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Posts posted by zisforzyprexa

  1. If the'yre stress or tension induced as you say, have you considered taking a benzodiazepine or other anti anxiety medication? I often get dull, throbbing neck aches that, before making the connection w/ anxiety instead of injury/strain, would never respond to OTC pain meds. Also, for non-drug related suggestions, I would strongly suggest an ice hat and eye mask, at least if you're at home. I almost always take something, put the ice hat on, then go lay down with the mask as I get pretty photosensitive and the ice hat helps to distract.

  2. Outside of Abilify, Risperdal, and maybe Latuda, you're going to have a hard time finding an AP that's not at least somewhat sedating, at least within the family of SGA's (second generation antipsychotics). 

    FGA's like Thorazine, Haldol, etc. are known for less sedation than SGA's, but also come with their own unique side effects you might not find pleasant either. Plus, they're straight D2 blockers and known even less for anti-depressant properties than newer SGA's.

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  3. On 5/23/2018 at 6:19 AM, Blahblah said:

    Seems my choice is to either be emotionally depressed or a complete apathetic sloth!!! Any ideas?



    Anhedonia — lack of pleasure or inability to enjoy everyday things — is pretty common with major depression, even when being actively treated and some symptoms resign. I know it's definitely something I struggle with a lot of the time. I also took Effexor XR at one point for a couple of years, going as high as 300mg, but never saw much improvement beyond when I first started taking it, regardless of dosage. I can manage, but I wouldn't say I feel great (or even good some days).

    Eventually though, largely due to a return of depressive symptoms triggered by life stuff, my PDOC and I decided to switch off of Effexor and try something else. He gave me a lot of freedom to research and make my own decisions, so initially, I tried modafinil (Provigil) because I figured it'd be easier to add than take away; plus, it's not a stimulant, which I personally would rather avoid, if at all humanly possible. But, ultimately, it didn't do much, if anything, even at the max dosage (400mg/day), so I came off of it.

    Ended up on duloxetine (Cymbalta) because it was another SNRI and I wasn't sure if I wanted to quit SNRI's all together yet (worried what it would do if I came off the NRI portion of the drug and went with something else, like an SSRI, that doesn't affect norepinephrine receptors). As it stands right now, I'm on 80mg and I feel mostly okay. My PDOC said the ceiling for the drug is 120mg/day. I've thought about increasing it, mostly to see if I'd get any benefit at a higher dose, but I'm also afraid it won't do anything and I might have to find another drug again.

    Long story short: you still have quite a bit of Effexor to play with (the highest dose I've seen is 425mg/day), if you're so inclined; you could try modafinil like I did (assuming your doctor is open to it and you can afford it if it's not covered by insurance) or a different SNRI entirely. There are newer, novel anti-depressants that might do some good, but I don't know much about them and probably wouldn't try them anyway 'cause they're still patented and expensive af. Beyond that, there are tricyclics that sometimes affect both serotonin and norepinephrine, but they're also notoriously bad in regards to side effect profile; plus, I don't know your history, but your doc might be reluctant to try them because they're very cardio-toxic when used in an OD attempt.

  4. On 3/27/2018 at 8:01 PM, looking for answers said:

    could also try a stim

    Me personally? I've thought about it and I'm pretty sure my psychiatrist wouldn't care, but between working in the field and seeing the dark side of amphetamines, amphetamine abuse and amphetamine-induced psychosis and worrying about becoming dependent on or taking too much of the klonopin I'm already prescribed, I'm reluctant to take that leap. I can see it working well for some people though.

  5. On 3/24/2018 at 1:47 AM, BrianOCD said:

    Well sadly I'm here again...My depression has hit that flat point where everything around me is exactly the same, whether I go out, go here and there, I feel lifeless.

    When you get to this point what do you do?  How do you survive under Anhedonia?  I haven't learned yet to live with this, it did go away before after medication, but I'm already on meds and no dice...

    I think the Seroquel may have some value in helping, even the Ativan, but I'm reluctant to tamper with meds at this point as I've tried so hard to level myself out...Do you guy have any suggestions when you're in this state?

    In terms of medication, it doesn't look like you've had a med trial of Wellbutrin (bupropion); might be worth a try. You could also try a "wakefulness drug" like Modafinil. It's FDA-approved for narcolepsy, shift work disorder, and fatigue from sleep apnea, but some people endorse getting energy from it. Personally, I tried it up to 400mg/day and didn't notice much, if anything. I also don't know how much it would cost you because it'd be an off-label usage.

  6. In Boston, we've had two storms so far, one Nor'easter and the other a straight-up blizzard that dropped 18+" of snow and another storm next week.

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  7. 18 hours ago, SheltieUnderdog said:

    I'm going to mention Lithium and Depakote and relay some of the information I have gotten and go with whichever one my psychiatrist recommends to use first.

    I've never been diagnosed with insomnia but my situation is that if I get a good nights rest, I can't sleep for **** the following night and the next day I'll be tired enough that I'll sleep the respective night at the end of that day. I'm not very active with the exception of the akathisia and physical therapy 2x per week. I am currently morbidly obese and have too many orthopedic problems to be active so that may play a role in why I have trouble sleeping in general. I currently depend on Clonazepam 2mg for sleep. I was on Trazadone previously and found it less effective overall, I had to be somewhat tired for it to work at all.

