mikl_pls

Suicidal every day, what combo can stop this?

61 posts in this topic

What was your experience with Vyvanse? I strongly believe this is the only FDA med approved to treat binge eating disorder, which would be ideal for you because it may help out with your hypersomnia.

Is your biggest concern still being suicidal every day? Or are you battling mania, psychosis, depression, anxiety, etcetera or a combination of the above? Do benzos help you much or not at all during your really bad times? Have you been on Symbyax, a combination of fluoxetine and olanzapine, found very effective as an antidepressant in bipolar patients?

When do your symptoms usually become the worst or heighten? The morning, evening, bedtime, etcetera?

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On 8/12/2017 at 11:00 PM, mmaryland said:

What was your experience with Vyvanse? I strongly believe this is the only FDA med approved to treat binge eating disorder, which would be ideal for you because it may help out with your hypersomnia.

I didn't like it. It made my heart pound really hard and it wasn't nearly strong enough even at 70 mg. I felt like it was doing nothing for my attention, hypersomnia, or binge eating. Adderall was better insofar as the three symptoms I mentioned that was uncontrolled, but it, too, causes my heart to pound. I prefer Dexedrine, but my psychiatrist hates it, and refuses to prescribe it anymore, and we got into a big battle over it in our last appointment and when I pinned her down about equivalencies between Adderall and Dexedine and when she could no longer repeat the same BS answer (which was different from the last time I asked her about it, and I had proof of my stance on it this time with research that I printed out and showed her, which she did not like at all), she brought out the "I'm the doctor" card and waved it around in my face, something I never thought she'd do... Anyway </tangent>

On 8/12/2017 at 11:00 PM, mmaryland said:

Is your biggest concern still being suicidal every day? Or are you battling mania, psychosis, depression, anxiety, etcetera or a combination of the above? Do benzos help you much or not at all during your really bad times? Have you been on Symbyax, a combination of fluoxetine and olanzapine, found very effective as an antidepressant in bipolar patients?

I've been doing a little better since I made this post, but my main concern was being suicidal all day every day. There was some psychotic depression here recently that I've been dealing with, which I'm still battling. Anxiety, not a huge deal... If it comes up I take a Serax and everything's fine. I'm very benzo resistant so I barely feel the effects of them. Noooooooooo I haven't been on Symbyax and plan on never touching it. I've been on fluoxetine and it was helpful but made me extremely apathetic at 80 mg. I've also been on olanzapine and no thanks. I don't like sleeping 15 hours a day and binge eating all the things ever.

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Posted (edited)

4 hours ago, Iceberg said:

Could you try Provigil/ nuvigil ? 

I've tried that and Nuvigil. Insurance will no longer pay for it. They want you to have narcolepsy, sleep shift work disorder, or OSA. Otherwise, I'd be all over that.

Edited by mikl_pls
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9 hours ago, mikl_pls said:

I didn't like it. It made my heart pound really hard and it wasn't nearly strong enough even at 70 mg. I felt like it was doing nothing for my attention, hypersomnia, or binge eating. Adderall was better insofar as the three symptoms I mentioned that was uncontrolled, but it, too, causes my heart to pound. I prefer Dexedrine, but my psychiatrist hates it, and refuses to prescribe it anymore, and we got into a big battle over it in our last appointment and when I pinned her down about equivalencies between Adderall and Dexedine and when she could no longer repeat the same BS answer (which was different from the last time I asked her about it, and I had proof of my stance on it this time with research that I printed out and showed her, which she did not like at all), she brought out the "I'm the doctor" card and waved it around in my face, something I never thought she'd do... Anyway </tangent>

I don't know why so many p.docs are so against prescribing Dexedrine and refuse to prescribe it. Their reasoning behind this often can be easily refuted but like you said it usually turns into a big fight or battle over why the p.doc will not prescribe it. It's a very fair drug with less side effects than some of the other ADHD stims on the market, so I don't know what the (unnecessary) pushback is alll about. I always like to bring out printed information and my doc at least looks at it and takes it into consideration rather than shrug it off. I would persist about Dexedrine, given it was once marketed as a weight loss drug, and continue to pester her/him about making the switch to dexedrine. Seems very unfair.

