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Welcome to Dr. Landon Trost - Directly answering member questions in the "Medical Professionals" section below the Treatment boards. https://www.peyroniesforum.net/index.php/topic,16512.0.html

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Author Topic: PENTOX - Side effects  (Read 99051 times)

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crashbandit

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Re: Possible solution to Pentox induced anxiety ...
« Reply #50 on: April 06, 2011, 06:11:37 PM »

Thanks again George, I'm gonna give this stuff a try, I could really use some help in this department.

I'm convinced now. We are all just little Georges running around here 8)
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crashbandit

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Re: Possible solution to Pentox induced anxiety ...
« Reply #51 on: April 06, 2011, 06:35:43 PM »

How do you dose this stuff George? Did you start off taking more at the start then back off abit once it's built up in the system?
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George999

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Re: Possible solution to Pentox induced anxiety ...
« Reply #52 on: April 06, 2011, 06:51:21 PM »

I'm pretty much just following the instructions on the label.  - George
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George999

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Re: Possible solution to Pentox induced anxiety ...
« Reply #53 on: April 06, 2011, 08:59:17 PM »

I would caution that although this stuff certainly *seems* to be working well for me, the objective evidence for it is nowhere near as good as the evidence for Pentoxifylline and Ubiquinol.  Certainly it is for anxiety and the other two are for Peyronie's.  But although I am impressed with Stabilium, it is short on objective evidence and that needs to be noted.  - George
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crashbandit

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Re: Possible solution to Pentox induced anxiety ...
« Reply #54 on: April 06, 2011, 10:22:04 PM »

For sure George. It's worth a shot. Yeah, I'm not sure ubiquinol is doing much for me. I like to keep my regime very simple with little room for interactions and easy maintenance (not popping a billion pills). It is a tough call though since Ubiquinol has so much evidence behind it but something has to go. I could always get back on it too.
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Fred22

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Re: Possible solution to Pentox induced anxiety ...
« Reply #55 on: April 08, 2011, 02:51:31 PM »

For the past week I have been using a product called Stabilium 200 which is marketed as a solution for anxiety.  Years ago I took Klonopin/Clonazepam for anxiety and never have found anything as effective since.  But Klonopin is essentially a controlled substance and getting a doc to prescribe it is nearly impossible.  They much prefer Xanax or Valium, neither of which were helpful for me.  Things like Valerian did the job, but nowhere to the degree of Klonopin.  But now I have found something, which seems to actually be *better* than Klonopin.   Stabilium 200 immediately lowered my blood pressure significantly, which for me is a marker of significantly decreased anxiety.  It also has improved my sleep noticeably.  As such, it might be worth a shot if you have anxiety issues with Pentoxifylline.  ADDITIONALLY, I believe that anxiety and stress aggravate Peyronie's directly, so it might help in more ways than one.  A very concise description of what this substance is can be found on ehow.com for those of you who might be interested.  - George

George...This sounds interesting.  Have you noticed any side effects?  Pretty expensive...does iHerb have the best price?...Fred
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George999

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Re: Possible solution to Pentox induced anxiety ...
« Reply #56 on: April 08, 2011, 09:16:34 PM »

I haven't noted any side effects at this point.  What really surprised me is not seeing a BP spike when I ate salty food at a memorial service.  This is pretty unusual for me since salty food always pushes up my BP.  I have also been using Valerian Nightime again and Bio-active Milk Peptides.  But I think it is the Stabilium that is really doing the trick for me.  It may be available for a lower price than iHerb, all I know is that iHerb's price is less than LEFs.  Actually it looks like this place has it on sale right now.  And here is another low cost vendor.  - George
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ComeBacKid

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Pentox and shortness of breathe
« Reply #57 on: April 09, 2011, 04:45:03 AM »

One side effect I've noticed with this medicine is a distinct shortness of breath when going up steps or walking fast or running while on pentox, its clear the pentox is causing it since I used to be an avid runner.  Has anyone noticed this?  When I stopped pentox it went away, but not totally, but a lot better.  Also I've had a like mini stabbing pain in my heart or a stabbing quick one time pain in my neck.  I went to the cardiologist a year ago and they told me everything is normal with my heart, and a normal EKG.  I read somewhere that pentox can cause heart angina, maybe doctor tim could way on it.  There is no pattern to this needle like pain in my heart, and I'm not sure its actually my heart.  However the shortness of breathe seems suspicious and clearly linked to pentox.  I've also seen noticeable improvement everytime I'm on pentox, my penis gets softer and more flexible, I gain size, and curve gets less, better erections as well.

