Tricyclic Antidepressants

fishing for suggestions

Question:

Hi, I just found this group this morning while researching pain management. I’m looking for information that I can take into my Doc. He has good intentions but little time for keeping up on new developments.My situation: cervical spinal fusion (skull to c3) following accident 12-95. Post-surgical bilateral numbness and pain traced to spinal cyst caused by shunt left in place following fusion surgery. 9-98 surgery to close shunt gave temporary relief. Currently experiencing "BAD sunburn-like" feeling all over upperbody with several "hot" spots more severe. Taking prozac–emotionally feel great. Low dosage flexeril and amitriptyline for pain control—no effect. Also on nerurontin for pain control–no effect. Have "backup" script for roxicet when things become totally unbearable but current Dr. will only give about 30/YEAR because he fears I will become addicted. However, it takes 1 to 2 of those to have a normal-like day where I can function without screaming anytime my clothes or my family so little as touches me. Please, please any suggestions that I can take to the Dr???colleen

Response:

Colleen, Tell your DR. as firm as your able that you are in REAL PAIN and that your not seeking to get DRUGS for any reason other then the purpose of getting on with you LIFE!!!!! Remind him/her that’s why there’s DR’s and there in place to help THE HURTING and tell him that your pain is REAL!!!!!! CW CARES!!! – Hide quoted text — Show quoted text – > Hi, I just found this group this morning while researching pain > management. I’m looking for information that I can take into my Doc. He > has good intentions but little time for keeping up on new > developments.My situation: cervical spinal fusion (skull to c3) > following accident 12-95. Post-surgical bilateral numbness and pain > traced to spinal cyst caused by shunt left in place following fusion > surgery. 9-98 surgery to close shunt gave temporary relief. Currently > experiencing "BAD sunburn-like" feeling all over upperbody with several > "hot" spots more severe. Taking prozac–emotionally feel great. Low > dosage flexeril and amitriptyline for pain control—no effect. Also on > nerurontin for pain control–no effect. Have "backup" script for roxicet > when things become totally unbearable but current Dr. will only give > about 30/YEAR because he fears I will become addicted. However, it takes > 1 to 2 of those to have a normal-like day where I can function without > screaming anytime my clothes or my family so little as touches me. > Please, please any suggestions that I can take to the Dr???colleen

Response:

I have tried the same medication for my chronic pain as you plus a garbage pail more to no avail. Recently a friend gave me a marijuana muffin which decreased my pain level to the point whereby I had my first complete night’s sleep in more than a year. The specialist that I am presently seeing to deal with the pain suggested that I get a prescription from my GP for more that I can take as required. Looking forward to some relief. Jim – Hide quoted text — Show quoted text – > Hi, I just found this group this morning while researching pain > management. I’m looking for information that I can take into my Doc. He > has good intentions but little time for keeping up on new > developments.My situation: cervical spinal fusion (skull to c3) > following accident 12-95. Post-surgical bilateral numbness and pain > traced to spinal cyst caused by shunt left in place following fusion > surgery. 9-98 surgery to close shunt gave temporary relief. Currently > experiencing "BAD sunburn-like" feeling all over upperbody with several > "hot" spots more severe. Taking prozac–emotionally feel great. Low > dosage flexeril and amitriptyline for pain control—no effect. Also on > nerurontin for pain control–no effect. Have "backup" script for roxicet > when things become totally unbearable but current Dr. will only give > about 30/YEAR because he fears I will become addicted. However, it takes > 1 to 2 of those to have a normal-like day where I can function without > screaming anytime my clothes or my family so little as touches me. > Please, please any suggestions that I can take to the Dr???colleen

Response:

Colleen: You are an obvious candidate for referral to a competent pain clinic, especially given a doc who doesn’t have time to keep up with latest developments. Don’t criticize him, just ask for referral to someone with a different area of expertise. I wonder about that >BAD sunburn-like" feeling all over upper body with several "hot" spots >more severe

perhaps you should also see — can anyone help me ? — a neurologist? an allergist? I’m just guessing here. In any event, it’s time to seek additional medical input. Good luck!! –Chips – Hide quoted text — Show quoted text – >Hi, I just found this group this morning while researching pain >management. I’m looking for information that I can take into my Doc. He >has good intentions but little time for keeping up on new >developments.My situation: cervical spinal fusion (skull to c3) >following accident 12-95. Post-surgical bilateral numbness and pain >traced to spinal cyst caused by shunt left in place following fusion >surgery. 9-98 surgery to close shunt gave temporary relief. Currently >experiencing "BAD sunburn-like" feeling all over upperbody with several >"hot" spots more severe. Taking prozac–emotionally feel great. Low >dosage flexeril and amitriptyline for pain control—no effect. Also on >nerurontin for pain control–no effect. Have "backup" script for roxicet >when things become totally unbearable but current Dr. will only give >about 30/YEAR because he fears I will become addicted. However, it takes >1 to 2 of those to have a normal-like day where I can function without >screaming anytime my clothes or my family so little as touches me. >Please, please any suggestions that I can take to the Dr???colleen

Response:

As you all know….I am a BIG supporter of MJ for pain relief. I have seen it work on people with illnesses from glaucoma to AIDS, MS, CP, FMS, CPS, Auto-immune diseases! It is a crime that our government is so caught up in their ridiculous "WAR ON DRUGS" that they will not even look at thousands and thousands of medical records that show it’s worth! There is a wonderful, brave lady in San Fran named Mary that goes around to AIDS patients and gives them MJ brownies…they are delicious, from all reports, and they do the trick! I ask all of you to read the book : Marijuana RX, the patients fight for medical Marijuana by Robert Randall. It is available at Amazon, com, Barnes & Noble.com and Dalton books. ( Robert is a good friend of mine. I do not wish for you to think that this is a spam for his book. Many of you know of our friendship, so I want this understood) It only costs about $12.00, Alice and Robert decided to print it in paperback so that more people would have access to it! {{{{ Peace }}} Joani – Hide quoted text — Show quoted text – >I have tried the same medication for my chronic pain as you plus a garbage >pail more to no avail. Recently a friend gave me a marijuana muffin which >decreased my pain level to the point whereby I had my first complete night’s >sleep in more than a year. The specialist that I am presently seeing to deal >with the pain suggested that I get a prescription from my GP for more that I >can take as required. Looking forward to some relief. >Jim > Hi, I just found this group this morning while researching pain > management. I’m looking for information that I can take into my Doc. He > has good intentions but little time for keeping up on new > developments.My situation: cervical spinal fusion (skull to c3) > following accident 12-95. Post-surgical bilateral numbness and pain > traced to spinal cyst caused by shunt left in place following fusion > surgery. 9-98 surgery to close shunt gave temporary relief. Currently > experiencing "BAD sunburn-like" feeling all over upperbody with several > "hot" spots more severe. Taking prozac–emotionally feel great. Low > dosage flexeril and amitriptyline for pain control—no effect. Also on > nerurontin for pain control–no effect. Have "backup" script for roxicet > when things become totally unbearable but current Dr. will only give > about 30/YEAR because he fears I will become addicted. However, it takes > 1 to 2 of those to have a normal-like day where I can function without > screaming anytime my clothes or my family so little as touches me. > Please, please any suggestions that I can take to the Dr???colleen

Response:

Sleepwalking

Question:

Hello Everyone, I have been trying very hard to keep a low profile in here and post only when I have to. I have a problem and I tried to do a deja search on it without any luck. I had a weird thing happen to me last night and I was wondering what if any of my meds could cause me to do something like this: I fell asleep on the couch. I have not been getting much sleep lately because I feel bad (sick) and I have been sleeping on the couch to avoid waking my husband up during my nightly trips for water for the sore throat, the porcelin Gods for hehe other things ( yup ewwwwww) and what have you. I remember dreaming last night about something that had to do with fire. I thought I might have been dreaming about buring trash in a barrel but I am not sure. I wake up because my hands are hurting. I look down and there I am standing in the living room of my home with a wad of toilet paper on fire in my hand. I did not know what else to do so I dropped it and stomped the fire out. This completely scared me to death, besides burning a hole in my carpet. I have two small children and I have to look out for them. I am currently taking the following: Oxycontin 40mg 2X per day OxyIr up to 10mg 1X per day Neurontin 400mg 3X a day Tofranil PM 300mg 1X a day I have been prescribed Trazadone to help me sleep. I have not taken it in the last few days because I did not want to be really out of it if I woke up and had to go to the bathroom. Everything that I am on except the Trazadone and the OxyIR, the dosages have been doubled on as of my last visit less than a week ago to my doctor. I called her today on her day off and asked about this happening. She said she would call me back but I guess she got busy or could not find the information on which drug could be causing this. I don’t know what happened really or why she did not return my call. Maybe it was because I was using someone elses’ phone. All I know is that I am sitting here at 11:22 at night with my eyes trying to close on me and I am to scared to go to bed. I am afraid of what I might do in my sleep. If anyone happens to be out there right now please answer as soon as possible if you have had same trouble and been on any of these same medications. I apologise for my bad punctuation and everything. I am so tired I am barely paying attnetion to spelling and grammar just watching the time hoping I get to go to bed soon. Thank you Tammy

Response:

Tammy, At the risk of waking your husband, I would suggest that you try to sleep near him so that you do wake him up if you get up. At least until your doc calls you back. The Oxycontin gave me small spasms in my back and legs, but nothing has made me sleep- walk yet. I have some strange dreams, but I think it’s because I have a terrible habit of eating right before I go to sleep. It might be in my head, but I like to think that it helps calm my upset stomach for the night. Maybe I’m wrong, but the dreams are entertaining for the most part. For you kids sake, sleep next to your husband and hope he wakes up if you get up. John D. —> yes, it’s me. JDOD28, turning over a new leaf. You can e-mail me if you wish.

Response:

Babygirl: CYM-Hope it got out. Mama Deanie – Hide quoted text — Show quoted text -> Tammy, > At the risk of waking your husband, I would suggest that you try to sleep > near > him so that you do wake him up if you get up. At least until your doc calls > you back. > The Oxycontin gave me small spasms in my back and legs, but nothing has made > me sleep- > walk yet. I have some strange dreams, but I think it’s because I have a > terrible habit of > eating right before I go to sleep. It might be in my head, but I like to > think that it > helps calm my upset stomach for the night. Maybe I’m wrong, but the dreams > are entertaining > for the most part. > For you kids sake, sleep next to your husband and hope he wakes up if you > get up. > John D. —> yes, it’s me. JDOD28, turning over a new leaf. You can e- mail > me if you wish. > Hello Everyone, > I have been trying very hard to keep a low profile in here and post only > when I have to. I have a problem and I tried to do a deja search on it > without any luck. I had a weird thing happen to me last night and I was > wondering what if any of my meds could cause me to do something like this: > I fell asleep on the couch. I have not been getting much sleep lately > because I feel bad (sick) and I have been sleeping on the couch to avoid > waking my husband up during my nightly trips for water for the sore > throat, > the porcelin Gods for hehe other things ( yup ewwwwww) and what have you. > I > remember dreaming last night about something that had to do with fire. I > thought I might have been dreaming about buring trash in a barrel but I am > not sure. I wake up because my hands are hurting. I look down and there I > am > standing in the living room of my home with a wad of toilet paper on fire > in > my hand. I did not know what else to do so I dropped it and stomped the > fire > out. > This completely scared me to death, besides burning a hole in my carpet. I > have two small children and I have to look out for them. I am currently > taking the following: > Oxycontin 40mg 2X per day > OxyIr up to 10mg 1X per day > Neurontin 400mg 3X a day > Tofranil PM 300mg 1X a day > I have been prescribed Trazadone to help me sleep. I have not taken it in > the last few days because I did not want to be really out of it if I woke > up > and had to go to the bathroom. Everything that I am on except the > Trazadone > and the OxyIR, the dosages have been doubled on as of my last visit less > than a week ago to my doctor. I called her today on her day off and asked > about this happening. She said she would call me back but I guess she got > busy or could not find the information on which drug could be causing > this. > I don’t know what happened really or why she did not return my call. Maybe > it was because I was using someone elses’ phone. All I know is that I am > sitting here at 11:22 at night with my eyes trying to close on me and I am > to scared to go to bed. I am afraid of what I might do in my sleep. If > anyone happens to be out there right now please answer as soon as possible > if you have had same trouble and been on any of these same medications. I > apologise for my bad punctuation and everything. I am so tired I am barely > paying attnetion to spelling and grammar just watching the time hoping I > get > to go to bed soon. > Thank you > Tammy

Response:

A similar incident happened to me a couple of weeks ago. I’ve been on 20mg bid of Methadone for about 3 months now and have never been a sleepwalker prior to taking this med. Now in recent weeks my girlfriend reports that I frequently sleep with my arms in the air..very bizarre. Anyhow, on this particular night I was dreaming that I was in a church passing around the collection plate. When I awoke (came to?) I was standing in the corner of my bedroom holding out a large glass ashtray which I then dropped and shattered into a million pieces in my surprise. Needless to say I was wide awake then! All I can recommend is what the others have said. Sleep in the bedroom so that your husband can keep an eye on you if you happen to go firefighting in the middle of the night again. It seems like the stronger time-released narcotics can bring on these sleepwalking instances. Best to have someone available to steer you back to bed. BTW, I’ve always heard that you should never wake up a sleepwalker. Why is that? Anyone know? TIA TK – Hide quoted text — Show quoted text -> Hello Everyone, > I have been trying very hard to keep a low profile in here and post only > when I have to. I have a problem and I tried to do a deja search on it > without any luck. I had a weird thing happen to me last night and I was > wondering what if any of my meds could cause me to do something like this: > I fell asleep on the couch. I have not been getting much sleep lately > because I feel bad (sick) and I have been sleeping on the couch to avoid > waking my husband up during my nightly trips for water for the sore throat, > the porcelin Gods for hehe other things ( yup ewwwwww) and what have you. I > remember dreaming last night about something that had to do with fire. I > thought I might have been dreaming about buring trash in a barrel but I am > not sure. I wake up because my hands are hurting. I look down and there I am > standing in the living room of my home with a wad of toilet paper on fire in > my hand. I did not know what else to do so I dropped it and stomped the fire > out. > This completely scared me to death, besides burning a hole in my carpet. I > have two small children and I have to look out for them. I am currently > taking the following: > Oxycontin 40mg 2X per day > OxyIr up to 10mg 1X per day > Neurontin 400mg 3X a day > Tofranil PM 300mg 1X a day > I have been prescribed Trazadone to help me sleep. I have not taken it in > the last few days because I did not want to be really out of it if I woke up > and had to go to the bathroom. Everything that I am on except the Trazadone > and the OxyIR, the dosages have been doubled on as of my last visit less > than a week ago to my doctor. I called her today on her day off and asked > about this happening. She said she would call me back but I guess she got > busy or could not find the information on which drug could be causing this. > I don’t know what happened really or why she did not return my call. Maybe > it was because I was using someone elses’ phone. All I know is that I am > sitting here at 11:22 at night with my eyes trying to close on me and I am > to scared to go to bed. I am afraid of what I might do in my sleep. If > anyone happens to be out there right now please answer as soon as possible > if you have had same trouble and been on any of these same medications. I > apologise for my bad punctuation and everything. I am so tired I am barely > paying attnetion to spelling and grammar just watching the time hoping I get > to go to bed soon. > Thank you > Tammy

