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About MuddlingThru

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    Mama Ain't Getting Her Groove Back

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  1. I've been on Fetzima & Wellbutrin combo for a few years. I had to stop Fetzima when I had cervical spinal surgery two years ago, but went back on it after I had tapered off of the heavy duty post-op meds. Lately though I feel foggy and just blah. Lots of personal stuff going on but that's always the case. Left my job recently so that doesn't help. I'm in therapy and eating (which is a big deal for me) and am doing PT for my back and neck, trying to taper off some of my neuropathic pain meds & muscle relaxants. Adjuvants generally haven't worked. I had GeneSight done a few years ago and it confirmed what I'd experienced: SSRIs and I do not mix. My list of attempted meds (in sig) is long. Essentially, my genetic profile showed Fetzima and Pristiq. I'm wondering aside from what I'm doing on the pain stuff, what meds my shrink can try? I'm thinking the only thing left is some of the milder TCAs - as long as they don't cause weight gain or lethargy because I can't handle that. Thoughts? What do you do when what you've got is essentially the end of the second-tier road?
  2. Just realized my sig setting was wonked. Fixed it - yea me. I've been on gaba for a long time for nerve pain and am tapering so I hope that helps. I like to think I was doing better before I left my job two months ago, but really I wasn't, I was just busy. Shrink = psychiatrist & a very good one. I've been with her for 13 years now, after I had postpartum depression and had a wicked reaction to Zoloft (long painful story). My therapist, who is a psychologist (I'm big on therapy with highly qualified pushy women who are smarter than I am), wants me to plan out my day in writing (no apps - my Todoist list is 17 items long) the day before. Each day is either job hunt or my dad's estate. Today was supposed to be job hunt. But it's 1pm and I'm on the couch in my bathrobe and I have to leave for physical therapy in a little bit. It started off as a good day but then I just sort of waned off into black fog. The rest of the day will be auto pilot. PT, then a little time, then drive to shrink, pick up one of my kids from school, drive home, make dinner, eat, maybe start the wood stove 'cause it's freezing right now, and then watch TV and play solitaire. I have 7 emails to respond to - easy stuff - and yet... not sure I will do it today. Maybe. I'll try. I live in the country now, used to live in NYC so I know what you mean. I can't think of the last time I was able to get myself to go for a walk. I try to have my coffee on my porch in the morning so at least I get some sun, birds, air, leaves... life. I also get into the "not enough" mode. I took over for my parents when my mom died. I nurture my kids, I rein in my "not enough" with them, but I can't with myself. All I see is what's not done. AA helps (not an alcoholic but I consider myself addicted to anorexia & self-harm). It's such a nice group when I go, no expectations, nothing but acceptance and love. And my dog too. Pure love. I feel so foggy now though, like I'm just in a big grey stupor in a purple bathrobe on the couch. Thanks for your support - now that my sig is fixed, if you have ideas on meds, please post. I'll pop in later to see your thoughts. Any experience with tricyclics?
  3. I was on Trintellix when it was Brintellix - haha - and truly hated it. I didn't get a boost to anything other than my weight (as I recall, it was like 10 pounds in 3 weeks, no exaggeration and no Reese's or Cheetos either!). I also had a lot of bloating. That said, Wellbutrin was always lovely for me as a booster - and Vyvanse 2x/d - but my meds right now aren't doing much for me other than keeping my head above water. I didn't think they mixed Trintellix and Risperidol? Any thoughts about going for the genetic testing? I used GeneSight a few years ago, and it really helped to rule a bunch of stuff out (and make sense of why what we'd tried didn't work... or didn't work for long). Good luck on dosing - it's tough at first, but the stomach stuff does get better. Ginger tea can help - also omega-3s (I like the chewies) just in general.
  4. Thanks, @water. I've had worse and survived so I guess that's something, right? 😉 I do think, at some level, I deserve more. There's still a lot I want to do, and as I remember, I'm pretty freakin' smart and did some really good work, not to mention raise two amazing now-teen boys and give my dad a safe and mostly-happy journey for the last five years of his life. And I'm married to the nicest guy I ever met, even if our sex life is on life support. I see my shrink today and I was thinking about that. I'm tapering off my pain meds, working on the gabapentin now then I think probably the muscle relaxants though I've got to be super careful. The challenge is, what meds COULD we even try? Do we try something radical like tricyclics? My updated med list is on my sig - any thoughts?