Comebackid
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Worried Guy

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Re: Possible solution to Pentox induced anxiety ...
« Reply #58 on: April 09, 2011, 07:52:51 AM »

Hey comebackkid,

I've been on Pentox for about 5 weeks now and have not had any side effects as of yet.  Not seen any improvements either but i'm not expecting to yet.  I went to the gym the other night and spent half an hour on the treadmill  and then went on a bike and had no problems with my breathing.  
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George999

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Re: Possible solution to Pentox induced anxiety ...
« Reply #59 on: April 09, 2011, 11:37:40 AM »

Fred's question about side effects here was about side effects for Stabilium, NOT for Pentox.  I am suggesting that Stabilium might actually reduce Pentox side effects by countering Pentox's effect on the brain that seems to induce anxiety.  Anxiety reverberates through the body and can cause things like shortness of breath and angina.  Stabilium is a fish extract that has a calming effect and thus might dampen the effects of Pentox.  - George
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Fred22

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Re: Possible solution to Pentox induced anxiety ...
« Reply #60 on: April 09, 2011, 12:19:12 PM »

I haven't noted any side effects at this point.  What really surprised me is not seeing a BP spike when I ate salty food at a memorial service.  This is pretty unusual for me since salty food always pushes up my BP.  I have also been using Valerian Nightime again and Bio-active Milk Peptides.  But I think it is the Stabilium that is really doing the trick for me.  It may be available for a lower price than iHerb, all I know is that iHerb's price is less than LEFs.  Actually it looks like this place has it on sale right now.  And here is another low cost vendor.  - George

Never heard of vitaGlo or SuperSupplements.  Does anyone know if they are a reliable vendor. Their price sure beats the iHerb price, but then I've done business with iHerb and know them to be very reliable and honest. 
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lespleen

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PENTOX - Side effects
« Reply #61 on: April 19, 2011, 07:47:40 AM »

Anybody notice a marked decline in libido while on pentox for < 3 months? Perhaps some of the anxiety experienced while on the drug has some effect on libido?
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skunkworks

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Re: Pentox: decline in libido
« Reply #62 on: April 19, 2011, 08:10:31 AM »

My erectile function went up, not too sure about libido, I can never separate it from being able to get a hard on. It is a mild pde 5 inhibitor after all.
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Review of current treatment options by Levine and Sherer]

LWillisjr

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Re: Pentox: decline in libido
« Reply #63 on: April 19, 2011, 06:21:18 PM »

It does increase blood flow to the penis, but I do not believe it is a PDE5 inhibitor.
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chefcasey

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Re: Pentox: decline in libido
« Reply #64 on: April 19, 2011, 08:13:58 PM »

I think what you're experiencing is lack of libido due to stress/ anxiety.  Pentox early on can cause excess anxiety, but this should disappear with time.  Willis is right, it is not a pde5 inhibitor, but a pde inhibitor.  It does increase blood flow to the lower extremities including the penis, but doesn't quite work like pde5s such as viagra, levitra, etc.
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skunkworks

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Re: Pentox: decline in libido
« Reply #65 on: April 19, 2011, 10:43:29 PM »

It is a general pde inhibitor which means it inhibits pde 1 - 5.

Thus a mild pde 5 inhibitor.

http://www.ncbi.nlm.nih.gov/pubmed/19232362

Quote
pentoxifylline (PTX), a PDE 1-5 inhibitor
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LWillisjr

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Re: Pentox: decline in libido
« Reply #66 on: April 19, 2011, 11:01:06 PM »

Thanks,
Another reason why I like this forum. Constantly learning something new.
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skunkworks

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Re: Pentox: decline in libido
« Reply #67 on: April 20, 2011, 03:58:35 AM »

Thanks,
Another reason why I like this forum. Constantly learning something new.

