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Your Cocktail Deconstructed

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Been a while since I updated, and some of my meds have changed so here is my current cocktail:

Lamictal 100mg once daily (working up to 200mg by 2/16)

Memantine 5mg twice daily (working up to 10mg twice daily)

Dexedrine 15mg two capsules twice daily

Zenzedi 30mg once daily

Xanax 1mg two to three times daily

Valium 10mg once daily at bedtime

Halcion 0.25mg at bedtime as needed

Recently had a seizure on 1/30 from benzo (mainly Xanax) withdraw; I was not taking Valium at the time either (stopped on 1/22) so I guess Lamictal wasn't enough to prevent benzo withdraw seizures. Resumed Valium 10mg 2/2 and am really serious this time about trying to get off Xanax so I don't have to deal with dependency/addiction for the rest of my life. My psychiatrist mentioned in-patient detox as an option to get off benzos but I want to actually give myself a chance to take this seriously and wean off without having to admit myself. Why are these depressants so damn attractive and addictive?? You can officially add me to the group of people who can legitimately say I wish I never even began taking Xanax. At least I am fortunate enough to have a doctor who is willing to go as slow as I need to get my body off alprazolam. Lamictal is working pretty well for my mood, I'd say as good as Lithium without as many side effects. Memantine to help reduce/prevent further stimulant tolerance; don't know how effective it is since I've only been on it for 3 weeks. Halcion is amazing, my ideal sleep aid. Finally found something that helps me get to sleep and wake up feeling refreshed, not drugged or over-sedated. I try to only take it 4-5x a week so it maintains its effectiveness. Will keep you guys updated on my progress over the next weeks/months, please wish me as much luck as possible :)

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Well, here we go.

  • Lithium: for mood stabilization, mania/depression
  • Latuda: I'm honestly not sure, I think depression?
  • Seroquel: For psychosis, depression, sleep 
  • Zyprexa: Psychosis and mood stabilization
  • Xanax: for severe anxiety
  • Dexedrine: for my sleep disorder 

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I've had some minor changes (doses are total per day):

Seroquel XR 600mg - Schizophrenia
Lamictal 300mg  - Mood
Prazosin 3mg - Anxiety
Klonopin 1mg - Anxiety
Mirapex 1mg - Negative symptoms
N-acetylcysteine 2000mg - Negative symptoms & OCD
Metformin 1000mg - Metabolic syndrome

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Not major changes, but some adjustments...

Rexulti 2mg (same) - Still the backbone of my cocktail. Kills my depression 90% of the time. I will fight you if you try to take this from me.
Trintellix 5mg (new) - Adjunct for depression, since my last depressive episode was pretty severe. Pdoc thinks it will be enough of a boost to keep me from slipping.
Trokendi XR 100mg (same) - Migraine prophy. Works pretty damn well, went from 8-10 a month to maybe 1 a month. I can live with that.
Xanax 0.5mg (same) - PRN up to 1.5mg/day for anxiety. Works as described, except it makes me sleepy at doses of 1mg and higher. Kills anxiety like nothing else.
Nuvigil 250mg (was 150mg) - For excessive sleepiness due to sleep apnea. Keeps me going for a good 12-14h a day before it rolls off, unless I'm depressed, in which case, I can sleep through it.
Klonopin 1-2mg (new) - QHS insomnia/anxiety. Had a rough week of rebound insomnia and transition off of Lunesta and Restoril, but now that the Klonopin has leveled out, my general anxiety is lower, and my sleep is good.


Zomig 5mg (same) - PRN migraine
Zofran 4mg (same) - PRN nausea from migraine + from Zomig (stupid triptan makes the nausea worse)

Sleep doc hopes that with CPAP and Nuvigil my level of wakefulness will be high enough that I will be naturally tired by the end of day and my mind will basically wear itself out. I've only been on the higher doses for less than a week, but prior to now, that didn't happen. Yesterday, though, I was able to get up and function from 6am - 9pm, take 1mg of Klonopin, and sleep well until 6am again. I might not have even needed the Klonopin as tired as I felt, but I wasn't willing to risk waking up in the middle of the night because of insomnia (which has been completely horrible the past few weeks.) I've done Klonopin 1mg BID anxiety before, and it didn't work, but for some reason in this combo it is working. I haven't touched Xanax in over a week, and that's only dosing the Klonopin QHS. The long half-life of Klonopin does mitigate some of the effects of Nuvigil, but not enough that I'm sleepy, I'm just not super-energized, which really isn't an effect of Nuvigil anyway. 

