DrugBuyers.Com: Hydro for stress relief?????

Toe,

I would love to have validated you by continuing to use your "a bunch of goobers talking about psychmeds" title, however, in every one of your posts, you have referred to me as "yakjaw" instead of "yawkaw," so I felt validation was contraindicated.

But seriously, I first wanted to thank you for your support (and everyone's who's wished me luck becoming a doctor), and I wanted to answer one of your posts where you asked if I was male or female. I'm male, and despite some psychiatric problems and chronic pain, I am making the best of it, seeking out the best treatment possible, getting support when I need it, and moving on to a career where I can hopefully help people with similar problems.

I have mixed feeling about SSRI's. I think the pharmaceutical companies pushing them have popularized depression to a point where it's trendy (has anyone ever read Prozac Nation by Elizabeth Wurtzel?). Their advantage is that they have less side effects compared to the amount of relief they give than other antidepressants, but even that is questionable. A lot of people they do seem to work for though, like I said before, and if they work, great. But it does seem their effectiveness lessens over time, and the hope is that the depression will have gone away by this point.

It sounds like you have refractory depression (which is when you stop responding to traditional antidepressants), and I forget the statistic, but I think 10-20% of cases are treatment-refractory.

The problem with TCA's (tricyclic antidepressants, for everyone's reference) is that it is easy for the patient to OD and kill him or herself with a small amount of pills. For this reason, you don't want to give them to someone with serious suicidal ideation, unless they are institutionalized. Trazodone, btw, isn't a TCA, it's sort of a heterocyclic antidepressant. TCA's are imipramine, desipramine, amitryptaline, and a bunch of others. They're excellent drugs for depression, it's just you must watch who you give them to. They are also sometimes combined with an SSRI for an added effect, buy you've got to watch blood levels of the tricyclic because some of them boost it too high (prozac, for example, will do that). So, that's one option.

Do you have a seizure disorder? You mention it a few times in your posts. It's too bad wellbutrin is contraindicated if you do because that's a great drug.

Throwing Risperdal (even if you're not psychotic) into the mix does help some people, and seem to boost the effectiveness of antidepressants, too. In Europe, they use Ultram as an antidepressant in these cases too (though you've got to be careful of mixing it with an SSRI).

Have you had your thyroid levels checked recently? Sometimes a small dose of synthroid can be the real solution. If you have thyroid problems, they can mimick depression, and if you have both thyroid problems and depression, that has to be looked into. Even if your thyroid tests only show a borderline or slight problem, again, synthroid can give you an extra psychiatric boost.

Your eating disorder probably contraindicates any kind of stimulant. I don't know if you'd want to try this, but maybe a small dose of Ritalin (which is only going to have a modest effect on your weight) may really help things get going.

So those are some suggestions, keep in mind I'm not yet a doctor, so as I tell everyone I give medical advice to, take it with a grain of salt. Are you happy with your current psychiatrist? It doesn't seem like you're happy with how your case is being handled- maybe you'd want to switch, or at least mention some of the things I've brought up? If you want to talk about anything else, feel free to PM me or we can talk more in the thread.

Good luck.

-yawkaw