All good, the more we know the better equiped we are to fight/treat this thing.
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powerlift66

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PENTOX - Side effects
« Reply #68 on: June 21, 2011, 08:09:35 PM »

I have been on it for almost a month now, literally ZERO side effects until this started about a week ago. It is 3 times a day, starting to really piss me off! I looked it up but zero people in the studies using the extended release version had this side effect. Can anyone provide any input? Thanks so much.

On a side note, the medicine seems to be working well when combined with cialis. Erections are dynamite and zero intestinal issues besides this loose stool crap.
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Skjaldborg

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Re: Pentox suddenly causing diarrea?
« Reply #69 on: June 21, 2011, 08:27:38 PM »

powerlift66,

I was on pentox for 8 months and I had more bowel movements throughout the time I used the drug. Not quite diarrhea, but I was going a lot more than usual. It has a chemical structure similar to the stimulant caffeine so I'm not surprised at such side effects. It also caused some extra gas but that was no big deal.

I noticed that if I stayed away from acidic foods such as tomato sauce or balsamic vinegar that the GI symptoms were much better. Also, if you are a power lifter (as your name implies) and using some sort of whey protein, that can cause extra gas and possibly diarrhea.

-Skjald
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jserletti

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Re: Pentox suddenly causing diarrea?
« Reply #70 on: June 23, 2011, 09:08:02 AM »

you have something else that is causing the diarrhea.....it is NOT Pentox....stop Pentox for few days and see if the symptoms go away....good luck
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dioporcolorisolvo

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Pentox stresses bladder-prostate problems
« Reply #71 on: August 04, 2011, 04:59:05 PM »

I have bladder-prostate problems. I'm young.
I urinate very often and i have a lot of burning in urethra.
I'm doing a lot of exams to understand exactly what i have.
I know only that when i assume pentox, symptoms worsen a lot and i urinate even 30-40 times in a day.
Do you know something about this?
Thanks
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George999

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Re: Pentox stresses bladder-prostate problems
« Reply #72 on: August 04, 2011, 09:17:52 PM »

This sounds like it *could* be some sort of urinary tract infection.  Pentoxifylline will marginally suppress the immune system which would make a UTI worse.  I would get it very well screened if I were you.  - George
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ComeBacKid

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Re: Pentox suddenly causing diarrea?
« Reply #73 on: August 18, 2011, 04:43:57 PM »

Pentox caused diarrea for me, my crap was either rock hard unless I gulped down water, and sometimes I would have to take a crap multiple times a day, not much would come out or it would be like water.  This was one of my least favorite side effects, however with my penis seeing solid improvement it was tolerable.

Comebackid
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Worried Guy

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Re: Pentox suddenly causing diarrea?
« Reply #74 on: August 18, 2011, 06:21:57 PM »

Stats show that side effects with Pentox are unlikely.  I put most of these things down to coincidence.  After 6 months on an Pentox I can honestly say no problems.
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powerlift66

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Re: Pentox suddenly causing diarrea?
« Reply #75 on: September 02, 2011, 04:22:51 AM »

Late reply on my end!

Looks like mixed reviews, some say side effects are near impossible, others definitely experienced them. I find it interesting that when I recently started back on it (firm flaccid returned) I farted a lot more, and my appetite decreased.

I have been using traction devices and pumps on and off for years, I think I always did too much traction though aka too much force.
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newguy

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Re: Pentox suddenly causing diarrea?
« Reply #76 on: September 02, 2011, 01:17:07 PM »

I've never notied any significant side effects. The odd bad stomach early on, but taking it with food seemed to all but eliminate that.
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dioporcolorisolvo

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Re: Pentox suddenly causing diarrea?
« Reply #77 on: September 03, 2011, 04:07:31 PM »

For diarrea:
you can decrease the dosage from 1,2g to 800mg daily.
And you must eliminate bread and leaven from your diet.
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ComeBacKid

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Re: Pentox suddenly causing diarrea?
« Reply #78 on: September 11, 2011, 02:38:53 PM »

When I took the pentox with food it seemed to eliminate the stomach aches to.  I had a lot of farting though, and my crap was either diarrea or rock hard, I had to drink a lot of water and wait to take a crap for it to be comfortable, it was def worth the results though, my penis came back full and soft flaccid, it was normal and healthy , kind of like if I was pumping it with the VED all the time, my erections were solid, i had almost no venous leakage, and my bend got less. 

