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SKC

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Posts posted by SKC

  1. 19 hours ago, Iceberg said:

    SNRI for strattera is selective norepinephrine uptake inhibitor as opposed to serotonin norepinephrine reuptake inhibitor (Effexor etc) 

    I never tried Ritalin but I've focalin which is part of the methylphenadate family and adderall had way more impact 

    Sorry Iceberg but there's no such thing as an uptake inhibitor. Strattera inhibits the reuptake of serotonin and norepinephrine just like the two others 

  2. 19 hours ago, saintalto said:

     

    There is a reason we are secretive. I can understand telling a potential partner about it because I need to know if that relationship is ever going to be anything or if the person is going to bolt. But I have had very damaging experiences being very open about my mental health. At first I really was and it bit me in the ass. I found that family wasn’t particularly supportive. I found that friends I valued ran the other way, and I found that coworkers started distancing themselves from me. At University I found that even in graduate school, I faced poor treatment from my professors. I was told no one wanted to know I was ill or how it affected my work when I asked to write about its Influence. This is not on us.

    I'm really sorry you had to deal with and go thru all of that. It's really fucking sad that people react that way. I hope I didn't come across as being insensitive. I know everyone's situation is different.

    • Like 1
  3. I haven't had experience in length of time in disclosing mental illness in regards to a relationship because I just got out of a long term one and haven't started looking yet. That being said, I am VERY open about my mental illness and the meds and therapy I use. I personally think that the stigma surrounding mental illness is partly due to the fact that people who suffer from, and medicate because of, it are secretive and act like it's something that's wrong. All of my friends, coworkers, managers, and family members know about mine. I try to be so open about it in the hopes that someone who may be suppressing their own issues might become a little more comfortable with considering treatment. 

    • Like 1
  4. 8 hours ago, Blahblah said:

    You've tried a good amount of SSRIs and they haven't been a good fit (I haven't had luck with them either) you have the option of SNRIs (like Cymbalta or Effexor) I think they are good for anxiety and also not as "lethargy inducing" as SSRIs. Could cause a bit of sleep disturbance in the beginning.

    Wellbutrin: Is a bit different/unique, I think it is good for decreasing addictions (like smoking, alcohol, eating?)

    Since you are dealing with: anxiety, depression, and restlessness to give Lamictal a solid try. I have been on the range 100mg for over a year now (tried up to 400mg) and I find that if you are in the 100-200mg range you are way less likely to deal with cognitive-type side effects. It is a very gentle med that is not known for being too activating or sedating. A solid mood-stabilizer that plays well with other meds!

    Stimulants: Have you ever tried Ritalin? IMO, out of the stimulants, it really helps with focus without causing mania, insomnia or extreme restlessness. What I like to do, is take the extended in the morning, and then add-on the IR immediate release in afternoons when sluggish and need a mental/concentration boost. The IR wears off by dinner time and I always feel more tired at night going to bed and sleep like a baby!

    Adderall seems like a heavier-hitter compared to ritalin. I haven't tried other stims, so I can't comment on Vyvnase, etc. But those seem more apt to keep you up at night, which further intensifies depression & anxiety, and Bipolar swings.

    Strattera is an SNRI so she has tried one. I personally tried Cymbalta and it was hell and my mom was on Effexor and that was terrible for her. Obviously every drug has bad reactions to some people, so this is just a personal anecdote.

    Wellbutrin is considered a stimulant as well and can increase anxiety and insomnia but it is definitely worth a try as it's stimulant effect isn't anywhere near amphetamines. 

    LAMICTAL :D

    I've never tried Ritalin but I've heard from other people that it's harsher than Adderall. What makes you say that Adderall hits harder? 

  5. @CrazyRedhead If you can't find an ERP therapist, ACT therapy may be easier to find and is definitely worth a try. My therapist is still in the process of figuring out what style is best for me, but ACT is one that she suggested.

    Quote

    The effectiveness of ACT for OCD has recently been tested in a large trial funded through the National Institute of Mental Health (Twohig et al. 2010) In this study, eight one-hour sessions of ACT for OCD with no in-session ERP were compared to Progressive Muscle Relaxation (PMR), with assessments taken at pre-treatment, post-treatment, and at a three month follow-up. PMR was viewed as a control condition in this experiment, so most of this review will focus on the results for the ACT condition. In this study, 79 adults (41 in the ACT condition) diagnosed with OCD were treated. All types of OCD were included in this study (hoarding, primary obsessions, checking, cleaning, etc.) and there were very few exclusion criteria, thus, hopefully representing a fairly realistic sample of participants. The treatment was found to be highly acceptable. Only 12% of the sample in the ACT condition refused or dropped out, which is quite low for OCD treatment trials. All participants in the ACT condition rated the treatment as a 4 or greater on a 5 point scale, with 5 being the most positive score. These findings are meaningful because low drop-out and high acceptability are difficult to achieve in the treatment of OCD.