Response:

TK I do that too! Sleep with my arms in the air. My husband says when he asks me about it I tell him that they are more comfortable and I’m in balance:) I guess sometimes tho my arms fall and smack him, lol. I’ve always thought sleeping would be far more comfortable if I could just unscrew my arms and set them on the floor beside the bed for the night. It’d be tricky getting them back on tho I’ll bet. love, catherine

– Hide quoted text — Show quoted text -> A similar incident happened to me a couple of weeks ago. I’ve been on > 20mg bid of Methadone for about 3 months now and have never been a > sleepwalker prior to taking this med. Now in recent weeks my girlfriend > reports that I frequently sleep with my arms in the air..very bizarre. > Anyhow, on this particular night I was dreaming that I was in a church > passing around the collection plate. When I awoke (came to?) I was > standing in the corner of my bedroom holding out a large glass ashtray > which I then dropped and shattered into a million pieces in my surprise. > Needless to say I was wide awake then! All I can recommend is what the > others have said. Sleep in the bedroom so that your husband can keep an > eye on you if you happen to go firefighting in the middle of the night > again. It seems like the stronger time-released narcotics can bring on > these sleepwalking instances. Best to have someone available to steer > you back to bed. > BTW, I’ve always heard that you should never wake up a sleepwalker. Why > is that? Anyone know? TIA > TK > Hello Everyone, > I have been trying very hard to keep a low profile in here and post > only > when I have to. I have a problem and I tried to do a deja search on it > without any luck. I had a weird thing happen to me last night and I > was > wondering what if any of my meds could cause me to do something like > this: > I fell asleep on the couch. I have not been getting much sleep lately > because I feel bad (sick) and I have been sleeping on the couch to > avoid > waking my husband up during my nightly trips for water for the sore > throat, > the porcelin Gods for hehe other things ( yup ewwwwww) and what have > you. I > remember dreaming last night about something that had to do with fire. > I > thought I might have been dreaming about buring trash in a barrel but > I am > not sure. I wake up because my hands are hurting. I look down and > there I am > standing in the living room of my home with a wad of toilet paper on > fire in > my hand. I did not know what else to do so I dropped it and stomped > the fire > out. > This completely scared me to death, besides burning a hole in my > carpet. I > have two small children and I have to look out for them. I am > currently > taking the following: > Oxycontin 40mg 2X per day > OxyIr up to 10mg 1X per day > Neurontin 400mg 3X a day > Tofranil PM 300mg 1X a day > I have been prescribed Trazadone to help me sleep. I have not taken it > in > the last few days because I did not want to be really out of it if I > woke up > and had to go to the bathroom. Everything that I am on except the > Trazadone > and the OxyIR, the dosages have been doubled on as of my last visit > less > than a week ago to my doctor. I called her today on her day off and > asked > about this happening. She said she would call me back but I guess she > got > busy or could not find the information on which drug could be causing > this. > I don’t know what happened really or why she did not return my call. > Maybe > it was because I was using someone elses’ phone. All I know is that I > am > sitting here at 11:22 at night with my eyes trying to close on me and > I am > to scared to go to bed. I am afraid of what I might do in my sleep. If > anyone happens to be out there right now please answer as soon as > possible > if you have had same trouble and been on any of these same > medications. I > apologise for my bad punctuation and everything. I am so tired I am > barely > paying attnetion to spelling and grammar just watching the time hoping > I get > to go to bed soon. > Thank you > Tammy

Response:

I have had similar incidents of "sleepwalking" since I was prescribed methadone in 1993. While the doctor was titrating my dosage upwards to control the pain, I did not have any problems, however, once I reached a maintenance level of about 80 – 90mg per day, I began to do some really weird things at night – its like you are in a fog. One incident involved a large glass bowl of wooden fruit on my kitchen table – I poured honey nut cheerios on top of the fruit – added milk & sat down to eat. As I was sitting at the table – my brain is telling me that something doesn’t quite look right & thankfully I went back to bed. (that could have been a nasty dental bill) Once I opened a can of cat food – placed it in the toaster oven – the smell was horrendous – that was enough to jar me fully awake. I’ve fallen asleep in the bathroom while sitting on the "hopper/commode/john/toilet" – & even taken a couple of tumbles off – now that was truly embarassing. In addition to being comical at times – it was serious concern for both of us. In my case, it was a simple solution as we divided up my dosage of methadone – currently I am at 140 mg & take 70 mg around 6 am or 7 am & then 70 mg around 4 pm or 5 pm plus roxicodone 5 mg for breakthrough pain prn. Hang in there – talk to your doctor – your husband has probably become a "light sleeper". (any noise out of the ordinary brings my hubby to check on me) Take care! Deborah

Response:

I >remember dreaming last night about something that had to do with fire. I >thought I might have been dreaming about buring trash in a barrel but I am >not sure. I wake up because my hands are hurting. I look down and there I am >standing in the living room of my home with a wad of toilet paper on fire in >my hand. I did not know what else to do so I dropped it and stomped the fire >out.

Tammy,please be sure to test your smoke alarms,often Lem

Response:

I know what you mean about trazadone putting you out. It sure knocks me out. Maybe sleeping near your husband is the answer. I know I’d want to know if my wife was trying to burn the house down while snoozing. Good luck. John K. – Hide quoted text — Show quoted text -> Hello Everyone, > I have been trying very hard to keep a low profile in here and post only > when I have to. I have a problem and I tried to do a deja search on it > without any luck. I had a weird thing happen to me last night and I was > wondering what if any of my meds could cause me to do something like this: > I fell asleep on the couch. I have not been getting much sleep lately > because I feel bad (sick) and I have been sleeping on the couch to avoid > waking my husband up during my nightly trips for water for the sore throat, > the porcelin Gods for hehe other things ( yup ewwwwww) and what have you. I > remember dreaming last night about something that had to do with fire. I > thought I might have been dreaming about buring trash in a barrel but I am > not sure. I wake up because my hands are hurting. I look down and there I am > standing in the living room of my home with a wad of toilet paper on fire in > my hand. I did not know what else to do so I dropped it and stomped the fire > out. > This completely scared me to death, besides burning a hole in my carpet. I > have two small children and I have to look out for them. I am currently > taking the following: > Oxycontin 40mg 2X per day > OxyIr up to 10mg 1X per day > Neurontin 400mg 3X a day > Tofranil PM 300mg 1X a day > I have been prescribed Trazadone to help me sleep. I have not taken it in > the last few days because I did not want to be really out of it if I woke up > and had to go to the bathroom. Everything that I am on except the Trazadone > and the OxyIR, the dosages have been doubled on as of my last visit less > than a week ago to my doctor. I called her today on her day off and asked > about this happening. She said she would call me back but I guess she got > busy or could not find the information on which drug could be causing this. > I don’t know what happened really or why she did not return my call. Maybe > it was because I was using someone elses’ phone. All I know is that I am > sitting here at 11:22 at night with my eyes trying to close on me and I am > to scared to go to bed. I am afraid of what I might do in my sleep. If > anyone happens to be out there right now please answer as soon as possible > if you have had same trouble and been on any of these same medications. I > apologise for my bad punctuation and everything. I am so tired I am barely > paying attnetion to spelling and grammar just watching the time hoping I get > to go to bed soon. > Thank you > Tammy

Response:

- Hide quoted text — Show quoted text – >Hello Everyone, > I have been trying very hard to keep a low profile in here and post only >when I have to. I have a problem and I tried to do a deja search on it >without any luck. I had a weird thing happen to me last night and I was >wondering what if any of my meds could cause me to do something like this: > I fell asleep on the couch. I have not been getting much sleep lately >because I feel bad (sick) and I have been sleeping on the couch to avoid >waking my husband up during my nightly trips for water for the sore throat, >the porcelin Gods for hehe other things ( yup ewwwwww) and what have you. I >remember dreaming last night about something that had to do with fire. I >thought I might have been dreaming about buring trash in a barrel but I am >not sure. I wake up because my hands are hurting. I look down and there I am >standing in the living room of my home with a wad of toilet paper on fire in >my hand. I did not know what else to do so I dropped it and stomped the fire >out. >This completely scared me to death, besides burning a hole in my carpet. I >have two small children and I have to look out for them. I am currently >taking the following: >Oxycontin 40mg 2X per day >OxyIr up to 10mg 1X per day >Neurontin 400mg 3X a day >Tofranil PM 300mg 1X a day >I have been prescribed Trazadone to help me sleep. I have not taken it in >the last few days because I did not want to be really out of it if I woke up >and had to go to the bathroom. Everything that I am on except the Trazadone >and the OxyIR, the dosages have been doubled on as of my last visit less >than a week ago to my doctor. I called her today on her day off and asked >about this happening. She said she would call me back but I guess she got >busy or could not find the information on which drug could be causing this. >I don’t know what happened really or why she did not return my call. Maybe >it was because I was using someone elses’ phone. All I know is that I am >sitting here at 11:22 at night with my eyes trying to close on me and I am >to scared to go to bed. I am afraid of what I might do in my sleep. If >anyone happens to be out there right now please answer as soon as possible >if you have had same trouble and been on any of these same medications. I >apologise for my bad punctuation and everything. I am so tired I am barely >paying attnetion to spelling and grammar just watching the time hoping I get >to go to bed soon. >Thank you >Tammy

Well, from http://www.mentalhealth.com/drug/p30-t03.html Adults: Initial dosage: 25 mg 3 times daily. This should be increased gradually as required and tolerated up to 150 mg/day. Dosages over 200 mg/day are not recommended. 300mg might be a bit high. I’m not sure this has anything to do with what happened to you, but all the other medical doses are well within a reasonable and accepted range. It also adds (under dosage): In severely ill, hospitalized patients, initially 100 mg/day in divided doses, gradually increasing to 200 mg/day, if required. If no significant response is observed after 3 weeks, dosage may be increased up to 250 to 300 mg/day. Elderly and debilitated patients: 30 to 40 mg/day, in divided doses, gradually increasing dosage if necessary, and tolerated; it is generally not necessary to exceed 100 mg/day. Maintenance dosage: Dosage during maintenance therapy should be kept at the lowest effective level. Medication should be continued for the expected duration of the depressive episode in order to minimize the possibility of relapse following clinical improvement. When a maintenance dosage has been established as described above, imipramine may be administered in a single daily dose at bedtime, provided such a dosage regimen is well tolerated. So, it says that 300mg *can* be taken, but that seems to definitely be the upper ceiling dose. Maybe a high dose like this, combined with the other meds, contributed to your episode. I’d alert my physician and let him(her) know exactly what occured to you. Good luck. ~alex

Response:

– Hide quoted text — Show quoted text ->Hello Everyone, > I have been trying very hard to keep a low profile in here and post only >when I have to. I have a problem and I tried to do a deja search on it >without any luck. I had a weird thing happen to me last night and I was >wondering what if any of my meds could cause me to do something like this: > I fell asleep on the couch. I have not been getting much sleep lately >because I feel bad (sick) and I have been sleeping on the couch to avoid >waking my husband up during my nightly trips for water for the sore throat, >the porcelin Gods for hehe other things ( yup ewwwwww) and what have you. I >remember dreaming last night about something that had to do with fire. I >thought I might have been dreaming about buring trash in a barrel but I am >not sure. I wake up because my hands are hurting. I look down and there I am >standing in the living room of my home with a wad of toilet paper on fire in >my hand. I did not know what else to do so I dropped it and stomped the fire >out. >This completely scared me to death, besides burning a hole in my carpet. I >have two small children and I have to look out for them. I am currently >taking the following: >Oxycontin 40mg 2X per day >OxyIr up to 10mg 1X per day >Neurontin 400mg 3X a day >Tofranil PM 300mg 1X a day >I have been prescribed Trazadone to help me sleep. I have not taken it in >the last few days because I did not want to be really out of it if I woke up >and had to go to the bathroom. Everything that I am on except the Trazadone >and the OxyIR, the dosages have been doubled on as of my last visit less >than a week ago to my doctor. I called her today on her day off and asked >about this happening. She said she would call me back but I guess she got >busy or could not find the information on which drug could be causing this. >I don’t know what happened really or why she did not return my call. Maybe >it was because I was using someone elses’ phone. All I know is that I am >sitting here at 11:22 at night with my eyes trying to close on me and I am >to scared to go to bed. I am afraid of what I might do in my sleep. If >anyone happens to be out there right now please answer as soon as possible >if you have had same trouble and been on any of these same medications. I >apologise for my bad punctuation and everything. I am so tired I am barely >paying attnetion to spelling and grammar just watching the time hoping I get >to go to bed soon. >Thank you >Tammy > Well, from > http://www.mentalhealth.com/drug/p30-t03.html > Adults: > Initial dosage: > 25 mg 3 times daily. This should be increased gradually as required and > tolerated up to 150 mg/day. Dosages over 200 mg/day are not recommended. > 300mg might be a bit high. > I’m not sure this has anything to do with what happened to you, but all the > other medical doses are well within a reasonable and accepted range. > It also adds (under dosage): > In severely ill, hospitalized patients, initially 100 mg/day in divided doses, > gradually increasing to 200 mg/day, if required. If no significant response is > observed after 3 weeks, dosage may be increased up to 250 to 300 mg/day. > Elderly and debilitated patients: > 30 to 40 mg/day, in divided doses, gradually increasing dosage if necessary, > and tolerated; it is generally not necessary to exceed 100 mg/day. > Maintenance dosage: > Dosage during maintenance therapy should be kept at the lowest effective level. > Medication should be continued for the expected duration of the depressive > episode in order to minimize the possibility of relapse following clinical > improvement. > When a maintenance dosage has been established as described above, imipramine > may be administered in a single daily dose at bedtime, provided such a dosage > regimen is well tolerated. > So, it says that 300mg *can* be taken, but that seems to definitely be the > upper ceiling dose. > Maybe a high dose like this, combined with the other meds, contributed to your > episode. > I’d alert my physician and let him(her) know exactly what occured to you. > Good luck. > ~alex >I read the insert to the medication. It lists all of the usual

possible side effects – and more as usual. Then in smaller type at the bottom; * a small percentage of patients have experienced awakening with a flaming roll of toilet paper in their hands. Please consult your physician immediately. Seriously Tammy please let us know what he says, that’s pretty scary. codeee