    I have sleep apnea and went for an overnight study recently and they wouldn't allow me to carry any medications with me in the facility without authorization from the prescribing doctor (in this case my psychiatrist). The pulmonary center gave me nasty attitude and didn't want to do any additional work getting the script faxed over and deemed it unnecessary so I arrived without the Clonazepam and only slept for about 1 1/2 hours the entire night, not even long enough for them to get the mask on me and evaluate me properly. I now have to return for the sleep study with my Clonazepam in order to even hope to fall asleep long enough the 2nd time. The pulmonary center only started requesting that my psych fax over the script after the 1st test failed and I wasted my time driving and sleeping there that night. They didn't even apologize for not listening to me originally. Just an example of my sleep issues.

    I have sleep apnea too and my sleep doc actually prefers me not to use any meds for sleep as they can relax the muscles in your mouth and throat and make your apnea worse. Just FYI. 

    • Thanks 1

  8. Whether you're BPAD I w/ psychotic features or Schizoaffective: Bipolar type, you're likely going to need an anti-manic drug. As someone else already said, Lithium is the gold standard for mood stabilization and does wonders for people when it works, but it doesn't work for everyone and has the potential to cause serious medical issues. It's also a drug you have to commit to as it'll take time and bloodwork to get you to a therapeutic level and make sure it's not causing harm to your kidneys. And even when you reach a therapeutic level, you'll still have to do blood tests every 3-6 months as long as you're on the drug as well as be careful of drug and food interactions. I think you might be barking up the wrong tree with Lamictal though. > 400mg/day is typically only prescribed when used as an anti-seizure drug, not a mood stabilizer. And even then, Lamictal is only really known for use in the depressed phase of bipolar disorder, not mania. 

    You also honestly haven't tried many AP's from either generation. Trilafon, Prolixin, Stelazine, Loxitane, Orap, Rexulti, Vraylar, Geodon, Clozaril, Seroquel, Zyprexa, etc.


  9. Having worked in inpatient psych for the last eight years with people who have severe psychotic/mood disorders, IMHO it's usually easy to tease apart psychosis/mood/personality with rare exceptions. That being said, anything's possible and I've met people who had co-occurring psychotic/mood and personality disorders, people masking personality disorders by feigning psychosis/mood dysregulation and people whose personality vulnerabilities weren't visible at all until the psychosis/mania started clearing.

    Normally, I would suggest trying not to get too hung up on the diagnosis as much as the treatment, but since the treatments for schizoaffective and borderline pd are so different (i.e. psychopharmacologically-based vs. talk therapy-based) it might be worth looking into. 

  10. 17 hours ago, BrianOCD said:

    How much Effexor were you on when you took it?  I've found that to be most helpful for all of the above...Higher dosages for the intrusive thoughts.  Effexor also cleans up anxiety pretty nicely.

    I'd recommend Seroquel as well.

    Perhaps anxiolytic efficacy depends on the type of anxiety because I've been on Effexor for more than a year and been up to 300mg at various points, but experienced minimal relief at best for my social anxiety. YMMV though obviously.

  11. 6 hours ago, jt07 said:

    Abilify is great for depression and can help with intrusive thoughts and OCD. 

    Didn't you once say that you had anorexia? Amphetamine is the worst thing you can take if you suffer from food restrictions. 

    I was also going to suggest Abilify, as it can definitely help with intrusive thoughts better than traditional antidepressants and is FDA-approved for adjunctive use in unipolar depression (for whatever that's worth to you). Anecdotally, I've also heard from multiple patients (I work in inpatient psych) that they find it energizing at lower doses (up to 15 mg) and has some type of use, at least initially, kind of like Wellbutrin, as an appetite suppressant. That being said, Abilify, as with other second generation antipsychotics, has the ability to cause things like metabolic issues (weight gain, diabetes mellitus, hyperlipidemia, etc.) , tardive dyskinesia, akathisia, tremor, etc., which is something to consider given your concurrent issues with binge eating disorder. Ultimately, you have to weigh the pros and cons because it's a crap shoot, but it might be worth it. 

    I've definitely considered trying it for my intrusive thoughts, social anxiety and depression. Just haven't pulled the trigger yet for worry about weight gain and such (already a big boy — 280lbs).

  12. Normally, I'm pretty good about it, but that's usually in the context of working 40+ hours a week, so I don't put too much weight on that. When I have a lot of time to myself ― like the past couple days ― hygiene compliance gets a little dicey. Like, right now, it's not potent enough to peel wallpaper but I ain't no rose neither. It's just very hard to get motivated around the holidays.

  13. Honestly? Largely sad and ashamed. Have had a lot of problems recently with family and getting back with my ex (who has her own mental health issues ― depression, borderline pd, etc.). They essentially threatened to cut me out of their lives ― not coming to the wedding if there is one and they're invited, not accepting any grandchildren, etc. ― so I've kept my distant, staying at the SO's apartment and only stopping at home to get clothes and take care of my aquariums. I've had the last handful of days off but haven't done anything except sleep, watch TV, etc. because my car was totaled in an accident a few weeks ago and haven't been cut a check by insurance and had time to go car shopping. Anyway, between my relationship with family and SA, I've never been great with communication, especially initiation, so when Thanksgiving came up I hoped someone would get a hold of me. Nothing though. Silence. I probably should've been. nature and texted them but I was terribly anxious and trying to avoid it. Fast forward to the end of the night: I got a text from my mom. I didn't read the whole thing, just about her being hurt and something else about me being done with them. It was really hard to read. Not to mention it wasn't true. It's been +/- 24h since and I still haven't responded. I don't know what to say and even thinking about it floods me with anxiety.

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