     Link to information about ACT and the source of the above clinical trial information.

  6. @SheltieUnderdog 1. Definitely stay on Topamax if you're receiving a benefit and it doesn't seem to impair you. Just because a medication is notorious for doing something doesn't mean it always will, so maybe you're the lucky one who escaped its "Dopamax" effect! You could still bring up amitriptyline to your docs but it is contraindicated with Topamax, meaning it could cause side effects by using them together. When I looked it up, it appears that both medications potentially increase internal body temperature and decrease sweating which could possibly lead to a heat stroke, so s/he may not like that combo even though major contraindicated combos are prescribed all the time. 

    2. There are mixed clinical trials on whether Lamictal helps with Psychosis. Dating from 1998-2016, it's constantly debated so it's believed it just comes down to the individual. It MAY help your Psychosis, but the main reason for Lamictal use would be for instability of mood. It helps the regulation of both depression and mania so it is definitely on par (in my non-medically licensed opinion) with APs when it comes to mood regulation. There is no link between Lamictal and Akathisia. One of the major benefits of Lamictal is its relatively subtle side effect scale. There is the chance of the rash which is the biggest side effect and another common one is vision change. I personally had my vision start to turn worse while on Lamictal but it was nothing that caused me to need glasses. My vision went from 20/25 to 20/40, but I see this as completely inconsequential compared to the benefit I received.

    About impairment of thinking; there is a chance of this with Lamictal. It's listed as an uncommon side effect. I personally am not sure if I experienced or not. When I went from 150 to 200, I began to have trouble finding words and became forgetful of where I put things and what I was doing. This wasn't a constant thing; just something that would happen more often than it used to. This effect subsided after about 2 months of being on 200 mg. That being said, I also have ADHD-Inattentive Type and was not on medication for that disorder at the time so it could have just been the Lamictal exacerbating the symptoms of my ADD.

     Fun fact, there's also some evidence that Lamictal helps with migraines, so that's another possible benefit. 

    @Iceberg  It obviously depends on the individual person but Lamictal is considered first line over Lithium for mood disorders because of the lower chance of side effects and because Lithium require blood work every three months because it can easily become toxic. A combination of both of them has been shown to be even more effective than either one individually. 

  7. 7 hours ago, Mms said:

    Medications I "tried/re-tried" more recently:

    Lexapro - Stopped after a couple weeks because of trouble sleeping / anxiety that I was talking too much (excitability?)

    Strattera - Stopped after a couple weeks because of trouble sleeping.

    Lamictal - Stopped at 75 mg, because I was anxious about the possible cognitive side effects and also not feeling any better (I know now that the dose was too low.)

    Vybriid - Actually helped a lot with my anxiety/mood, but I was having trouble sleeping and binge+purging more for some reason (increased appetite? increased impulsivity?)

    Prozac - HORRIBLE, cried/slept for 5 days, then stopped.

    Currently:

    Started Buspar on Saturday (5 mg twice daily.)

    So far I am having more side effects than benefits.. but I'm trying to stick with it..

    (Also take Xanax PRN, but even 0.25 mg puts me to sleep)

     

    Lexapro - made me feel so tired and mentally fatigued yet I couldn't sleep at night, even when tripling the dose of my trazodone (oops). 

    Strattera - Would you consider Adderall? I'm on the XR and it does make sleeping harder until you figure out when you have to take it and what not to also use while on it i.e caffeine. It also curbs your appetite and, while some people think adderall should be avoided by people who have eating disorders, Vyvanse is in the same class and is FDA approved for Binge Eating and Bulimia. Since you tried Vyvanse before (and I have a friend who doesn't like it...plus it's starting to be linked highly to long term liver damage) I think Adderall might be an interesting thought not only for bulimia but for your possible adhd. It's helped a lot for both my SA and ADD. If you actually need it, it doesn't get you high. It just makes you feel normal.

    Lamictal - I REALLY think you should try Lamictal again. I was on it for 8 months and it was my absolute life changer. Sadly I had to discontinue due to developing the rash. You have to decide which is worse: possible cognitive impairment or the unstable/depressive moods you have. I can tell you that I experienced some memory decline when I initially hit my target dose of 200 mg but I noticed it slowly went away after about 2 months. 

    Viibryd - If this one was the wonder drug, it may be worth asking your Psych to create a cocktail with Vybriid as a part of it. Maybe if you can add a low dose of Adderall (10 mg) and then Trazodone 50-100 mg for insomnia. It may be worth a shot. Or you could try another SSRI like Paxil or Zoloft. 