Comebackid
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Woodman

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PENTOX - Side effects
« Reply #79 on: November 15, 2011, 01:27:43 AM »

I was searching to find out if Pentox "Trental" is a immune suppressant. I cannot find the ansewer and was wondering if anyone knew if it is or isn't. I ve been taking Trental again for about one month now and noticed in that time I ve got Jock itch, Athletes foot & now a sore throat.

Usually if I get jock itch and or athletes foot I can just treat it with OTC medicine and it will go away. Now I ve tryed all the OTC stuff and can't seem to shake it. Treatal is the only real medicine I am taking besides omeprazole witch I ve been taking for years for reflux. The only other things are just supplements L Arginine, CoQ10, fish oil & vitamin D. I also take a generic Clariton for allergies.

Any input would be great.
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George999

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #80 on: November 15, 2011, 10:55:37 AM »

I was searching to find out if Pentox "Trental" is a immune suppressant. I cannot find the ansewer and was wondering if anyone knew if it is or isn't. I ve been taking Trental again for about one month now and noticed in that time I ve got Jock itch, Athletes foot & now a sore throat.

Usually if I get jock itch and or athletes foot I can just treat it with OTC medicine and it will go away. Now I ve tryed all the OTC stuff and can't seem to shake it. Treatal is the only real medicine I am taking besides omeprazole witch I ve been taking for years for reflux. The only other things are just supplements L Arginine, CoQ10, fish oil & vitamin D. I also take a generic Clariton for allergies.

Any input would be great.

The answer is YES.  Pentox IS a mild immune suppressant.  It can cause an abnormally low white cell count and it can exacerbate any type of infectious disease.  It is advised that when one is fighting an infection of any kind, one should briefly stop Pentox to allow the infection to clear up and then restart Pentox.  - George
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KAC

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #81 on: November 15, 2011, 10:59:25 PM »

I'm glad to know this.  I've never had jock itch in my life, but had an awful case last month.  My GP prescribed some ointment and I reacted to that badly and eventually had to use a steroid cream.  It seemed like the only solution was to use both the ointment and the steroid in order to get rid of it without reacting to the ointment.  I never thought Pentox would have anything to do with it.  Should I try to get a flu shot this season for this reason?
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Woodman

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #82 on: November 16, 2011, 01:04:03 AM »

Thank you George for the info. I am gonna stop taking the Trental for a bit and see if I can get my issues to resolve.
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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #83 on: November 16, 2011, 03:48:48 AM »

Woodman,

I think it def. is.  I had some kind of skin infection with red bumps on my neck, back, butt etc.  When I started taking pentox they worsened and became more in number.  By the time I ended my pentox they faded away significantly.  I'm now back on pentox, I'm sick and usually in 2-3 days I'm over it.  I've had a cough now for two weeks, the rest of my congestion basic cold went away except this cough.  I believe it is proven pentox will suppress your immune system.  For us though, that is good, thats why it works really.  However with a weaker immune system, you could get sick easier or pick up warts from touching things in public, or some kind of a skin virus. 

At this point my main concern is getting my penis back to normal health so I'm willing to eat the lower immune system.

Comebackid
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corvette2010

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #84 on: November 16, 2011, 08:56:54 AM »

I'm also wondering about the flu shot? Should I go ahead and get one like I normally do?
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ppain

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #85 on: December 02, 2011, 10:16:53 PM »

... Pentox IS a mild immune suppressant.  It can cause an abnormally low white cell count and it can exacerbate any type of infectious disease.  It is advised that when one is fighting an infection of any kind, one should briefly stop Pentox to allow the infection to clear up and then restart Pentox.

Thanks for this info.  I'm 25 days into by far the longest cold of my life and will quit the Pentox for a while.  
Do you happen to know if on/off/on has untoward effects in Pentox Peyronie's therapy?
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0x5555

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #86 on: December 02, 2011, 11:44:50 PM »

I've read that stopping pentox means you have to take a few weeks to get back it's effects.

