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About mikl_pls

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  • Birthday 09/11/1987

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    Alabama, US

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  1. I would maybe try asking about a different atypical antipsychotic than quetiapine (Seroquel), like ziprasidone (Geodon) or aripiprazole (Abilify) (if you haven't already taken it) especially, even Rexulti (brexpiprazole) or Vraylar (cariprazine) (some of the newest ones), and I second Lamictal (which has a long and strict titration schedule). You could also always increase your Effexor XR to 300-375 mg. As has already been said, the drowsiness from Remeron is dose-dependent. 15 mg will make you much more drowsy than 30-45 mg will, but 30-45 mg will still make you drowsy, just not as much. But it will also put quite a lot of weight on you if that's also of concern. You could also augment the Effexor with a secondary amine tricyclic like nortriptyline (Pamelor), desipramine (Norpramin), or protriptyline (Vivactil), the latter two of which are stimulating (but not necessarily anxiety-provoking). These would boost the norepinephrine reuptake inhibition of Effexor XR and thus boost the antidepressant effect. So just a quick list: Augment with Abilify, Geodon, Rexulti, or Vraylar (or some other atypical antipsychotic, but not Zyprexa, which causes type 2 diabetes) Augment with Lamictal Increase Effexor XR dose to 300-375 mg Augment with Remeron 30-45 mg Augment with Pamelor, Norpramin, or Vivactil You can ask your doctor to do any number of these one at a time or several at once, but probably best to do one at a time because you want to know what is doing what, and what is working, etc. Low doses of Geodon are stimulating (20-40 mg 2x/day), while high doses are sedating (60-80 mg 2x/day). It must be taken with 500 calories per dose. The same goes with Abilify, generally, except it can be taken with or without food (however, I'm on 20 mg and still being stimulated by it). Lamictal can also be stimulating, especially when first starting up, so you might actually get a bit anxious when starting up on it, so you might need those Xanax. But that will go away once you get settled around 100-200 mg/day. The titration schedule, as per the PI sheet of Lamictal, for Lamictal for bipolar patients (which could also apply for unipolar depressed patients too, I suppose) who are not taking carbamazepine, phenytoin, phenytoin, phenobarbital primidone, or valproate, is: 25 mg daily x2 weeks 50 mg daily x2 weeks 100 mg daily x1 week 200 mg daily target dose Usually, it's divided into two daily doses past 25 mg. Vivactil is taken in divided doses in the day. Like 10 mg 3x/day for 30 mg. I hope you get the relief you need!
  2. When I was on Geodon the first time, I was on 200 mg Zoloft with 40 mg Geodon BID.
  3. In low doses, it preferentially antagonizes the presynaptic dopamine autoreceptors, causing dopamine release. Quite honestly, I wish we had sulpiride, amisulpride, and flupenthixol in the US for this reason. Right now the only medicine we have that does this is buspirone.
  4. I was on 225 mg for a little while and had nothing but side effects too. My side effects were blurry vision, urinary retention (bad!), weight gain (30 lb in just a couple of months), and worsening of depression.
  5. Have you considered adding Remeron to the mix for "California Rocketfuel?"
  6. It's the time of year again when I start having trouble sleeping, and I've tried numerous meds for insomnia (and at the same time I have hypersomnia too... go figure...). My insurance doesn't cover Silenor, brand-named doxepin in 3 mg and 6 mg micro-doses, so my pdoc gave me Sinequan (doxepin) 50 mg. I've tried doxepin before, but at 75 mg, which for some stupid reason my insurance treats as tier IV non-preferred brand name, but all the other doses my insurance is like "oh you're cool, that's tier II..." Anyway... So the doxepin 50 mg worked extremely well the first night, and the first night only. After that, I have trouble initiating and maintaining sleep, so I get anywhere from 3-4 hours of fragmented sleep according to my Fitbit. Then I'm tired all day, but I can't really nap because of my stimulant, which is nice because it keeps me going and whatnot, but I don't feel like keeping going because I'm exhausted. So I tried taking two doxepin one night for 100 mg and I actually felt a little stimulated and got about 2 hours of sleep. So I have two questions for those who have taken doxepin: If 50 mg isn't working for sleep, do I need to go lower in dose? Like 25 mg or even 10 mg? Does doxepin actually become stimulating in higher doses like some of the TCAs? Thanks in advance for any input!
  7. That's exactly how it was for me... I felt great after the first few days of the dose increase and then felt back to my crappy self afterward,
  8. I was on it for only a few months... it was VERY effective, but only for a week or so of the dose I was increased to when it did take effect (which was practically immediately)... It was so strange... It was unlike any antidepressant I've ever taken (except maybe Zoloft). I actually don't remember how I came off the Effexor... I know I didn't use Prozac... I think I cross-titrated to nortriptyline and then started Emsam... my memory is so crappy anymore.
  9. Lol nope, I just had a lot more of it to withdraw from. :X I wish I could tell you otherwise.
  10. This article should answer a lot of your questions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656324/ (Perhaps this would apply to Vraylar too?) So Geodon definitely needs to be taken with food. Here's an article that talks about the caloric content that needs to be taken with Geodon: https://www.ncbi.nlm.nih.gov/pubmed/19026256 500 calories need to be eaten when taking each Geodon dose. You really probably should be eating something in the middle of the day so you don't put your body into starvation mode and slow your metabolism down, especially if you wish to lose weight. If you want to lose weight that you gained from the Vraylar, create a calorie deficit (there are calculators online to help you do this, or you can use Myfitnesspal, to help you do this), and follow a particular diet with specific macronutrients, such as a low-carb diet, an ultra-low-carb diet like the ketogenic diet, or a low-fat diet. All of these diets are going to have raised protein from the American standard diet. Myfitnesspal can help you with maintaining the daily macronutrient goals and allows you to enter your custom daily calorie limit and macronutrient percentages. That would be my advice and what has worked for me anyway. It's just a matter of sticking to it... lol.
  11. XR, and I wasn't on it for too long... All that happened was it pooped out ... What was happening was my dose was pooping out within 4-7 days after raising it, so we were raising it literally every week to every two weeks because I was deathly depressed one summer. Oh, also, it made me gain a ton of weight too (about 30-40 lb in the period of about a month in the dose range of 375 mg to 825 mg).
  12. I have taken up to 825 mg.
  13. Hi Mike.....