  5. Thank you, @Cerberus, This is where I am and yet I don't know what else to do. Therapy - yup, and she's good. Meds - doing what we can with what we have left. Exercise - hahahahaha. Socialization - really? My kids keep me going and sort of my hubby too, I guess. Mostly the kids, because my mom died when I was a teen and that royally sucked to say the least. I want to live - I don't think about suicide, much. Physically, I'm getting stronger thanks to PT. I can find at least 3 things at the end of the day that I've done though I usually blow off writing them (sorry, therapist) and instead play solitaire and watch Law & Order and Rachel Maddow. Good thing this world has mashed potatoes, chocolate cake, dry-rubbed ribs, arancini, and apple fritters to dunk in my coffee. And my dog. And the beach.
  6. Wow - this is me, and why I'm back on here. My depression is okay, I guess, but I seem to remember back in the day feeling a heck of a lot better most days and not posting on the boards in my PJs at noon. I don't hate myself much, I don't think life sucks much, I feel sorta numb... but I'm generally not... living. Days wash over me and plans are tossed in the crapper. I can't get out of bed in the morning unless I dose myself with meds and caffeine. My kids bring me coffee in bed every day and despite having a gazillion things to do (like get a new job), I'm... not. Even following my therapist's advice is difficult. I feel like I'm on a giant mountain of red sticky mud - mudslide mud - trying to climb but slipping just when I get a small toehold. Exercise? Yeah, I wish. In theory. Eating? Force myself. Getting out? Ditto. Friends - I think I had some, didn't I? Job hunt - fits and starts. Family work (dad's estate, our financials, cleaning, laundry) - whenever I can get up and force myself. I just remember life not being THIS hard - right? Or do I have selective memory?
  7. Crap. Thanks for the input. I'm thinking of maybe the Fetzima route. I feel like we're playing whack-a-mole with my meds and it's not working well.
  8. Thanks all - I wound up with Percocet and Advil plus an anti-inflammatory/steroidal for the first 2 days. Felt awful for about 3-4 days, p-doc discontinued vyvanse during that time since I wasn't having to think, and it would increase the pain. Also didn't take p-drugs on day of surgery per p-doc. Continued jaw pain managed with Advil for 2 weeks. So glad I had my wisdom teeth out - just wish I'd done it 27 years earlier! And JT07 - yes, I always make sure they have the full list, as my PCP accidentally scripted Imitrex for me last year and caused a huge serotonin crisis which took about one month to resolve fully. Thank God I had plenty of klonopin to help come down from it. I can say that the pain was worse than a kidney stone while pregnant, and worse than labor!
  9. Dx: Major Depressive Disorder with generalized anxiety, chronic insomnia, atypical anorexia with purging tendencies (including over-exercising), self-harm. Tried most ADs to little or limited success except wellbutrin. Had Gene-sight done which was awesome - confirmed exactly what I've experienced with SSRIs. Meds: Pristiq 50mg - MDD - ok, takes off the worst of my symptoms but leaves a lot on the table Wellbutrin XR 450 mg - MDD (love WB, but it's not enough anymore, sniff sniff) Vyvanse 60 mg - Med or MDD-caused ADD & exhaustion, eating disorder - helps with energy but only short-term, and with cravings which leads to ED worsening. Evokeo 5 mg 2x/day in afternoon - Med/MDD-caused ADD & exhaustion - just started, not really a fan, doesn't seem to help with cognition or energy Klonopin 1mg 2x/day in evening - Anxiety/Insomnia Ambien 10mg at bedtime - Insomnia Script for Ativan 10mg for anxiety after I had a panic attack, but I don't use it anymore. My nighttime cocktail works great. Still continually tweaking my daytime to try to cover as many of my MDD symptoms as we can. Still having problems with motivation, anger/anxiety at not getting things done, self-hate, energy, memory, and general cognition. Basically, vyvanse gets me out of bed and lets me use my brain for the morning, and then I try to keep it going with the Evekeo but not really working well. Thinking about switching to Fetzima. Other conditions/meds: butalbital-acetaminophin 50-325 for migraines; albuterol, Dymista, & Pulmicort daily for seasonal allergies & mild asthma; Zantac & benadryl (and Epi Pen) (and/or hydroxyzine) for allergic r/x as needed. Flexeril 10 3x/d, vicodin (325, as needed), and naproxen 500 2x/d after back & arm injury from car accident 3 weeks ago; expect to go off of them hopefully in a few weeks. TOO MANY MEDS!
