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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by MrBrice on February 23, 2007, at 3:27:45
Hi guys, everybody doing good i hope?
I'm in a position in which I can choose to either continue my regimen with my current meds, which are working good, or I can drop some of them and reduce my cocktail that way, but with the chance of a relapse...
I'm actually QUITE happy with the current situation, only i'm taking 5 meds at the same time and I don't know if i want to do this for a long time.
And thus the question remains: should i be glad that I'm doing ok and leave everything the way it is OR should I take the risk and go for the med-kill... I know it's a personal thing but maybe someone has some advise?
Thanks
Posted by TheMeanReds on February 23, 2007, at 10:20:14
In reply to Dropping meds or not...Luxury choice!, posted by MrBrice on February 23, 2007, at 3:27:45
Im not trying to pry, but which meds are you on? Im in a situation that Im switching meds. Long term meds, or so Ive noticed, are sometimes difficult to drop. Are you in a good situation where you have time off work and responsibilities, just incase you relapse?
Posted by Quintal on February 23, 2007, at 10:39:41
In reply to Dropping meds or not...Luxury choice!, posted by MrBrice on February 23, 2007, at 3:27:45
As I said in the beginning Mr Brice, I wouldn't be happy myself taking that combo you're on with all the potentially toxic interactions between the different meds. The combination of an SSRI and TCA are usually contraindicated as the SSRI inhibits an enzyme that breaks down the TCA. The Ritalin you're taking further inhibits an enzyme that breaks down both the SSRI and the TCA. So your plasma levels could be slowly rising all the time you're taking them.
I'm sure Larry Hoover, our retired toxicologist, will be able to clarify things further, but from what I read in that interaction checker that combo you're taking is far from safe and stable. Might be better to ditch the paroxetine and dothiepin and switch to clomipramine for your antidepressant needs, which is a TCA with powerful SRI properties - so combining the best properties of both dothiepin and paroxetine.
Q
Posted by MrBrice on February 23, 2007, at 11:08:04
In reply to Re: Dropping meds or not...Luxury choice!, posted by Quintal on February 23, 2007, at 10:39:41
> As I said in the beginning Mr Brice, I wouldn't be happy myself taking that combo you're on with all the potentially toxic interactions between the different meds. The combination of an SSRI and TCA are usually contraindicated as the SSRI inhibits an enzyme that breaks down the TCA. The Ritalin you're taking further inhibits an enzyme that breaks down both the SSRI and the TCA. So your plasma levels could be slowly rising all the time you're taking them.
>
> I'm sure Larry Hoover, our retired toxicologist, will be able to clarify things further, but from what I read in that interaction checker that combo you're taking is far from safe and stable. Might be better to ditch the paroxetine and dothiepin and switch to clomipramine for your antidepressant needs, which is a TCA with powerful SRI properties - so combining the best properties of both dothiepin and paroxetine.
>
> QLet me first answer the previous poster's message:
I'm on Sulpiride, Dosulepin (two meds which have to be taken over a long period before having decent results (1 year for the dosulepin for me!)), paroxetine, ritaline and Valium.
BUT all of these are on VERY minimal doses: 1/4 sulpiride / 50mg dosulepin (where 75 is the 'lowest' dose) / 15mg paroxetine and just 2,5 mg of rilatine (which is 1/4th of the minimum 10mg tablet!).
Now quintal, your knowledge interests me and I'm actually learning things from you, but i really must once again say that i trust my docter who has been one for over 40 years AND, what's most important, he really has proven that he's capable: in 2 years i have gone from a very closed and anti-social person to my open and 'normal' self (tough lets not forget the problems i still have...).
Best greetings,
Brice
Posted by Phillipa on February 23, 2007, at 11:16:26
In reply to Re: Dropping meds or not...Luxury choice! » Quintal, posted by MrBrice on February 23, 2007, at 11:08:04
Mr. Brice so you have a good pdoc or doc prescribing these meds in those doses for you? And you feel good? I would do anything to feel good so I'd stick with it as what if it didn't work again? Just my uneducated thought. Love Phillipa
Posted by Quintal on February 23, 2007, at 11:57:08
In reply to Re: Dropping meds or not...Luxury choice! » Quintal, posted by MrBrice on February 23, 2007, at 11:08:04
Okay MrBrice. I respect our doctor's knowledge and experience, I was simply highlighting the fact that it is an unusual choice and one that would be strongly discouraged by most pharmacologists I imagine. (Dosulepin/dothiepin are generic names for the same drug, but it was called dothiepin here in the UK when I was using it a number of years ago. It is a good antidepressant, but very dowdy and not at all in vogue).
Were you planning on taking any alternative meds? I wonder if something like Nardil would be better for taking care of your anxiety and depression? You can combine stimulants with it if you need them. Your doctor probably would have too much of a problem with that considering the cocktail you're on already.
