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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 sgtbob on September 7, 2001, at 15:57:12
Last month, I was given concerta to try. I have severe depression and fatigue. First I tried the 18mg capsules and a week later I added, as my psych. nurse directed a 36 mg dose. This brought me to the maximum dose of 54 mg a day. It has been a month and I feel no change, I still have extreme fatigue and crave sleep. When I asked to be changed to another medication, she said no and took me off of it all together. I can't stand being tried anymore!!! No matter what I do, I am always tried and sleepy. In 1996 Doctors from a Sleep Center in Nashville recomended that I be put on Stimulants, but she declined, saying that counseling would be the answer. Ever since then my fatigue has only gotten worse. Maybe I wouldn't be as upset as I am now, but a couple of months ago, I met a gentlemen basically in the same situtation, fatigued and depressed. About a month later, he was tried on stimulants and as he put it "he woke up from a long long sleep." He moved away shortly after I met him, so I don't know how to locate him. I feel that I am sleeping my life away, and I can't do anything about it. Does anyone have any advice for me???
Thanks
Bob
Posted by Kathleen6674 on September 7, 2001, at 17:49:58
In reply to changing medication, posted by sgtbob on September 7, 2001, at 15:57:12
It just occurred to me that since there's a thread up above with a bunch of us talking about Wellbutrin-induced insomnia and/or getting an "energy boost" from the med, it might be a good antidepressant for you to try, either alone or in conjunction with another med. Try running it past your doctor (or a new doctor) if you think it could help. I have lots more energy on Wellbutrin than off. I think it might balance things out for you if your default state is fatigued and depressed.
Just a thought.
Posted by JohnL on September 7, 2001, at 18:14:28
In reply to changing medication, posted by sgtbob on September 7, 2001, at 15:57:12
Normally I prefer to offer suggestions rather than advice. But since you asked for advice, here is mine. Go online and do a search on Adrafinil. You will find a couple places that sell it. Order some. All you need is a credit card. No prescription needed.
Adrafinil is a mild stimulant popular in Europe but not available in the USA. It is used to treat narcolepsy, depression, and to improve energy, motivation, pleasure, and memory. I am well experienced with Adrafinil, and for me it does everything it is said to do. If I were you, I would do a search on it, read about, study it, and then consider ordering it.
Normally I would not go this route, but instead would encourage you to work with your doctor. But since your medical pros are obviously not working with you, then fine, there are other ways. There are plenty of us here that choose and order our own meds and do wonderfully fine. Adrafinil is a rather mild drug, so it isn't as if you were stepping into some dangerous situation.
Importation is legal. Delivery takes about 2 to 4 weeks. You asked for advice, and that is my 2 cents worth. It has been helpful to a lot more people than just me. It's a mild drug, dirt cheap, few if any side effects, and very effective generally for the the exact symptoms you described. If your doctors are not doing the trick, then the ultimate responsibility for getting something done always lies with the patient anyway. You need not depend on the whims of others to determine whether you get the privilege of feeling well or not.
As far as counseling goes, it is indeed helpful, but usually only after a medication has started to work. It sounds more like a cop-out to me than anything else. Tell your doc that once you start feeling better on a medication you will do counseling, but not before. See how they react to that. If they think you are full of nonsense, then you will in fact know that they are the ones full of nonsense.
Adrafinil, my friend.
John> Last month, I was given concerta to try. I have severe depression and fatigue. First I tried the 18mg capsules and a week later I added, as my psych. nurse directed a 36 mg dose. This brought me to the maximum dose of 54 mg a day. It has been a month and I feel no change, I still have extreme fatigue and crave sleep. When I asked to be changed to another medication, she said no and took me off of it all together. I can't stand being tried anymore!!! No matter what I do, I am always tried and sleepy. In 1996 Doctors from a Sleep Center in Nashville recomended that I be put on Stimulants, but she declined, saying that counseling would be the answer. Ever since then my fatigue has only gotten worse. Maybe I wouldn't be as upset as I am now, but a couple of months ago, I met a gentlemen basically in the same situtation, fatigued and depressed. About a month later, he was tried on stimulants and as he put it "he woke up from a long long sleep." He moved away shortly after I met him, so I don't know how to locate him. I feel that I am sleeping my life away, and I can't do anything about it. Does anyone have any advice for me???