    New to this forum, but I love reading about these things. So many pple have been told so many different things about all that you speak of. All Drs. have their very own way of Doctoring and sometimes we walk out of their office saying "where the hell did he get HIS diploma? ""WALMART""??? ....and the script goes in the nearest garbage can !! 

    Truth is... we ALL get depressed @ sometime or another. Medication may help, but if we busy ourselves w FUN things, we can usually shake it ourselves. (i know you are ALL saying "kiss my ass"...) but, i find it to be true......

  14. Yes. Somewhat. I followed the instructions (somewhat... lol). I sit in front of the sun lamp (can't remember the exact distance) for about 30 minutes (or an hour if further away). This is the kind I got: https://www.amazon.com/Northern-Light-Technology-Therapy-Pyramid/dp/B0030MK31G/ref=sr_1_9_a_it?ie=UTF8&qid=1519394386&sr=8-9&keywords=northern+light+technologies No, the possibility of UV damage didn't give me anxiety.
  15. I don't understand why your pdoc would increase your Effexor dose for OCD past 75 mg... At 75 mg, the serotonin transporter is saturated and you don't get any more serotonin reuptake inhibition by raising the dose beyond 75 mg... The only thing you get is norepinephrine reuptake inhibition at 150 mg and more of it as you increase the dose, and weak dopamine reuptake inhibition at 300 mg, which can possibly worsen OCD, which gets stronger at doses above 300 mg. Have you tried anything with sigma-1 receptor affinity like Luvox or Zoloft at high doses? He is correct in that regard insofar as OCD and anxiety disorders needing high doses of serotonergic antidepressants, but it doesn't work that way with the SNRIs. To each their own, though, YMMV, etc. I mean, I'm on Cymbalta 120 mg and my OCD is more under control than it ever has been. SSRIs don't do jack for me. I just think that if you haven't tried either of those meds at the max dose, if not at a supratherapeutic dose, then it may be worth a try (but Effexor withdrawal is a bitch!).