Depression....again

Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

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Polar Bear
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Re: Depression....again

Postby Polar Bear » Fri Jul 29, 2016 3:16 pm

Steve, I am so sorry that there has been such a down turn and so so sorry that you could envisage the outcome of some extra medication becoming attractive.
I was so pleased that you were getting your 8 hours sleep little knowing how difficult things have otherwise become.
It seems we are destined to always have to balance symptoms, side affects and medications.

Well done on having the foresight to know that your medication combination was a likely culprit and making immediate contact with your doctor.
What does come to mind is your move to your present area so that you would have access to MMJ and it now being suggested that you cease taking it, but of course at different times us sufferers are taking different medication cocktails and it is good to know that MMJ will always be available for consideration.

Thumbs up on your improved mood - alas thumbs down on your fractured sleep.
I 'm sending positive vibes for your continued mood improvement.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

Rustsmith
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Re: Depression....again

Postby Rustsmith » Fri Jul 29, 2016 3:33 pm

PB, all is not lost with respect to the MMJ and our move. MMJ has turned out to provide a significant benefit for my wife's MS. The MMJ is more effective in treating the spasticity component of her MS than any prescription medication that she has been given in the last 40 years. Another factor in our move was the heat in Houston during the summers. She was practically a prisoner in our house from June through mid-September every year and we both worried about what would happen if the AC or the electricity went out for more than about an hour. Although summers in Colorado can get quite warm in the afternoon, it isn't even close to what we had to deal with for 40+ years in Houston.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Depression....again

Postby ViewsAskew » Fri Jul 29, 2016 5:57 pm

I wish I had no idea what you were talking about, Steve. I imagine many of us feel that way. Glad that the med change has helped - but at the cost of sleep just isn't fair!

I few weeks ago, I started to get more depressed again. I felt good - believe it or not - when I was withdrawing from the methadone. I think the kratom is a good boost for me. I stopped taking the energizing kratom during the day when I was finished with withdrawal and only took it at night when I used the pramipexole. I also had added neurontin back in. I am not sure if it's the neurontin or the lack of kratom. I dumped the neurontin a few days ago. I am better, but I have decided that it's much more complex for me -yet maybe as simple as the medication I take. Who knows.

I feel that my life is so out of my control. I cannot work as I did. I cannot find medications that work for me. I keep fighting to make my sleep schedule "normal" so that I can work and find medications that don't make me a zombie so that I can work, but my body isn't happy doing that. Over the years, all these little things add up - I feel I "must" have dinner ready each evening because my husband works hard and doesn't eat during the day - but I'm usually not hungry then. So, I eat anyway, but don't like me for having done it. Because we live in a city, I sold my car about ten years ago; while I was fine with this before I spent ten years dealing with everything else, the fact that I can't get anywhere when I want to as is just one more way I have no control.

Before I took the job last fall, I was allowing myself to sleep when I could and just "go" with the side effects and their ramifications. No more fighting it. I lost 25 pounds and was the happiest I've been (in many ways) for years. But, to do that again is essentially to give up - or is it? Is it simply acceptance? Not sure. And, given that medication is tightly entwined with this, who knows how I'd really feel if I didn't have to take all this crap? Maybe the same....maybe not.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Polar Bear
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Re: Depression....again

Postby Polar Bear » Fri Jul 29, 2016 6:17 pm

Steve, how awful that the heat of Texas restricted your wife so much. I am glad for both of you that Colorado (and MMJ) is a positive.

Views, I feel that everything for us .... absolutely everything... is trial and error. It's a term we use often with regard to medication and whether it is helpful or not but there's the trial and error of sleep/not sleep, will I try to sleep or shall I just keep going until sleep takes over whenever and wherever that may be. I'm actually finding myself in the camp of letting sleep take over, I don't ever lie down and try to sleep. Sleep comes while I do something and inevitably I awaken still wearing my reading glasses after having taken a sleeping pill and then sat down/lay down and done some reading.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

Rustsmith
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Re: Depression....again

Postby Rustsmith » Fri Jul 29, 2016 7:13 pm

We really are a sorry (and very complicated) lot at times, aren't we. :lol:
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Depression....again

Postby ViewsAskew » Fri Jul 29, 2016 9:05 pm

Rustsmith wrote:We really are a sorry (and very complicated) lot at times, aren't we. :lol:


That we are!

