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About mikl_pls

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    Alabama, US (not native Alabamian!)

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About Me

Prior medications (with dose range):


  • amitriptyline (Elavil) 25 mg: used for sleep, not very effective
  • amoxapine (Asendin) 50-100 mg: partial response
  • clomipramine (Anafranil) 50-225 mg: horrible response, worsened depression, severe side effects
  • desipramine (Norpramin) 25-200 mg: worked great as an adjunct but not too well by itself (even in high doses), eventually had to stop when starting Caplyta as the two don't seem to get along somehow...
  • desvenlafaxine succinate ER (Pristiq) 100-150 mg: generic Pristiq did absolutely nothing for me, even at the supratherapeutic dose of 150 mg
  • doxepin (Sinequan) 10-75 mg: used for sleep, worked a little too well too late into the next day (next day hangover), not at all for sleep induction
  • duloxetine (Cymbalta) 30-120 mg: works great at high doses (120 mg), but my pdoc doesn't like me to be on that dose, and it keeps pooping out anyway, but I keep revisiting it anyway so...
  • Emsam (selegiline transdermal system) 6-9 mg/24 hr: didn't really do much at all... My pdoc refused to go above 9 mg/24 hr, so I feel I wasn't allowed to give the medicine a proper trial. 12 mg/24 hr would've probably worked.
  • Fetzima (levomilnacipran) 40 mg: Made me feel awful, dysphoric, crying, withdrawal effects halfway through the day...
  • fluoxetine (Prozac) 20-80 mg: Works okay, but isn't quite strong enough.
  • fluvoxamine (Luvox) 100 mg: This may as well have been me dropping acid... Hallucinations (visual, auditory, etc.) and kept me in a complete trance-like daze/stupor for the entire time I took it.
  • Forfivo XL (bupropion XL) 450 mg: worked extremely well, but caused extreme and intolerable nausea
  • imipramine (Tofranil) 25-50 mg: nightmares, hyperhidrosis, depression exacerbation, anxiety exacerbation (probably not dosed high enough, or maybe too potent for me...)
  • Lexapro (escitalopram) 10 mg (brand name): Took this back in high school before we knew I was bipolar; psychosis, rapid cycling between mania and depression, disinhibited behavior (probably part of mania)
  • Marplan (isocarboxazid) 40 mg: worked okay for a very short time, then pooped out, and it was extremely expensive... even with copay coupon ($200+ per month). Cost vs benefits didn't weight out in the end.
  • mirtazapine (Remeron) 30-45 mg: 30 mg was rather innocuous except for inducing binge eating, but it did help me sleep. 45 mg made me suicidal, feel and look miserable, and feel generally awful.
  • nefazodone (Serzone) 200 mg/day: Didn't really do anything, but didn't really take for long, so I can't really say for sure that it didn't do anything.
  • Pristiq (desvenlafaxine succinate) 50-100 mg (brand name): No response, if anything, worsened depression
  • nortriptyline (Pamelor) 50 mg: meh, kinda worked a little... I had to increase the dose to 150 mg to get any benefit
  • protriptyline (Vivactil) 30 mg: very stimulating in a good way, very good antidepressant, but caused urinary retention after a while of taking it
  • sertraline (Zoloft) 25-200 mg: Probably the best SSRI I've ever taken. It works extremely well but poops out after a while. I can come back to it later and it will work again and poop out again, cycle repeats.
  • tranylcypromine (Parnate) 20-40 mg: Hands down best antidepressant I've ever taken, but in combo with a stimulant only. At 40 mg, my pdoc took away Adderall and I crashed through the floor. Also, it caused me extreme weight gain which is paradoxical as it is not supposed to do that at all.
  • trimipramine (Surmontil) 25-75 mg: I took it mainly for sleep, but also for mood. I didn't get to take it long enough for mood benefits, but helped quite well with sleep. Hard to find!
  • Trintellix (vortioxetine) 10-20 mg: probably one of the worst antidepressants I've ever taken. Worsened depression, anxiety, etc., extreme nausea
  • venlafaxine XR (Effexor XR) 37.5-825 mg: took at heroic dose because of lack of efficacy and rapid poop out at next dose. I decided it wasn't worth it to keep increasing the dose to toxic levels. But it worked great while it worked (a week at a time after each dose increase).
  • Viibryd (vilazodone) 10-40 mg: This one is one I keep revisiting because of how well it works. It just works for a very short time. I've considered taking 60-80 mg as my pdoc suggested once, but I don't know how my insurance would react to that.


