![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 55. Go back in thread:
Posted by emme on May 28, 2009, at 5:50:53
In reply to Re: Need an alternative to Abilify, posted by Sigismund on May 28, 2009, at 3:46:23
> So you went off hydrocodone (do I have that right)?
>
> What exactly was the problem with Abilify?
>
> What were the side effects that made you stop?And how long were you on it?
Posted by greywolf on May 28, 2009, at 6:32:21
In reply to Re: Need an alternative to Abilify, posted by emme on May 28, 2009, at 5:50:53
I was on Abilify for quite some time. I experienced neither benefits nor side effects. Consequently, my psychiatrist took me off Abilify.
He then substituted Cytomel as an augmentation agent to Parnate. I truly don't understand the mechanism of additional synthetic thyroid hormone when my thyroid numbers have always been within the norm, but after many years of not having even a single good day, I've had 4 or 5 since starting the Cytomel. You may want to check Cytomel out as an option.
Greywolf
Posted by SLS on May 28, 2009, at 8:08:00
In reply to Need an alternative to Abilify, posted by jerrypharmstudent on May 27, 2009, at 23:25:59
My vote is for Geodon.
If you have already tried Geodon and Seroquel, you might consider getting your hands on amisulpride.
- Scott
Posted by jerrypharmstudent on May 28, 2009, at 20:44:02
In reply to Re: Need an alternative to Abilify, posted by Sigismund on May 28, 2009, at 3:46:23
> So you went off hydrocodone (do I have that right)?
>
> What exactly was the problem with Abilify?
>
> What were the side effects that made you stop?Doc took me off the hydrocodone because of his malpractice insurance - unfortunately. Abilify caused severe restless legs (not helped with Cogentin by the way), complete shutdown of my sex drive & functioning and trouble swallowing.
Posted by jerrypharmstudent on May 28, 2009, at 20:44:34
In reply to Re: Need an alternative to Abilify, posted by emme on May 28, 2009, at 5:50:53
> > So you went off hydrocodone (do I have that right)?
> >
> > What exactly was the problem with Abilify?
> >
> > What were the side effects that made you stop?
>
> And how long were you on it?I had been on it for about a year.
Posted by jerrypharmstudent on May 28, 2009, at 20:46:22
In reply to Re: Need an alternative to Abilify » jerrypharmstudent, posted by SLS on May 28, 2009, at 8:08:00
> My vote is for Geodon.
>
> If you have already tried Geodon and Seroquel, you might consider getting your hands on amisulpride.
>
>
> - ScottDo you know Geodon's mechanism of action? Any tough side effects like restlessness/weight gain/etc.?
Posted by Sigismund on May 28, 2009, at 22:39:44
In reply to Re: Need an alternative to Abilify » Sigismund, posted by jerrypharmstudent on May 28, 2009, at 20:44:02
>Abilify caused severe restless legs (not helped with Cogentin by the way), complete shutdown of my sex drive & functioning and trouble swallowing.
One expects psych drugs to wreck the sex drive, the restless legs come with the territory, but I'd really worry about the swallowing.
That malpractice thing is ridiculous.
There is no comparison to the safety of hydrocodone compared to any psych drug, except perhaps those that produce dependence such as benzos.
Posted by Sigismund on May 28, 2009, at 22:41:23
In reply to Re: Need an alternative to Abilify » SLS, posted by jerrypharmstudent on May 28, 2009, at 20:46:22
>Do you know Geodon's mechanism of action?
Is there some 5ht2c antagonism?
Maybe keep the dose low?
Posted by garnet71 on May 28, 2009, at 23:01:30
In reply to Re: Need an alternative to Abilify » jerrypharmstudent, posted by Sigismund on May 28, 2009, at 22:39:44
RE: malpractice insurance- My doctor can't treat me anymore because of his malpractice insurance. I tried Ritalin and didn't really like it; tried Adderall and got an adverse effect--so I asked for dextroamphetamine. The RN there wouldn't scribe it for me--she said "that's worse!", but next I saw the PDoc who said ok, he gave me one month's script and said he couldn't treat me anymore cause his malpractice insurance won't cover my treatment; referred me to a guy with more malpractice insurance.