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I have also had unusual "dreams" like this periodically even before I was on all the meds. My walking around in the room really scared my sister when we were younger! I recently read about this in a sleep book my hubby got at the library, but I can’t remember what the exact term is. It isn’t regular sleepwalking and it isn’t regular dreaming, meaning that it occurs at a different level of sleep than REM. During REM, our muscles are paralyzed, so to speak, so that we DON’T act out the things in our dreams. But at other levels of sleep, it can happen. And during regular sleepwalking, we don’t usually remember a dream or doing anything. I really wish I could remember the term for this type of thing. I think it has something to do with improper arousal from deeper sleep stages. Rather than going up slowly, we go from stage 4 directly to stage 2 or something like that. It isn’t sleep terrors or nightmares, either. Perhaps a posting on the Sleep Disorders group can help. If I’m not mistaken, some antidepressants can cause weird dreams. Acting them out is another story. I wish all of you the best luck in finding out what’s happening. And I hope that nothing serious happens in the meantime. But definitely let your doctor know! Good luck! Carly – Hide quoted text — Show quoted text – >A similar incident happened to me a couple of weeks ago. I’ve been on >20mg bid of Methadone for about 3 months now and have never been a >sleepwalker prior to taking this med. Now in recent weeks my girlfriend >reports that I frequently sleep with my arms in the air..very bizarre. >Anyhow, on this particular night I was dreaming that I was in a church >passing around the collection plate. When I awoke (came to?) I was >standing in the corner of my bedroom holding out a large glass ashtray >which I then dropped and shattered into a million pieces in my surprise. > Needless to say I was wide awake then! All I can recommend is what the >others have said. Sleep in the bedroom so that your husband can keep an >eye on you if you happen to go firefighting in the middle of the night >again. It seems like the stronger time-released narcotics can bring on >these sleepwalking instances. Best to have someone available to steer >you back to bed. >BTW, I’ve always heard that you should never wake up a sleepwalker. Why >is that? Anyone know? TIA >TK > Hello Everyone, > I have been trying very hard to keep a low profile in here and post >only > when I have to. I have a problem and I tried to do a deja search on it > without any luck. I had a weird thing happen to me last night and I >was > wondering what if any of my meds could cause me to do something like >this: > I fell asleep on the couch. I have not been getting much sleep lately > because I feel bad (sick) and I have been sleeping on the couch to >avoid > waking my husband up during my nightly trips for water for the sore >throat, > the porcelin Gods for hehe other things ( yup ewwwwww) and what have >you. I > remember dreaming last night about something that had to do with fire. >I > thought I might have been dreaming about buring trash in a barrel but >I am > not sure. I wake up because my hands are hurting. I look down and >there I am > standing in the living room of my home with a wad of toilet paper on >fire in > my hand. I did not know what else to do so I dropped it and stomped >the fire > out. > This completely scared me to death, besides burning a hole in my >carpet. I > have two small children and I have to look out for them. I am >currently > taking the following: > Oxycontin 40mg 2X per day > OxyIr up to 10mg 1X per day > Neurontin 400mg 3X a day > Tofranil PM 300mg 1X a day > I have been prescribed Trazadone to help me sleep. I have not taken it >in > the last few days because I did not want to be really out of it if I >woke up > and had to go to the bathroom. Everything that I am on except the >Trazadone > and the OxyIR, the dosages have been doubled on as of my last visit >less > than a week ago to my doctor. I called her today on her day off and >asked > about this happening. She said she would call me back but I guess she >got > busy or could not find the information on which drug could be causing >this. > I don’t know what happened really or why she did not return my call. >Maybe > it was because I was using someone elses’ phone. All I know is that I >am > sitting here at 11:22 at night with my eyes trying to close on me and >I am > to scared to go to bed. I am afraid of what I might do in my sleep. If > anyone happens to be out there right now please answer as soon as >possible > if you have had same trouble and been on any of these same >medications. I > apologise for my bad punctuation and everything. I am so tired I am >barely > paying attnetion to spelling and grammar just watching the time hoping >I get > to go to bed soon. > Thank you > Tammy

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Kinda stupid, but it might work: I was watching a Pokemon episode, where Brock had to put a bell around his little sisters wrist so he could hear her when she would sleepwalk. I don’t know how someone could hear a little bell, but if nothing else works, maybe this will. Gee, I watch too much tv. (sigh) Sara

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> Kinda stupid, but it might work: I was watching a Pokemon episode, where > Brock had to put a bell around his little sisters wrist so he could hear > her when she would sleepwalk. I don’t know how someone could hear a > little bell, but if nothing else works, maybe this will. Gee, I watch > too much tv. (sigh) > Sara

lol And it says a lot that you only watch kid’s shows too. :-} It might not be a bad idea to tie a bell or something to the door knob of the child’s room. That way if they get the door open you would hear it. (See, it wasn’t so silly after all Sara. :-}) Sharon

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Coming in a week late on this, sorry. But My brother did the same thing. He was a BIG one for talking in his sleep, too. One night my dad was up late watching TV, and My brother Kenny (I think about 7 or 8 yrs old then) came out of his room, down into the utility room, opened the upright freezer, and peed into it. Then promptly went back to bed, and didn’t remember a thing in the morning. My Dad was too dumbfounded to stop it while it was happening. I think he grew out of the sleep walking, (he passed away at age 19 — not related to sleep walking) but he never did stop talking and yelling in his sleep. I also recall that he was a VERY heavy sleeper. I would make certain that she cannot leave the house during her evening strolls, and that your home is basically safe. Maybe you could put a gate at the kitchen, or any other room that would be particularly dangerous for a less than alert child to stumble into. Maybe a talk with your Ped would be comforting to you, and provide information. Krystal If evolution really works, then why do mothers have only two arms? Eat the "treat" in my address to e-mail me.

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My son has ended up in some weird places as well…the bathtub, corners, etc. Most generally, the living room somewhere. My pediatrician said that some of it is caused by stress. Although it doesn’t seem possible for a child to have stress, they do. Namely, school. You aren’t supposed to wake them up. Just redirect them into bed and most generally, they won’t do it again that night. Just make sure paths are clear of any obstructions. Of course, keep doors unaccesible. Michelle…mommy of 3

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>If it were my child, I’d at least get deadbolts locks (the kind with both >sides >needing a key) for the doors, so she never ended up outdoors

I have thought of this as well. I make sure the alarm is on every night so it will go off if the door is opened. I also put a deadbolt up at the top of the door that goes to the back yard because we have a pool. I tried the monitor thing but since she talks so much in her sleep, I was not getting any sleep. You had some great suggestions. Thanks Jackie "Single parent…..who not only is happy about it, but proud of it…."

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>Do you notice that she sleepwalks when she is really really tired, and is >sleeping >soundly?

I do think she is more "active" when she is more tired. She goes to bed at 7:30 on school nights and 8:30 otherwise. She is up between 6:30 and 7:00 am. Some nights she sleeps soundly though. Tonight this just concerned me because it was so dramatic. I hadn’t thought about calling her doctor….i will in the morning. Jackie "Single parent…..who not only is happy about it, but proud of it…."

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- Hide quoted text — Show quoted text – >My 6 yr old has been a sleepwalker since she could walk ! She is also very >"vocal" while sleeping, sometimes even shouting out. >When she sleepwalks, usually I just redirect her into bed and there is no >problem. Tonight I heard a crash in the laundry room and go in to find that >she >is in the laundry basket that was on the floor, peeing! She was complaining >that there was no toilet paper! She finished, got up, pulled up her panties, >looked around puzzled for a minute and then went to bed. >I am now concerned that she could actually do something to hurt herself and >that I may not wake up in time. Our house is a one story so I don’t ahve to >worry about the stairs. >Anyone have anything to tell me about sleep walking? Anything I should be >concerned about?? >Thanks >Jackie

I really don’t know what to tell you because I’ve never had this problem or known anyone who has. I would be quite concerned though, if I were you…I saw on an Unsolved Mysteries show once where a young man in his twenties was sleepwalking and went outdoors and was killed by a train. I’m not trying to frighten you, honestly…but I would be worried. If it were my child, I’d at least get deadbolts locks (the kind with both sides needing a key) for the doors, so she never ended up outdoors. I would also get a baby moniter for her room and keep it turned up as high volume as it can go, so you can hear her rustling around and getting out of bed maybe. It might not work, but it’s worth a try. Josie–mommy to Sarah (10), Lynne (6), and Parker (4)….. (by the way, the name is Dieu Vous Garde)…… I hope that someday we can put away our fears and prejudices,and just laugh at

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Hi. I don’t know if this topic has been covered before or not…so here goes. My 6 yr old has been a sleepwalker since she could walk ! She is also very "vocal" while sleeping, sometimes even shouting out. When she sleepwalks, usually I just redirect her into bed and there is no problem. Tonight I heard a crash in the laundry room and go in to find that she is in the laundry basket that was on the floor, peeing! She was complaining that there was no toilet paper! She finished, got up, pulled up her panties, looked around puzzled for a minute and then went to bed. I am now concerned that she could actually do something to hurt herself and that I may not wake up in time. Our house is a one story so I don’t ahve to worry about the stairs. Anyone have anything to tell me about sleep walking? Anything I should be concerned about?? Thanks Jackie "Single parent…..who not only is happy about it, but proud of it…."

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Do you notice that she sleepwalks when she is really really tired, and is sleeping soundly? I use to sleepwalk as a child, and I ended up doing silly stuff, like talk on the phone, bring my parents a toy and then walk back to bed, ect… My parents just made me go to bed earlier if they noticed that I was tired than normal, that way I wouldn’t sleepwalk. I grew out of it by age 12 or 13. You might ask your doctor what he would suggest. Momalot – Hide quoted text — Show quoted text – > Hi. I don’t know if this topic has been covered before or not…so here goes. > My 6 yr old has been a sleepwalker since she could walk ! She is also very > "vocal" while sleeping, sometimes even shouting out. > When she sleepwalks, usually I just redirect her into bed and there is no > problem. Tonight I heard a crash in the laundry room and go in to find that she > is in the laundry basket that was on the floor, peeing! She was complaining > that there was no toilet paper! She finished, got up, pulled up her panties, > looked around puzzled for a minute and then went to bed. > I am now concerned that she could actually do something to hurt herself and > that I may not wake up in time. Our house is a one story so I don’t ahve to > worry about the stairs. > Anyone have anything to tell me about sleep walking? Anything I should be > concerned about?? > Thanks > Jackie > "Single parent…..who not only is happy about it, but proud of it…."

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Immune system vs bipolar disorder

Question:

Addendum: I think psychologically seeing what it meant to be "hospitalized" made me realized that I want to avoid that place like the plague again. This may have had the indirect effect of strengthing my immune system to prevent me from a physical illness causing me to wind up there again. -Rob

– Hide quoted text — Show quoted text -> I used to get sick a lot. > Then I had my first hospitalization for bipolar in 1996. > Since then, I don’t think I’ve even had a fever. That’s more than 4 years, > when I often became sick for at least 1 week (about 4-5 days) a year. > Does that say anything significant? I’m not sure, but it is interesting.. > I’ve never given it serious consideration. > -Rob > > I’m a newcomer on this site. can anyone direct me to some information on > the > > relation between manic depression and the immune system. > I was having a problem with a staph infection that had flared up for years > and had my immune system fully *tested*…… it turns out I have a hell > of > an immune system! > Hope it helps… at least comparatively….. > EileenB

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I’m not sure I’ve seen anything on Manic Depression specifically, but I know that depression (and hence the depression side of manic depression) can certainly weaken your immune system. One good website for all sorts of information on Bipolar (including links to hundreds of related sites) is http://bipolar.about.com -Rob

– Hide quoted text — Show quoted text -> I’m a newcomer on this site. can anyone direct me to some information on the > relation between manic depression and the immune system.

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> I’m a newcomer on this site. can anyone direct me to some information on the > relation between manic depression and the immune system.

I was having a problem with a staph infection that had flared up for years and had my immune system fully *tested*…… it turns out I have a hell of an immune system! Hope it helps… at least comparatively….. EileenB

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>the depression side of manic depression)

What does the manic side do to the immune system? I had a rash disappear when h-manic in 1994 Ralph V. Dammit Jim, I’m a Bike Courier, not a Doctor

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Hi, Pierre… Just passing through here myself. I have a whole catalogue of mental/psychological symptoms: bi-polar, depression, anxiety, panic, ADHD, obsessive-compulsive, chronic fatigue, brain fag, brain fog, short and long term memory loss, loss of comprehension…have I missed anything? I get these symptoms upon exposure to chemicals in the air and a number of foods. (Suicidal depression with just a taste of wheat, brain fog, neurotic upon exposure to auto exhaust, psychotic ranting with exposure to combustion products of natural gas–and it goes on and on and on and on.) I’m moving shortly to a country with clean air…!? I have been symptom-free. It’s possible (at least for me)(and others, I am sure but I’m not going to preach {too much}). I wonder how many of us here have concommitant problems with allergies and sensitivities and immune system disorder? Raise your hands! Yes, you in the back hiding under the chair, too…. How about seasonal ebb and flow of symptoms? TM Check out the case studies in this book which is probably available in the library: An Alternatative Approach to Allergies Theron G. Randolph, M.D. & Ralph W. Moss, Ph.D. > I’m a newcomer on this site. can anyone direct me to some information on > the > relation between manic depression and the immune system. mune system!

Before you buy.

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>the depression side of manic depression) > What does the manic side do to the immune system? I had a rash disappear when > h-manic in 1994 > Ralph V.

in brief, mania is associated with higher than normal levels of adrenaline (norepinephrine and epinepinephrine). In prescription form, epinephrine is given for allergic/immune reactions which might be severe enough to require an emergency room visit (ex bad reactions to bee stings). I;ve noticed personally, that my allergies (and pain, for that matter) improve when I;m manic. regards, julie

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I used to get sick a lot. Then I had my first hospitalization for bipolar in 1996. Since then, I don’t think I’ve even had a fever. That’s more than 4 years, when I often became sick for at least 1 week (about 4-5 days) a year. Does that say anything significant? I’m not sure, but it is interesting.. I’ve never given it serious consideration. -Rob

– Hide quoted text — Show quoted text -> I’m a newcomer on this site. can anyone direct me to some information on > the > relation between manic depression and the immune system. > I was having a problem with a staph infection that had flared up for years > and had my immune system fully *tested*…… it turns out I have a hell of > an immune system! > Hope it helps… at least comparatively….. > EileenB

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I’m a newcomer on this site. can anyone direct me to some information on the relation between manic depression and the immune system.

Response:

Hi Pierre, Welcome to ASDM. Here is what I found using Metacrawler. > I’m a newcomer on this site. can anyone direct me to some information on the > relation between manic depression and the immune system.