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11 hours ago, mikl_pls said:

I've tried that and Nuvigil. Insurance will no longer pay for it. They want you to have narcolepsy, sleep shift work disorder, or OSA. Otherwise, I'd be all over that.

Your p.doc can't even fill out prior authorization for either provigil of nuvigil? If not, I know Nuvigil offers a coupon for the first prescription free and refills as low as $5 (https://www.nuvigil.com/). I just looked up retail price of both provigil and nuvigil and it was around $60 and $75, respectively. 

I would take a look at the Nuvigil savings card and ask your doctor to write a script for it. Then take both the prescription and the Nuvigil savings card to the pharmacy and see if they are able to hook you up with the first month free and after that, $5 refills. But this is for brand name, not generic, so it likely would require prior authorization. 

If none of that works, and if you have the money to do it, I would suggest that you pay for the generic out of pocket (average goodRx price listed above). I hope this was somewhat helpful!

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Yeah that sucks about insurance blocking the Provigil...it might be worth a try with a PA....but I think you said somewhere that the office sucks at them. But sometimes if you can get the doc totally on board it can open up options...what about the methylphenidate family? 

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On 8/15/2017 at 0:20 AM, mmaryland said:

I always like to bring out printed information and my doc at least looks at it and takes it into consideration rather than shrug it off. I would persist about Dexedrine, given it was once marketed as a weight loss drug, and continue to pester her/him about making the switch to dexedrine. Seems very unfair.

I did bring lots of printed out things. She got pissed. Her first reasoning was that Dexedrine was harder on the heart. I brought a page from the Evekeo PI sheet that said dextroamphetamine is more powerful as a CNS stimulant, and amphetamine works harder on the peripheral system, causing more strain on the heart. So when I showed that to her, she changed it to "it's rawer." It hits more dopamine subreceptos. I knew she was blowing smoke up my ass at that point. But when she bared her teeth at me by pulling the "I'm the doctor" card on me, I don't think it's a good idea to bring it up with her anymore. She even went so far as to say that she was reluctant to put me on Adderall 60 mg since that's such a high dose, but since I insisted that I would do well on it, she prescribed it. 

 

Edited by mikl_pls

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On 8/15/2017 at 7:49 AM, mmaryland said:

Your p.doc can't even fill out prior authorization for either provigil of nuvigil? If not, I know Nuvigil offers a coupon for the first prescription free and refills as low as $5 (https://www.nuvigil.com/). I just looked up retail price of both provigil and nuvigil and it was around $60 and $75, respectively.

It's not her, it's her office staff that doesn't get the PA documents off the fax machine. They're under staffed and overworked.

On 8/15/2017 at 3:57 PM, Iceberg said:

Yeah that sucks about insurance blocking the Provigil...it might be worth a try with a PA....but I think you said somewhere that the office sucks at them. But sometimes if you can get the doc totally on board it can open up options...what about the methylphenidate family?

TBH, Provigil didn't do much for me, even at 400 mg. Nuvigil was better for me. They have apparently changed the indications for both -vigils such that they require SOREMPs on the sleep study or something like that.

The methylphenidate family does nothing whatsoever for me. Even up to 200 mg (tried it just to see, wasn't trying to abuse or have fun with it). Same as dexmethylphenidate.

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17 hours ago, Iceberg said:

Is there any stim u haven't tried? 

Lol no pretty much not... I haven't tried any of the extended release methylphenidates like Metadate CD, Concerta, Daytrana, etc. But I have tried Focalin and Focalin XR.

I am doing much better than when I started this post, but I'm still rapid cycling. Lithium helped a little. but it gave me horrible tremors and seizures... I did see in a separate thread that @notloki said that Depakote is the choice med for rapid cycling, but I'm reluctant to try it because of side effects, especially weight gain. I would also have to half my Lamictal dose, so I'd be at 150 mg and thus have to switch from ER to IR since they don't make ER 150 mg.

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