>
> Thanks
> Bob
Posted by sgtbob on September 7, 2001, at 18:15:48
In reply to Re: changing medication, posted by Kathleen6674 on September 7, 2001, at 17:49:58
> It just occurred to me that since there's a thread up above with a bunch of us talking about Wellbutrin-induced insomnia and/or getting an "energy boost" from the med, it might be a good antidepressant for you to try, either alone or in conjunction with another med. Try running it past your doctor (or a new doctor) if you think it could help. I have lots more energy on Wellbutrin than off. I think it might balance things out for you if your default state is fatigued and depressed.
>
> Just a thought.Thanks for thought but I have been taking Wellbutrin since 1999 and it hasn't helped with the fatigue.
Posted by adamie on September 7, 2001, at 19:06:05
In reply to changing medication, posted by sgtbob on September 7, 2001, at 15:57:12
> Last month, I was given concerta to try. I have severe depression and fatigue. First I tried the 18mg capsules and a week later I added, as my psych. nurse directed a 36 mg dose. This brought me to the maximum dose of 54 mg a day. It has been a month and I feel no change, I still have extreme fatigue and crave sleep. When I asked to be changed to another medication, she said no and took me off of it all together. I can't stand being tried anymore!!! No matter what I do, I am always tried and sleepy. In 1996 Doctors from a Sleep Center in Nashville recomended that I be put on Stimulants, but she declined, saying that counseling would be the answer. Ever since then my fatigue has only gotten worse. Maybe I wouldn't be as upset as I am now, but a couple of months ago, I met a gentlemen basically in the same situtation, fatigued and depressed. About a month later, he was tried on stimulants and as he put it "he woke up from a long long sleep." He moved away shortly after I met him, so I don't know how to locate him. I feel that I am sleeping my life away, and I can't do anything about it. Does anyone have any advice for me???
>
> Thanks
> Bobyour pdoc is doesn't know what she is talking about. it's as simple as that. talk therapy can work for personal life problems but not medical conditions. when something is wrong with someone's brain they need medication and only medication will help that problem. I really think you should try to find another pdoc to try and get yourself a stimulant.
Posted by Cam W. on September 8, 2001, at 19:14:46
In reply to Re: changing medication » sgtbob, posted by adamie on September 7, 2001, at 19:06:05
> your pdoc is doesn't know what she is talking about. it's as simple as that. talk therapy can work for personal life problems but not medical conditions. when something is wrong with someone's brain they need medication and only medication will help that problem. I really think you should try to find another pdoc to try and get yourself a stimulant.
Adamie - Talk therapy, depending on the kind, can definitely help medical conditions. Cognitive therapy can help people learn to cope with their disorder, thus improving their quality of life. It can also help to change a person from a victim of a disease, and empower tham to take control of the disorder, rather than the disorder controling them.
- Cam
Posted by akc on September 8, 2001, at 20:29:20
In reply to Re: talk therapy - beg to differ » adamie, posted by Cam W. on September 8, 2001, at 19:14:46
> Adamie - Talk therapy, depending on the kind, can definitely help medical conditions. Cognitive therapy can help people learn to cope with their disorder, thus improving their quality of life. It can also help to change a person from a victim of a disease, and empower tham to take control of the disorder, rather than the disorder controling them.
>
> - CamI have to jump in here and add my support to what Cam says. I can only speak from my experience. But medication alone would not solve my disease. I had developed years of poor coping mechanisms (from alcoholism to isolating myself from others to black and white thinking and so on and so on) in an attempt to control/treat my disease. Adding a medicine, even the right medicine, didn't take these poor coping skills away. I've needed help in identifying and relearning these skills.