DEPRESSION AND THE IMMUNE SYSTEM http://sulcus.berkeley.edu/mcb165/mcb165sp98tPaper/mcb165sp98R.manuscrip t/_38.html Category: Neurochemistry Term Paper Code: 38 Abstract Depression affects the human body in more than one way. Its physiological effects can be seen in the depressive moods of the person. A general sense of apathy is observed. However, depression more than just affects moods; it also affects the human immune system. The neurotranmsitters responsible for the psychological aspects of depression also exert a physical effect by influencing the endocrine system in the body. These two systems then combine their efforts and modify the immune system. People suffering from depression almost always suffer from some other disease, such as colds. These people are more susceptible to diseases because depression lowered their immune system’s ability to combat the illness. Since the beginning of civilization, depression has plagued the human population. Countless literary classics, art works, and musical masterpieces reflect the artists’ own private battles with one of the major psychiatric disorders of modern times: depression. The Greek physician Galen recorded more than 2000 years ago that people suffering from depression were more susceptible to cancer. However, until recently, depression is not recognized as a psychiatric disorder. With its widespread occurrences in the population, depression is often looked upon as a part of the life experience. Though many experience every once a while depression symptoms such as unhappy mood, hopelessness, loss of energy, weight loss, irregular sleep pattern, and decreased appetite, some experience these symptoms with cyclic regularity. These people are clinically diagnosed as possessing depression as a psychiatric disorder, either as unipolar depression or bipolar illness. For the rest of the population with depression, though the disorder many not impair daily life as much as clinical depression, it handicaps daily life in a more subtle fashion. People in depression have weaker immune systems, allowing them to be susceptible to diseases that their immune systems can normally defeat. For example, college students during periods of final exam often are more likely to catch colds or flu. The lower immunity for disease is undoubtably due to the stress of the bombardment of exams, which has similar effects to depression. The mental state of a being can directly affect his immune system; the brain or the central nervous system (CNS) control the release of hormones, which then act upon the immune system. To understand the exact pathway of how a mental or emotional state such as depression can alter the immune system, the hormone releasing mechanisms and the immune system must be examined along with the neuropathways of depression itself. Depression is an affective disorder that is thought to relate to the functioning of the monoamines, especially serotonin and norepinephrine. There are several hypothesis to the development of depression. The catecholamine hypothesis of affective disorders states that such disorders result from decreased norepinephrine levels. The first generation antidepressants were monoamine oxidase inhibitors and tricyclics. Monoamine oxidases are enzymes which break down monoamines such as norepinephrine, serotonin, and dopamine. With this enzyme blocked, these neurotransmitters will not be metabolized when released into the synpase. Over time, the neurotransmitters will accumulate and increase firing at the monoamine synapses. Tricyclics work in the same fashion as the stimulant cocaine. It prevent the reabsorption of monoamines after they have been released into the synapse. The tricyclics are more selective than MAO inhibitors. They are more effective in increasing norepinephrine levels. Despite their effectiveness in treating depression, MAOIs and tricyclics both have some unwanted side effects. Monoamine oxidase not only destroys monoamines, but also other substances in food such as tyramine. Accumulation of tyramine in the body can cause high blood pressure, headaches, and internal bleeding, leading to stroke or death. Tricyclics block transmission at cholinergic synapses, thus causing anticholinergic effects. These unwanted side effects encouraged the finding of the second generation antidepressants. The drug reserpine depletes monoamines from the brain and causes severe depression. Stimulants, MAO inhibitors, and tricyclics all increase catecholamines and alleviate depression, even inducing some mania. Using these two pieces of data, depression was thought to develop as a result of low levels of monoamines in the synapses. However, tests soon showed that though all three monoamines are involved in mood, serotonin is actually the major neurotransmitter responsible for major depression. This is evident since treatments that effectively relieve depression symptoms have all been shown to change transmission at serotonin synapses. However, this does not indicate that other neurotransmitters are not involved since increase in serotonin levels is know to affect other neurotransmitter levels. For example, low levels of serotonin might lead to lower levels of norepinephrine, making it hard to distinguish which neurotransmitter is actually more responsible for the symptoms of depression. The serotonin hypothesis of depression now states that depression develops mainly as result of low levels of serotonin. In order to treat depression, selective serotonin reuptake inhibitors, or SSRIs, are used in place of monoamine oxidase inhibitors or tricyclics. These drugs are employed to block the reuptake of serotonin at synapses, thus prolonging the availability of serotonin at the synapses. As the reuptake mechanisms are blocked, the level of serotonin at the synapses eventually accumulate and reverse the symptoms of depression. SSRIs are discovered to work only after about two weeks of lag time. This is thought to due to the down-regulation, or reduction, of receptors. It is thought that one of the causes of depression is the oversensitivity of monoamine receptors. Antidepressants might work by reducing the supersensitivity of the receptors by causing down-regulation. Another explanation for why increased levels of serotonin do not cause immediate increase in firing at the synapse is that serotonin synapses may have autoreceptors. When these autoreceptors detect excessive amounts of serotonin, they inhibit the release of more serotonin. Therefore, when SSRIs are first used, these autoreceptors have not yet adjust to the increased amount of serotonin at the synapses. They then naturally prevent more release of serotonin. It is only when these autoreceptors have adapted to the increased levels of serotonin at the synpase that they allow more serotonin to be released. Despite the strong evidence of the serotonin hypothesis, depression may have other causes. The neuroendochrinological hypothesis suggests that circadian cortisol levels may induce depression. According to the hypothesis, the hypothamlamic-pituitary-adrenal cortex may be hyperactive in depressives. Increased levels of cortisol is correlated with depression. Depressives increase their release of ACTH. Since hormones play an important role in the body’s immune system, the increase of ACTH due to depression associates depression with the body’s immune system. The hypothalamus-pituitary-adrenal axis is one of the major hormone systems, or endocrine pathways, involved in depression. The hypothalamus is a region in lower brain which receives information from other parts of the brain and then initiates an endocrine response. The hypothalamus integrates signals from the nervous system with the endocrine system. It contains hormone-releasing cells, which are neurons that release hormones into the blood stream. There are two types of hormone-releasing cell: one releases hormones of the posterior pituitary gland while the other produces releasing hormones that promotes hormone release in the anterior pituitary gland. The pituitary gland is a small gland near the hypothalamus. It is regulated by the hormones of the hypothalamus. While the posterior pituitary gland releases such hormones as oxytocin, a milk-production stimulating hormone, the anterior pituitary gland produces the hormone that is most associated with stress and depression: adrenocorticotropin or ACTH. ACTH is a peptide hormone which stimulates the adrenal cortex to release steroid hormones such as glucocorticoids. While steroid hormones are able to pass through the hydrophobic cell membrane with ease to pass on the chemical signal, peptide hormones such as ACTH can not. They must bind to specific surface receptors on the cell surface in order to activate a second messenger pathway. The receptors they activate actually have enzymatic activity on the cytoplasmic side. They activate another protein called G-protein by exchanging the guanosine diphosphate (GDP) bound on the protein for guanosine triphosphate (GTP). Once the G-protein binds to GTP, its catalytic alpha-subunit dissociates from the beta and gamma regulatory subunits and diffuses laterally across the plasma membrane to activate another enzyme called adenylate cyclase. Adenylate cyclase in turn catalyzes the reaction of converting adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP). Cyclic AMP goes on to activate translation factors which initiates translation of certain genes. It is by this pathway that ACTH stimulates the cells of the adrenal cortex to synthesize and secrete corticosteroids such as glucocorticoids. High … read more »

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Does anyone drink heavily only when MANIC?

Question:

Can it really be true that other countries are more stringent about approving meds than the US? How can that be? Codeine preparations seem to be sold OTC in all the world but the US. Most new drugs in the US have already been used in europe for years. Drugs are routinely yanked off the market here for slight problems that could be avoided by proper prescribing and dosing. And then there is the demonization of any drug that has any "recreational appeal". Look what happened to GHB, simply because some few people abused it. And then there is the economic blackmail campaign that the US has waged upon the rest of the world to force compliance with puritanical drug prohibitions dreamed up in america. Comments, anyone? Keith

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– Hide quoted text — Show quoted text -> sites. Sure its dangerous, and sure it can be abused, but then so can > any of the sleeping tablet formulations. Tamazepam used to be a popular > one here, and even some tricyclic antidepressants have been used for > recreational purposes, and they’re lethal if you take enough of them… > Hugh Davies-Webb >True enough. I was just reacting from an emotional standpoint because of >my own irresponsible, self-destructive behaviour. I’m sure I could get >high off the Klonopin my pdoc prescribes if I was still into that sort of >thing. Instead I’m fastidious about using my prescription drugs as >prescribed and continually ask my pdoc if I should be weaning myself off >it. I got a little freaked out when my pdoc said I could take up to 3 >trazodone and I ended up almost passed out on the bathroom floor like my >GHB episode. I’m sure GHB has many uses. I justified using it around the >clock because of it’s reported anti-depressant effects, the quantities I >was taking turned me into a severe rapid-cycler, from laughing my head off >in love with the world to crying and suicidal in minutes. >I’m on here now because I can’t sleep even after hours of meditation and 1 >Klonopin. >Aurora(posting from dad’s account)

Well this is where GHB would help… <g> I’m also a narcolepsy sufferer, and GHB is one of the great hopes for sufferers, if it ever gets pat the hypocritical/ corrupt/ puritanical FDA. If taken in correct dosages, and of pharmaceutical grade etc, etc, it can give us the next best thing to a decent night’s sleep, as well as sorting out cataplexy and sleep paralysis. You might try old-fashioned tricyclics/tetracyclics in small doses to help with your sleep though… Hugh. Hugh Davies-Webb

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> sites. Sure its dangerous, and sure it can be abused, but then so can > any of the sleeping tablet formulations. Tamazepam used to be a popular > one here, and even some tricyclic antidepressants have been used for > recreational purposes, and they’re lethal if you take enough of them… > Hugh Davies-Webb

True enough. I was just reacting from an emotional standpoint because of my own irresponsible, self-destructive behaviour. I’m sure I could get high off the Klonopin my pdoc prescribes if I was still into that sort of thing. Instead I’m fastidious about using my prescription drugs as prescribed and continually ask my pdoc if I should be weaning myself off it. I got a little freaked out when my pdoc said I could take up to 3 trazodone and I ended up almost passed out on the bathroom floor like my GHB episode. I’m sure GHB has many uses. I justified using it around the clock because of it’s reported anti-depressant effects, the quantities I was taking turned me into a severe rapid-cycler, from laughing my head off in love with the world to crying and suicidal in minutes. I’m on here now because I can’t sleep even after hours of meditation and 1 Klonopin. Aurora(posting from dad’s account)

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writes – Hide quoted text — Show quoted text -> >Codeine preparations seem to be sold OTC in all the world > >but the US. Most new drugs in the US have already been used > >in europe for years. Drugs are routinely yanked off the > >market here for slight problems that could be avoided by > >proper prescribing and dosing. And then there is the > >demonization of any drug that has any "recreational appeal". > >Look what happened to GHB, simply because some few people > >abused it. > A lot of what goes on between the FDA and FBI seems very strange… > There is a lot of evidence to suggest that GHB is of great theraputic > benefit to people with narcolepsy (like myself), however, GHB is an > orphan medicine with no big pharmaceutical company doing funny > handshakes with the FDA to get it approval… From what I’ve read on the > NGs the FDA seems to be a rather corrupt organisation. After all, >[snip] >GHB is a dangerous substance. I almost died from OD’ing on it, >unintentionally, although earlier that evening I considered that the >quantity I had on hand would be a convenient suicide method, probably >painless too. The problem with it is the low margin between what gets >you high, what makes you pass out, what puts you in a coma, what kills >you. Many young people have died from this stuff (ie. River Pheonix) I >know that what happened to me is my fault and others are also >responsible for their actions, but if it does have a medical use it >should be controlled by prescription. I got mine by mailing away for a >kit to make it by adding KOH to an acid that was almost GHB, so they >could get away with selling it. >Aurora

The GHB I’m talking about is pharmaceutical grade stuff, prescibed under the supervision of a consultant physician, not the stuff that people make from kits. If you want to know about GHB and its benefits to narcoleptics I suggest you go to any of of the many excellent narcolepsy sites. Sure its dangerous, and sure it can be abused, but then so can any of the sleeping tablet formulations. Tamazepam used to be a popular one here, and even some tricyclic antidepressants have been used for recreational purposes, and they’re lethal if you take enough of them… Hugh Davies-Webb

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So? We’re still good guys. Regards, John – Hide quoted text — Show quoted text -> Because of people using GHB carelessly I don’t even get the > chance to try to use this quite promising stuff responsibly. > I have done enough research to learn that it is not possible > to OD on GHB alone; if you take too much you sleep until it > is done with you. Only fools who mixed GHB and alcohol > despite the very prominent warnings on the internet not to > ever died. BTW, GHB was sold over the counter in this > country for many years without any problems. > GHB’s mode of action is apparently quite similiar to > Neurontin! > — > Keith Hardwick > web page is up at > http://home.att.net/~keithncarol/web_page.htm > Lots of good info for newcomers to > alt.support.depression.manic > and soc.support.depression.manic! >Well, forgive me for doing stupid things, but I guess that is part of >BP, believing that the warnings don’t apply to me and that if a little >is good a lot is better. But even without alcohol taking enough of it >will make you unstable(more so than I was anyway). >And there is some question as to whether a drug that is easy and >enjoyable to use irresponsibly is a good choice for BP’s since according >to Jamison’s book ‘Touched with Fire’ almost half have drug/alcohol >problems. >Aurora

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- Hide quoted text — Show quoted text – > Because of people using GHB carelessly I don’t even get the > chance to try to use this quite promising stuff responsibly. > I have done enough research to learn that it is not possible > to OD on GHB alone; if you take too much you sleep until it > is done with you. Only fools who mixed GHB and alcohol > despite the very prominent warnings on the internet not to > ever died. BTW, GHB was sold over the counter in this > country for many years without any problems. > GHB’s mode of action is apparently quite similiar to > Neurontin! > — > Keith Hardwick > web page is up at > http://home.att.net/~keithncarol/web_page.htm > Lots of good info for newcomers to > alt.support.depression.manic > and soc.support.depression.manic!

Well, forgive me for doing stupid things, but I guess that is part of BP, believing that the warnings don’t apply to me and that if a little is good a lot is better. But even without alcohol taking enough of it will make you unstable(more so than I was anyway). And there is some question as to whether a drug that is easy and enjoyable to use irresponsibly is a good choice for BP’s since according to Jamison’s book ‘Touched with Fire’ almost half have drug/alcohol problems. Aurora

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- Hide quoted text — Show quoted text – > gamma hydroxy butyrate, something like that > It is useful as a sleep aid, anti-depressant, helps hard > core addicts deal with their cravings, etc.. It is a mild > relaxant and is not really a drug to get high on, although > that is why it is now banned. > — > Keith Hardwick > web page is up at > http://home.att.net/~keithncarol/web_page.htm > Lots of good info for newcomers to > alt.support.depression.manic > and soc.support.depression.manic!