I honestly feel much less dependent upon d-amp than any SSRI I've ever had for anxiety. I realize I will be dependent upon ANY drug for anxiety, possibly the rest of my life. SSRIs really are not as safe as they make them out to be, and the adverse effects are horrible for me. What's the diff. if I'm dependent upon, say, Effexor, or Klonopin? Either way, if you have to taper off, you have to move on to something else and have w/d effects.
For d-amp, I notice no side effects. I wouldn't want to take it long term, but for now until I find a long-term solution that doesn't involve possibly a year of trials, 2 months per med, of being debilitated while I try to finish grad school, it's a better option than sSRIs that make me depressed and so amotivational that I can't get out of bed or even function. I don't have to take it everyday and don't get withdraw symptoms like w/Adderall. I don't understand how having no detectable adverse side effects or withdrawal symtoms is "worse". If I don't take it, my motivation and ability to stay on task disappears; no irritability, no 'cravings'; that's not w/d-that's the way I was before I took the drug. I simply go back to the way I was before. It's one of the cleanest, most effective drugs I've ever taken; yet, my PDoc won't continue treatment w/me now.
As far as malpractice ins. goes, I could sue my PDoc for what xxRIs did to me over the last 3 years. I have lots documented about how the mess my life is in today is a direct result of being prescribed SSRIs over the past 3 years. Yet, there is no basis at all for a lawsuit for being prescribed D-AMP.
I don't get it.
Posted by SLS on May 28, 2009, at 23:16:03
In reply to Re: Need an alternative to Abilify » SLS, posted by jerrypharmstudent on May 28, 2009, at 20:46:22
> > My vote is for Geodon.
> >
> > If you have already tried Geodon and Seroquel, you might consider getting your hands on amisulpride.
> >
> >
> > - Scott
>
> Do you know Geodon's mechanism of action?It has quite a few. It is the most antidepressant-like of the neuroleptics.
DA2 antagonist ++
DA3 antagonist ++
5-HT1a agonist ++
5-HT1d antagonist
5-HT2a antagonist +++
NE reuptake inhibition
5-HT reuptake inhibition
> Any tough side effects like restlessnessPerhaps some insomnia. I don't think it produces akathisia at the same rate as does Abilify.
> weight gain/etc.?
Geodon is perhaps the only truly weight-neutral atypical neuroleptic. Of the older drugs, I am pretty sure that Stelazine, is weight neutral.
The dosage range for Geodon in the treatment of depression seems to be 40-80mg.
- Scott
Posted by desolationrower on May 29, 2009, at 0:53:13
In reply to Re: Need an alternative to Abilify » jerrypharmstudent, posted by SLS on May 28, 2009, at 23:16:03
Pramipexole.
-d/r
Posted by Sigismund on May 29, 2009, at 18:17:20
In reply to Re: Need an alternative to Abilify, posted by garnet71 on May 28, 2009, at 23:01:30
>The RN there wouldn't scribe it for me--she said "that's worse!"
I know what she means, almost. There's a logic there somewhere. But what is it?
Posted by garnet71 on May 29, 2009, at 19:22:27
In reply to Re: Need an alternative to Abilify » garnet71, posted by Sigismund on May 29, 2009, at 18:17:20
I thought I was asking you? lol
> >The RN there wouldn't scribe it for me--she said "that's worse!"
>
> I know what she means, almost. There's a logic there somewhere. But what is it?
Posted by Sigismund on May 29, 2009, at 21:31:09
In reply to Re: Need an alternative to Abilify, posted by garnet71 on May 28, 2009, at 23:01:30
Maybe if you had told her how unpleasant but necessary dex was she would have felt better about it?
Or maybe if you had said 'I'm glad we have people like you to stop all those drug seekers out there'?
There was a treatment for depersonalisation that comprised methamphetamine plus ECT. You could have offered to have that.
As in 'Can I have ECT with that?'
Posted by garnet71 on May 29, 2009, at 22:14:21
In reply to Re: Need an alternative to Abilify » garnet71, posted by Sigismund on May 29, 2009, at 21:31:09
lol Yeah, and if I asked for *Abilify*, they'd get right on it! lol
Hmm..if this trend keeps up, maybe someday I'll become the first patient to sue for NOT being prescribed an "addictive" drug, rather than the other way around. 8| Maybe others have done that?
