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mikl_pls

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Everything posted by mikl_pls

  1. I had forgotten just how sweet Adderall tastes! Why is it so sweet?!

  2. Yes, brand name is Muse, generic name is alprostadil urethral. Yohimbine (Yocon) is another medicine, but it can really ramp up anxiety if you are prone to it.
  3. Yes I remember him. His stuff was free, then he maid all his stuff pay to view, which kinda miffed me, and then he disappeared. Now suddenly his stuff is reappearing, and it looks as though someone is recording these videos on a phone camera while they're playing on a computer or something. He was pretty quirky alright. He had what I think is called reactive attachment disorder, which he talked about in one of his videos. My mother was a 1st grade teacher for a while after she went back to work after having me, and she had a girl in her class room with RAD and other issues, and that girl was *LEGIT* nuts. I kinda agree on some of the things he talks about, but I am also kinda under the impression that he is very, very conservative. Like he said he would never prescribe a stimulant with venlafaxine and whatnot.
  4. I saw my sleep doc today and brought up how my pdoc diagnosed me with a circadian rhythm sleep disorder (CRSD) years ago, but didn't specify which one... I speculate that I may have delayed sleep phase disorder (DSPD) or non-24-hour sleep-wake disorder (non-24), the latter of which I understand is very rare in sighted individuals, but it can progress from DSPD if not treated properly. Also, ADHD, obesity, and OCD are all comorbidities associated with DSPD, and bipolar a comorbidity with non-24. My sleep doc wants me to download an app that uses my smart watch to track my movement during the day and night, basically to use my smart watch as an actigraphy device. He has an app called "Sleepwatch" that uses the Apple Watch to do this very thing. It's a very advanced app, I read about it. I have scoured (so I feel) the Internet for an alternative for an Android app that does the same thing, and have come up empty handed. All there seem to be are "sleep trackers" and "smart alarm clocks" and such for Android. Does anyone around happen to know of an alternative or equivalent to this app for Android that does the same thing? I need to have the data for my sleep doc by next visit (next month) so he can have something to go off of.
  5. Yes I'm on Caplyta. The difference in me is night and day since being on it. It has been a total life changer. I would highly encourage giving it a trial if you can.
  6. Saw my pdoc on the 22nd of July. These are the changes she made (in bold). Caplyta 42 mg 1 PO qam Cymbalta 60 mg 1 PO bid (120 mg) Vivactil 10 mg 1 PO tid (30 mg) Doxepin 10 mg 1 PO qhs prn Belsomra 20 mg 1 PO qhs prn Zofran ODT 4 mg 1 PO bid prn On the Caplyta, I told her I felt like maybe it wasn't stabilizing me enough because I've been having to patch myself up occasionally with Stelazine, and she said sometimes with brand new antipsychotics, it can take up to 9 months for them to really start working, so she wanted me to give it the full 9 months trial before we consider starting something new. Zoloft pooped out rapidly and started causing withdrawal symptoms even while taking up to 150 mg (I was prescribed 50-75 mg down from that dose over a long period of time). Brain zaps, anxiety, impending doom/death feeling, panic attacks, dark ominous cloud hanging over my head, you name it. So I switched to the next strongest thing I had in my meds (bad patient, I know), Cymbalta, and took 60 mg + 20 mg for 80 mg, and eventually bumped it up to 120 mg just before I saw her. It helped immensely. Only problem is my manly parts don't want to work anymore. I guess it's a fair trade off.... Also sorry if TMI. Doxepin was just too damn strong at 50 mg. It made me sleep all day the next day, so she lowered it to 10 mg at my request. Zofran ODT is just a safety blanket since I'm an emetophobe and I've been having some nasty migraines lately where I almost got sick. She wrote it for x60 but apparently my insurance only cleared x21, because they cut up the blister packs in put them in a Ziplock baggie... lol. She took off the prescription for Doral because it wasn't doing anything. ___________ Then today (29th of July) I saw my sleep doctor. He kinda just claimed the prescriptions of Belsomra and doxepin, so now my pdoc has even less to prescribe me, and added temazepam (Restoril). He also replaced the Dexedrine 30 mg with Adderall 20 mg (why he lowered the dose I don't know...?). I started to get him to give me Evekeo but I told him it would need a PA because insurance won't cover it, etc., so he said "let's do Adderall first." So from him, here is what I have: Belsomra 20 mg 1 PO qhs prn Doxepin 10 mg 1 PO qhs prn Restoril 30 mg 1 PO qhs prn Adderall 20 mg ½ PO bid (20 mg) I do plan on telling my pdoc about all these changes, including the Adderall.