And I will add, because it has been a battle these past two years to find the "right" medicine (or combination of medicines), I have needed the help of talk therapy in learning how to accept that I have a chronic, even possibly deadly, illness. As Cam said -- to do that without taking the role of a victim -- I couldn't have done that without the help of a very good therapist. I think this acceptance has helped me as I have worked with my pdoc in trying to find the right combination of meds.
akc
Posted by Tony P on September 9, 2001, at 0:33:57
In reply to Re: talk therapy - beg to differ -- my two cents, posted by akc on September 8, 2001, at 20:29:20
There was a study recently -- wish I could give you reference, but I probably saw the summary in Scientific American -- of depressed people on medication and/or counselling. The two groups on medication alone and counselling alone did about equally well (or badly); the group receiving both did much better, not just a small difference, but (if I remember correctly) twice as well. It was like 30% had significant improvement on mrds alone or psychotherapy alone, but 60% improved on the combination. Please don't quote me, i'm just guessing aat the numbers from memory!
Those are just group statistics, but I can also personally state that both 1:1 couselling and peer support groups have been a very important part of my recovery in the past - but I wasn't really getting anywhere until I started on A/D.
Guess I'd better phone my counselor (whom I haven't seen for a couple of months) and book an appointment next week ....
Tony P
> > Adamie - Talk therapy, depending on the kind, can definitely help medical conditions. Cognitive therapy can help people learn to cope with their disorder, thus improving their quality of life. It can also help to change a person from a victim of a disease, and empower tham to take control of the disorder, rather than the disorder controling them.
> >
> > - Cam
>
> I have to jump in here and add my support to what Cam says. I can only speak from my experience. But medication alone would not solve my disease. I had developed years of poor coping mechanisms (from alcoholism to isolating myself from others to black and white thinking and so on and so on) in an attempt to control/treat my disease. Adding a medicine, even the right medicine, didn't take these poor coping skills away. I've needed help in identifying and relearning these skills.
>
> And I will add, because it has been a battle these past two years to find the "right" medicine (or combination of medicines), I have needed the help of talk therapy in learning how to accept that I have a chronic, even possibly deadly, illness. As Cam said -- to do that without taking the role of a victim -- I couldn't have done that without the help of a very good therapist. I think this acceptance has helped me as I have worked with my pdoc in trying to find the right combination of meds.
>
> akc
Posted by Terlo on September 9, 2001, at 9:21:40
In reply to Re: changing medication, posted by sgtbob on September 7, 2001, at 18:15:48
I also suffer from the same fatigue and sleepiness. It is a constant struggle just to do every day things. I take Prozac and Wellbutrin. No stimulating effects from either one for me. It's strange how it effects everyone else differently. I recently quit taking Ritalin after taking it for several years. Sometimes it helped a little for a short time but there was always a crash. Sometimes I could take it and promptly take a nap for 2 hours. (When I first started taking it, it did help me get through the day. It may be helpful for you.) After reading posts from JohnL, I am taking his advice about Adrafinil. I ordered it a few days ago and I feel like it's my last hope.
>
> Thanks for thought but I have been taking Wellbutrin since 1999 and it hasn't helped with the fatigue.
Posted by Cecilia on September 10, 2001, at 4:13:07
In reply to Re: talk therapy - beg to differ -- my two cents, posted by akc on September 8, 2001, at 20:29:20
> > Adamie - Talk therapy, depending on the kind, can definitely help medical conditions. Cognitive therapy can help people learn to cope with their disorder, thus improving their quality of life. It can also help to change a person from a victim of a disease, and empower tham to take control of the disorder, rather than the disorder controling them.
> >
> > - Cam
>
> I have to jump in here and add my support to what Cam says. I can only speak from my experience. But medication alone would not solve my disease. I had developed years of poor coping mechanisms (from alcoholism to isolating myself from others to black and white thinking and so on and so on) in an attempt to control/treat my disease. Adding a medicine, even the right medicine, didn't take these poor coping skills away. I've needed help in identifying and relearning these skills.
>
> And I will add, because it has been a battle these past two years to find the "right" medicine (or combination of medicines), I have needed the help of talk therapy in learning how to accept that I have a chronic, even possibly deadly, illness. As Cam said -- to do that without taking the role of a victim -- I couldn't have done that without the help of a very good therapist. I think this acceptance has helped me as I have worked with my pdoc in trying to find the right combination of meds.