Speak with you doctor about this.
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Woodman

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #87 on: December 02, 2011, 11:49:07 PM »

It is now Dec. 2 nd I stopped taking Pentox on Nov. 17th after Georges post. I finally got rid of the jock itch for the moment but the athletics foot I cannot get rid of it. It was getting better for a bit but the past two days its gotten worse and has spread. My sinuses have gotten alittle better but still having problems blowing nose often flem etc.

I ve never had ailments of this nature hang on and or so hard to shake. I am wondering how long it will take for the Trental to play out of my system and for it to kick back into normal. Interesting thing is I was just on it for about a month before I stopped taking it.

On a side note two of my plaques seem smaller flaccid and my pain has improved. Does anyone know what supplements that could help with the lower immune issues?

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George999

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #88 on: December 03, 2011, 01:24:54 AM »

Astragalus is the quintessential herb for stimulating the immune system.  The risk is that it can activate or aggravate auto-immune type reactions in the process.  That is what happened to me.  I had a problem with a chronically low white cell count.  I took astragalus for two weeks and my white cell count went way up higher than it had been for the past two or three years.  BUT, along with that, my Peyronie's reactivated after being dormant for quite a while.  AND my peripheral neuropathy as well.  The two problems run counter to each other which generally means you are damned if you do and damned if you don't and you have to pick your poison carefully.  Comeback, I know, has been through this whole game and perhaps he will have some input on this one.  Hopefully you are using a good fungal med on the feet.  - George
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ppain

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #89 on: December 03, 2011, 11:59:09 PM »

Pentox has been in medical use since at least the 1980's.  It's principal use, for intermittent claudication, is generally on elderly patients.  With the elderly, immune suppression causing increase of colds, flu's, etc. would constitute a serious side effect of Pentox.  Yet immune suppression is never listed among Pentox's side effects.  Smith et al. (2011) states: "In general, the side effects of PTX are mild and consist of nausea, dizziness and headache" and the official Pentox FDA trials actually found dizziness and headache more prevalent in the placebo arm.  I'm puzzled why immune suppression isn't included if in fact it occurs.

George999's line seems to be that since Pentox treatment of Peyronie's is based on suppression of a certain autoimmune response, the more general immune suppression isn't a side effect at all but an expected part of the drug's operation. My medical understanding to too slight to agree or disagree with that reasoning, but since Pentox's efficacy with, e.g., intermittent claudication has nothing to do with suppression of an autoimmune response, general immune suppression should be regarded as a side effect if in fact it occurs.

You have to remember that Dr Lue's primary theory regarding Peyronie's is that it is driven, at least in part, by the cytokine TGF-beta1.  And that theory is supported by a significant amount of research.  Pentoxifylline blocks TGF-beta1.
Smith was Lue's student.  Lue is behind the 2011 paper (and listed as the 8th and last author). Interestingly the 2011 paper reverts to the older understanding of Pentox for explaining its efficacy at reducing Peyronie's calcification.

"Although some data suggest that PTX blocks the tumor growth
factor-beta pathways, the mechanism by which PTX might induce
regression of calcified plaques is unclear. PTX has been shown to
improve microcirculation through reducing blood viscosity."     
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Luciano

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #90 on: December 04, 2011, 07:46:34 AM »


Smith was Lue's student.  Lue is behind the 2011 paper (and listed as the 8th and last author). Interestingly the 2011 paper reverts to the older understanding of Pentox for explaining its efficacy at reducing Peyronie's calcification.

I have a lot of doctors among my friends.. so just a remark.
Usually when younger doctors publish a paper in a journal, they do it to collect points..  they do it because the number of publications count in their curiculum when they apply for a job. (the more publication points you have, the better job you can get - allthough this is only one aspect)
Usually the younger doctors ask one of their teachers, or senior colleagues to sign in as co author. This gives their paper more weight (and it might be published in a more important journal). The senior doctor, by signing in gets free publishing points.
This is the way it works here in europe, but I think also in the states.

Of course the senior doctor only signs in if he thinks that the theorie behind this publications is right.


But what I am trying to say is, that we cannot be sure that Dr. Lue is behind this publication, he might only have signed in as coauthor, because he was asked to by his students and principly agrees with the publication.

NOTE: i said: "might" have signed in.. not has signed in.