  10. My mother-in-law is not psychologically well (neither am I - takes one to know one!). She has horrid insomnia and if I were to play pretend p-doc, I'd say depression, severe anxiety disorder, and atypical eating disorder. She's been having lots of memory and cognitive issues lately, and lives alone (she's 80, widowed 6 years ago, we live nearby but not that close). She's gone off her rocker before because she will just abruptly stop taking meds and then wig out. She thinks her primary care doc is a god, so he prescribes her meds for her. She had a breakdown this past week and was hospitalized. She's on Paxil (not sure of the dose), 1mg klonopin in the evening, 12.5 mg Ambien, a statin, some sort of eyedrops, and something for acid reflux. She's 5'1 and was 98 lbs at the ER (BMI of 18). In the past year, she's had a few falls, one where she broke her collarbone and my stupid BIL didn't take her to a real doctor but to his PT friend... sorry, I get upset. She had a car accident where she was completely at fault. We've seen her completely out of it like she's the guy from Fast Times at Ridgemont High or Matthew McConoughy playing bongos. 18mo after FIL died, she went completely ballistic (unprovoked) for an hour, saying that I was putting hair in her food, that I walked around their house in a lacey see-thru lingerie (don't own any - geez!), and that I was a horrible person, a horrible wife, and an awful and abusive mother. It caused an enormous schism in the family. We later found out that she had abruptly discontinued her Paxil but she never apologized, and it became a big thing because the family thinks she's a saint, but we see her instability. Anywhooo.... Whacked out most of the weekend, family member calls us concerned, hubby talks to her, she won't go to the hospital... finally goes and is admitted. Delusional, hallucinations, disoriented, high BP, slurring words on and off, tingles in her head, difficulty with her legs, etc. Turns out, she discontinued her Klonopin on Thursday before without tapering or doc's consent. She's now in a senior rehab center and we're trying to figure out what to do. Docs put her back on .5 mg Klonopin, discontinued Ambien, and continued Paxil. 1. Could the Ambien and abrupt discontinuation of Klonopin cause delirium? I take 10mg Ambien and 2 of Klonopin, and I can drop a dose of K and just get antsy and can't sleep. I don't go nuts. 2. Ambien at 12.5mg for an 80 year old with risk of fall? Isn't this a lot of potent meds to be scripted by a generalist/PCP? 3. I think she needs to switch docs to a geriatric specialist AND a geriatric p-doc, or at least a p-doc, and see a qualified therapist and move into assisted living. Geriatric p-doc or just p-doc? Other info I can give my hubby to help him convince her to see a p-doc, or switch meds? Is this really med related or is it just such a royal f-up that we'll never know and just have to toss darts at to get her to the right cocktail (and make sure she's med compliant)? 4. It also came out that she drinks 3 glasses of wine a day (could be more) and is hiding wine bottles, embarrassed, etc. I say drinking problem, especially with meds. Could that have aggravated this delusional almost psychotic episode? Even after 4 days in the hospital, she got up and started yelling at people to get out of her house at 11p the night before she was discharged - she has no memory of it. Help, advice, suggestions - even been-there-done-thats .... thanks!
  11. I'm currently on: Pristiq 50, Wellbutrin 450, Vyvanse 60, Evekeo 10 (5 2x/d in the afternoon), Ambien 10, Klonopin 2 (1 at 6p, 1 at 9p), plus meds for other conditions (seasonal allergies & mild asthma, and back/arm injury from car accident 3 weeks ago - muscle relaxants, NSAIDs, and the occasional vicodin). I would REALLY like to go to 600mg of Wellbutrin but my p-doc has said no because of seizure risk. Note, I used to purge but have been completely "sober" of purging for 16 mo (I attend open AA meetings and have a sponsor, am working the program for my food and exercise/self-harm addictions as an "anorexic/addict"). When I first was on just Welly, it worked great for me, but then life started to suck more after a few months and I needed more. Gene-Sight has ruled out all of the SSRIs for me (I tried most anyway and had very limited or no success), so I'm left with Welly, Pristiq, and Fetzima as options. Has anyone tried 600mg of Welly? How did you get your pdoc to switch you up? I hate taking so many meds and would like to go to Welly 600, and then if need be, add Fetzima but drop the Pristiq and Evekeo (I like the vyvanse for my eating disorder - helps with cravings). Suggestions? I see her in about a month.
