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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by shellie on September 7, 2000, at 22:43:55
After a very scary one day trial of resperdal with Nardil, I am finally trying a trial of adrafinil with Nardil. I am feeling sort of scared and alone. My pdoc said as long as I was taking the adrafinil, she can not be my doctor, but I could return to her after the trial.
(Will I want to?)My most immediate problem is that I will run out of Nardil in two weeks, which I should have anticipated before I lost my pdoc. I'm not sure who will prescribe it to me, knowing that my pdoc thought it was unsafe. I never imagined that I'd ever be creating a strategy for finding nardil.
But also, after torturing me with two very long useless trials of topomax and provigil (I slept 16 hours a day for almost a month each time), then creating a real scare with risperdal (without warning me of possible side effects), she says she cannot be there for me at all since she disagrees with my decision. So I don't even have anyone to ask if I'm having a weird reaction, except I guess the emergency room. I know she is doing what she truely thinks is right, but after six years with her, I am really sad. She also has the best reputation for "hard to treat" depression in my city, so anyone I talk to will feel nervous to treat me after her. (That's what happened in the hospital--my hospital doctor wanted to take me off topomax, but deferred to my outpatient doc (because of her reputation)). I am very angry at myself for letting that happen-- for not dropping the topomax after no good effect and total tiredness.
Anyway, first three days, no bad effects on adrafinil--maybe even good. I am on 300mg and may very very slowly go up to 600. I think I'll be fine; it just would have been nice if my pdoc had disagreed with my decision but agreed to be there for me in case of medical questions. I'm going to see if I can find a French doctor tomorrow at NIMH--or one who's spent time in France to answer any questions.
I don't really need anything--just needed to vent.
Shellie
Posted by Anna P. on September 8, 2000, at 10:31:21
In reply to MAOI and Afrafinil Trial - Very Long, Venting, posted by shellie on September 7, 2000, at 22:43:55
> Hi Shellie,
I know what you're going through - my local doctor was
absolutely against taking the moclobemide and dexedrine by me in the past.
When I saw a good psychopharmacologist, he said it's a very common practice.Shellie, do you mind telling me how to find a doctor from France?
I just got a new AD from France, and would like to get in touch with a French doctor.Anna P.
Posted by shellie on September 8, 2000, at 11:49:46
In reply to Re: MAOI and Afrafinil Trial, posted by Anna P. on September 8, 2000, at 10:31:21
> Shellie, do you mind telling me how to find a doctor from France?
> I just got a new AD from France, and would like to get in touch with a French doctor.
>
> Anna P.Hi Anna. I called the washington, d.c. chapter of the american psychiatric association (where I live) and they gave me two names. I haven't reached either yet, but I'm not sure if they are just french speaking, or actually have lived recently in France--but they may also be able to refer me. I am also calling a pdoc I know who attends lots of meetings on medication and depression and will ask him if he has any names. NIMH wouldn't give out any names. I don't know if I'll come up with anyone or not, but the APA is probably the best place to start. Good luck, Shellie
Posted by AndrewB on September 8, 2000, at 14:00:37
In reply to Re: French doctors » Anna P., posted by shellie on September 8, 2000, at 11:49:46
Hi!
I also would like to find a good French psychopharmocologist that will do long-distance sessions. Please keep me informed.
AndrewB
andrewb@seanet.com
Posted by shellie on September 8, 2000, at 19:01:20
In reply to Re: MAOI and Afrafinil Trial, posted by Anna P. on September 8, 2000, at 10:31:21
>Really to everyone, especially Anthony and anyone else taking adrafinil with an MAOI. I had a seratonin reaction early this evening with nardil and adrafinil. I was feeling let down at about 4 o'clock after a good morning and afternoon, so I took another 3mg of adrafinil. My pulse went way down, my back and shoulders stiffened. I rushed to the pharmacy up the street and my blood pressure, which is usually no higher than 110/68 was up to 161/47. Pulse was 60 (usually 80s for me). 161 is not that high, but very high for me. I don't know why the systolic (?) was lower than usual. I talked to the pharmacist, took my blood pressure again and it was down to 108 after about 15 minutes. So I think I was not as careful as I should have been. Just a warning; there may be a risk. In 20 years I have never before had a reaction to a combination with nardil and I never watch what I eat from the list. Shellie
Posted by JohnL on September 9, 2000, at 6:30:09
In reply to MAOI and Afrafinil Trial - Very Long, Venting, posted by shellie on September 7, 2000, at 22:43:55
Shellie,
I can sure relate to your frustrations. I know it doesn't help much, but you aren't alone. Plenty of us have the same difficulties and problems with our depressions, our medications, and our doctors. I sure feel for you. But you are smart and strong willed. More than your pdoc will ever know.I wouldn't put so much emphasis on reputation. After all, if your doc has been impotent at ending your suffering with six years of her best, then that reputation seems meaningless to me. So what if she's supposedly good with treatment resistance in other people. Doesn't matter. She's not good with that in your case. Results are what matter. Not reputation. It wouldn't surprise me at all if you found another doctor with only half the reputation, but much greater success with your unique case.
Hang in there. I know you're doing your best. Everything will work out. You sound smart, strong willed, and determined to me. Those are powerful ingredients for success.
