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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by floatingbridge on November 13, 2009, at 18:27:22
Well, today, the emsam was a no-go. My doc said it would be unkind to withdraw me from my meds (and basically become non-functional) with out, what he felt was at least 35% optimism rate for success. He's not sure emsam is the ticket for me, and as my caregiver (and therapist), did not want to put me through that. He does want me to go to the Stanford Mood Disorders Clinic (there's, I think, a six week wait). In the meantime, I am trying an add-on of Strattera which I can stop and start as easily as Wellbutrin.
He also wants me to take my temp every day--he thinks I might need to see the infectious agent specialist at Stanford as well.
My doctor sees no reason to discontinue the dexedrine--he says people take it for years and years w/o deleterious affect. He wants to know what my mental block is about it. I've never wanted to take 'drugs' (meds). I was always mother nature's child. I thought I had embraced 'meds' as a necessity, but still can't wrap my head around the stimulant. I think of it as a 'drug' and not a med.
(Of course, my chinese herbalist would like me off of it, though she accepts and treats me as I am.)
My pdoc/T has known me for over a year--almost a year and a half. He's worked with other maois back in the day, but not with emsam. I think he's right when he says the withdrawal might be too much for me--he just thinks and feels there is too much at stake for me for him to feel comfortable making this change. So off to the clinic I go.
I cried, talked, listened. I think this is the best for now--I can't stop my life, which is what, I'm afraid, would happen. For now, I'll wait and see what the mood clinic will have to say. I have med charts, mood charts, health charts for the past year and a half. Guess they will come in handy.
If the Strattera helps (or not), I'll let you know. Maybe then I can taper off pristiq and retry prozac again (which I had taken before the advent of dex to my regime). Wouldn't prozac be easier to taper (though longer) that pristiq in the event that the clinic gives me a green light for an MAOI?
Thanks for all the hand-holding. I really appreciate it!
fb
Posted by Phillipa on November 13, 2009, at 20:23:49
In reply to mood clinic recommended, posted by floatingbridge on November 13, 2009, at 18:27:22
Fb I'm impressed with the infection control specialist sounds like a smart doc. I know the feeling of meds as when had to take synthroid felt like my body failed me and almost vomited it. It's good about the mood clinic and Stanford is an excellent facility. Love Phillipa
Posted by southernsky on November 14, 2009, at 1:10:57
In reply to mood clinic recommended, posted by floatingbridge on November 13, 2009, at 18:27:22
That sounds like wonderful news. I think you will get plenty of attention, with the latest research in mind, to address your issues. It sounds like a compeltely positive thing to do.
Please keep us posted and good luck.
Posted by bulldog2 on November 14, 2009, at 12:10:02
In reply to mood clinic recommended, posted by floatingbridge on November 13, 2009, at 18:27:22
> Well, today, the emsam was a no-go. My doc said it would be unkind to withdraw me from my meds (and basically become non-functional) with out, what he felt was at least 35% optimism rate for success. He's not sure emsam is the ticket for me, and as my caregiver (and therapist), did not want to put me through that. He does want me to go to the Stanford Mood Disorders Clinic (there's, I think, a six week wait). In the meantime, I am trying an add-on of Strattera which I can stop and start as easily as Wellbutrin.
>
> He also wants me to take my temp every day--he thinks I might need to see the infectious agent specialist at Stanford as well.
>
> My doctor sees no reason to discontinue the dexedrine--he says people take it for years and years w/o deleterious affect. He wants to know what my mental block is about it. I've never wanted to take 'drugs' (meds). I was always mother nature's child. I thought I had embraced 'meds' as a necessity, but still can't wrap my head around the stimulant. I think of it as a 'drug' and not a med.
>
> (Of course, my chinese herbalist would like me off of it, though she accepts and treats me as I am.)
>
> My pdoc/T has known me for over a year--almost a year and a half. He's worked with other maois back in the day, but not with emsam. I think he's right when he says the withdrawal might be too much for me--he just thinks and feels there is too much at stake for me for him to feel comfortable making this change. So off to the clinic I go.
>
> I cried, talked, listened. I think this is the best for now--I can't stop my life, which is what, I'm afraid, would happen. For now, I'll wait and see what the mood clinic will have to say. I have med charts, mood charts, health charts for the past year and a half. Guess they will come in handy.
>
> If the Strattera helps (or not), I'll let you know. Maybe then I can taper off pristiq and retry prozac again (which I had taken before the advent of dex to my regime). Wouldn't prozac be easier to taper (though longer) that pristiq in the event that the clinic gives me a green light for an MAOI?
>
> Thanks for all the hand-holding. I really appreciate it!
>
> fbIt's all semantics. They're all drugs. There's no need for you to stigmatize the dexedrine. If it works stay with it. You might want to look at different meds to prevent tolerance with the dex such as memantine. The more diagnostics the better. The docs have a better chance of prescribing the correct meds with the right diagnostics. As far as maois go parnate and nardil are more effective than emsam. There's also another maoi called marplan that is still made. It's in the same family of meds as nardil but most think the sides are more tolerable.
Good Luck!
Posted by Phidippus on November 14, 2009, at 13:42:05
In reply to mood clinic recommended, posted by floatingbridge on November 13, 2009, at 18:27:22
>still can't wrap my head around the stimulant. >I think of it as a 'drug' and not a med.
Plenty of ADHDers like myself would cringe at the thought of not having their stimulants. Drug/Med, it makes no difference what you call it as long as it helps. Dexedrine has a complex mechanism of action and not only helps with attentional problems, but can help with mood and obsessions. All drugs have their place, even PCP.
> If the Strattera helps (or not), I'll let you know.
What are you taking the Straterra for?