Can you sue a doctor for providing treatment according to his malpractice insurance rather than your well-being? It seems unethical to me. Had I not researched my own treatment, I'd still be on an xxRI. In fact, if I didn't find this site about 6 months ago to figure out what was wrong, I would have failed out of grad school-guaranteed. I couldn't sue my last PDoc though, he really was a nice guy. I hate to say that, because it's really not a good reason, but I could not get myself to do that to him.
I feel for them, the system sux, but still...I'll just have to ask my new PDoc's i'm shopping for about the level of malpractice insurance they carry before who I decide to see, I guess.
Posted by jerrypharmstudent on May 29, 2009, at 22:19:11
In reply to Re: Need an alternative to Abilify, posted by garnet71 on May 29, 2009, at 22:14:21
> lol Yeah, and if I asked for *Abilify*, they'd get right on it! lol
>
> Hmm..if this trend keeps up, maybe someday I'll become the first patient to sue for NOT being prescribed an "addictive" drug, rather than the other way around. 8| Maybe others have done that?
>
> Can you sue a doctor for providing treatment according to his malpractice insurance rather than your well-being? It seems unethical to me. Had I not researched my own treatment, I'd still be on an xxRI. In fact, if I didn't find this site about 6 months ago to figure out what was wrong, I would have failed out of grad school-guaranteed. I couldn't sue my last PDoc though, he really was a nice guy. I hate to say that, because it's really not a good reason, but I could not get myself to do that to him.
>
> I feel for them, the system sux, but still...I'll just have to ask my new PDoc's i'm shopping for about the level of malpractice insurance they carry before who I decide to see, I guess.I think the "Oh I can't prescribe that because of my insurance" line is bullcrap. I'd been on hydrocodone for depression for over 3 years with no problems and he one day decides his insurance won't cover him? I don't get it.
Posted by garnet71 on May 29, 2009, at 22:40:24
In reply to Re: Need an alternative to Abilify » garnet71, posted by jerrypharmstudent on May 29, 2009, at 22:19:11
I'm suspecting my PDoc was recently sued for scribing "controversial" meds. He always was a pretty resonable guy. I mean, if he didn't want to prescribe me d-amp, he wouldn't have done it-he could have easily said no. Instead, he asked me why I wanted it, I told him and he listened carefully; then he let me have it for a month and referred me to malpractice insurance guy-friend of his. I was going to talk to him about this in more detail, about malpractice, but never really found a good opportunity to.
Plus, they have the DEA breathing down their back. It's insane. I also think last PDoc was the same-thinking he was sued, or maybe even lost his license temporarily, sanctioned by a medical board, or almost lost his license. Just guessing...There's was never any other patient in his office, the phone never rang, and could get an appt. w/him any day, anytime I wanted. It could be that he just moved here for all I know, but he had that cynicism about him, with my treatment--the same new attitude I noticed with the other PDoc.
When my PDoc asked me who i tried for a second opinion, I told him the name of empty office guy-he got real quiet like he immediately knew why....and nodded and paused for a long time..it was the one i tried for a few months before going back to that one. He would only give me SSRIs or Wellbutrin. When I told him they made me depressed and unable to function, and almost totally nonfunctional due to amotivation, he said 'what do you want me to do?" This was after I asked for Wellbutrin and found out it didn't work anymore. Meanwhile, I find out a few months ago there's tons of other stuff that can be prescribed to make me better. There were very few doctors who wanted to be on my insurance list, and I wonder why these particular doctors wanted to go through all the red tape to be approved.
I also think doctors who would be willing to prescribe these drugs that work for people like me would appear to be suspicious by the DEA. Say, if one Doc was prescribing d-amp to 10 patients, while others only prescribe it to 1. You'd wonder if they'd get investigated. I'm going to ask some of the doctors I'm shopping for about that, because I'm really curious. Not fact, just my intuition/suspicion.
Plus all states are different with medical malpractice laws. Maybe I live in one of the worst states for that.
I'm really curious now about all this, will have to find out more and "report" back. I thought I was the only one who experienced this, sorry you had to as well.