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I've actually been on the same thing for four months.  Fingers crossed that it stays the same next week.

  • lithium (600 mg) - mood stabilization and anti-manic
  • lamictal (200 mg) - anti-depressant/mood stabilization
  • zyprexa (7.5 mg) - antipsychotic [this might have to change because I'm having a weight gain issue]
  • ativan (1 mg) - anxiety
  • prazosin (2 mg) - PTSD nightmares

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Lithium 600mg - mood stabilization

Trileptal 450mg - mood stabilization? I actually have no idea why I'm on this medication.

Zyprexa 20mg - for psychosis, currently not working very well

Clonazepam .5mg PRN - anxiety and sleep

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Posted (edited)

UPDATE AS ON 3/8/2018

Lamictal 400mg daily in the morning - bipolar disorder and seizures

Namenda 10mg twice daily - reduce stimulant tolerance

Vraylar 3mg once daily in the evening - mania

Xanax 0.5mg three times daily - currently tapering off, but use for panic attacks

Valium 40mg once daily in the evening - helping me taper off Xanax and avoid withdrawal seizures and symptoms

Halcion 0.25mg to 0.5mg as needed (about 2-3 times a week) - insomnia

Dexedrine Spansules 15mg twice daily - ADHD

Zenzedi 30mg once daily around 4pm-5pm - ADHD

L-methylfolate (generic Deplin) 7.5mg - MTHFR genetic mutation

Edited by mmaryland
forgot a med and correct spelling

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Still undergoing some major med changes (no more Seroquel XR, no more wellbutrin XL, lowering invega dose in half, I'm not sure if pdoc will let me lower Abilify to 30 mg instead of 35 mg, etc)

I'm pretty nervous that I will go crazy and end up fat with being on only 2 AAP's. I feel ok now but feel pretty stupid because I initiated these changes. I don't want to end up IP or worse (dead).


Abilify 35 mg - mood stabilizer and psychosis......5 mg AM and 30 mg bedtime

Klonopin 3 mg - severe anxiety........1 mg AM, 1 mg afternoon, 1 mg evening

Zyprexa Zydis 20 mg - mood stabilizer and psychosis........20 mg bedtime

Invega 12 mg (about to titrate down to 6 mg then see how I do?!?) - for psychosis....12 mg AM for now, then next week 6 mg

Lamictal 300 mg - mood stabilizer......300 mg bedtime

Yaz - birth control and heavy period control.......one pill AM

Nuvigil 200 mg - sleep disorders/wakefulness.....200 mg AM

Synthroid 25 mcg - hypothyroidism.....25 mcg AM

Metformin 2000 mg - weight gain prevention from psych meds.......1000 mg AM and 1000 mg evening

Topamax 200 mg - weight management/loss, controlling overeating.....100 mg AM and 100 mg evening

Lunesta 3 mg PRN - insomnia.....3 mg PRN bedtime

Vistaril 150 mg PRN - panic attacks or severe anxiety attacks.....50 mg up to three times daily

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(First post... Hi etc.)

Effexor 225 - Depression & anxiety

Abilify 5 - OCD & tics

Ritalin 30 - ADHD

I have an “almost there” feeling, maybe a minor adjustment (or time?) will do.

Various degrees of failure: Cymbalta (worked but killed sex drive), Prozac, Zoloft, Wellbutrin, Milnacipran (WAY too activating), Trintellix (placebo, as far as I can tell), Risperdal (worked but was too sedating).

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Maybe... a little bit scared of increasing this one, being an AAP, but I'll ask the doc :) 

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