  • Adderall XR (amphetamine salts XR) (brand name) 30-90 mg: second best stimulant to dextroamphetamine for me
  • Adzenys XR-ODT (amphetamine XR-ODT) 12.5 mg: no benefit at all
  • amphetamine salts (Adderall) 20-60 mg: decent stimulant, third best stimulant I'd say
  • armodafinil (Nuvigil) 200 mg: no benefit
  • atomoxetine (Strattera) (generic) 80 mg: relapsed severely into psychotic depression when I was switched to generic from brand-name
  • dexmethylphenidate (Focalin) 5 mg (taken with Focalin XR): no benefit, anxiogenic
  • dexmethylphenidate XR (Focalin XR) 20 mg (taken with Focalin): no benefit, anxiogenic
  • dextroamphetamine ER (Dexedrine Spansule) 15-45 mg: best stimulant for me, but I think I prefer instant release
  • dextroamphetamine (Dexedrine/Destrostat) 10 mg 2 tid (60 mg): best stimulant by far
  • Evekeo (amphetamine sulfate) 20 mg: no real benefit, but probably under-dosed, would like to try at higher dose
  • methamphetamine (Desoxyn) 5-15 mg: bad news for me! very dysphoric and doesn't help ADHD or idiopathic hypersomnia at all
  • methylphenidate (Ritalin) 30 mg: no benefit or effect
  • methylphenidate CD (Metadate CD) 20 mg: some benefit/effect but pdoc wouldn't prescribe any higher of a dose, so I think I was under-dosed
  • modafinil (Provigil) 400 mg: no benefit
  • Nuvigil (armodafinil) (brand name) 250 mg: very helpful for dissociation and EDS, with an added benefit of weight loss to boot
  • Strattera (atomoxetine) (brand name) 25-60 mg: very helpful as an adjunct for depression and ADHD, but unfortunately the generic form is crap
  • Vyvanse (lisdexamfetamine) 50-70 mg: somewhat helpful, but can't get high enough dose prescribed to match my current dose of Dexedrine/Dextrostat

Dopamine agonists:

  • Neupro (rotigotine transdermal system) 4 mg: works okay for tremor and depression but I'm apparently allergic to something in the patch (probably the adhesive) as it makes my skin red and itchy
  • pramipexole (Mirapex) 2.25 mg: compulsive eating
  • ropinirole (Requip) 0.25 mg: compulsive shopping/eating

Atypical antipsychotics:

  • aripiprazole (Abilify) 2-30 mg: wonder drug for depression and mood stabilization, but eventually caused compulsive shopping/buying
  • Latuda (lurasidone) 40-80 mg: first AAP, worked great for about a year then suddenly had akathisia, tried multiple times, became less effective each time, would like to revisit; last revisit was awful, made depression worse, lost will to do anything, even eat and get out of bed...
  • olanzapine (Zyprexa) 5-10 mg prn: used as needed for mania and depression or sleep sometimes, makes me binge eat
  • quetiapine (Seroquel) 25-100 mg prn: used as needed for sleep; at the doses I took, didn't really cause weight gain or binge eating surprisingly
  • Rexulti (brexpiprazole) 0.25-3 mg: very dysphorogenic (is that even a word? It is now!) and depressogenic for me, made me gain weight
  • Saphris (asenapine) 5-10 mg: wonderful for sleep and anxiety, but becomes depressogenic after a while of taking it and loses its hypnotic qualities
  • ziprasidone (Geodon) 40-120 mg: great at higher doses but is a little sedating, not very useful in lower doses
  • Vraylar (cariprazine) 1.5-4.5 mg: kinda meh, didn't really do much of anything for me except give me akathisia at 4.5 mg the first time I took it at that dose

