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About sming

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    PDoc Confounder

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  1. Thanks so much again man! I've been gently pushing for dexedrine without much luck. As per my post just now though, I'm not sure my brain is respecting stims any more, devastatingly. I bumped my Abilify from 5 to 7.5mg yesterday so I just have to pray (to no God - I'm atheist) that does something positive. I might see if I can chuck in Lexapro to get some stability since right now I'm an aggressive, despondent mess :/ Pete hah. Amen.
  2. Hi guys, thanks so much for all the input on Vyvanse and its brethren and apologies for not keeping up - I've been in a bad way. Unfortunately this topic is moot now since Vyvanse seems to have completely pooped out on me. Since Saturday, these changes have happened: Emotional balance -> erratic, negative emotions. Anger, depression, aggression, despondency. Generally OK mood -> deep, dark depression. That horrible empty feeling in your gut. Interested in things, hobbies etc. -> deep anhedonia & staring at the wall for hours. Energy and feeling alert -> spontaneously falling asleep. Positive outlook -> can't see anything but doom & suicide. This is my MO when I find a med/combo that helps it would seem. I get 2-6 weeks of benefit, then an abrupt crash back to the pits of depression. I've tried adding on 10mg or 20mg of Ritalin but that just makes me fall asleep faster and for longer. I may try the magnesium taurate & the Inositol at some point but it looks like the very mechanism of Vyvanse (and Concerta) has flipped on my brain. Increasing via supplements just feels the wrong direction. Now, I have to admit that I've had very, very bad pain since Saturday (I have chronic back & abdominal pain) however I don't know if that's contributing to the crash or because of it. Either way I'm seeing my PDoc sooner rather than later if this continues once my pain has let up (hopefully soon) since I'll be out of a job at this rate. Looking through mood spreadsheets, I did quite well on Lexapro (weirdly, for someone with TRD) and Bupropion years back. I might add Lexapro for some stability, take a break from stims and have another go with them. Thanks again and good luck to all, Pete
  3. Interesting. I take a PPI for NERD (GERD's non-erosive sibling). It does the job but I sometimes also take 150mg ranitidine if I'm still feeling the reflux. I wonder if that's a factor...
  4. from this I take "don't eat for a good 90 mins" after dosing Vyvanse. Is that about right? That may explain my malaise today since I ate a high-protein brekkie (whole wheat toast, lots of butter & peanut butter + glass of milk) just after dosing. I'm working on it. He's a steady-Eddie dinosaur type who you have to steer carefully. No sharp turns or you'll just get blanket "No"'s. My insurance just isn't playing ball at the moment so I'll have to goodrx whatever I get anyway. The main hurdle is actually the FDA (?) well, government. I'm not allowed my prescribed amount of Concerta because it's too much in their twisted calculations. Sigh.
  5. Hi & thanks for the idea. I take nothing with Vyvanse, except my other meds (apart from the antacids). I find it works best for me if I don't eat anything for a good hour+ after dosing. I learned about the acid/alkali thing last week. I'm already on the FODMAP diet and have IBS-C so a lot of those things I haven't had for 10 years anyway. I ordered Inositol, Magnesium Taurate and Magnesium Glycinate since numerous places recommend them to A) reduce side-effects (N/A for me, really) and B) raise blood-levels of the med. I'm trying one at a time in some vain hope of being scientific.
  6. roger that. Thanks. That's what I'd surmised but I wasn't confident in my surmisation. Not that that's a word but there you go. Also, apologies for the extremely slow responses. I have some weird OCD about replying to stuff. Just ask my friends & family. This is music to my ears. I've floated Dexedrine to my inexpensive, ignorant-but-sometimes-progressive PDoc to no response. I'll keep at it. I'm the same with 60mg Vyvanse. It helps immeasurably but I still feel somewhat empty/anhedonic - just not "right". I've tried not taking it and it was a short, sharp, horrific return to my normal state of wellbeing. I.e. I wanted to be dead very quickly and very intensely. I hear ya. And getting insurance to pay for anything hypersomnolence-related is like finding rocking horse sh*t. Yep, today was another day where I worry since Vyvanse lasted at best 3 hours. Very, very concerning. But so far I've "bounced back" twice so here's hoping. Thanks again man, Pete
  7. I take omeprazole and was going to ask about this. Now I don't - nice one!
  8. I did something like 40 dTMS and 16 ECT. Given all the meds I was on and the state of flux they were in (stopping, starting, increasing dose, decreasing etc.) I cannot say definitively but I'm pretty sure that neither had any effects at all, except I sometimes felt a bit wobbly/clumsy after ECT. I think I would have rather had even a negative effect TBH, just to see that it was doing something! Good luck.