  7. Ooh that's scary. 😢 There is a set of genetic mutations that supposedly makes one intolerant to any/all methyl donors of any kind. It involves having both a COMT V158M (rs4680) (+) allele and a VDR Taq (rs731236) (+) allele. That could've been the case for him.
  8. IME, Provigil did nothing, even up to 400 mg/day. Nuvigil barely did anything when it was brand-name, and did nothing when it went generic. So that probably includes atomoxetine (Strattera) then lol I can tell you from experience (my experience anyway) that if you start with amphetamines and are used to them, methylphenidate is far weaker. But don't rule it out, especially dexmethylphenidate. It's about as potent as dextroamphetamine, and with Focalin XR you can go up to 40 mg/day for some reason. I can say from my experience Dexedrine definitely combatted my depression far more/better than any amphetamine I've tried has ever done. Evekeo was surprisingly good at bringing my "goofy, silly" side out of me, but I didn't really give Evekeo a fair trial.
  9. What about atomoxetine (Strattera)? Do you think it might do the same? I mean, it's not the greatest med ever, but if taken in augmentation with your stimulants, it may help with vigilance and wakefulness. (I believe norepinephrine is highly related to the "wakefulness center" of the brain or something like that? Don't quote me on that...) Then again, dopamine has a strong wakefulness promoting effect too... That being said, perhaps augmenting (instead of switching) to modafinil/armodafinil could possibly help. They're not primarily dopaminergic, if anything orexigenic and histaminergic, but armodafinil is a D2 partial agonist I believe. My pdoc said that 200 mg modafinil = 150 mg armodafinil if that info is of any use. Modafinil is typically dosed up to 400 mg/day, but can be dosed even higher (with yet another PA I'm sure) up to 600 mg I've seen, and while armodafinil is typically dosed only up to 250 mg/day (highest dose pill they make), I've seen some people dosed up as high as 500 mg/day of it (they had to fight their insurance company tooth and nail, but they finally got them to approve it and they say it's totally worth it). I personally wasn't a responder to modafinil (up to 400 mg/day), and 250 mg armodafinil barely really did anything much for me except boost mood and cause extensive weight loss on top of the tremendous weight loss I had from first starting Adderall earlier at that time. I wonder if trimipramine (Surmontil) would throw you into mania? 🤔 Trimipramine is considered an "atypical tricyclic" because it has no monoamine reuptake inhibition to speak of. It works mainly as a 5-HT2A antagonist and a presynaptic D2 autoreceptor antagonist (releasing dopamine) (kinda like low doses of low-potency antipsychotics and some high-potency antipsychotics like flupenthixol, sulpiride, amisulpride, etc., none that are in the US, as well as low doses of buspirone). Trimipramine itself, in high doses, is sometimes used in schizophrenic patients because its antipsychotic properties are very close to those of clozapine. (But you're already on clozapine so...) Just wondering to myself aloud... lol. Don't get me wrong, Dexedrine has a "kick" all to itself, but it's just... "different" than Adderall's. I do wonder if I should go back to Adderall though because I have been so unmotivated to do anything. My room has become a maximal disaster zone. There's basically just a path (barely) from my door to one side of my bed and that's it, and I can't find anything. My keys have been missing for a week. No idea where they could be. Everywhere else, shin-deep in clutter and papers (probably mostly unpaid bills). Since my prescriber accidentally mistakenly wrote my Dexedrine prescription for 30 mg/day, I actually have noticed I have a lot more motivation to get stuff done (but I'm a lot more tired and want to take more naps). I kinda wonder if 60 mg was too much Dexedrine? And like I said, I also wonder if I should try going back to Adderall? 