>
> akcBoth talk therapy and drugs help many people though neither has worked for me. But I just wanted to say that most people think of talk therapy as kind of a benign harmless pastime that
won`t hurt even if it doesn`t help. Not true. I think you should have to sign an informed consent form before talk therapy like you do for surgery because that`s what it is- surgery of the mind and soul. I spent 7 years (632 sessions) in talk therapy and emerged far more depressed than when I began. It`s totally addictive, even if you know it`s not helping you, your obsession with your therapist can become your whole life, and the more you invest emotionally and financially the harder it is to put your cards down and walk away. I`ve tried many meds with horrible side effects but at least once I stopped taking them the side effects went away. But I`m still in terrible pain from therapy that ended four years ago. Just my experience.
Posted by Jane D on September 10, 2001, at 16:34:00
In reply to changing medication, posted by sgtbob on September 7, 2001, at 15:57:12
Bob,
Concerta is a stimulant. It is a longer acting version of Ritalin (methylphenidate). There are other stimulants that you could try but is it possible that your fatigue is an untreated symptom of your depression. I am always tired when depressed and can't ever tell, if an antidepressant seems to work but I am still tired, whether it is a side effect of the AD or a residual symptom. Maybe you should consider another AD.Jane
Posted by Marie1 on September 10, 2001, at 19:16:36
In reply to Re: talk therapy - beg to differ -- my two cents, posted by Cecilia on September 10, 2001, at 4:13:07
Wow! Cecilia, I couldn't agree more. I'm in the midst of a shrink "addiction" (I've even told him that!) and can't see myself quitting any time soon even though I'm not so sure therapy is that therapeutic anymore. So glad to hear someone else say it.
Marie
> > > Adamie - Talk therapy, depending on the kind, can definitely help medical conditions. Cognitive therapy can help people learn to cope with their disorder, thus improving their quality of life. It can also help to change a person from a victim of a disease, and empower tham to take control of the disorder, rather than the disorder controling them.
> > >
> > > - Cam
> >
> > I have to jump in here and add my support to what Cam says. I can only speak from my experience. But medication alone would not solve my disease. I had developed years of poor coping mechanisms (from alcoholism to isolating myself from others to black and white thinking and so on and so on) in an attempt to control/treat my disease. Adding a medicine, even the right medicine, didn't take these poor coping skills away. I've needed help in identifying and relearning these skills.
> >
> > And I will add, because it has been a battle these past two years to find the "right" medicine (or combination of medicines), I have needed the help of talk therapy in learning how to accept that I have a chronic, even possibly deadly, illness. As Cam said -- to do that without taking the role of a victim -- I couldn't have done that without the help of a very good therapist. I think this acceptance has helped me as I have worked with my pdoc in trying to find the right combination of meds.
> >
> > akc
>
> Both talk therapy and drugs help many people though neither has worked for me. But I just wanted to say that most people think of talk therapy as kind of a benign harmless pastime that
> won`t hurt even if it doesn`t help. Not true. I think you should have to sign an informed consent form before talk therapy like you do for surgery because that`s what it is- surgery of the mind and soul. I spent 7 years (632 sessions) in talk therapy and emerged far more depressed than when I began. It`s totally addictive, even if you know it`s not helping you, your obsession with your therapist can become your whole life, and the more you invest emotionally and financially the harder it is to put your cards down and walk away. I`ve tried many meds with horrible side effects but at least once I stopped taking them the side effects went away. But I`m still in terrible pain from therapy that ended four years ago. Just my experience.
Posted by Zo on September 10, 2001, at 21:34:06
In reply to Re: talk therapy - beg to differ -- my two cents, posted by Cecilia on September 10, 2001, at 4:13:07
For me, it was something to do that belied the fact that things were hopeless.
It was buying an hour of the illusion of progress. And of course I would feel worse after, the last thing you need when your life is desperate is another lie.
Zo
Posted by Elizabeth on September 12, 2001, at 5:48:46
In reply to when talk therapy is an addiction, posted by Zo on September 10, 2001, at 21:34:06
This is the end of the thread.
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