Typical antipsychotics:

  • chlorpromazine (Thorazine) 25-100 mg prn: this is not a medicine to mess around with... this is a serious business medicine!
  • fluphenazine (Prolixin) 1-5 mg prn: didn't do anything for me whatsoever
  • haloperidol (Haldol) 0.5-5 mg prn: an emotional sledgehammer, but knocks the hell out of mania and agitation
  • loxapine (Loxitane) 5-10 mg prn: I cannot speak highly enough of this medicine for how well it helped me get out of a deep psychotic depression
  • pimozide (Orap) 2-4 mg: took for Tourette's, stopped because of worrying about heart arrhythmia
  • perphenazine (Trilafon) 4 mg tid prn: took for anxiety, didn't do a single thing (maybe dose wasn't high enough?)
  • prochlorperazine (Compazine) 5-10 mg prn: took mostly for nausea, sometimes for anxiety, but wasn't effective for the latter
  • thiothixene (Navane) 2 mg tid prn: I'm not sure about this one... sometimes it's sedating, sometimes it's not; sometimes it's effective for psychosis, sometimes it's not...
  • trifluoperazine (Stelazine) 1-2 mg tid prn—5 mg bid: I can't speak highly enough about this medication. This is literally my brain glue. It pieces me back together when my brain becomes discombobulated. It helps with my anxiety like nothing else does. It helps with psychosis like nothing else does. It helps with depression like nothing else does. I wish I could just take this and only this, but my pdoc won't let me. 

Mood stabilizers/anticonvulsants:

  • carbamazepine (Tegretol) 200 mg
  • divalproex sodium ER (Depakote ER) 500 mg
  • gabapentin (Neurontin) 300-900 mg
  • lamotrigine (Lamictal) 25-400 mg
  • lamotrigine XR (Lamictal XR) 50-400 mg
  • oxcarbazepine (Trileptal) 300-1200 mg
  • topiramate (Topamax) 50-400 mg
  • topiramate XR (Qudexy XR) 150 mg
  • Trokendi XR (topiramate XR) 25-100 mg
  • lithium carbonate (Eskalith) 300 mg
  • zonisamide (Zonegran) 25-400 mg


  • alprazolam XR (Xanax XR) 1-2 mg: not very impressive of a benzo, not very effective
  • alprazolam ODT (Niravam) 2 mg: the best form of alprazolam!
  • clonazepam (Klonopin) 1 mg bid + 1 prn: very sedating and depressogenic
  • clorazepate (Tranxene T-Tab) 15 mg tid: moderately effective, not very sedating
  • chlordiazepoxide 25 mg bid-qid (50-100 mg): moderately effective, somewhat sedating
  • diazepam (Valium) 2 mg qid/5 mg tid/10 mg tid prn: very effective at low doses, sedating at high doses
  • estazolam (ProSom) 2 mg: no benefit
  • lorazepam (Ativan) 0.5-1 mg tid prn: no benefit, extremely amnestic
  • oxazepam (Serax) 10-30 mg qd-tid prn: second best benzo to alprazolam for me, works very well for anxiety associated with depression and in tandem with trifluoperazine (Stelazine) for anxiety
  • temazepam (Restoril) 15-30 mg qhs prn: kinda okay for insomnia
  • eszopiclone (Lunesta) 3 mg qhs prn: absolutely zero effect whatsoever, completely useless (notloki has advocated for going up to 6 mg though, but my insurance would never cover that)
  • zaleplon (Sonata) 10 mg qhs prn: beneficial, but doesn't work long enough
  • zolpidem (Ambien) 10 mg qhs prn: no benefit
  • zolpidem CR (Ambien CR) 12.5 mg qhs prn: no benefit
  • Zolpimist (zolpidem oral spray) 10 mg qhs prn: better than regular zolpidem, but tastes horrible (deterrent for abuse probably)