I had a meltdown today....I went to swim at the Y - it wasn't open for lap swimming. It's the third or forth time that's happened - the published schedule is changed and there is no notice. I was already soaking wet from my pre-swim shower when I found out.

I came home and was yelling - poor husband. Then I started to cry, of course. Fortunately for him I had a conference call shortly there after so I've been in my office. He is likely very grateful.

But, that meltdown tells me that things are not much better in terms of my mental health. This is the moderate range - it's not where I think of suicide, but where everything bothers me and extremely irritable. I guess I should be glad that I'm not where Steve was recently. That is definitely a scary place.

Steve, I am so happy for you and your wife that you were able to move so quickly and that it's benefited you both so much.
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Depression....again

Postby Rustsmith » Fri Jul 29, 2016 9:40 pm

So Ann, how much longer until the two of you will be able to get on your way?
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Depression....again

Postby ViewsAskew » Fri Jul 29, 2016 10:19 pm

We've set March as our goal. I don't want to move in the winter (did that last time) and we had a few open issues that have just resolved and allowed us to move forward. That is part of the mental health problems, I think, and why I went to meet with Dr. Park. I couldn't stand being on hold for another 8 months regarding the RLS/PLMS. I'm barely holding it together as it is.
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Depression....again

Postby Rustsmith » Fri Jul 29, 2016 10:42 pm

Yes, you definitely need to get things sorted out before you add the stresses involved with moving. At least we had only been in our last house for three years, had weeded out LARGE volumes of stuff before that move and had just spent 3 months in an apartment while we renovated our kitchen. Living in the apartment really helped identify what we REALLY needed and what we should get rid of.

Even with that, we were giving stuff away up until the very last minute. But in many ways it worked out best since my wife's best friend had one son who had just gotten married and the other just had twins. So, all of our yard equipment and large appliances went to homes that really needed them and not just off to some faceless charity organization that would put them up for sale.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

stjohnh
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Re: Depression....again

Postby stjohnh » Fri Jul 29, 2016 11:05 pm

A few months ago when I went off neupro to reset my dopamine receptors, I had a month or so of very little sleep and got somewhat depressed. For the last several years I've taken very low dose Cymbalta (12mg daily) which seems to help quite a bit in keeping depressive symptoms at bay for me. My wife is mentally ill so I need to keep my wits and remain sensitive and mindful as much as possible. I know that in general if I leave off the Cymbalta within a few days I start getting grouchy, although not obviously depressed. I know that this dose of Cymbalta does not affect my RLS symptoms directly at all.

It took a couple of months of juggling the various medications and dosing schedules to get to my current relatively good situation. Not depressed, most nights out of the week getting about 6-7 hours of sleep, and having fair but not wonderful energy during the day time. During the bad spell I would occasionally think that I would be better off dead. But that was as bad as it got.

I've been on a stable regimen for the last couple of months. 2 hours before bedtime I take .125 milligrams mirapex, 720 milligrams kratom, 14 milligrams THC and 50 milligram Gabapentin. 4 to 5 hours later I take 360 milligrams Kratom, 50 milligrams of Gabapentin and 7 milligrams THC. It took at least two months of nightly experimentation to come up with that regimen. Considering how much changing that more than minimally causes all kinds of difficulties for me, I am amazed that anybody manages to get decent control of significant RLS symptoms. I'm a retired doctor and have much more flexibility in self adjusting medication doses than most people probably have.

If I had to call my doctor every time I made a medication adjustment it would probably take a year or two before I could get on a decent regimen. This is truly a horrible disease, made significantly worse by our dysfunctional Medical Care system and further aggravated by doctors without the training or time to figure out what would really help most people. I pray for you Steve and for all the other people with poorly controlled RLS symptoms.
Blessings,
Holland

Rustsmith
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Re: Depression....again

Postby Rustsmith » Sat Jul 30, 2016 2:30 am

Thanks Holland!