60 mg should suffice, but I may need 80 mg or higher to equate to the 60 mg I was used to in Dexedrine (although lower might be better). I've also considered giving Evekeo another spin but at a higher dose. It's not nearly as potent a CNS stimulant as Adderall or Dexedrine, more peripheral nervous system stimulant than anything, but I imagine the "kick in the butt" effect is pretty strong with Evekeo if it's 50% levoamphetamine. Next appointment I honestly may do Adderall and then Evekeo after that (sort of to transition from the ratios of D-:L-amphetamine more gradually) because I've been extremely curious about Evekeo. I was also curious about trying oral selegiline for the L-methamphetamine/L-amphetamine metabolites that it confers along with the Dexedrine (that way I wouldn't have to make a switch). I do believe my reward center is just completely broken which is why I can't motivate myself to do anything (dopamine thing rather than noradrenergic thing I believe), but having selegiline on board would give the L-methamphetamine/L-amphetamine (which are basically selective norepinephrine releasing agents and hardly work on dopamine at all), plus the selegiline, which in the doses I'd be taking (5-10 mg PO) would be selective for MAO-B inhibition, so theoretically it should be safe to take with the rest of my cocktail.
  10. I get you on wanting to put it off for the current reasons at hand... Wow, I can't believe my memory served me right for once! Lol usually my memory is terrible lol. I think I have associated your profile picture + your avatar with some of your meds somehow... (I don't know why or how those things have made a connection in my mind...) I got off Victoza for the same reason. I was getting knots in my tummy where I would inject. My tremor is too severe to inject in my thigh or upper arm, and it hurts worse since I have a WHOLE lot more fat in my belly lol. If you go for any other GLP-1 agonist like Victoza, I would highly recommend Ozempic. It has been wonderful for me. No GI side effects (particularly nausea) starting up like with Victoza, the injections aren't as painful (somoething to so with the Ozempic itself maybe?). I just love it all around. Trulicity was okay but I didn't feel like it was really doing anything for me. Never taken any of the other GLP-1 agonists, but haven't heard too many good things about Bydureon/Bydureon BCse, Byetta, or Adlyxin. Tanzeum got discontinued I think. They make an oral form of Ozempic, called "Rybelsus," if you don't even want to bother with weekly injections, I almost forgot. GLP-1 agonists are kinda the future of weight loss, weight management, and diabetes management I feel, as does my gdoc. There are DPP-4 inhibitors that sort of act similarly to GLP-1 agonists. They stimulate insulin release and I believe inhibit glucagon release (a hormone that causes your liver to generate glucose from glycogen stores). They are weight neutral I believe, perhaps can lose a couple of pounds on them, but nothing serious. Stay away from the SGLT2 inhibitors (Invokana, Jardiance, Farxiga, Steglatro) or any product containing one... A fellow user on this site got the infamous genital mycotic infection and had to have skin grafts on his genitals from it. They also have black box warnings for increased chances of limb amputation. They're nothing to mess around with. They basically make you pee out extra sugar in your body. They can cause weight loss. But none of it I don't think is worth the potential risks. But you can't go wrong with good old metformin (if it works for you that is, I don't think it really does anything for me).
  11. Oh I forgot... Metformin depletes your body of vitamin B12, so you might go out and grab yourself a good vitamin B12 supplement. Preferably methylcobalamin (methyl B12) over cyanocobalamin (what most OTC B12 supplements are). I don't know about dosage, I take 1000 mcg per day (for MTRR and MTR genetic mutations) along with 25 mg P-5-P (activated form of vitamin B6 I have to take due to genetic mutations, I think CBS upregulation it was...) and 15-30 mg L-methylfolate (for MTHFR genetic mutations).
  12. Metformin while on Zyprexa is definitely a good idea, however high a dose you can handle. The XR formulation is, as I said, much easier to tolerate with your tummy and gut-workings. If you have insufficient blood sugar coverage at 2000 mg XR, you can add a small dose of IR to it I believe. There are also other meds. Aren't you the one who takes/took liraglutide (Victoza)? If so, that would be actually a fantastic medicine to take while on Zyprexa. If you don't like the daily injections, Ozempic IMO/IME is a lot better. Made by the same people (Novo Nordisk), it's kinda like "Victoza 2.0" in that it's weekly injections and lowers A1c, blood sugar, weight, cardiovascular risk, etc. by a lot more. I didn't experience too much of a drop in anything (weight especially) I guess since I took Victoza for several years beforehand and then Trulicity for a short while. But it helps keep me in check (lately I've been having some very high readings and I wonder if I need an adjunct med to it).