  • atenolol (Tenormin) 50 mg: no benefit
  • acebutolol (Sectral) 400 mg: worsened tremor
  • metoprolol succinate (Toprol-XL): profound hypotension and bradycardia
  • nadolol (Corgard) 20 mg: worked wonders for tremor and even shy bladder but caused severe bradycardia
  • pindolol (Visken) 5 mg: helped a little for depression and anxiety, but caused bradycardia
  • propranolol (Inderal) 20-40 mg: works well for tremor but I prefer the LA version
  • propranolol LA (Inderal LA) 60-160 mg: at these doses, hypotension and bradycardia


  • Belsomra (suvorexant) 20 mg qhs prn: hit or miss, sometimes would work, sometimes wouldn't
  • hydroxyzine hydrochloride (Atarax) 25 mg q6h prn—50 mg x1 prn: useless
  • hydroxyzine pamoate (Vistaril) 50 mg bid prn: semi-useless
  • Rozerem (ramelteon) 8 mg qhs prn: 100% useless

Neurotransmitter precursors:

  • carbidopa/levodopa (Sinemet) 25 mg/100 mg tid: didn't help tremor
  • Rytary (carbidopa/levodopa IR/ER) 23.75 mg/95 mg tid: helped a little with tremor, felt like I needed a higher dose, but pdoc wouldn't prescribe it, so I gave up on it...


  • Belviq XR (lorcaserin XR) 20 mg qam: nothing spectacular... very expensive even with coupon, insurance won't cover, and now it has been taken off the market because of concerns of cancer!
  • Contrave (naltrexone/bupropion SR) 8 mg/90 mg 2 bid: no results whatsoever, 100% useless
  • diethylpropion (Tenuate) 25 mg tid: worked pretty decently, actually quite well, but not as well as phentermine
  • diethylpropion ER (Tenuate Dospan) 75 mg qam: for some reason, this didn't do a single thing for me despite the instant release version working pretty decently
  • naltrexone (ReVia) 50-200 mg: actually caused me to gain weight...
  • phendimetrazine (Bontril-PDM) 35 mg 1-2 tid (105-210 mg): not much benefit whatsoever, actually caused me to feel pretty awful at the max dose of 210 mg/day (probably withdrawal from Dexedrine though...) and I suffered pretty bad withdrawal from the phendimetrazine at 210 mg itself and getting back onto Dexedrine too...
  • phentermine (Adipex-P) 37.5 mg qam: probably the best anorectic available that I've tried (never tried benzphetamine before but you may as well take Desoxyn and Dexedrine together... I mean... It's the same thing...)

Thyroid hormones:

  • liothyronine (Cytomel) 25-50 mcg: a wonder drug for depression, but I think it screwed up my thyroid big time...
  • WP Thyroid ¼-¾ grain: much better than levothyroxine, but a little pricey.

Medical foods:

  • Deplin (L-methylfolate Ca) 15 mg qam
  • L-methylfolate Ca 15 mg qam

NMDA antagonists:

  • amantadine (Symetrel) 100 mg bid (200 mg): caused me to feel extremely sedated and stimulated at the same time, profound fatigue, lack of motivation to do anything, yet very restless. Generally an extremely unpleasant experience, which is unfortunate considering the potential benefits it could've had.
  • memantine (Namenda) 5 bid-10 mg bid-tid: took for compulsive buying/shopping as well as OCD, but it didn't really work, even at the supratherapeutic dose of 30 mg/day.


  • benztropine (Cogentin) 0.5-2 mg bid prn: a wonder for akathisia and other EPS, but can't take for too many days in a row or I lose my close-up vision and get extremely dry throat/mouth
  • glycopyrrolate (Robinul Forte) 2 mg qid (8 mg): miracle drug for hyperhidrosis without causing too many anticholinergic side effects; downside is dry mouth/throat and occasional constipation (8 mg/day is the max dose for hyperhidrosis)

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