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HydroCat

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  1. My experience: 5mg/10mg/20mg did nothing. No effect. No side effects. No withdrawal. There was a tiny improvement in mood every dosage change, for about two days. (Placebo effect maybe)
  2. What I meant by "stabilize-from-below" is that Lamictal is more of an anti-depression rather than anti-mania. I understand that you don't have manic tendency, but even if you did have - Lamictal is also anti-manic.
  3. Not a doctor here... As you said that depression, anxiety and sensitivity are issues, then raising Lamictal (as a "stabilize-from-below" kind of drug) may be a good idea. Not sure about anhedonia, though making an educated guess I'd say that it is part of the depressive state. Raising Buspirone also makes sense, but this is a tricky one because it can either lower or enhance Serotonergic activity by a rather unique mechanism. This may produce many different results. Edit: Thinking about it again more thoroughly, you are mentioning many symptoms of depression but you are not taking any antidepressant. They usually are the most "basic" meds for depression. I can think of Buspirone as sort-of an antidepressant, but maybe a low-dose SSRI can help here. Or even replace it...
  4. SSRIs can be taken at doses higher than the recommended max. Sometimes twice as much. Research suggests that going above the recommended max will not usually yield better results, though it is not dangerous. There are evidence of above-max doses being helpful, mainly for treating OCD spectrum disorders. From personal experience, switching from above-max SSRIs to a normal dose SNRI did the trick for lack of motivation. I would try to switch to a SNRI (Preferrably Cymbalta for its S/N balance, but Effexor is also an option) before trying augmentation and polypharmacy. If you do want to go the augmentation path, you should probably go with @Iceberg's suggestion
  5. Right, minus the energizing/activating Noradrenaline boost, which can be good or bad. Note that Risperidone is on the calming/sedating side of the spectrum.
  6. SSRI + Risperidone is a good combination. I've tried Sertraline/Fluoxetine with 0.5mg-1mg Risperidone and it worked great.
  7. Amisulpride is relatively selective to Dopamine D2/D3 receptors. Olanzapine us quite the opposite, hits many other receptors. These attributes, in theory, makes Olanzapine effective for more conditions and at the same time can cause more side effects. FWIW, I don't have any experience with Olanzapine, but had a bad one on Amisulpride. Either is was bad by itself or it was just useless compared to Abilify. BTW, why do you have to choose between these two particular AAPs?
  8. Adding to what @mikl_pls said, more selective means that more of the substance binds to the receptors/transporters it is selective to, as opposed to being spread out between different ones. In this sense, more selective can be called “stronger”. Subjectively, Lexapro 10mg felt as strong for me as Sertraline 300mg (or Prozac 80mg). Even more, taking into account side effects.
  9. I take Klonopin at night because of the potential sedation. I thought that it was making me sleepy during the day but looking back it more likely was the Mirtazapine (which is a strong antihistamine and super-sedating by itself) I was on at the time. Anyway, either the sedation effect wears out with time or it wasn't there to begin with. That being said, I am only on 0.25mg. Good luck!
  10. I take .25mg Clonazepam as part of my daily cocktail for OCD related anxiety. It made me sleepy when I was not taking it daily, now it just keeps my anxiety levels low (and constant). Alprazolam is short acting so it is considered better as PRN. Clonazepam is the longest acting so it is theoretically better for constant anxiety levels.
  11. Thanks Cheese Maybe it is just me, but Lamictal feels like it fits right into place. (They should start paying me for this PR)
  12. (yet another) new cocktail: Sertraline 50mg - Anxiety & OCD Bupropion XR 300mg - Depression Clonazepam 0.25mg - Anxiety Abilify 5mg - Intrusive thougts & Tics Lamictal 200mg - Cosmic balance Fingers crossed, I think I am approaching "normal", again.
  13. Abilify is considered one of the meds that are less likely to affect appetite and for most it has the opposite effect. Activation of the 5HT2c receptor by Serotonin decreases appetite. Pharmacologically, Abilify is a Serotonin 5HT2c partial agonist. The meaning of this is that it activates the receptor, but less so than Serotonin. So, depends on your Serotonin levels (after introducing an SSRI/SNRI like Cymbalta, in your signature), Abilify can actually reduce signalling on this receptor and cause an increase in appetite, mostly for carbs (and sugar). The 5HT2c receptors have a regulation mechnism so I believe that this effect is temporary. I would ask your pdoc, of course. Edit: AFAIK, Abilify does not affect blood glucose/lipds level. I had high blood lipids from Risperidone and my pdoc switched it for Abilify, for this reason.
  14. If you are looking for a selective NRI then Straterra is an option, although it is only approved for ADHD. Reboxetine (Edronax) has a similar pharmacological profile, if available. I have asked my pdoc about the latter some time ago and he said that one SNRI is better than two different meds that have a similar effect.
  15. The basic action of antipsychotics is antagonism of certain Dopamine receptors. Taking a DRI (stimulants, for example) that boost dopamine levels can counter their effect... and, well, cause psychosis. Sertraline is a mild DRI too, on higher doses. If I were you I would want to try something that boosts Noradrenaline and not Dopamine. Venlafaxine becomes a “true” SNRI at higher doses. Cymbalta can be a good choice. There is also Milnacipran, but it was so extremely too activating for me that I cannot recommend it but it may also be an option.
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