>Wouldn't prozac be easier to taper (though longer) that pristiq in the event that the clinic gives me a green light for an MAOI?
There should be no difference in taper strategy.
P
Posted by floatingbridge on November 14, 2009, at 18:00:14
In reply to Re: mood clinic recommended » floatingbridge, posted by Phidippus on November 14, 2009, at 13:42:05
Hi--thanks for the responses.
I'm feeling better today. I took a Strattera (40mg) last night and actually felt better in the morning. Mornings are the worst for me (well then there are always the terrifying dips that can happen mid-late afternoon, but that's different). I woke up brighter--not Disney bright, just easier and lighter. Doc said to take Strattera in the evening as it is usually sedating (?!). I had no trouble sleeping, and frankly expected no response, so was pleasantly surprised. Today, I haven't had the drop off I usually experience w/ the generic dex spansules. So maybe there is something synergistic about the combo as my doc had hoped--though we are still in the honeymoon phase of the med
:-).I will still go through the clinic, thanks Phillipa and Southernsky for your input, and my husband also thinks it's a great idea.
And I will continue to work on the cognitive piece about meds. Thank you Bulldog and Phiddipus (spelling? I remember it means a jumping spider) for your comments regarding this.
Thank you all for your encouragement--really.
hugs of appreciation,
fb
Posted by floatingbridge on November 14, 2009, at 18:01:23
In reply to better today--thanks! Re: mood clinic recommended » Phidippus, posted by floatingbridge on November 14, 2009, at 18:00:14
Posted by Katgirl on November 16, 2009, at 10:14:11
In reply to above post meant for everyone :-D (nm) » floatingbridge, posted by floatingbridge on November 14, 2009, at 18:01:23
Glad you are feeling better! Hang in there!
Posted by ColoradoSnowflake on November 16, 2009, at 14:26:38
In reply to mood clinic recommended, posted by floatingbridge on November 13, 2009, at 18:27:22
> Well, today, the emsam was a no-go. My doc said it would be unkind to withdraw me from my meds (and basically become non-functional) with out, what he felt was at least 35% optimism rate for success. He's not sure emsam is the ticket for me, and as my caregiver (and therapist), did not want to put me through that. He does want me to go to the Stanford Mood Disorders Clinic (there's, I think, a six week wait). In the meantime, I am trying an add-on of Strattera which I can stop and start as easily as Wellbutrin.
>
> He also wants me to take my temp every day--he thinks I might need to see the infectious agent specialist at Stanford as well.
>
> My doctor sees no reason to discontinue the dexedrine--he says people take it for years and years w/o deleterious affect. He wants to know what my mental block is about it. I've never wanted to take 'drugs' (meds). I was always mother nature's child. I thought I had embraced 'meds' as a necessity, but still can't wrap my head around the stimulant. I think of it as a 'drug' and not a med.
>
> (Of course, my chinese herbalist would like me off of it, though she accepts and treats me as I am.)
>
> My pdoc/T has known me for over a year--almost a year and a half. He's worked with other maois back in the day, but not with emsam. I think he's right when he says the withdrawal might be too much for me--he just thinks and feels there is too much at stake for me for him to feel comfortable making this change. So off to the clinic I go.
>
> I cried, talked, listened. I think this is the best for now--I can't stop my life, which is what, I'm afraid, would happen. For now, I'll wait and see what the mood clinic will have to say. I have med charts, mood charts, health charts for the past year and a half. Guess they will come in handy.
>
> If the Strattera helps (or not), I'll let you know. Maybe then I can taper off pristiq and retry prozac again (which I had taken before the advent of dex to my regime). Wouldn't prozac be easier to taper (though longer) that pristiq in the event that the clinic gives me a green light for an MAOI?
>
> Thanks for all the hand-holding. I really appreciate it!
>
> fbWOW !!!
It sounds great to me!! Stanford must have an awsome clinic!! Maybe you can get a cancellation more quickly, or something like that. I think it's a great idea.
I'm also impressed with your pdoc that he wants you to explore the infectious piece as well. The problem there in my estimation is that there is a lot of that kind of thing, similar to HIV, that no on yet knows enough about or understands enough to diagnose or, more importantly, to treat.
I wonder if Standford is doing a lot of research in that direction? I'm so glad you are looking at that, as well. I think a lot of that unremitting fatigue that a lot of us have is from something like that, in addition to depression.I'm so happy the Strattera made you feel better! What is it? How does it work? I thought it was something like Adderal for ADHD? I'm anxious to hear more about Strattera and much more about how you are feeling!!
Good luck on MANY fronts!!
Love and hugs,
Gayle
Posted by floatingbridge on November 16, 2009, at 21:05:25
In reply to Re: above post meant for everyone :-D, posted by Katgirl on November 16, 2009, at 10:14:11
> Glad you are feeling better! Hang in there!
Thanks Katgirl! (I can't help it--I'm hearing the Batman T.V. show theme right no in my head!)
:-D
fb
Posted by floatingbridge on November 16, 2009, at 21:08:45
In reply to Re: mood clinic recommended, posted by ColoradoSnowflake on November 16, 2009, at 14:26:38
Hi Gayle,
Yes, I do think it is best--I agree. The Strattera I'm not so sure about. After that nice first morning, I've been tired and 'cloudy-headed' throughout the day. Today I go up to 60mg. I'm just trying to be open minded.
I start intake evaluation on Thursday.
hugs back,
fb
Posted by Phillipa on November 16, 2009, at 22:09:47
In reply to Re: mood clinic recommended » ColoradoSnowflake, posted by floatingbridge on November 16, 2009, at 21:08:45
fb oh wow that soon? Things are fast where you are not slow like here. Love Phillipa
This is the end of the thread.
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