  13. Also, I've been up to 400 mg lamotrigine in hopes that it would help my depression, and all it did was flatten me out. I was gray, everything was gray. Nothing was even black or white, there were no shapes or figures, just haze. It was like someone turned the contrast all the way down on a TV or something. It was abysmal. Not to mention I suffered tremendous cognitive side effects on that dose (Topamax has nothing on Lamictal for me), my hair was falling out like crazy (it was visibly thinner, but my hair was long at the time and I pulled it back all the time so it could've also been traction alopecia), the zits and cysts all over my back, shoulders, and chest just got even more flared up and nothing I did (benzoyl peroxide 10%, tretinoin 0.05% topical, adapalene 0.3% topical, clindamycin topical 1%, oral monocycline and doxycycline, all of it did nothing to help... I never reached isotretinoin territory though). Just be very careful and very watchful if you decide to go up to 400 mg in lamotrigine for depression. Don't expect much. IME, past 100 mg, it starts acting more like a true "mood stabilizer" in that it "narrows down your emotional color gamut" until there's just nothing but gray with very little variance in the huelessness so as to be able to make shapes out. I'm of course being figurative about that, it didn't literally make me color blind, but that's just what it felt like was a constant struggle to make sense of what was what emotionally and had no insight emotionally. And the rashes, oh the rashes... If you are not prone to these with this medicine, you're soooo lucky! I had all kinds of rashses plus the aforementioned acne.
  14. Ooh, oh my... I assume because of the risk of mania? It makes perfect sense, I feel the same works better for me and my idiopathic hypersomnia. XR's don't help me stay awake either, neither Adderall nor Dexedrine, but Dexedrine more than Adderall, if that makes sense. Dextroamphetamine IR tablets, 10 mg 2 PO tid has been what I've been on for three years now (until recently my prescriber screwed it up after I tried switching to Zenzedi and not being able to find ANYONE who could fill Zenzedi 20 mg, I'm now on 30 mg/day instead, but it's something, and that whole weekend without it was just torturous hell. I'm so glad to have it in my system again I'm just happy with 30 mg.). Sometimes I would lump two doses together for 40 mg if I waited too long to take the 2nd dose or something like that. Probably not what you're supposed to do, but if I don't have all my D-AMP in my system, I turn into the living dead. D-AMP is definitely the best I've taken hands down. And I've even tried Desoxyn, that stuff is crappy. Not nearly as stimulating as dextroamphetamine. I honestly believe dextromethamphetamine is weaker than dextroamphetamine, at least IME... I then became suicidally depressed and weepy on Desoxyn the second time around and gave it back to my pdoc to dispose of properly. The first time I was just in a constant haze, but that was also when I was on Luvox, which may as well have been dropping acid. I've heard Adderall is better for giving you a motivational "kick in the butt" and can even make you feel listless if you're not doing anything, like you HAVE to be doing something all the time on it. It's been so long since I was on it I don't remember what it felt like. But I don't remember anything that major. I just remember the magic of switching from Adderall 40 mg to Dexedrine Spansule 15 mg (that was what my pdoc said was the equivalency and she stuyck with it) and how much more socially outgoing it made me. It did make me liable to being a little cranky at first but that passed within a week or two. If you can, find a pharmacy that distributes Mallinckrodt generic (whether IR or ER). It is virtually unanimously agreed upon that it is the strongest, most potent generic out there. Amneal is the authorized generic of the ER spansules, so it's just like take brand-name. Sometimes you can request a brand, but usually you're just SOL as to what brand they have if it's not the one you want. Not even Mom and Pop pharmacies are that good about ordering because if your insurance won't pay for it you have to pay cash up front. (Boo!) Evekeo (racemic amphetamine sulfate) is a bit of a mystery stimulant. I've tried it twice, both times at 20 mg/day because that was what the free voucher was for, and I didn't notice anything. I have pretty extensive experience wth stimulants, as long as they're amphetamines... lol. They methylphenidates don't work for me at all, so I haven't taken them much. I just know Ritalin is placebo and Focalin XR is a panic attack pill. lol
  15. I like it here y'all. Thanks to everyone who works and puts so much effort into making this website a reality for everyone. Even crazy weirdos like me. :P 858004556_rainbowheart.gif.a8579a157db8529d38a0fee766e57ba2.gif