BUT it will get you high and a lot of teens and Gen-X’ers are doing it. I was taking it in liquid solution so I don’t know what the dosage is compared to those who use it as an antidepressant or whatever. I do know that after using large amounts continuously for a day and a half I couldn’t stop crying and was really suicidal but then refused to let my fiance take my supply away from me. That night I OD’d and he had to pick me up off the bathroom floor of a club. Of course I was not doing all that well before I discovered this stuff either. It is a lot like alcohol, and probably like other downers at first makes it easy to socialize feel connected with others, carefree and laugh a lot but then just as easy to switch into crying or rage. The problem with using it to help addicts/alcoholics with cravings is the fact that addicts think if some is good, more is better and the results can be deadly with this stuff. Maybe it would be useful for this purpose in a hospital setting where dosage is controlled. I could probably get interesting effects if I took large amounts of some of my prescribed meds but I have no interest in trying. 3 trazodone’s took me straight to the worshipping the porcelain goddess stage (and that was pdoc’s recommendation) Aurora

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gamma hydroxy butyrate, something like that It is useful as a sleep aid, anti-depressant, helps hard core addicts deal with their cravings, etc.. It is a mild relaxant and is not really a drug to get high on, although that is why it is now banned. — Keith Hardwick web page is up at http://home.att.net/~keithncarol/web_page.htm Lots of good info for newcomers to alt.support.depression.manic and soc.support.depression.manic!

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What is GHB?

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Because of people using GHB carelessly I don’t even get the chance to try to use this quite promising stuff responsibly. I have done enough research to learn that it is not possible to OD on GHB alone; if you take too much you sleep until it is done with you. Only fools who mixed GHB and alcohol despite the very prominent warnings on the internet not to ever died. BTW, GHB was sold over the counter in this country for many years without any problems. GHB’s mode of action is apparently quite similiar to Neurontin! — Keith Hardwick web page is up at http://home.att.net/~keithncarol/web_page.htm Lots of good info for newcomers to alt.support.depression.manic and soc.support.depression.manic!

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> >Codeine preparations seem to be sold OTC in all the world >but the US. Most new drugs in the US have already been used >in europe for years. Drugs are routinely yanked off the >market here for slight problems that could be avoided by >proper prescribing and dosing. And then there is the >demonization of any drug that has any "recreational appeal". >Look what happened to GHB, simply because some few people >abused it. > A lot of what goes on between the FDA and FBI seems very strange… > There is a lot of evidence to suggest that GHB is of great theraputic > benefit to people with narcolepsy (like myself), however, GHB is an > orphan medicine with no big pharmaceutical company doing funny > handshakes with the FDA to get it approval… From what I’ve read on the > NGs the FDA seems to be a rather corrupt organisation. After all,

[snip] GHB is a dangerous substance. I almost died from OD’ing on it, unintentionally, although earlier that evening I considered that the quantity I had on hand would be a convenient suicide method, probably painless too. The problem with it is the low margin between what gets you high, what makes you pass out, what puts you in a coma, what kills you. Many young people have died from this stuff (ie. River Pheonix) I know that what happened to me is my fault and others are also responsible for their actions, but if it does have a medical use it should be controlled by prescription. I got mine by mailing away for a kit to make it by adding KOH to an acid that was almost GHB, so they could get away with selling it. Aurora

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America in gereral has a problem of having a near schiz. type of society: puritanical on the outside and hendoistic on the inside….makes for strange behavior in all sorts of sectors on American culture. Personally, I’ve always learned from other cultures and societies and after living in Germany for 3 years….have become very European in thinking. Puritanical thinking is all well and good for those who can live up to it’s mores and demands…but I for one have never been able to. As for medications, you’re right…..America is the slowest to approve and/or allow drugs to be used, even if studies in other countries have been done and the benifits seen. The FDA needs to get off it’s duff and stop the big pharmacutical companies from bulling the little guys and also greasing palms and such. The FDA also needs to start looking a benifits and stop pulling drugs off the market because of abuse. The FDA needs to fine the pharacutical companies for lack of educating doctors on these drugs (instead of just giving them a ton of samples and telling the docs that its the newest wonder drug) and also fining the doctors for not following the guidlines of prescribing the meds. And lastly….as for geriatric care….America is probably worse in that area too…as I know a good portion of countries have families take care of the elderly. And only those with no family are placed into a nursing home to be cared for. Sorry….I don’t care if my parents are both incontenent of bowel and bladder, agressive to the point that things have to be locked up, etc…ect….they will stay at home and they will not go into a nursing home. — Jacque Miller ICQ # 10876877 AIM; PowWow; and Ichat – Jymata noli illigitimi carborundum "don’t let the bastards grind you down" – Hide quoted text — Show quoted text – >I read Keith’s posting with some interest. Firstly, I’d point out that >I’ve always felt that the psychiatric care I’ve received excellent. UK >doctors use lithium because there are more long term to prove its >effectiveness. In short it is a very ‘known about’ drug. And I would say >that using cognitive therapy to manage bp is a rather forward way of >thinking… >Doctors in the UK are not under pressure to prescibe the cheapest drugs >- I have narcolepsy as well, and my general practitioner has no problems >prescribing modafnil (Provigil) which can be as expensive as Viagra, >depending on dose, and SSRI’s are very popular over here and they aren’t >exactly cheap. >The NHS does have a problem with geriatric care however… (Our whole >country has a problem with this) >best wishes, >Hugh >Hugh Davies-Webb

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I read Keith’s posting with some interest. Firstly, I’d point out that I’ve always felt that the psychiatric care I’ve received excellent. UK doctors use lithium because there are more long term to prove its effectiveness. In short it is a very ‘known about’ drug. And I would say that using cognitive therapy to manage bp is a rather forward way of thinking… Doctors in the UK are not under pressure to prescibe the cheapest drugs – I have narcolepsy as well, and my general practitioner has no problems prescribing modafnil (Provigil) which can be as expensive as Viagra, depending on dose, and SSRI’s are very popular over here and they aren’t exactly cheap. The NHS does have a problem with geriatric care however… (Our whole country has a problem with this) best wishes, Hugh Hugh Davies-Webb

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– Hide quoted text — Show quoted text ->Can it really be true that other countries are more >stringent about approving meds than the US? How can that be? >Codeine preparations seem to be sold OTC in all the world >but the US. Most new drugs in the US have already been used >in europe for years. Drugs are routinely yanked off the >market here for slight problems that could be avoided by >proper prescribing and dosing. And then there is the >demonization of any drug that has any "recreational appeal". >Look what happened to GHB, simply because some few people >abused it. >And then there is the economic blackmail campaign that the >US has waged upon the rest of the world to force compliance >with puritanical drug prohibitions dreamed up in america. >Comments, anyone? >Keith

A lot of what goes on between the FDA and FBI seems very strange… There is a lot of evidence to suggest that GHB is of great theraputic benefit to people with narcolepsy (like myself), however, GHB is an orphan medicine with no big pharmaceutical company doing funny handshakes with the FDA to get it approval… From what I’ve read on the NGs the FDA seems to be a rather corrupt organisation. After all, puritanism is what America was founded on and must linger in the national psyche… Prohibition, McCarthyism etc… Hugh Hugh Davies-Webb

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Gary- Please email me your phone number. KI – Hide quoted text — Show quoted text -> We have a > psychologist visit at least once each week always someone on call if > an emergency arises. > Tony, I’d give my left testicle to have a psycholgist visit me in my home > once a week. That, above anything else, in my opinion would, would cut my > "down" time at least in half, make the day to day drudgery of being on > medical leave while trying desperately to find meds that work (seeing my > PDoc only once a month, maybe twice if I push to get any cancellations), > improve my rather reclusive social situation and hasten my return to the > working world. > I asked my PDoc about seeing a Therp, but he seemed to feel I needed > "specific goals" before he would make the recommendation. But actually > having someone see me in my home…someone who cared, who is qualified and > experienced in BP, someone I could look forward each week to seeing so I’d > clean up a bit, put on some coffee, God, someone I could really talk to > while I’m actually living this hell rather than ‘preparing’ for the > artificial environment of an office where I’d feel compelled to give the > "correct" answers… > Oh well. I sure do envy you and Nolene in this matter. > Sorry for rambling, but your post really touched a tender nerve in me. I > guess I should push for a Therp when I see the PDoc on Wednesday. > Thanks For Listening, > GaryO

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Lots of snips Although this is not regarding Lithium as such I think it is still on thread. Keith feel free to correct me if not. This time around when Nolene developed major symptoms of mental unwellness we went along the usual diagnosis merry-go-round and it stopped after several hospital visits for various reasons with our local Psychiatric Services Team. First admittance to the local (60 mile away) Psych ward ended with the doctor saying "you shouldn’t be here." He’d made his mind up that nothing was really wrong, probably a personality disorder but that could be treated at home with support from me. I’ve since heard several people refer to this person as an arrogant prick who doesn’t want to listen, only to tell you what is wrong with you. Our experience didn’t differ from this view point. Fortunately the doctor assigned to the team was not the same person. He got us both in and asked us to fill him in with what was going on. He listened. He asked if this or that occurred. He told us what he thought. He asked how we thought it should be treated. He seemed to care. This gave us a great deal of confidence in him and allowed Nolene to have a degree of control over her treatment. Diagnosis was Borderline Personality Disorder. Unfortunately this doctor changed jobs within the organisation so we then came to our present doctor. He also sat us down after going through all the notes and said tell me about your depressions. He listened to Nolene and he also listened to me. Not a common thing for Doctors to ask or listen to me. He then said tell me about these periods of activity. Something we had always just accepted as a better then depressed time. At least Nolene could do something She had he energy and the stamina. Sure she didn’t sleep and couldn’t sit still but we didn’t see that as a problem. The ideas were great. Not always practical but always ambitious and the furniture. Always the furniture. Move it here. No, that’s not right move it back. Let’s try this. The only place the couch didn’t go was on the roof. But still this wasn’t a problem. Nolene didn’t want to hurt herself like when she was depressed. The doctor then said I think it is Bi-polar disorder and went on to explain 15 major depressions and 10 manic episodes in 5 years wasn’t what normal people went through. We knew that. It was just good to hear someone with qualifications say it too. He then suggested Epilim (Sodium Valporate) as a mood stabiliser. Something Nolene had never had before. She had been on lithicarb in the past and had been on Aropax (paroxine – Paxil) Prozac, and most of the other common anti-depressants without any on going benefits. He went on to explain Lithium as a mood stabiliser was an Australian discovery and tradition was that it was used but he had no problems with Epilim or Tergatol either. He explained the side-effects etc but felt Epilim was best in Nolene’s case due to the problems she might have with her liver due to a previous addiction to paracetamol and codeine. (purchasable across the counter. Nasty stuff and she still fights the urge now. Was up to 50 tablets of 10mg codeine 500mg Para per day. The sister in the Emergency department wouldn’t believe her that she was taking them because it was a fatal dose. But that’s a whole other story for another time.) Total cost for this treatment. Zero except for the medication. We have no private insurance either medical or hospital. We have a psychologist visit at least once each week always someone on call if an emergency arises. Still no cost. Sure we pay for it in taxes but we don’t have the situation where we can’t see anyone due to the cost. My guess is that we in Australia drag a little behind the states in cutting edge technology but the totally different health care system seems from where I’m sitting to be worth the sacrifice. We also have a far more stringent acceptance standard for drugs then America. Whether for good or bad I’m not sure. (Although they seem to have fast tracked viagra here. Perhaps the politicians wanted it?) Our social welfare system is also vastly different. I’m horrified to read what you poor people in USA are made to go through if you cannot work. I work in the agency here that pays disability, unemployment, age pension and family payments and cannot imagine the stress your system puts on the sick (ill) people of america. I feel that I’ve rambled on her quite enough for the moment but will post further details of the welfare system later on a new posting. ynoT still here and reading everything I post carefully.

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A few comments: It appears that lithium can be stopped and restarted without running any risk of losing its effectiveness…provided that it is restarted prior to the next affective episode. It is now recognized that lithium is less useful in people who have had the most manias or depressions than in people who have had few. I doubt that the average manic-depressive in Britain is substantially different than in America, and I know very few people with bipolar who could safely predict their cycles well enough to go on and off their meds safely. I wouldn’t risk my life that way! Verapamil is the only drug with any antimanic/mood stabilizing properties that has a side effect profile suitable for pregnant women. It is to our discredit that we do not have a national health care plan, however I suggest that in Britain doctors are under tremendous pressure to use only the very cheapest drug for bipolar, which happens to be lithium. It is very easy to justify such a policy since there is such a wealth of info on lithium and not on any other antimanic. What is conveniently ignored is the overwhelming evidence that only about 40% of bipolars receive adequate relief from symptoms while taking lithium, and 20% are not helped at all! Shall we fine tune the lithium levels of all these people? That is a delusion. Lithium comes in few different sizes and formulations. You have sub-therapeutic, therapeutic, and toxic blood levels; no room for fine tuning. Lithium was hardly developed for bipolar; neither were the anticonvulsants. Should we turn our back on them? Perhaps we should return to the days when manic-depressives were Dx’ed schizophrenic and confined for life? Maybe the UK does a better job with drug approvals than the US but I rather doubt it. It seems to me as if UK health care, at least in the area of mental health, is very backward. But don’t copy us; try to be more like Canada! Keith

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Dear James, Thanks for replying to my post. I was discussing this very subject with my psychiatrist last time I saw him. I’m a narcoleptic as well as a rapid-cycling bp, and some of the medications involved with the treatment of narcolepsy (which are also used in the treatment of depression) react rather badly with lithium, and I was inquiring about an alternative… One of the wonders of UK psychiatry is not having to pay for it. Also, psychiatrists are are far less likely to be sued in the UK than their colleagues in the States, so they do not shy away from lithium therapy. Love it or hate it, lithium is very effective in most cases (on this side of the Atlantic); however, it does require constant supervision in the form of blood tests, especially if your psychiatrist is tweaking levels. This is fine in the UK, where such care is free, but elsewhere its a pain in the arse, because it costs you (or the dreaded insurance company) lots of money. Things like carbamazepine have an advantage, as they do not require the supervision that lithium does. Over here, anti-psychotic drugs are used sometimes to bring a manic bp back down to earth again (with a bump!), but only in emergencies, as lithium can sometimes take a few days to work properly. You describe some of the drugs in your list as ’second generation mood stabilisers’. I would say this is slightly inaccurate or misleading. Most of these drugs were developed for something else, and okay, if they work, all well and good, but there isn’t a great deal of research or trials to back that up – if there were, psychiatrists would use them over here. After all, many of the drugs on your list are not expensive. Remember UK and EEC drugs trials are much stricter than the US, and certainly in the UK – are much less likely to be swayed by drug company hype and marketing. Lets have a look at the list: >1. Lithium carbonate — Lithobid, Eskalith CR >2. Carbamazepine — Tegretol, Epital

Antiepileptic – not a good idea to take with lithium (neurotoxicity) or other antiepileptic drugs (can become more toxic without any increase in effectiveness) or MAOI antidepressants >3. Divalproex sodium — Depakote, Depakene, Epival — valproate

Antiepileptic – Not a good idea to take with antidepressants or other antiepileptics. > Second Generation Mood Stabilizers >1. Gabapentin – Neurontin (may enhance cognitive abilities)

Antiepileptic – a newer medication- don’t know much about this one (I’ll find out though) >2. Lamotrigine — Lamictal (possibly more effective than Neurontin)

Not a good idea to take with other antepileptics >3. Topiramate – Topamax (may cause weight loss)

Don’t know anything about this… >4. Verapamil — Isoptin (caution indicated with heart problems)

Calcium channel blocker used in hypertension and angina (wasn’t Viagra originally developed for this purpose!?). Neurotoxicity with Lithium, potentially dangerous with antiepileptics. You should see the list of other drug interactions….! >5. Tiagabine — Gabatril

Know bugger all about this >Combining two (or more) mood stabilizers may be more effective than when >each is taken alone. One med may "potentiate" the effectiveness of >another — so that the whole effect becomes greater than the sum of its >individual contributors. Lithium carbonate may prove helpful as a >secondary adjunct to one of the newer mood stabilizers which have >demonstrated antidepressive properties. Consequently I suggest that >Neurontin-Lithium, Lamictal-Lithium, and Topamax-Lithium combinations be >considered. It is also possible that subtherapeutic dosages of lithium >carbonate may be taken so as to minimize its adverse side effects.