I have always been one to self medicate, at least so far as adjustment of the doses that I need within the scope of the treatment plan laid out by my doctors. It started many years ago when all I needed was treatment for my very severe allergies and has extended now into my RLS treatments. With everything that I have learned from this website and reading the medical literature, I have always felt comfortable tweaking the dosage of what I take. However, when the depression hit I had no idea which of the four meds was responsible or if it was an interaction between two or more of them. I knew that it was way too far out of my league and that I needed the guidance of my doctor. She even admitted that my treatment is sort of a razor edge balance in an attempt to keep my movement issues under control while also trying to give me a chance to sleep for more than 3 or 4 hrs/night. Add in the complications of PLMS and the UARS form of sleep apnea and it gets real complex. Further, we agreed that although adding bupropion would help with my mood, it would be best not to further complicate matters.

So, at this point I am just thankful to have found a research grade sleep neurologist who 1) understands RLS and doesn't think it is just a movement issue and 2) accepts the fact that I know as much or more than many doctors about the specifics of treating RLS, but understands that I am willing to follow her guidance. After being semi-abused by poor treatment from previous neurologists, it is refreshing to have a doctor who treats me as an almost equal and is comfortable with discussing my treatment and is actually willing to accept my suggestions on occasion. I only wish that everyone on this board had an opportunity to be half as lucky as that.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Depression....again

Postby Rustsmith » Mon Aug 01, 2016 7:05 pm

I have been doing just fine this past week. No problems with depression since my medication change, but my sleep quality has definitely degraded without the edible MMJ that was allowing me to extend my sleep past the early hours of the morning.

While doing some Internet surfing this morning, I think that I may have found what happened to me. As backstory, I was taking a combination of methadone, gabapentin, pramipexole and THC. I was almost certain that either something in that cocktail was causing the depression or else it was an interaction between them. After talking with my doctor, I cut back on methadone, increased gabapentin and stopped the THC. The depression went away but my sleep quality degraded and the hours dropped from 7.5 to 5.5. I also got a constant mild headache every day until I dropped the gabapentin dose back to where it was.

I think that what I found in the following reference explains my experience perfectly. When I looked at my meds, individually each of them is occasionally used to treat depression, so it did not make sense that any one of them should be causing the depression. But this paper reports on research that found that a little bit of THC is a very effective depression treatment, but too much swings the serotonin neurochemistry the other way and can quickly cause depression rather than treating it. I had been using low dose THC for over seven months with no problems. But I suspected that the last batch of edibles that I bought was a bit more concentrated than normal because I would still feel a bit stoned for an hour or so after getting up each morning. Too much THC every day would definitely explain what I experienced and stopping the THC would explain the immediate disappearance of the depression. I am therefore going to experiment a bit by going back, but only every other day until I use up my current batch. I should not have any problems that way and hopefully will see an improvement in my sleep.

https://www.sciencedaily.com/releases/2007/10/071023183937.htm
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Depression....again

Postby ViewsAskew » Mon Aug 01, 2016 9:07 pm

Hope it helps.
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

stjohnh
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Re: Depression....again

Postby stjohnh » Mon Aug 01, 2016 11:29 pm

My main MM edible is a commercially made "20 dose" Brownie that is supposed to contain 1000 mg THC. I grind it in a food processor then make 500mg capsules. They seem fairly consistent in effects. Problem is, the gross weight of one Brownie varies from 72g to 111g. So do both Brownies each have 1000mg? Seems more likely that they make a commercial cookie sheet of Brownies, then cut them up. But not very precisely. Package does not list net Wt of Brownie. Also different edibles have differing potency. I read an article that said that MM products were poorly standardized and the amt of THC varied wildly from lot to lot, in spite of state regulations requiring better quality control. One Brownie lasts me 2 months or so. Really a good deal at $40 per Brownie. I take about 10-20mg THC daily depending on how I calculate the potency of the edible. I take about 10 mg 2 hours before bed, then 5mg 4-6 hours after the first dose. No stoned feeling at 6 am as long as the second dose is no later than 2AM.

I buy my kratom in 1kg bags (should be enough for about a year at my current dosing) to help reduce batch to batch variation. Maybe I'll do that w my MM as well.

I take the same combination of meds as Steve, if you substitute kratom for the methadone.
Blessings,
Holland


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