Larry and I met for dinner before the meeting. We ate at the KitchenBar where we each had salmon on a cedar plank. Scrumptious, plus as Larry pointed out at the meeting, salmon is full of fish oil, very healthy for folks with mood disorders.
Larry spends much of his time volunteering for the Family Resource Center at Friends Hospital. Call him with any med questions at 215-514-5110. Guaranteed to return your call.
Today, he and his wife Anna are heading out to spend T'giving with their daughter and her family in Fredericksberg, MD. I always remember the time I went to their home - very far away - I went with Denis and Fran Hazem for a meeting of DBSA groups - and Anna made delicious pound cake. A food-lover and diabetic like moi never forgets delicious food.
At KitchenBar, Larry and I discussed my kidney transplant and the damage done by lithium. I told him I contacted a woman to see if she'd publish my fabulous novel - her small press only publishes mysteries and sci-fi - and she told me she's waiting for a kidney. Yes, lithium. She's avoided dialysis by staying on a strict diet but has a fistula in place.
The above photo is their fish pond with coi.
Then we headed for Abington Prez.
We had a good turnout. Larry is candid, honest and funny. Always a great speaker. In fact, I'm gonna call a woman in our group with IBS and tell her to call Larry for questions.
Before the meeting, "Jay" came up to me. He had taken Ambien for sleep and went into a horrific depression, as did another member of our group, who is still severely suicidal.
Jay said he heard on the news that the Mayo Clinic will stop prescribing Ambien b/c hospitalized patients often slip and fall when on the drug.
Highlights:
Use a mood chart - rate your moods between 0 (fine) and 3 (severely depressed) - and give it to your doctor.
Titrate (wean) all medications. Psychiatrists say: Start low, go slow, until desired effects are achieved OR intolerable side effects occur. Decide whether you can tolerate the side effects b/c of the benefits of the drug.
New drugs include:
- Viibryd, a serotonin increaser
- Savella - dual-acting, increases both serotonin and epinephrine. Indicated for fibromyalgia. "Indicated" means that drug tests have been done. Not indicated as yet for depression. These tests cost a fortune.
It's an effective antidepressant, said Larry, and doesn't cause mania, as many antidepressants do.
- Abilify has been out since 2002. My former psychiatrist gave me an Abilify tissue box which I kept in my upstairs office for many years until cobwebs started growing on it. Did you know humans have an innate fear of spiders and snakes? Just learned that on my audio book The Social Animal by David Brooks.
Abilify is now used as an add-on, or enhancer. Use from 2 mg to 15 mg. Indicated for both bipolar and schizophrenia. You use less in schizophrenia than for bipolar.
- Seroquel is also used as an add-on...use 300 to 500 mg. I love the generic name for Seroquel - quetiapine. Look at the suffixes of these drugs. That's how you find their derivation.
People take a lo-dose of Seroquel to sleep - maybe 25 mg - and a higher dose as a mood stabilizer, up to 800 mg.
Somnolence - or sleepiness - is a side effect.
What's a milligram?
A teaspoon of sugar contains 5,000 milligrams. Thanks, Larry. Great point!
- Saphris. Not used a lot. Dosage: 5 to 10 mg. Asenipine is the generic name. Same 'pine' as quetiapine. Taken sublingually, under the tongue so it doesn't upset the stomach. All the above meds are used for both schizophrenia and bipolar.
- Latuda is only indicated for schizophrenia. But as we know off-label drugs often work for folks with bipolar when nothing else has worked.
- Clozaril is the first of the so-called atypical antipsychotics. Like most great drugs, it was discovered by accident. The Germans used it as an anesthetic and it was found to be a calming agent for schizophrenics. After that came Risperdal and Zyprexa. (I used to take Risperdal when I got psychotic and was very happy with it. However, I ended my manic-depressive career on thiothixene or Navane.)
And, yes, I did have the bottle. It was a great comfort to me.
Larry DiBello believes the best antidepressant is PROZAC. It's got a seven-day half-life, he said, so if you forget a dose it stays in your body. Many people in our group who forget to take a med feel the effect immediately!
Prozac is also indicated for OCD at 80 mg.
Many antidepressants are also indicated for pain. Cymbalta is a popular pain medication. It has numerous applications - including generalized anxiety disorder. It's also used for diabetic neuropathy.
- Some of the generic Wellbutrins are no good. "It's tricky to make a time-release capsule," said Larry.
Larry fought depression by running.
"I ran in 24 marathons," he said. "I'm not depressed anymore, I'm a cripple."
He has a metal knee and will get the other knee fixed in the near future.
Larry goes on his elliptical machine for half hour every morning. He might listen to music or simply run with his eyes closed and think.
Ah, that life has come to this. Machines.
Drugs for pain either work in your brain or in the affected area. Opiates do nothing to help with the problem, but anti-inflammatory drugs do, by reducing inflammation in swollen joints or wherever: Advil, Alleve, Naproxyn, and good old willow bark (aspirin).
- An extract of pineapple - Bromelain - has several uses - anti-inflammatory and also to reduce growth of tumors.
Larry suggests taking 800 mg of SAM-E. In Europe, you need a prescription for this, where it was studied. For some people it works as an antidepressant.
Be sure to ask your doctor if you can take any supplement. They may be contraindicated with your other meds.
- Sleep. Try Benedryl - 25 mg or Melatonin 1 to 3 mg, sublingual. Takes a week to work. Gee thanks.
- Omega 3 fatty acids. Larry suggests OmegaBrite. It was developed at Harvard. It was wrin up in the Archives of General Psychiatry for prevention of psychotic disorders!
Thanks Larry! Great talk.
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