Posted by garnet71 on May 29, 2009, at 22:42:39
In reply to Re: Need an alternative to Abilify » garnet71, posted by jerrypharmstudent on May 29, 2009, at 22:19:11
Hmmm. Maybe new federal laws with the Obama admin? That's strange after 3 years, he'd refuse. or check your state laws. If I get around to it, I'll check mine...
Posted by greywolf on May 29, 2009, at 23:00:10
In reply to Re: Need an alternative to Abilify, posted by garnet71 on May 29, 2009, at 22:14:21
>I'll just have to ask my new PDoc's i'm shopping for about the level of malpractice insurance they carry before who I decide to see, I guess.You might as well just say goodbye to those pdocs right now.
Greywolf
Posted by garnet71 on May 29, 2009, at 23:03:53
In reply to Re: Need an alternative to Abilify » garnet71, posted by jerrypharmstudent on May 29, 2009, at 22:19:11
Well, not too many bills were passed by the 111th Congress yet, and nothing about controlled substances; could only find something about drugs in the newest appropriations bill:
http://thomas.loc.gov/cgi-bin/query/F?c111:18:./temp/~c111EUHvbW:e372419:
But it doesn't tell you much in context of what was done in the past, could be just the same type of funding. Did find out there is a U.S. "Anti-Doping Agency" though. lol!
There is too much to look through, there could be something else in here, but I can't search through it all:
http://thomas.loc.gov/cgi-bin/query/D?c111:18:./temp/~c111EUHvbW::
Posted by garnet71 on May 29, 2009, at 23:09:08
In reply to Re: Need an alternative to Abilify, posted by greywolf on May 29, 2009, at 23:00:10
Lol-there's a methampheatmine log book act that passed last year:
http://thomas.loc.gov/cgi-bin/query/D?c110:45:./temp/~c110Y5iXyN::
Maybe it is for wholesale purchases/pharmacy deliveries...hmmm. I'm in investigation mode now.
Posted by jerrypharmstudent on May 29, 2009, at 23:19:08
In reply to Re: Need an alternative to Abilify, posted by garnet71 on May 29, 2009, at 23:09:08
> Lol-there's a methampheatmine log book act that passed last year:
>
> http://thomas.loc.gov/cgi-bin/query/D?c110:45:./temp/~c110Y5iXyN::
>
> Maybe it is for wholesale purchases/pharmacy deliveries...hmmm. I'm in investigation mode now.i wonder why pdocs can prescribe amphetamines but when it comes to opiates they get all uncomfortable?
Posted by garnet71 on May 29, 2009, at 23:30:54
In reply to Re: Need an alternative to Abilify » garnet71, posted by jerrypharmstudent on May 29, 2009, at 23:19:08
Well doctors might be getting sued-maybe a case went thru recently that had a lot of significance for doctors who prescribe these types of drugs, something we don't know about.
But Hang on, still searching...
There was a lot of new drug regulation passed at the end of October 2007:
http://thomas.loc.gov/cgi-bin/query/D?c110:126:./temp/~c110bVsr6A::
I don't know what the implications are for PDocs though, but there is way too much to read thru.
Posted by garnet71 on May 29, 2009, at 23:43:17
In reply to Re: Need an alternative to Abilify » garnet71, posted by jerrypharmstudent on May 29, 2009, at 23:19:08
Jerry,
I just noticed your drug was a schedule III, while mine is a schedule II. yeah I wonder about that.
This isn't what I was looking for, but they actually post some of the doctor's names who violate the Controlled Substances act. That's brutal!
http://www.deadiversion.usdoj.gov/crim_admin_actions/admin_2007.htm
Posted by garnet71 on May 29, 2009, at 23:45:54
In reply to Re: Need an alternative to Abilify » garnet71, posted by jerrypharmstudent on May 29, 2009, at 23:19:08
Maybe this is why-could be that the DEA is giving doctors a hard time recently.
"The DEA is currently reviewing a petition to increase the regulatory controls on hydrocodone combination products from schedule III to schedule II of the Controlled Substances Act (CSA)."
http://www.deadiversion.usdoj.gov/drugs_concern/hydrocodone/hydrocodone.htm
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
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.