I’d check the interactions first! I have an old copy of the British National Formulary knocking about and that through up the above interactions. It is worth remembering that its not a terribly good idea to mix a lot of antiepileptics. Also, lithium interacts with many drugs. Apart from some of the above, lithium also interacts rather nastily with SSRI’s. Verapamil is a seriously nasty drug… Not all the drugs in America make it past our drugs trials (Viagra is having a real beasting at the moment). I guess that we all want to be taking medication that works, and as you say, we’re all different, but having read up on some of the above medications, I’ll stick with lithium. Incidently, I’ve been ’stopping and starting’ with lithium for 18 months – no problems yet. My psychiatrist is rather pleased with the results. But he does keep an eye on me…. Love and hugs, Hugh Hugh Davies-Webb

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<Posted and Mailed to Hugh> >It is possible to have holidays from lithium and get back on it when you >need to take it again.

How long have you been utilizing this "on-again off-again" approach? This is apparently a fairly new British approach to mood stabilization. In previous posts I have expressed strong reservations about this philosophy — particularly if a person has a cyclical mood disorder more severe than cyclothymia. Has your pdoc ever discussed the well-known phenomenon of developing "tolerance" to psychoaffective meds? When you need to go back on a mood stabilizer, you may well find that it not nearly as effective as previously. Consequently you may need to take ever-increasing dosages in order to achieve the same effect. I suspect that the effectiveness of any mood stabilizer would eventually wear off using such an approach. >I have been treated with cognitive therapy with respect to knowing when >to get back on the lithium. This is a rather new-fangled technique, and >I find it very effective, and means that I can spend a lot of time off >lithium.

Hugh, I certainly hope that this procedure continues to works for you! To me — it sounds like a recipe for disaster just waiting to happen! >My psychiatrist allows me to be ’self-prescribing’, although he >keeps a close eye on me.

I have no problem with an informed patient increasing or decreasing their psychoaffective meds — as long as they know what they are doing. Stopping them totally periodically is not a viable option as far as I am personally concerned. Perhaps those who have also attempted this could give us the benefit of their experiences (both pro and con)? TIA! >With respect to coming off lithium permanently, I’m afraid that there >isn’t anything that is nearly as effective.

That entirely depends upon the person. In the US we are currently using 8 mood stabilizers that I am aware of. Lithium carbonate does work quite well for many of us with non-rapid cycling BP disorders. However for rapid, ultra-rapid, and refractory cases other mood stabilizers may well be required in order to achieve reasonable mood stability. The latest therapy in the US (and I believe in Canada as well) is to use a primary second generation mood stabilizer (such as Neurontin or Lamictal) together with a secondary first generation stabilizer (such as lithium carbonate). The latter may possibly be used in subtherapeutic dosages. For additional information — please see the following FAQ on this subject. >You might try lowering your >lithium level. Lithium has differing effects depending on where you are >in the therapeutic band. Some people, myself included, find that a >reasonably low level, say 0.4 – 0.5 mmol/ml works for them, and that you >get more effect and less side effects.

That is very true for some people. However others require much higher levels of lithium for adequate stabilization. >Some people in the UK take Tegretol (carbamazepine) if they have a real >problem with lithium. I believe it is not supposed to be anything like >as good as lithium, and there is not much in the way of tests to support >it’s effectiveness at treating BP, just drug company hype.

Hugh, I must strongly disagree! Therapy with the newer second generation mood stabilizers (or combinations) as well as other first generation mood stabilizers has saved many a life for those who prove resistant to lithium therapy. >Best wishes, >Hugh

FAQ: "Mood Stabilizers Being Used in the Treatment of BP Disorder" By James D. Milton Please see below for 8 psychoaffective meds that are currently being used as mood stabilizers in the United States. I currently post FAQs about some of the newer ones on a bimonthly basis. I have not attempted to list adverse side effects because they vary considerably from person to person. You will just have to keep on experimenting until you find the ones that are effective for each person with side effects that can be tolerated. You can find out a lot about the treatment of bipolar disorder by visiting this Web site: http://www.psycom.net/depression.central.drugs.html There also are many links to other informative sites. Knowledge, Patience, Persistence, and Consistency IMO are keys to success over our common illness. I wish you well! Best regards from, James Information Regarding BP Mood Stabilizers First Generation Mood Stabilizers 1. Lithium carbonate — Lithobid, Eskalith CR 2. Carbamazepine — Tegretol, Epital 3. Divalproex sodium — Depakote, Depakene, Epival — valproate Second Generation Mood Stabilizers 1. Gabapentin – Neurontin (may enhance cognitive abilities) 2. Lamotrigine — Lamictal (possibly more effective than Neurontin) 3. Topiramate – Topamax (may cause weight loss) 4. Verapamil — Isoptin (caution indicated with heart problems) 5. Tiagabine — Gabatril Combining two (or more) mood stabilizers may be more effective than when each is taken alone. One med may "potentiate" the effectiveness of another — so that the whole effect becomes greater than the sum of its individual contributors. Lithium carbonate may prove helpful as a secondary adjunct to one of the newer mood stabilizers which have demonstrated antidepressive properties. Consequently I suggest that Neurontin-Lithium, Lamictal-Lithium, and Topamax-Lithium combinations be considered. It is also possible that subtherapeutic dosages of lithium carbonate may be taken so as to minimize its adverse side effects. It is important to realize that each of us has very individualistic reactions to ALL psychoaffective meds. YBMV (Your Brain May Vary) — and likely will. What is a blessing for one person may prove to be a curse for another and ineffective for a third. We are moving targets that are VERY difficult to hit. With some people their brain neurochemistry appears to change from time to time — thus necessitating further changes in the dosage and composition of their psychoaffective medications. Also there are many antidepressant, antianxiety, antimania, antiseizure, and antipsychotic meds that may prove to be very useful adjuncts to mood stabilizers in the treatment of a BP condition. Where available I highly recommend the time-release formulation of any psychoaffective med. If such is currently unavailable or is too expensive, smaller dosages taken more frequently (4 times daily in equal amounts) may well enhance mood stabilization and potentially lessen any adverse side effects. Any and all med or dosage changes should be first thoroughly discussed with your psychiatrist or psychopharmacologist. Some people apparently seem to think I come across like a medical professional. I would once again like to emphatically state that I am NOT! I am just a person that has had a bipolar (manic-depressive) condition for many years. However I do attempt to keep up with meds and dosage regimens that might prove potentially beneficial in the treatment of BP. Also I have personally experienced the importance of taking lesser dosages more frequently. This IMO is unfortunately greatly under appreciated by many health care professionals! FYI my professional background includes degrees in Engineering Sciences, Nuclear Engineering, and Nuclear Science and Engineering.

Response:

It is possible to have holidays from lithium and get back on it when you need to take it again. I have been treated with cognitive therapy with respect to knowing when to get back on the lithium. This is a rather new-fangled technique, and I find it very effective, and means that I can spend a lot of time off lithium. My psychiatrist allows me to be ’self-prescribing’, although he keeps a close eye on me. With respect to coming off lithium permanently, I’m afraid that there isn’t anything that is nearly as effective. You might try lowering your lithium level. Lithium has differing effects depending on where you are in the theraputic band. Some people, myself included, find that a reasonably low level, say 0.4 – 0.5 mmol/ml works for them, and that you get more effect and less side effects. Some people in the UK take Tegretol (carbamazepine) if they have a real problem with lithium. I believe it is not supposed to be anything like as good as lithium, and there is not much in the way of tests to support its effectiveness at treating bp, just drug company hype. Best wishes, Hugh. Hugh Davies-Webb

Response:

I started drinking heavily 2 years ago….immediately stopped drinking when I was diagnosed with BP II and was placed on Lithium and Zoloft. However, I have become terribly apathetic and numb taking these meds and decided last week just to come off the Lithium for good. The 5 days to follow were BAD ones and included manic behavior and drinking again…..(way too much). However I did feel more energetic and focused when not drinking. I have heard about Wellbutrin and wonder if it would work better with Lithium….I need to feel something again…to care about something…to start a project and finish….Lately Im just slush taking up space…..Any suggestions?

Response:

important question … please respond

Question:

The 200 mg limit for Lamictal dosing is for epilepsy, not bipolar. I don’t really know what dosing should be used for bipolar–it varies widely. But at any rate, I believe that Lamictal has the most anti-depressant properties of any drug since imipramine, and I believe it will become the drug of choice in 10 years. I take around 1000 mg per day in divided doses every 6 hours. Don’t follow my example. I only have depression, not bipolar, but I find the Lamictal helps me to have clear thoughts and surprisingly, less obsessions. The incidence of rash was reported as 3%. These were non-serious rashes and they occurred mostly while people were taking Depakote. {The rash was not dependent on the amount of Lamictal taken.} I would be willing to take this risk 7 times a week and twice on Sundays. The incidence of serious rash was reported as 0.03%. There is more of a chance of getting hit by lightening. * Sent from AltaVista http://www.altavista.com Where you can also find related Web Pages, Images, Audios, Videos, News, and Shopping. Smart is Beautiful

Response:

>It’s me again. 2400mg Neurontin, 200mg Lamictal, 150mg Seroquel and 4mg >Klonopin daily, with incomplete remission of depressive symptoms. >The question is this: should I try to get my pdoc to increase my >Lamictal dosage or should I try to stay on the medication regimen that

I think you should push for more Lamictal. I’m not sure how you can sway the reluctant doctor. I usually take a dim view of people taking information they have found on these groups or on the web to their doctor; however I make an exception to that for people who have some knowledge of their medications, effects, side effects…and I consider you one of those people. If there is _any_ way you can see a more experienced doctor for a consultation, your present doctor will almost certainly go along with what he says. Are there any good medical schools anywhere near you? How are the chilis doing? I’m going to have a massive crop of Tabascos soon. I don’t actually eat them…just worry them about in my mouth and gradually release the juice…yum.

Response:

Your going to have to hire the best psychotherapist in town, yourself, All they do is help define the ego and show you how to work with it. Normal people use friends in place of psychotherapists. Once you get in touch with your true self life will be better. Your lack of funds will make this a do it yourself project. – Hide quoted text — Show quoted text – >x-no-archive: yes >It’s me again. 2400mg Neurontin, 200mg Lamictal, 150mg Seroquel and 4mg >Klonopin daily, with incomplete remission of depressive symptoms. >The question is this: should I try to get my pdoc to increase my >Lamictal dosage or should I try to stay on the medication regimen that >I’m on, with no changes whatsoever, and assume that the remaining >depressive symptoms are psychological artifacts that will eventually >resolve themselves or that I’m going to have to work on consciously? >My caseworker is a Psychiatric Social Worker, not a psychotherapist, but >she’s willing to help me work on the issues that are bothering me on an >unofficial basis. >I can’t see a psychotherapist. Psychotherapy is not an option for >outpatient mental health care consumers at the ‘public’ center that I go >to

Response:

– Hide quoted text — Show quoted text – >x-no-archive: yes >It’s me again. 2400mg Neurontin, 200mg Lamictal, 150mg Seroquel and 4mg >Klonopin daily, with incomplete remission of depressive symptoms. >The question is this: should I try to get my pdoc to increase my >Lamictal dosage or should I try to stay on the medication regimen that >I’m on, with no changes whatsoever, and assume that the remaining >depressive symptoms are psychological artifacts that will eventually >resolve themselves or that I’m going to have to work on consciously? >My caseworker is a Psychiatric Social Worker, not a psychotherapist, but >she’s willing to help me work on the issues that are bothering me on an >unofficial basis. >I can’t see a psychotherapist. Psychotherapy is not an option for >outpatient mental health care consumers at the ‘public’ center that I go >to

I’ve had cognitive therapy, which I feel is a very positive treatment for depression. It’s as successful as antidepressants with unipolar depressives in proper trials. But I only got that because I enrolled in a trial to test it – there’s a 2 year waiting list to get it in the UK. As I said in response to another post, my pdoc also thinks that 200mg Lamictal is the highest dose validated by current trials, but I know there are people out there (in the US, hardly anyone takes it in the UK) who take considerably higher doses. Anecdotal evidence might help your case. How long have you been on the Lamictal? Stuff I’ve read suggests that it takes quite a long time to reach its theraputic level, at least a month after the full dose is achieved. Do antidepressants make you manic? (They do me.) I’ve been on the 200mg Lamictal (and Tegretol and Haldol) for more than a month now. Preliminary evidence suggests that it doesn’t stop me from getting depressed, but it may be helping me recover more quickly. I go down, but then I bounce up again very fast. So I’m not as stable as I would like, but it does seem to be a bit better than it was when I was on Tegretol and Lithium. It’s all fiddling about, isn’t it. When it comes down to it hey just push buttons at random, and hope it will work. Good luck Jackie Web page at http://dspace.dial.pipex.com/town/close/xhq10/mem.htm I’ve been Jay H, Canarybird, Empty Cage, Serin, Phoenix, even Crow. Let’s see if I can stick with this one for a while.

Response:

If effexor xr is only doing 1/2 the job??

Question:

Is it comment to be on 2 AD’s at the same,me time….several people have recommended being on effexor xr and Wellbutrin at the same time?????? is this something I should check more into…..why easy…..tired…then wired….then happy…..crying….alone..and so on…

Response:

Still at this time in the 21st Century, little is actually known about how and why antidepressants work. There are some theories, but studies periodically come along that seem to put them in serious question. The reason there are so many different ADs and the reason some people need more than one is that EACH one, … even if they are "classed" the same.. eg. "SSRI" or tricyclic, or "norepinephrine reuptake inhibitor", and so forth.. all are slightly different in the AMOUNT of effect they have on various kinds of synapses. They keep finding more and more subclasses of different major types of neuroreceptors and find that some ADs affect different subclasses more or less than other ADs. Depression seems to be a very complex phenomenon and not the same set of "imbalances" between one person and the next seem to cause the subjective feeling of depression. Hence, some people need more than one AD to tweak their receptors just the right way to make them feel better without tweaking other receptors that make them experience other problems, such as sleeplessness, anorgasmia, etc, etc. Much is left to be learned, and IMHO the area is still very primative and full of hope and hype. Perhaps you have to think of it a little bit like aromas… fragrances.. odorants tweak different receptors.. there are many different kinds, combinations of them cause different more complex smells and different people react genetically differently to various ones and find that different combinations are what they "need" to make them feel good.