  9. Interesting. I should have said in my post that this variability was happening before I tacked on Concerta for the afternoons. That said, I can certainly see how something like this would be affecting things. But if it was, wouldn't the canceling-out-ness be consistent? I'm a pharmacological layman Does this paragraph essentially mean that the Ritalin stomps the build-up of Vyvanse? On the topic of steady state and all that, I always find with stims that the duration I've taken them for does not affect their effectiveness - apart from when they poop out. Every day goes like this, irrespective of the number of days since starting them: 5a : wake up and dose Vyvanse. Feel quite crap until 630a give or take 30 mins (again, that variability) 630a -> 130p : feel 4/10 to 7/10 good, which is a huge variation. 130p : start feeling depressed. Dose Concerta. Feel quite crap until ~ 2:30p 230p -> 830p : again, feel 4/10 to 7/10 good 830p : start feeling depressed. Drink booze to feel better or just go to bed. I.e. there's no build-up over the days for me seemingly. I'd come to a (much less authoritative and detailed) similar conclusion. Thanks for verifying it. Nice. Thanks again for the ideas. Can you expound on Adderall v.s. Dexedrine a bit? Which do you prefer? And what does peripherally-acting mean in this context? Much, much obliged once again @mikl_pls. You're a champion of the interwebs! I should say BTW that the reason I posted about this seemingly-minor issue is because every time the Vyvanse is late to kick-in or only gives me a small boost, I freak out thinking that this is it pooping out. And I freak out because every other med I've responded to poops out =/
  10. Heyup, I'm taking Vyvanse for my 20+ year treatment-resistant depression and it's working better than anything I've ever tried (the bad news is that the last 3-4 days it's losing its potency and/or taking longer to kick in, but that's another story). I am asking about its variable effectiveness since I also found it to vary even when it was still potent. E.g. Monday my mood would be 6/10 depression (10/10 is best mood) then Tues 4/10 then Weds 7/10. Anyone know why this variability happens? Anyone got any tips? FTR I'm on 150mg Brand Lamictal, Abilify 5mg, 15mg Percocet (for chronic pain), 60mg Vyvanse, 36mg concerta (since the Vyvanse lasts 8 hours max), 20mg Omeprazole (for NERD, GERD's geeky cousin), 100mg trazodone (for sleep), 300 ranitidine (for NERD). I take the meds at the same times every day. Many thanks! Pete
  11. I feel like this when I have a "good patch". I still am 5/10 depressed and I still wouldn't mind ceasing to live. Like the previous poster, if that's all you've tried then you've a "fun" journey ahead. Unlike said poster though I've tried pretty much everything (meds and other eg dTMS, ECT, you name it) over the decades and can never get more than a few weeks respite. You've a very small probability of being in this stinking boat though.
  12. I can't speak for Medic* coverage but I went to a dTMS place that offers "scholarships" where you pay $0 and they were empty and looking for suitable participants. See https://hprtc.com/ (they were called TMS Centres of America). Why would they do this? I was told that the billionaire owner's daughter's depression was resolved by TMS and he wants to give something back and eventually make money from TMS. HTH.
  13. Hi - not really! I'm no ECT guru. However slides #2 and #3 here describe what he was on about I think. It's also a pretty good intro to the nuts and bolts of ECT IMO. BTW those are not low doses - typically speaking. They had problems with me taking 1mg of Lorazapam near the ECT session. That could be problematic. How did it go (assuming it happened)?
  14. This isn't correct AFAIK. They generally start on a lower charge to see how you do (our brains are all different - they found mine had one structure on the "wrong" side) and if you tolerate it and haven't had a major improvement (which can happen after 1-2 sessions), only then do they up the charge. I've had many ECT sessions - this isn't just theoretical protocol I happen to know. Also, I'd ask the ECT docs exactly how much higher the charge will be for you and exactly how much higher the risks are. The ECT doc told me that there's a parabolic relationship between charge and seizure, meaning that it's not as simple as: big charge == big seizure & high risks and small charge == small seizure & low risks. Ask the ECT doc "would you advise your kid to have this high a charge?". My ECT docs were fantastic and already proffered this info ("yes"). Unfortunately for me ECT had no appreciable effect. If you're suicidal and have tried everything else - what have you got to lose? Being dead generally has a zero percent chance of helping (joke but not really). HTH.
  15. Yes, flipping WNYC on helps for me too. It's almost like it signifies that showering is no longer such a chore since I can listen to something I might care a bit about. That's really interesting, I've not heard of that specific technique. Sounds similar to forcing yourself which my brain unpicks by going "well, you actually don't have to do it - you're just telling yourself that". Ugh. Yeah positive affirmations/notes just don't work for me. I can recall all I like about how good the water feels etc. and it doesn't do a thing. When I do shower I do take note to deeply smell the fragrances and really feel the water, just in case those memories make the battle easier in the future.