Luc
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George999

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #91 on: December 04, 2011, 11:07:59 AM »

In terms of Pentox's ability to "thin the blood", it does so in a very unique way which might explain some of its capabilities.  Pentox uniquely makes blood cells flexible so they squeeze through damaged capillaries that would otherwise be impassible.  No other blood thinner that I know of operates in this manner.  It is unique to Pentoxifylline.  - George
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Skjaldborg

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #92 on: December 04, 2011, 01:10:28 PM »


But what I am trying to say is, that we cannot be sure that Dr. Lue is behind this publication, he might only have signed in as coauthor, because he was asked to by his students and principly agrees with the publication.

NOTE: i said: "might" have signed in.. not has signed in.

Luc

While this is possible, also note that Dr. Shindle, who is one of Dr. Lue's colleagues, signed on as well. Rather than racking up points, I believe they are one of the few urology groups trying to publish research on the disease. I'm only speculating here, but I imagine that it's tough to get a large Peyronie's drug study together because pentox is so dirt cheap, i.e. the large drug companies have little financial incentive to support or encourage such research. Therefore I believe that Dr. Lue and the others are carrying out such research to further understanding of the disease and encourage more research that could piggyback on what little research already exists. Just my 2 cents.

Skjaldborg
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ComeBacKid

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Re: Is Pentox "Trental" a Immune Suppressant?
« Reply #93 on: December 07, 2011, 06:29:12 AM »

Dont stop pentox altogether, just go down to one pill per day or one every other day.

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0x5555

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Having trouble eating
« Reply #94 on: December 20, 2011, 01:46:16 PM »

I'm on pentox.  I'm not sure if it's related but I have a very hard time eating these days.  Basically I have absolutely no appetite, never really feel hungry and it's a struggle to force myself to eat something.

I'm not sure if this is the medication, the lack of sleep I've been having or some mental health issues (I've been feeling very bummed out lately - went to the hospital to set up an appointment with a social worker).  I have definitely lost weight - since things took a turn for the worse I have probably lost 15 pounds (from 140 down to 125 since September).  I don't have nausea or sickness per say from the pills, but I generally just feel kind of 'meh' about food. 
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jackp

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Re: Having trouble eating
« Reply #95 on: December 20, 2011, 05:14:35 PM »

An old doctor once told me. If you think the medication is causing a problem stop it for 5 days and see what happens.

I would not do this for any heart of other serious health issues without consulting the doctor that prescribed it for you.

My 2 cents.

Jackp
http://jackp-penileimplant.blogspot.com/
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0x5555

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Re: Having trouble eating
« Reply #96 on: December 20, 2011, 08:56:57 PM »

Did anyone have problems getting off pentox?  Any side effects - did you have to go to 1 pill a day and then down further.

I have to say I am in a really bad place.  I find myself spontaneously breaking down into tears.  I'm normally pretty strong but I'm having a hard time dealing with this.  It's hard to describe just how low my energy levels are.  I am completely drained of any energy - even going for a walk is a tough thing to do.  I haven't been to work in over 3 months, I am basically a zombie the whole day.

I'm trying to figure out if this is depression, the pentox or the fact that I'm having trouble sleeping.  Any advice is appreciated.  BTW sorry for the sob story, I just need to get this out.
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jackp

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Re: Having trouble eating
« Reply #97 on: December 20, 2011, 10:10:39 PM »

You sound severely depressed. Get to a mental health professional for an evaluation, just as soon as possible.

There is help.

Jackp
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corvette2010

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Re: Having trouble eating
« Reply #98 on: December 20, 2011, 10:23:36 PM »

Sounds like depression. I don't know how old you are but a sure fire way to boost self esteem,gain more energy and get your weight back up is to hit the gym. Start focusing your anger (depression) on the gym and make it a positive! If you need any encouragement or any questions feel free to pm me!
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0x5555

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Re: Having trouble eating
« Reply #99 on: December 20, 2011, 10:50:19 PM »

I'm definitely depressed - I have asked for a councilor at the hospital and will be following up with them tomorrow.

I don't think it's JUST depression - for example it's 10:47pm now and I feel absolutely fine.  It's night and day from how I felt this afternoon - in the afternoon even cleaning a bowl from lunch would be an effort.  I don't know if that's how depression works.
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