 50 mg, but that was impossible for me to tolerate.I am in a terrible state and bedridden. the anxiety is crippling.
addition of olanzapine 200 mg made the parnate work again but lasted only 3 months and the unbearable anxiety retuned. Olanzapine also wiped out my memory.... I am now almost off it.
addition of 150 mg lithium again was a miracuous recovery but lasted only 2 months, and again this horrible anxiety returned.
>What do you mean by tolerance?
I took the lithium under the guidance of a mexican psychoneurologist, on whatsapp, as our english NHS is so hopeless. When the lithium helped for just 2 months, and then stopped working he told me some patients have issues of 'tolerance' and meds only work for a certain time with them, and he has to rotate the meds around every two months or so. I really dont know how he does this on a practical basis.... I have to speak spanish with him and have appt. on whatsapp which is not entirely satisfactory.The treatments I have had in my life are:
1. amitryptiline/imipramine combo when I was 21, I hated it, as it just made me eat and sleep all the time, and I soon took myself off it.
2. Nardil 45mg. worked for 20 ish years, until it just stopped working. Increasing it make no difference. I usually can only tolerate lower levels of meds than other people.
3. paroxetine - which was just like a sugar pill - no effect whatsoever.
4. Parnate 30 mg - worked brilliantly for 6 years, until I stupidly reduced it and it stopped working, inspite of increasing it to 40 mg.
The NHS work acc. to what they call the NICE guidelines. Because I am still taking the parnate, there are only 3 drugs I have been offered: Lithium, Valproic Acid and Pregabalin. I asked to be switched to Nardil, but they have refused because they consult with their pharmacist who told them it didnt make sense to change from one maoi to another.
I havent taken a long list of drugs as you have and the NHS only allow 2 drugs at one time. This is what I am dealing with. I was lucky that both maois worked so well for me and I only wish I had not reduced the parnate, or reduced the olanzapine when it was added to it. I would be ok if I had just left it. But others do increase and decrease their meds at will. Why cant I?
It means the earth to me that you have responded, please respond to this. Thank you .Thank you.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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