John
Posted by shellie on September 9, 2000, at 9:22:36
In reply to Re: MAOI and Afrafinil Trial - Very Long, Venting, posted by JohnL on September 9, 2000, at 6:30:09
.
Posted by shellie on September 10, 2000, at 12:45:39
In reply to Thanks for the support JohnL. (NM), posted by shellie on September 9, 2000, at 9:22:36
Everyone seems to be combining adrafinil with ampisulpride. For now I've chosen the adrafinil over nardil (after two seratonin scares) and am thinking of other things to combine with the adrafinil. I am definitely feeling the effects of being off the Nardil, but have a good feeling about the adrafinil. I am not anxious to try another antipsychotic from any country. Any other ideas for combinations? Any combinations I should definitely stay away from with the adrafinil? I am not particularly interested in SSRIs which have done nothing for me in the past. I have also had very bad experiences with tricyclics and mood stabilizers, as well as ritalin and dexadrine.
Again my diagnosis is major depression and dissociation, the dissociation is never approached by meds except for klonpin as needed. Shellie
P.S. Also my pdoc just dumped me (she said she can't work with me if I don't trust her-had to do with the adrafinil), so if anyone knows a good pdoc in the washington, d.c. area, I'm open. NIMH is too conservative (and expensive if you see their docs outside their protocals) and John Hopkins would probably also not approve of the adrafinil.
Posted by JohnB on September 10, 2000, at 15:09:05
In reply to Other ideas with Adrafinil besides Ampisulpride?, posted by shellie on September 10, 2000, at 12:45:39
I would think most pdocs are not going to approve using a drug not approved for use in the US, the reason being it might leave them open to a malpractice lawsuit if something should go wrong. The threat of malpractice, and the cosequent doubling of their malpractice insurance rate, is what drives many of these kinds of situations.
Posted by SLS on September 10, 2000, at 16:23:08
In reply to Other ideas with Adrafinil besides Ampisulpride?, posted by shellie on September 10, 2000, at 12:45:39
Hi Shellie.
What about combining Nardil with Zyprexa?I won't be able to follow-up on this thread. I hope you find something to use as an adjunct to adrafinil since you feel it is helping you. I would consider using Wellbutrin.
Good luck. Gotta' go.
- Scott
Posted by AndrewB on September 10, 2000, at 18:06:18
In reply to Other ideas with Adrafinil besides Ampisulpride?, posted by shellie on September 10, 2000, at 12:45:39
Shellie,
What is disassociation? What causes it. Do medications sometimes help with it?
Thank you,
AndrewB
Posted by shellie on September 10, 2000, at 19:07:19
In reply to Re: Other ideas with Adrafinil besides Ampisulpride?, posted by AndrewB on September 10, 2000, at 18:06:18
> Shellie,
>
> What is disassociation? What causes it. Do medications sometimes help with it?
>
> Thank you,
>
> AndrewBAndrew, you might want to go to www.voiceofwomen.com/centerarticle.html for an introduction which should answer your questions.
Shellie
Posted by JohnL on September 13, 2000, at 16:58:20
In reply to Other ideas with Adrafinil besides Ampisulpride?, posted by shellie on September 10, 2000, at 12:45:39
Shellie,
I understand your reluctance to avoid antipsychotics. But I really think you should consider Amisulpride. Unlike all the other APs, which affect a whole array of brain receptors, Amisulpride is very specific and targeted at what it does. In my experience it has probably the fewest side effects of anything out there, and yet is quite effective. Especially for your symptoms, I think Amisulpride would be an excellent choice.
I too, like you, had lousy experiences with a whole bunch of different meds, including most of those you've tried. But Amisulpride, to me, opened up a whole new world. From what I know of Amisulpride, depression and dissociation, as well as all the med choices, I can't think of anything that would come close to Amisulpride as a top choice to try next.
When I think of an antipsychotic, I think of something heavyduty. Something kind of scary. The same way the word lithium scares a lot of people. Amisulpride really doesn't have anything in common with other APs at all. The term antipsychotic does not do it any justice at all. It's different. It's not like the others. It's kind of in a class all its own, if you ask me. It not only stands an excellent chance of working for you, but side effects for most people have been minimal to nonexistant.
And since you don't have a current doctor, it's a prime candidate to try in the meantime. My gut feeling is pretty positive, or else I wouldn't mention it.
Just wanted to say, don't rule it out just yet.
John
Posted by shellie on September 14, 2000, at 10:57:04
In reply to Re: Other ideas with Adrafinil besides Ampisulpride?, posted by JohnL on September 13, 2000, at 16:58:20
Hi John. Thanks for the input. I tried resperal and could barely move or speak the next day and it was scary. So I'm not anxious to try another antipsychotic. Also, after my mistake of taking nardil with adrafinil and causing a serotonin reaction, it became clear for me, that I don't want to combine new meds without a doctor in the wings. I have an appointment next Friday with my old pdoc to go onto parnate, but then in a few weeks I have a consultation with someone who feels fine about using european drugs (I wish I could have gotten in earlier, before I go on the parnate.) I set it up that way because I crashed, but today I feel stable and may try to wait out for the second pdoc. shellie
This is the end of the thread.
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