  12. Just stumbled across this post as Fetzima is the only other AD that is on my genetic testing green list (the other being Pristiq, which I tolerate but don't like). I've run through almost all of the SSRIs only to find after Gene-Sight that the reason they don't work is that they won't work for me. Nice for the confirmation, wish I'd done this awhile ago! The problem for me with Pristiq is that it doesn't help with memory, get-up-and-go, motivation, concentration, and cognitive skills. It did help with the worst symptoms - the unbearable darkness of being, ideation, hopelessness, sharpness/anger/frustration - so I stayed. We pushed my wellbutrin back to 450 (600 would be ideal for me but my p-doc won't approve), and have added vyvanse 60mg in the morning and now evekeo 5mg 2x/day in the afternoon. I also take my evening "cocktail" - 1mg klonopin at 6p, 1 at 9p, and then Ambien when I am turning off the light/going to sleep. I'm wondering if I could drop the evekeo and try Fetzima instead. I don't want to lose the vyvanse as it really helps with cravings (though I haven't lost any weight). I have atypical anorexia with purging tendencies, and though I haven't purged in 16 months, the vyvanse made that much easier. Plus it's a nice zip, only too short (hence the evekeo). I see p-doc in a few weeks as I just started the evekeo but I'm going to ask her if we can try the Fetz instead. Anyone switch from Pristiq to Fetzima and not like it for side effects other than edgy/anxiety?
  13. I've been on Wellbutrin 450 (and down to 300, back up to 450) for several years as a stand-alone and with various other antidepressants, currently Pristiq. Sexual side effects, weight gain, and anxiety as side effects are a NO GO for me as I have MDD and an eating disorder, and I need sex. I actually decided to go back on Celexa then Lexapro then Brintellix in spite of sexual side effects because my depression was so bad I didn't give a crap about sex, I just needed to live. That said, my "best" times with depression was when I was on just the WB, especially the first few weeks - vivid amazing dreams, great orgasms, feeling sexy-mama, and relief from the big D. Unfortunately, I really need to be on 600 and my p-doc won't go there. Are you at risk of seizure from something else? It was the promise of going on WB that got me to stop purging and keep me from purging, although then my ED went in a different direction and I became more anorexic, but that's water under the bridge. I also have anxiety in the evenings & insomnia and WB has not exacerbated my symptoms one bit. Most of the folks I know on WB have felt the same. All ADs are risky for anxiety, but some anxiety disorders are part of the MDD, thus for those (according to my p-doc), the ADs and WB do not exacerbate anxiety. If you have general anxiety disorder not related to depression, it might. Long response, but short answer - get a new doc. WB was the best non-weight gain, pro-sex med I've been on, and I've tried them all. Interestingly, I did the Gene-Sight test, and WB was on my yellow (ok, may have some problems) list while all of the SSRIs were on my red/no-go list. Pristiq and one other were the only green/go MDD meds. Pristiq is ok but only treats part of my depression.
  14. Short story - treatment resistant depression + evening anxiety + chronic insomnia + anorexia & self-harm. Had the Gene-Sight test done because I've been through more antidepressants than I can count, and I had some nasty side effects (serotonin syndrome from interaction with my migraine med, panic attack because I mixed up my klonopin with an old bottle of citalopram). Because of that, pdoc has me on 50mg pristiq, 450mg wellbutrin, 30mg vyvanse 2x/d, then 1mg klonopin early evening and later evening, followed by 10mg Ambien at bedtime. It's working ok, but now I have to have oral surgery next week and I'm freaking out, because for whatever reason, with every procedure I've had done, I've always had more pain and more breakthrough pain than the docs plan. AGAIN my oral surgeon said "It really should be no big deal," and I told him that for me, it REALLY is. When I say more pain, I mean writhing in agony. For whatever reason, I don't have the mojo to call the docs when it happens, or it happens on the weekend, or whatever. I've had Vicodin and Perocet, and they've worked ok for me in the past. My Gene-Sight shows that tramadol & codeine have no effect for me - shocker, I found that out 10 years ago through unpleasant experiences - and that the oxy mixes and straight oxy are so-so. I thought about asking for a Fentanyl patch but then found out it affects serotonin levels and is contraindicated for pristiq. Told my oral doc this and he said he'd look into this. I don't see my pdoc until the end of the month but when I asked her via email, she was just like "???" Thoughts/suggestions? Surgery is next Thursday and I'm already freaking.
  15. Thanks - my pdoc is considering evekeo as a "short-acting stimulant a few times/day." She didn't listen, I guess. I want to take one dose in the a.m. as the afternoon dose gets squirrely. Either I take it too late and I crash in between, I take it too early and I crash too early, or if it's a little late it bleeds into my evening anxiety. Anyone try evekeo?
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