Response:

Anti-depressants for severe pain?

Question:

Does anyone have any experience using nefazadone or other anti-depressants for severe neck or back pain? I have been trying to get the pain specialist at the VA to prescribe something stronger, but he seems determined to try me on every anti-depressant going before he will treat my pain agressively. He also made it clear that i would have to see the anesthesiologist for possible epidural shots before he would prescribe serious pain medication. That will take more than two months from now! I have tried the various tri-cyclics before, and they were useless even when the pain was milder than it is now. I have spinal stenosis in the cervical spine and lower back, and I am in constant excruciating pain. I am starting to go off the deep end, and I would prefer something that acts faster for this type of pain. I am unable to communicate the seriousness or immediacy of the situation to this "specialist," and I have no idea if I will even get pain relief after I’ve gone though all the bullshit. So I’m playing an extremely demoralizing waiting game. If anyone has any personal experiences with these medications or overcoming doctor bullshit, please let me know. Sean C

Response:

Sean, I’ve been on Prozac for 10 years and it never *touched* my back pain (spondylolisthesis, etc.). I just went to my first real "pain doctor" a month ago. I had to fill out an 8 page form beforehand and bring it with me. On this form, I made it (nicely but firmly) clear that I did NOT want any invasive procedures done (epidural injections, etc.). He gave me enough Norco (no problem) to last me a month, which is when I return to him. Stand your ground. ***Get pain medication.*** Have you seen Skip Baker’s website yet? I’m not sure if this is his homepage, but it’ll sure give you a BIG start: http://www.asappain.com/2ThePatient.html Keep posting further questions here. These folks have been a *big* help to me. Best, Editor

– Hide quoted text — Show quoted text -> Does anyone have any experience using nefazadone or other > anti-depressants for severe neck or back pain? I have been trying to > get the pain specialist at the VA to prescribe something stronger, but > he seems determined to try me on every anti-depressant going before he > will treat my pain agressively. He also made it clear that i would have > to see the anesthesiologist for possible epidural shots before he would > prescribe serious pain medication. That will take more than two months > from now! I have tried the various tri-cyclics before, and they were > useless even when the pain was milder than it is now. I have spinal > stenosis in the cervical spine and lower back, and I am in constant > excruciating pain. I am starting to go off the deep end, and I would > prefer something that acts faster for this type of pain. > I am unable to communicate the seriousness or immediacy of the > situation to this "specialist," and I have no idea if I will even get > pain relief after I’ve gone though all the bullshit. So I’m playing an > extremely demoralizing waiting game. > If anyone has any personal experiences with these medications or > overcoming doctor bullshit, please let me know. > Sean C

Response:

I was already on Paxil ( had been put on about 6months b4 the wreck — in 1995) and in 2000, when I found a doc (b4 I realized he was tagged By the DEA) he put me on Effexor and Wellbutrin….the W for depression/pain and to help me quit smoking. Didn’t help the smoking, but it MIGHT have helped some in the depression dept. and the pain. The concept makes sense….Pain and the situation that put you there is DEPRESSING. If they can lift a patient out of the funk, then that person has a bit more strength ….An "up" patient may be able to ignore/deal w/ the pain, Am I upper? Well, I HAD considered blowing my brains out about 100 times a day……now maybe only 50 times a week. ;) Hope that helped…a little input….. Rae

Response:

> Does anyone have any experience using nefazadone or other > anti-depressants for severe neck or back pain?

They don’t know how or why, but some people respond to low doses of tricyclic antidepressants (and maybe some others now, they come out with a new one about every other week). I don’t think they do diddly-squat for severe pain. They sure didn’t for me. Jon Miller

Response:

Sean: >Does anyone have any experience using nefazadone or other >anti-depressants for severe neck or back pain?

I’ve never used nefazadone, but have used other kinds of anti-depressants for other kinds of chronic pain. Some doctors prescribe them because they think you’re just depressed and not really in pain…other doctors think chronic pain makes nerves hypersensitive to pain, which can be changed by adjusting neurotransmitters. And anti-depressants work by adjusting neurotransmitters. It sometimes seems to work this way, with some kinds of headaches or chronic pain involving nerve damage. There don’t seem to be very many people who find that anti-depressants alone relieve severe chronic pain. More often, the anti-depressants are helpful in combination with other kinds of medication (pain relievers, anti- inflammatories, some kinds of drugs which work directly on the nerves.) Some types and doses of anti-depressants help some patients sleep more soundly, and of course it’s easier to cope with chronic pain when you’re well rested. >I have been trying to >get the pain specialist at the VA to prescribe something stronger, but >he seems determined to try me on every anti-depressant going before he >will treat my pain agressively.

A pain specialist who will not treat you with ANYTHING but anti-depressants? Either he is completely incompetent, or he doesn’t believe anything is wrong with you except depression. Are you having problems with depression as well as chronic pain? Lots of people have both. >He also made it clear that i would have >to see the anesthesiologist for possible epidural shots before he would >prescribe serious pain medication.

It’s reasonable for you to talk to an anesthesiologist, but epidural shots might not be a good idea. They are less invasive than surgery, but they can be risky. It’s not right for a doctor to coerce you into taking that kind of risk. Some people on this newsgroup have had very bad experiences with epidural shots, and they explain what can go wrong. I understand that working through the VA limits your choice of doctors, but please try to find better pain treatment. Just because someone calls himself a pain specialist doesn’t always mean he knows what he is doing. I sympathize with your frustration. Adrian Turtle Opportunity knocks once. Temptation leans on the doorbell.

Response:

Hi Adrian, thanks for your response. > A pain specialist who will not treat you with ANYTHING > but anti-depressants? Either he is completely incompetent, > or he doesn’t believe anything is wrong with you except > depression. Are you having problems with depression as > well as chronic pain? Lots of people have both.

I believe he *might* treat me with something stonger–in fact, he had mentioned the possibility I might need methadone and then did an about-face the next visit. I believe there is an issue here of suspected drug abuse, since I made the mistake of asking for opiate pain medications directly from my VA primary care doc–who thinks tylenol is sufficient to treat my pain–and further compunded my error with the pain specialist by asking him what i should do if the anti-convulsant Topirimate he prescribed should fail to work–as if I planned for it to do so. I have only used opiods on a limited basis, a grand total of about 60 pills, with the strongest dose being 2 Percocet 5, which proved essentially useless. I’m hardly an addict. I was also referred to the staff psychiatrist, who insisted on discussing my childhood and other irrelevant nonsense and pointedly refused to discuss my pain or its impact on my life. Essentially, I got a knee-jerk diagnosis of depression from her, despite the fact that I *know* I am not clinically depressed. I know this because on the rare occasions my pain drops down to a 4 or 5, I feel perfectly fine mentally. – Hide quoted text — Show quoted text ->He also made it clear that i would have >to see the anesthesiologist for possible epidural shots before he would >prescribe serious pain medication. > It’s reasonable for you to talk to an anesthesiologist, > but epidural shots might not be a good idea. They are > less invasive than surgery, but they can be risky. It’s > not right for a doctor to coerce you into taking that > kind of risk. Some people on this newsgroup have had > very bad experiences with epidural shots, and they > explain what can go wrong. > I understand that working through the VA limits your choice > of doctors, but please try to find better pain treatment. > Just because someone calls himself a pain specialist doesn’t > always mean he knows what he is doing. I sympathize with > your frustration.

Thanks again. Sean C

Response:

Sorry about pain, but for a small number of people anti-depress do seem to work. If you are not satisfied with the quality of care you are receiving, make a trip to the patient advocate. Explain what you are feeling and the treatment is not working. The VA I go to has a marvelous pain clinic. george

Response:

I disagree. It makes more sense to treat the pain which is causing the depression first. It makes little sense to treat depression caused by pain when the pain itself is not being adequatly treated. People should not have to put up with or deal with pain when that pain could be treated with opioid pain medications. Doctors who use anti-depressants rather than opiate or opioid pain medications to treat pain are often "opiophobic". While some anti-depressants actualy may have some use in treating some types of nerve pain, physicians often prescribe or suggest this medication in order to avoid treating pain with narcotic pain medications. >Pain

and the situation that put you there is DEPRESSING. If they can lift a patient out of the funk, then that person has a bit more strength ….An "up" patient may be able to ignore/deal w/ the pain, <

Response:

More Depressed than Manic

Question:

Hi Everyone: Any thoughts on this will be helpful: Over the past 5 years, I have been more on the depressed side than manic. I get into these "physical" depressions where I can hardly move. I am not mentally depressed, I read, sit at the computer, watch tv, etc, I just have to desire to do a damn thing. My Dr. and I have been through a hell of a lot of meds trying to treat this, and right now we are trying Topomax, Synthyroid, and Dexedrine. He stopped the Zoloft. My question is I wonder if the older you get with this Disorder, the less manic you get and the more episodes of depression you have? There are days where I would just love to have one good manic moment again! I am 49 btw. Anyone else going through this? GM

Response:

Gayle- I think that some people just suffer from the depression more than the mania. I think that I’m in that category. You sound dysthymic to me; because you can still read, etc. and sound more apathetic than severely depressed. What are the Topomax and the Dexedrine for? Forgive my ignorance… And why are you now off of the Zoloft? -bpk

– Hide quoted text — Show quoted text -> Hi Everyone: > Any thoughts on this will be helpful: > Over the past 5 years, I have been more on the depressed side than manic. I > get into these "physical" depressions where I can hardly move. I am not > mentally depressed, I read, sit at the computer, watch tv, etc, I just have > to desire to do a damn thing. My Dr. and I have been through a hell of a lot > of meds trying to treat this, and right now we are trying Topomax, > Synthyroid, and Dexedrine. He stopped the Zoloft. > My question is I wonder if the older you get with this Disorder, the less > manic you get and the more episodes of depression you have? There are days > where I would just love to have one good manic moment again! I am 49 btw. > Anyone else going through this? > GM

Response:

I know exactly what you mean. When I am "depressed" I am not sad or melancholy, but I feel like when I am making bread and "punch" down the dough. Deflated. Even my heartbeat is depressed, my breathing is depressed, my thoughts are depressed. I am 54 next month. I am on lithium, neurontin and imipramine (low doses of all). The neurontin seems to be the best antidepressant I have ever had and believe me, I’ve tried them all. One thing I do NOT want, though, is a manic episode. I am a rapid cycler so my "moods" don’t usually last longer than a day or so. Good luck. Val in Boise

Response:

My father has is BP – I think that there are many variations in the severity and frequency of symptoms depending on the person. Some of his worst (from his family’s point of view) manic episodes were in his 40s and early 50s. That is why no particular med can help everyone. All of our individual Dr’s have to see us on a regular basis and see what they think will suit us best as individuals. Hope this helps…? Louise

Response:

Ok you guys…. once again I get up on my soap box. DO NOT EVER EVER EVER (did I say EVER?) let your pdoc fuck with your thyroid. PERIOD. They simply are not qualified. By all means, let them do the blood work and keep an eye on its functioning, but NEVER EVER EVER let them change it! Changes in your thyroid effect more than just mood disorders. Read up on what the thyroid gland does and THEN AND ONLY THEN, with the knowledge you glean, allow ANYONE to fuck with it. James and I went around and around on this one. And guess what… HE WAS/IS WRONG! Linda – Hide quoted text — Show quoted text – >Hi Everyone: >Any thoughts on this will be helpful: >Over the past 5 years, I have been more on the depressed side than manic. I >get into these "physical" depressions where I can hardly move. I am not >mentally depressed, I read, sit at the computer, watch tv, etc, I just have >to desire to do a damn thing. My Dr. and I have been through a hell of a lot >of meds trying to treat this, and right now we are trying Topomax, >Synthyroid, and Dexedrine. He stopped the Zoloft. >My question is I wonder if the older you get with this Disorder, the less >manic you get and the more episodes of depression you have? There are days >where I would just love to have one good manic moment again! I am 49 btw. >Anyone else going through this? >GM

Response:

I wonder that too, seems to be the case for me also. – Hide quoted text — Show quoted text – > My question is I wonder if the older you get with this Disorder, the less > manic you get and the more episodes of depression you have? There are days > where I would just love to have one good manic moment again! I am 49 btw. > Anyone else going through this? > GM

Response:

How long have you been on the Synthroid? Does it seem to be doing anything for you, and what dose are you on? As for Linda Channell’s comment, here is my story: My dad, a doctor of internal medicine, advised me against taking thyroid hormone. He said that the dose my doctor prescribed was the equivalent to half the average man’s full replacement of thyroid. And that it would give me jitters. I didn’t listen. And here’s why. I am fighting an enemy with my back to a river. I have tried numerous medications and the only other options are MAOIs and ECTs. So I am putting my faith in thyroid. I haven’t experienced any side-effects. Eric and I are going through the same treatment. * Sent from AltaVista http://www.altavista.com Where you can also find related Web Pages, Images, Audios, Videos, News, and Shopping. Smart is Beautiful

Response:

Here’s another comment. If you’re stupid enough to blindly let a pdoc fuck with your thyroid hormone WITHOUT researching it, you’re stupid. Plain and simple. Pretty much goes for any treatment, but common sense tells you that a pdoc doesn’t specialize in endrocine problems. Linda – Hide quoted text — Show quoted text – >How long have you been on the Synthroid? Does it seem to be >doing anything for you, and what dose are you on? >As for Linda Channell’s comment, here is my story: My dad, >a doctor of internal medicine, advised me against taking >thyroid hormone. He said that the dose my doctor prescribed >was the equivalent to half the average man’s full >replacement of thyroid. And that it would give me jitters. >I didn’t listen. >And here’s why. I am fighting an enemy with my back to a >river. I have tried numerous medications and the only other >options are MAOIs and ECTs. So I am putting my faith in >thyroid. I haven’t experienced any side-effects. >Eric and I are going through the same treatment. >* Sent from AltaVista http://www.altavista.com Where you can also find related Web Pages, Images, Audios, Videos, News, and Shopping. Smart is Beautiful

Response:

yep, i’ve experienced the same thing. in my late teens and early 20s, i was almost always manic. (there were several depression pop-ups.) when i was 25, i started into a black, suicidal, dabilitating depression. it has taken me 2 years and 12 or so failed medications to get most of ‘me’ back. mcmoebius – Hide quoted text — Show quoted text -> My question is I wonder if the older you get with this Disorder, the less > manic you get and the more episodes of depression you have? There are days > where I would just love to have one good manic moment again! I am 49 btw. > Anyone else going through this? > GM

Response:

Would you suggest only an endocrinologist prescribe thyroid meds then? What about a family doctor? — Deep

– Hide quoted text — Show quoted text -> Ok you guys…. once again I get up on my soap box. DO NOT EVER EVER > EVER (did I say EVER?) let your pdoc fuck with your thyroid. PERIOD. > They simply are not qualified. By all means, let them do the blood > work and keep an eye on its functioning, but NEVER EVER EVER let them > change it! > Changes in your thyroid effect more than just mood disorders. Read up > on what the thyroid gland does and THEN AND ONLY THEN, with the > knowledge you glean, allow ANYONE to fuck with it. > James and I went around and around on this one. And guess what… HE > WAS/IS WRONG! > Linda >Hi Everyone: >Any thoughts on this will be helpful: >Over the past 5 years, I have been more on the depressed side than manic. I >get into these "physical" depressions where I can hardly move. I am not >mentally depressed, I read, sit at the computer, watch tv, etc, I just have >to desire to do a damn thing. My Dr. and I have been through a hell of a lot >of meds trying to treat this, and right now we are trying Topomax, >Synthyroid, and Dexedrine. He stopped the Zoloft. >My question is I wonder if the older you get with this Disorder, the less >manic you get and the more episodes of depression you have? There are days >where I would just love to have one good manic moment again! I am 49 btw. >Anyone else going through this? >GM

Response:

Family doctors are ok to prescribe thyroid medications and keep an eye on your thyroid, but tell me… when was the last time your pdoc measured, PHYSICALLY MEASURED your thyroid gland. When did he make you swallow water and feel for lumps as it went down. Come on. You wouldn’t go to a podiatrist to deliver a baby. Or would you? A family doctor is perfectly suited to keep an eye on your thyroid, although I didn’t change from my endochronologist until I was 35. Linda – Hide quoted text — Show quoted text – >Would you suggest only an endocrinologist prescribe thyroid meds then? What >about a family doctor?