    Prozac - Yeah it made me feel void of all emotions. Fuck that drug.

    Buspar - Is your doc planning on Buspar being used for monotherapy? It's almost always used as an adjunct.

     

    Obviously I'm not a doctor but I think a cocktail would be the best bet because you have contradictory symptoms. Either Adderall or Vyvanse for Bulimia and ADHD. And then add in Viibryd since it worked so well for you and then top it off with a garnish of Trazodone for insomnia. Since you're prescribed Xanax already and it makes you sleepy, you could rely a bit more heavily on that (along with the Trazodone) while your body gets introduced and used to the stimulant. 

    Orrrrrr you could use the above cocktail but substitute Viibryd with Lamictal (I cannot stop talking about how amazing this medication is once you get to 150-200 mg). You can request another benzo like Valium to use to control anxiety if it gets that bad while titrating up. I know it's awkward to use medication to counter the side effects of medications, but the ultimate goal is to get you to a mentally stable state. 

    Just don't give up. People go years before finding their perfect medication/s. 

    And, of course, never rule out therapy. Since coming off of Lamictal I've been in therapy and I can actually see how it can be beneficial. 

  8. 20 hours ago, SheltieUnderdog said:

    1. I will suggest Amitriptyline at my next appointment but is the drug typically covered by most insurances and is there a generic?

    2. Exactly what type of drug is Lamictal? What is it primarily used for and what are the common side effects?

    3. I've been told that Lithium, although a mood-stabilizer, can treat psychosis (at least the hallucinatory aspects) at higher dosages. I'm not sure what your history / diagnosis is, but can you say this is true for yourself?

    1. Amitriptyline is the generic name for Elavil. It's in the class of tricyclic antidepressants (TCAs). Nowadays Amitriptyline is mainly prescribed for Migraine Prevention, Neuralgia, and Insomnia. I'm about to be put on a member of its class, Clomipramine, which is mainly used for OCD. TCAs have their fair share of side effects and are known to be nastier than newer ADs. but they seem to be less severe than APs. Weight gain is a side effect of Amitriptyline, but the studies have only been for 4-12 week usage so long term weight gain isn't clinically known. Propranolol, a Beta-Blocker, is another good alternative for Migraine prevention. It too can cause weight gain but Mayo Clinic says the average weight gain is 2.6 lbs so that may end up being a better alternative. Honestly, you can bring these two options up and then ask your Neuro for any other suggestions because you believe Topamax is affecting your cognitive ability. 

    2. Lamictal is an anti-convulsant. In higher doses it is used for seizure prevention but it is the gold standard in mood stability; mainly when dealing with the depressive side of a disorder. There was a clinical study done which showed promise with lamictal and schizoaffective disorder when dosage reached 400 mg, reaching considerable mood stability and complete remission from paranoid symptoms. (Ref.) It can cause drowsiness, vision changes, nausea, and a skin rash. I did develop blurred vision from Lamictal but I do not regret a thing; it's that good of a drug. 10% of people taking lamictal will develop a rash between 2-8 weeks of treatment. 1% of people develop a rash called Stevens-Johnson Syndrome which can be disfiguring and life threatening. Lamictal changed my life but I developed a rash 8 months into treatments and had to discontinue (although I'm starting to think it was from too high of a dose of Adderall so I'm titrating back up on Lamictal). I HIGHLY recommend this drug and here are some reviews so you can get an idea, both good and bad. 

    3. I have not been on Lithium but it is a very popular drug for any kind of mood disorder. It has been used either with APs or as part of another cocktail for Schizophrenic disorders. You do have to get your blood drawn while on Lithium but I believe it's only every three months. 

  9. 2 hours ago, CrazyRedhead said:

    I have very bad OCD.....So bad that I can't leave my house without help......Unfortunately, I have yet to find any meds that help my OCD.

    I have heard of a therapy for OCD that is called ERP (Exposure and Response Prevention)....It is a type of CBT therapy, but not all therapists are well-versed in it:     https://iocdf.org/about-ocd/treatment/erp/

    ERP is now considered to be the gold standard of therapy for OCD, but I have yet to locate a therapist in my area that is trained in it....        https://www.mentalhelp.net/articles/exposure-and-response-prevention-erp-therapy-for-obsessive-compulsive-and-related-disorders/

    What kind of meds have you tried?

  10. 7 hours ago, ReincarnatedCow said:

    He said he wanted me to just try Zoloft, I’m never trying that again and I don’t know why he would suggest it. We are finding a new doctor and hopefully specialist once we move.

    When you find a new dr, even if it's just another primary, please tell them about your Mania/Depression and explain what happened with you and the car. ANY competent doctor should see that as needing immediate attention. And I just can't believe your previous doc. Diagnosing you with BP1, knowing you were manic and yet trying to throw the Z at you? That's just disgraceful.