    1. jarn

      jarn

      Me too!  And you're a big part of what makes CB great :) 

    2. mikl_pls

      mikl_pls

      @jarn aww that's so sweet of you!! ❤️ :)  That literally made my heart swell.

    3. jarn

      jarn

      Oh good!  You really are great, and so incredibly helpful and thoughtful.

  16. Let me see here, I'm sure I've got some around here that I haven't shown already that someone might find funny too...
  17. Yeah 50 mg Risperdal Consta is the maximum dose. That's way up there. AND you're taking oral Risperdal. That's usually done at the beginning of IM treatment. Good lord, you gotta take that every 2 weeks?! My pdoc told me that that is one of the most uncomfortable shots to get because the liquid is so thick or something. They recently came out with a different risperidone injectable, Perseris, that you get every month. It's indicated for schizophrenia, but if you're bipolar, I'm sure your pdoc could pull some shift tricks to get it where you could try it. If risperidone is something you're looking to switch out, that would be a conversation between you and your pdoc I think. We're not professionals here. I could *probably* make a make-shift recommendation based on my experiences on all the meds I've been on if I had enough info from you (like what symptoms you are having mainly, what you want to get rid of side-effect- and symptom-wise) (to be taken with heaps of salt with the knowledge that I'm not a professional). You are on an extremely sedating dose of mirtazapine (7.5 mg). That's the dose they give patients when they want to sedate them and make them fatter (if they're not eating because of their depression).
  18. Make sure to ask your pdoc (if s/he is the prescriber of metformin) to have you on the ER metformin (Glucophage XR). It's way easier on your tummy. I speak from experience of being on both at extremely high doses. Lol 2000 mg IR metformin was like fecal incontinence and was always searching for a bathroom everywhere I went.
  19. Depending on how long you need the stimulation to last, you could add a booster Adderall XR (10-12 hours) or Mydayis (16 hours) in the morning and take your IR tablets as usual. Don't quote me on this, but I believe Adderall XR is 50% IR/50% ER, and Mydayis is 40% IR/40% ER/20% "delayed IR" (an IR dose that doesn't kick in until 12 hours after you take it). It's to basically simulate an IR booster dose taken 12 hours after an Adderall XR is all. Same could be done with Dexedrine. You could either use Vyvanse (bleh) or the Dexedrine Spansules ( ) for your ER stimulant along with your IR tablets. Another possibility is adding an NRI, but not sure if that would agree with your mood too well. Strattera is one, but one of its metabolites is a delta-opioid partial agonist, which can not only be depressogenic but also psychotomimetic. I like the secondary amine TCAs, nortriptyline, desipramine, and protriptyline. Desipramine is probably the "cleanest" out of the three. Protriptyline is probably the most stimulating out of the three, although nortriptyline in high enough doses can rival protriptyline's stimulation.
  20. I would say IME yes, Abilify is weight friendlier than Rexulti (by a lot!). But as @Iceberg said, watch out about switching meds if they're working for you. You can manage the weight gain (diet, exercise, increase the Prozac to 60-80 mg, add topiramate or zonisamide, and/or add metformin. It appears as though you're already on phentermine, which should help too. There's a combo med called Qsymia which is a combination of phentermine and topiramate. You could just try low doses of topiramate with the phentermine, both generic, and which would be way cheaper, and see how you do with that combination. If topiramate's side effects are too rough (and they are rough!), then switching to zonisamide might be better as it too promotes weight loss but its side effects are much subtler).
  21. How often are you taking your stims? Every 4-6 hours is generally recommended for Adderall and other amphetamines, but you could go every 3 hours. Yes, I'm (one of the) Dexedrine fans... lol. It provides me with more wakefulness promotion than Adderall every did. Dexedrine 60 mg seems stronger than Adderall XR 90 mg somehow... Or *seemed*. I think it may be the generic brand I'm on that sucks. As far as cross-tolerance goes, Adderall is 50% dextroamphetamine + 50% amphetamine, and Dexedrine is 100% dextroamphetamine, so I guess there could be some cross-tolerance. Evekeo is 100% amphetamine (racemic), so it's 50% dextro- and 50% levoamphetamine. It doesn't suppress appetite as much as Adderall or especially Dexedrine (that stuff obliterates your appetite). Evekeo is the most peripherally-acting stimulant what with the most content of levoamphetamine. Supposedly inattentive symptoms do better with more noradrenergic stims (Evekeo, Adderall), whereas combined and hyperactive type do better with dopaminergic ones (Adderall, Dexedrine). Even though I'm inattentive, I still prefer Dexedrine. I personally think that if you were to get your pdoc to switch you to Dexedrine 60 mg (either IR tablets or Spansules), you'd be feeling a lot better.
  22. The only side effect I had from any med was hair loss/thinning on high dose Lamictal (400 mg/day), but that may have been due to traction alopecia as I had very long hair at that time and always kept it pulled back.
  23. I would probably say that Saphris (asenapine) would be a close fit just simply because of the potent α1 antagonism as well as the potent 5-HT2A/2C antagonism that are both greater than D2 antagonism. That's just my two cents though.
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