Response:

Paxil and cancer

Question:

What’s this latest scare about? Too small a study to worry about? Anybody rethinking their med?

Response:

>What’s this latest scare about? Too small a study to worry about? >Anybody rethinking their med?

Nick, This isn’t meant to imply that some study (I’m not aware of a study, I’m just giving you a "what if" answer) showing a link to cancer from taking Paxil is baloney, but it does help to keep things in perspective too. In the U.S. and probably most other countries, testing is exhaustive before a drug gets a green light to be marketed. However, you can still have freak instances where someone might have a predisposition to getting cancer when a certain food certain food or drug is repeatedly ingested and sets the wheels in motion. Unless the link is pretty transparent though, such as with cigarettes, I remind myself of what hot dog producers said after a definite link was proven for nitrites causing cancer in test mice. (Hot dogs and other cured meats use nitrites in the manufacturing process as a preservative so it’s a pretty essential ingredient.) A paraphrase of what was said is that the quantity of nitrites administered to the mice was equivalent to a human eating 10,000 hot dogs a day. What people in the U.S. sometimes forget is that the Delaney Act requires carcinogenic testing with no limit as to the amount of chemical(s) administered in test animals. Therefore by administering massive doses of nitrites to the mice, the link between nitrites and cancer and therefore hotdogs was found to have validity. Doug

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Anyone heard of doctor anne blake tracey? not sure if i’m spelling that right but her opinion is she’s totally against SSRI type drugs she was on the artbell show(YES the nutso show) and I also heard on another radio program.

– Hide quoted text — Show quoted text -> What’s this latest scare about? Too small a study to worry about? > Anybody rethinking their med?

Response:

I heard her on the Art Bell Show (by the way it is not a nutso show) she did not convince me, she seemed as though she really did not know what she was talking about, she hemmed and hawed through every question asked of her and basically was just on there to promote her book. She did ramble off a few interesting facts now and again but the overall feeling I got from her is that she did not possess the knowledge to support her claims. Please let me know your thoughts on her presentation on the Art Bell Show.

– Hide quoted text — Show quoted text -> Anyone heard of doctor anne blake tracey? not sure if i’m spelling that > right but her opinion is she’s totally against SSRI type drugs she was on > the artbell show(YES the nutso show) and I also heard on another radio > program. > What’s this latest scare about? Too small a study to worry about? > Anybody rethinking their med?

Response:

>I heard her on the Art Bell Show (by the way it is not a nutso show) she did >not convince me, she seemed as though she really did not know what she was >talking about, she hemmed and hawed through every question asked of her and >basically was just on there to promote her book. She did ramble off a few >interesting facts now and again but the overall feeling I got from her is >that she did not possess the knowledge to support her claims. Please let me >know your thoughts on her presentation on the Art Bell Show.

Despite the title, she isn’t a medical doctor, but has a PhD is something. Not sure what, but suspect origami. Whatever its for, it apparently allows her to practice as a psychologist though, AFAIK, she doesn’t have a psychology degree. Her basic premise is that SSRIs cause over secretion of serotonin in much the same way as methamphetamines. She is wrong, as any psycho pharmacologist will tell her. Indeed, many people have, but she continues to parrot the same wild claims. Draw your own conclusions! Bottom line – she just another doom sayer who doesn’t let the facts get in the way of selling books. Just don’t ask them for solutions to your problem. They, IME, rarely have any answers. Just gloom and doom. I’ve appended just a few of the studies showing that SSRIs (and other antidepressants) don’t increase serotonin (5-HT) expression, but actually reduce its synthesis/expression. Ian Stenfors C, Yu H, Ross SB. (2001) "Pharmacological characterisation of the decrease in 5-HT synthesis in the mouse brain evoked by the selective serotonin re-uptake inhibitor citalopram." Naunyn Schmiedebergs Arch Pharmacol, vol 363(2):p 222-32 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Cremers TI, Spoelstra EN, de Boer P, et al. (2000) "Desensitisation of 5-HT autoreceptors upon pharmacokinetically monitored chronic treatment with citalopram." Eur J Pharmacol, vol 397(2-3):p 351-7 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Alvarez JC, Sanceaume M, Advenier C, et al. (1999) "Differential changes in brain and platelet 5-HT concentrations after steady-state achievement and repeated administration of antidepressant drugs in mice." Eur Neuropsychopharmacol, vol 10(1):p 31-6 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Gur E, Dremencov E, Lerer B, Newman ME. (1999) "Venlafaxine: acute and chronic effects on 5-hydroxytryptamine levels in rat brain in vivo." Eur J Pharmacol, vol 372(1):p 17-24 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Zangen A, Overstreet DH, Yadid G. (1997) "High serotonin and 5-hydroxyindoleacetic acid levels in limbic brain regions in a rat model of depression: normalization by chronic antidepressant treatment." J Neurochem, vol 69(6):p 2477-83 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Fekkes D, Timmerman L, Pepplinkhuizen L. (1997) "Effects of clomipramine on plasma amino acids and serotonergic parameters in panic disorder and depression." Eur Neuropsychopharmacol, vol 7(3):p 235-9 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Trouvin JH, Gardier AM, Chanut E, et al. (1993) "Time course of brain serotonin metabolism after cessation of long-term fluoxetine treatment in the rat." Life Sci, vol 52(18):p PL187-92 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… Leonard BE. (1988) "Pharmacological effects of serotonin reuptake inhibitors." J Clin Psychiatry, vol 49 Suppl:p 12-7 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… – Hide quoted text — Show quoted text -> Anyone heard of doctor anne blake tracey? not sure if i’m spelling that > right but her opinion is she’s totally against SSRI type drugs she was on > the artbell show(YES the nutso show) and I also heard on another radio > program.

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Might as well stop eating bread, french fries, and potato chips too!

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> Might as well stop eating bread, french fries, and potato chips too!

lol

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Just started Neurontin….advice???

Question:

Damn James! LOL I just read your message after I posted mine. You reiterated everything that I said and I hadn’t read your message yet! I think we have a meeting of the minds here . You’re absolutely right. Although I realize that the problems in the medical community aren’t just in my city, this doc is just the absolute mirror of the problem here. Another thing is that this doc is at the clinic that I reported to the main office in Washington DC for not answering their phones after 20 rings the day I was suicidal. I was actually letting DC know about a social worker that was VERY helpful and I wanted to ensure she was recognized. Unfortunately, and maybe I’m dreaming this up, but unfortunately that social worker hasn’t been at work since I reported to DC how good she was and no one knows when she’s coming back. Seems fishy to me… And at the same time the doctor is telling me I’m not depressed…well then why the hell am I on 300 mg a day of Wellbutrin? Duh! Anyway, I will contact you James separately. Maybe there is something we can do together on this situation.

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>Hi James, > Well, I didn’t get Zyprexa…but my family doc (who seems to know MUCH more > than my pdoc!!!) started me on Neurontin with my Effexor XR and clonazepam. > Now, I know all of the stuff about the drug in the medical literature and > stuff. BUT, I am curious, what is the starting dose for us BP’ers?

This varies james but I believe in the " start low, and go slow" and taking Neurontin every 6 hours as it’s half life is only 5-7 hours. >I know > that TOO high of a dose can actually send us spinning, and aggitate us. But, > he has me on 100mg tid to start. From looking at the doses in the med books, > this seems like a fine, and low, starting dose. If anybody else WHO IS on > the med could please pass their experiences on, it would be greatly > appreciated. Thanks!!!

I took Neurontin for over 1 year….and the frquency was every six hours. The highest dose I was on was 2100 mg….for me it also had the added benefit of alleviating the neuropathic pain from my Multiple Sclerosis. I hope the med works well for you. Peace, — Lynda

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031.remarq.com>, > Amen, James! That’s my pet-peeve, too. I

personally believe that – Hide quoted text — Show quoted text -> *anyone* prescribed AD’s, no matter what their history, should > be seen on a weekly basis for the first month – just in case > something goes wrong. > I count my blessings that I lucked out with my first entre into > the mental health system and got a first-rate pdoc. He prudently > put me on a mood stabilizer right away (along with Prozac and > other goodies), suspecting bipolar despite my lack of history > for any sort of depression or other mental problems. And he > turned out to be right on the mark, which

became very clear down > the road. Had I received a less-than-adequate pdoc, I may yet be > struggling with getting this illness under control, and surely > the condition would have deteriorated. > I do have another pet peeve, and that is pdoc’s who prescribe > anything other than lithium *OR* depakote on the first round. (I > don’t know your particular situation, James.) These first-line > meds help something like 70% of all bipolar

patients – therefore > it is prudent and wise to start with them *first* – not the > newer meds like Lamictal and Neurontin. Not that there’s > anything necessarily wrong with either of those – but they > really should be tried only when the others fail or cause > unreasonable side effects. Just my opinion. > jen > * Sent from RemarQ http://www.remarq.com The

Internet’s Discussion Network * > The fastest and easiest way to search and

participate in Usenet – Free! > RE:Neurontin vs. Depakote

This is myfirst time so please bear with me. I took Depakote for 2 1/2yrs, it saved my life,but it quit working. Now I take 3600mgs of Neurontin,its a little trickier, have to remember to dose on the same schedule every day or i feel dizzy and tired. have to take Zyprexa to sleep and the serazone for the lows. I sure would try the Depakote first, its a lot easier. I also had an immediate benefit from the Depakote, this is a little slower going. have been taking for 2 mos. woul appreciate hearing from anybody who’s been on it a little longer. clay Before you buy.

Response:

Amen, James! That’s my pet-peeve, too. I personally believe that *anyone* prescribed AD’s, no matter what their history, should be seen on a weekly basis for the first month – just in case something goes wrong. I count my blessings that I lucked out with my first entre into the mental health system and got a first-rate pdoc. He prudently put me on a mood stabilizer right away (along with Prozac and other goodies), suspecting bipolar despite my lack of history for any sort of depression or other mental problems. And he turned out to be right on the mark, which became very clear down the road. Had I received a less-than-adequate pdoc, I may yet be struggling with getting this illness under control, and surely the condition would have deteriorated. I do have another pet peeve, and that is pdoc’s who prescribe anything other than lithium *OR* depakote on the first round. (I don’t know your particular situation, James.) These first-line meds help something like 70% of all bipolar patients – therefore it is prudent and wise to start with them *first* – not the newer meds like Lamictal and Neurontin. Not that there’s anything necessarily wrong with either of those – but they really should be tried only when the others fail or cause unreasonable side effects. Just my opinion. jen * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

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– Hide quoted text — Show quoted text -> Hey folks: > Well, I didn’t get Zyprexa…but my family doc (who seems to know MUCH more > than my pdoc!!!) started me on Neurontin with my Effexor XR and clonazepam. > Now, I know all of the stuff about the drug in the medical literature and > stuff. BUT, I am curious, what is the starting dose for us BP’ers? I know > that TOO high of a dose can actually send us spinning, and aggitate us. But, > he has me on 100mg tid to start. From looking at the doses in the med books, > this seems like a fine, and low, starting dose. If anybody else WHO IS on > the med could please pass their experiences on, it would be greatly > appreciated. Thanks!!! > James MacLachlan:-)

Hey, you’re gettin’ some! Jim O – Hide quoted text — Show quoted text –

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>weeks–sort of normal; next two weeks–really sleepy in the afternoons. i >think i started on 900 mg and am now at 1500 daily. best of luck, julie

I got started on 3 x 300 a day and with the coming off depakote (2000 mg a caused by the depakote are almost gone

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>weeks–sort of normal; next two weeks–really sleepy in the afternoons. i >think i started on 900 mg and am now at 1500 daily. best of luck, julie > I got started on 3 x 300 a day and with the coming off depakote (2000 mg a > caused by the depakote are almost gone

I found Depakote to probably be the most "stimulating", yet "dysphoric producing", out of all of the mood stabalizers. I might suggest holding your dose of Neurontin where it is at for atleast another week or so. IMHO..anyhow… Best.. James:-) — "Dying is only one thing to be sad over. Living unhappily is something else." Morrie Schwartz "Some day we will wave hello…and wish we’d never waved goodbye…"

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I experienced virtually no side effects, except for some weight gain, at the 2400 mg level. It did, however, agitate me. Right now my heart feels as though it will burst from my chest; I cannot sleep and I want to stop my medication in order to drink excessively and go manic. Gabriel * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

Hey folks: Well, I didn’t get Zyprexa…but my family doc (who seems to know MUCH more than my pdoc!!!) started me on Neurontin with my Effexor XR and clonazepam. Now, I know all of the stuff about the drug in the medical literature and stuff. BUT, I am curious, what is the starting dose for us BP’ers? I know that TOO high of a dose can actually send us spinning, and aggitate us. But, he has me on 100mg tid to start. From looking at the doses in the med books, this seems like a fine, and low, starting dose. If anybody else WHO IS on the med could please pass their experiences on, it would be greatly appreciated. Thanks!!! James MacLachlan:-)

Response:

I started at 400TID and went to 400QID because I felt I was not getting "coverage" through the day. The short effective life of the drug (5-6 hours) had particular impact on me–but not others (YBMV, once again!). When I miss or am late for a dose, I get buzzy–when I tried an increase (to help alleviate some anxiety), it increased my slight depression. Ironically, though–right before that–when I reduced my dose to 400TID once again–I felt a dip. This makes me think that I am just at the right dose for me <G>. -Thumper

Treat You Depression

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