  11. What do you mean "not realized it"? Have you just now started experiencing these symptoms or are you just now aware that they have always been there?

    I'm ADHD-Inattentive type so I don't have a lot of advice for the hyperactive part but yes I absolutely suffer from some of what you do. I used to absolutely love to read. I could sit and read a book for an hour easily, sometimes for the whole day. But starting around 2 years ago I started to lose that ability; all the way to the point where I couldn't read two paragraphs without forgetting what I had just read or, if I am able to sit and read for 30 minutes, I'll realize two chapters later that I haven't actually been retaining the info because my mind was off somewhere else without me even noticing. It's led to me just not reading or watching movies/new shows. Before I went to my psych it got to the point where I couldn't even play my favorite video games anymore because my mind would be all over the place and I'd have no idea what I was doing halfway thru the match. 

    You're not alone my friend. I hope the Concerta is helping!

  12. "Potential for Cognitive and Motor Impairment FANAPT, like other antipsychotics, has the potential to impair judgment, thinking or motor skills. In shortterm, placebo-controlled trials, somnolence (including sedation) was reported in 11.9% (104/874) of adult patients treated with FANAPT at doses of 10 mg/day or greater versus 5.3% (31/587) treated with placebo."  (Page 11, 5.16)


    "The symptoms of this syndrome [Psychiatric Drug-Induced Cognitive Brain Impairment] include (l) Cognitive deficits, often first noticed as short-term memory dysfunction and impaired new learning, and difficulty with attention and concentration" (Page 7)

     

    "The findings indicate that there is evidence for grey and white matter atrophy of the frontal brain, which cannot be explained by the severity of the disease alone but is also very likely a manifestation of long term effects of antipsychotics. . . .Five of eight studies . . . show reductions in frontal grey matter . . . correlated with antipsychotic dose. . . .More recent studies suggest that changes occur already in the first weeks of treatment."  (European Psychiatry, Vol. 30, pg. 65)

     

    "The results revealed two findings: (1) better word comprehension was associated with increased [Grey Matter] volume . . . (2) better word and sentence production was associated with increased [Grey Matter] volume . . .The VBM analysis shows that [Grey Matter] volume . . . was positively associated with performance on *spoken word comprehension . . . we found that increased [Grey Matter] volume within the frontal region was associated with better [speech] production" 

     

    The first two show that APs can absolutely cause cognitive impairment, which can include speech problems. The third shows that Aps can lead to the deterioration of grey matter and the fourth shows the connection between grey matter and speech. That all being said, all medication -especially psych meds- act differently for every person. You just may be intolerant to APs (since almost all of them cause this problem for you) like how there are people (me) who are intolerant to SSRIs. Our chemistry varies so these medications won't do the same for everyone. The best thing you can do is to not listen to people who say "it's not the meds." If you notice that your speech improves while you're not medicated and then devolves when you become medicated, that tells you that it's the medication. 

    Now, looking at your current meds, I would try to find something different rather than Topamax. There's a reason it's referred to as "Dopamax/Stupamax". It is notorious for killing cognitive ability. I tried it after I had to come off of Lamictal and I felt like I went back into the first grade. Gabapentin is another med that can attribute to cognitive decline. I experienced that as well on 600mg a day and I see it in my mom because she's on 1800mg (combined with Tegratol) a day and talking to her can be frustrating at times because of the difficulty she has with thinking of words and forming sentences. So it could easily be that adding an AP on top of the Topamax and Gabapentin could just shoot the "cognitive impairment" side effect right to the top. 

    For your Migraines, I'd recommend Amitriptyline over Topamax. It's a TCA so the initial side effects might be a bit harsh but it is a wonderful drug. It can pull triple duty for you as it is indicated for migraine prevention, depression, anxiety, etc. Now when it comes to medications that won't have the cognitive effect on you...that's hard to say because it depends on how severe the positive symptoms of your SZA are. It sounds like rage/irritability is a big part of what you might suffer from so I would recommend trying a combination of Lamictal and Lithium. 

    Lamictal is an AMAZING drug. I had absolutely no control over my emotions and would switch rapidly throughout the day over the smallest of things. I would go from intense, irrational rage to depression so painful that I would call into work because it felt like all of my bones would shatter if I got out of bed. Lamictal 200mgs took 80% of that away just by itself. Only reason I had to come off was because I developed the rash so now I'm titrating back up slowly to hopefully avoid the rash again. But yeah, Lamictal can control the depression and the anger to an extent and then Lithium can pick up the rest. Lithium isn't really for depression; it's focus is on controlling Mania which Lamictal doesn't really help with. So they're a good duo. 

    Obviously I'm not a doctor but this would be the course I would go if it seems like you can't do APs.

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