Q
Posted by laima on February 23, 2007, at 15:52:02
In reply to Re: Dropping meds or not...Luxury choice! » MrBrice, posted by Quintal on February 23, 2007, at 11:57:08
I'm unfamiliar with most of your meds, but can relate to wanting to not take more than necessary in order to avoid complications, even to just simplify matters. What would you consider to be your primary medication? Are any add-ons? Any there to treat side effects of others? If you try cutting down, perhaps best to start with one at a time, and take it conservatively? that way, if you start to feel worse, you'd have a clue as to why. If you cut several pieces at once, it might be hard to untangle what specifically caused a drop in mood.
Posted by chiron on February 23, 2007, at 21:36:22
In reply to Re: Dropping meds or not...Luxury choice!, posted by laima on February 23, 2007, at 15:52:02
At the point I am at I could care less about the toxic dangers if I found a combo that worked. My suggestion is don't forget where you were before.
But I guess it depends where you were before. Such as: how long had you been depressed, how "far" down were you, how long it took to find something that worked, and did it seem more like a transient depression.
Posted by MrBrice on February 25, 2007, at 14:24:08
In reply to Re: Dropping meds or not...Luxury choice! » MrBrice, posted by Quintal on February 23, 2007, at 11:57:08
Well, i guess it remains a really difficult question. Quintal, the Nardil-idea is still in my mind and i think i'm going to drop meds and reduce doses until a switch to Nardil is possible.
Maybe this makes sense:
Drop the valium now, after all it's drugs and it will hide the real effects of the changes in my cocktail.
Then reduce Paroxetine to 10mg's
Then Slowly drop the dothiepin (wich will be the hardest I think)
then away with the Paroxetine and wait for 2 weeks.then the trip to paradise...Nardil.
But what if the Nardil sucks and i just wanna press the replay or Undo button? It's quite difficult, really.
Posted by elanor roosevelt on February 25, 2007, at 20:40:43
In reply to Re: Dropping meds or not...Luxury choice!, posted by MrBrice on February 25, 2007, at 14:24:08
if it ain't broke ...
Posted by laima on February 25, 2007, at 22:45:28
In reply to am i missing something here?, posted by elanor roosevelt on February 25, 2007, at 20:40:43
>
> if it ain't broke ...I think the concern is kind of like...if it ain't broke- I don't want to break it- can I stop while still ahead?
Posted by MrBrice on February 27, 2007, at 9:25:21
In reply to Re: am i missing something here? » elanor roosevelt, posted by laima on February 25, 2007, at 22:45:28
> >
> > if it ain't broke ...
>
> I think the concern is kind of like...if it ain't broke- I don't want to break it- can I stop while still ahead?
Hmm, this is also not quite right. Here's the problem: I'm coping for the moment, but I'm not 'repared' yet :)I'm not doing fine, but as most of the members here i still have my specific problems, like the anxiety wich is really the worst of all (If i sleep with a girl I can't sleep that night because i just can't find rest with someone besides me...:( )
So the question is: Go for full repare or settle for 'coping'.
greets,
brice
Posted by elanor roosevelt on February 27, 2007, at 22:21:54
In reply to Re: am i missing something here?, posted by MrBrice on February 27, 2007, at 9:25:21
i misread your original post and thought you had found a good med solution
sometimes people do and then decide they must be fine and stop
sorry about the anxiety
it's a big problem for me as well
i take meds for sleep
but if i am with a lover (an all too infrequent event) i wait until he falls asleep before i knock myself out
good luck
Posted by MrBrice on February 28, 2007, at 5:51:07
In reply to i get it now, posted by elanor roosevelt on February 27, 2007, at 22:21:54
> i misread your original post and thought you had found a good med solution
> sometimes people do and then decide they must be fine and stop
> sorry about the anxiety
> it's a big problem for me as well
> i take meds for sleep
> but if i am with a lover (an all too infrequent event) i wait until he falls asleep before i knock myself out
> good luckThat's usually also my cue to go to sleep :) It's not to comfortable is it :s
I'm HOPING that Nardil would be the solution for this, but the BIG problem really comes to light here Eleanor: In order to take Nardil, i have to stop my entire regimen (the dothiepin AND paroxetine). So if the Nardil doestn't work, it would mean a loss off a whole year on Dothiepin...
I think I'm going for it tough, I have to take the risk.
greetings,
Brice ;)
Posted by elanor roosevelt on February 28, 2007, at 20:50:44
In reply to Re: i get it now, posted by MrBrice on February 28, 2007, at 5:51:07
good luck
keep us posted on how the nardil works
Posted by MrBrice on March 1, 2007, at 18:50:57
In reply to Re: i get it now, posted by elanor roosevelt on February 28, 2007, at 20:50:44
Hi guys,
Quintal, I remember you suggesting me to drop the sulpiride in order to reduce my anxiety, well i didn't take my dose today and i felt a real difference.
The 'betablocker" really narrowed my point of vue and I think it was really time to stop it.
If anxiety is reduced with this pleasant act (it's allways nice to cut down on a med, instead of having to take an extra or higher the dose) I'll go for my easiest option i guess... Time will show.
grtz
This is the end of the thread.
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