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@Wonderful.CheeseThanks Cheese. I think I am going to talk to pdoc about reducing meds, without clozapine (hopefully). The good news is my depression seems to be lifting, so I think zoloft is doing something. We had a friend over who turns 50 on Tuesday last night (Saturday). I made a vegan chocolate pie that looked a little funny but was delicious. Previously I would've melted down but I stayed calm and was fine.

That's good to know. I see pdoc next week so I will ask about this then. I had a headache this morning and just lay down instead (perk from working from home).

@psychwardjesus Thanks for weighing in. I have been on Seroquel multiple times, Abilify I ended up in the hospital, same with Haldol. I don't remember much about Latuda other than that eventually it stopped working. I was Loxapine for years, had elevated prolactin (and pdoc doesn't feel meds to lower that are a good long term solution) and some mood instability. He put me on Haldol which went VERY badly. I have taken most of the AAPs and Haldol and Loxapine for APs. I can't remember if we held the small dose of Loxapine after I started Zyprexa (went back on Loxapine after Haldol) or if it was being Zyprexa needed a top up because it wasn't working well enough on it's own. But I suppose that is one thing we could eliminate, I can ask about that. I've never had a great experience with therapy. Behavioural activations (from CBT) are about the only thing I've ever found helpful.

Thanks Gear. My cocktail now is working well with minimal-ish side effects (high lipids and weight gain, thank you zyprexa - but cloz is not likely to fix those). It's funny, I'd come to a similar place in my process. I will raise it with pdoc as something to keep in mind, but yes. My depression and OCD are better since I started zoloft. That could be psychosomatic, could be work stress getting better (for now) - but I've been on zoloft for...2 weeks - at 100mg for a week - and I think things are better. I just feel like a pill popper.

@Iceberg That's a good point. Pdoc will definitely want that too, one thing at a time (though I would hope zyprexa/loxapine could go in lockstep). To be honest, lamotrigine is so side effect free I don't notice it. WITH that said - it has rarely been enough on its own for my depression. A few years back I decided to lower the dose (without pdoc's help) and very quickly got depressed. So it does something.

Thanks so much! That's helpful. What dose do you take? I eat a lot of fiber (often) so am hopefully I could minimize constipation. It sounds like the sedation is the worst. I am wondering if I could get off lamotrigine (or zoloft) as well as zyprexa and loxapine. Ativan is a PRN which I use mostly for sleep anyways. That's...5? meds including rybelsus.

@Iceberg in your experience of clozapine, have you had to take medications to deal with its side effects (peeing, constipation)? I would want to continue on rybelsus.

@CrazyRedhead @DogMan Thanks so much guys! I do feel comfortable talking with my pdoc about this - he's pretty responsive - and I think we can work together on this. The newest med (Zoloft) I think is still a bit too early. I am feeling a lot better but still have some intrusive thoughts. Depression has improved but some of that may be work stress improving. I had a 'too depressed to get work done, depressed because I'm behind at work' feedback loop going on. The rest I've been on for ages. If Zoloft doesn't help it's clozapine (and I assume ditching zyprexa and loxapine), and I know pdoc wants to be careful about that.

I currently take 6 psych meds, plus a type II diabetes drug to help with side effects, not because I have diabetes. -Zyprexa (30mg) -Loxapine (20mg) -Lamotrigine (300mg) -Gabapentin (900mg) -Zoloft (100mg) (this is new) -Ativan PRN -Rybelsus (14mg) (to help with side effects) Started Zoloft to help with depression and intrusive thoughts as yet another 'one last thing before clozapine'. Not that I'm anxious to go on clozapine, you understand, but I do feel like I take an awful lot of medication. Is there anything in particular to say if someone is overmedicated?

He does seem on top of things. I'm glad. Oh that's good about the meetings! Those will be helpful I am sure.

@browri I will, thanks. I see him in a couple of weeks. I may trial some acetaminophen in the meantime. My migraines are sporadic so hopefully they hold off. They've lessened in regularity since I started taking rybelsus (though that may be coincidence).

Thanks @browri - I am glad you weighed in with your expert opinion! That all makes sense and eases my mind a lot. I am going to try to reduce naproxen, unless I have a corker of a migraine.

Your pdoc seems great. I'm glad. Looking up an OCD support group in the meantime sounds like a great idea.

I found this fascinating. I hope they can develop it to treat psychosis too. https://www.nytimes.com/2021/10/04/health/depression-treatment-deep-brain-stimulation.html

That's frustrating they weren't more helpful. The resident sounds like a real jerk (I'm being polite). And that she didn't know what she was talking about. I would also trust your pdoc with meds. They know you best. OCD treatment sounds good, but the wait sucks. Does your pdoc have any access to other programs that could bridge you over until then? Sending gentle thoughts. I'm glad you're okay now.

That's a good tip, thanks. You guys are making me feel better.

Thanks so much @gabagaba - I appreciate it. I think some of the work stress lessening has helped a bit, but I still have a ways to go. Fingers crossed zoloft makes a difference.

Thanks Harp, that helps me feel better. I was worried about my headaches and the naproxen.

So reading some stuff online, it says NSAIDs and aspirin increase the risk of bleeding if you're taking zoloft (I'm on day 2, 50mg - go up to 100mg next Thursday (after a week)). I asked the pharmacist who looked it up and said that's only if you take it regularly and only in the stomach. That's not what I've read sounded like. I emailed pdoc's assistant to ask her to ask and she said she hadn't heard of it and the doctor wouldn't know anyways (which I don't think is true, but, I hit a wall there). So, I am asking the brain trust here...what do I need to be concerned with? I take naproxen when I have migraines and headaches, so not REGULARLY, but somewhat often.

Thanks @dancesintherain, me too.

Oh 50mg to start then up to 100mg after one week.

So saw - 'saw' - pdoc. I asked about an AD. He said yes. He felt Luvox wouldn't play nicely with my cocktail so he's going to put me on Zoloft. I think (80?)mg the first week, then double afterwards. If this doesn't work, then it's clozapine for me.

I went to the chiro to get migraine help. Not sure if you are comfortable with that. It wasn't a magic bullet, but it did help.

@DogMan I often find writing things out helpful. Though I don't feel much closer here. @dancesintherain I've been on two ADs, not luvox. I will ask pdoc about it. The first AD I was on triggered an episode and got me into the psych system - the second was fine. I feel like I need something more than zyprexa - if I stay on it - I don't know what to think.

Thanks Iceberg. I don't know how much to expect zyprexa to take care of this, or if I need something more (lord help me). If I really stay on top of doing behavioural activations I am okay, but if I miss anything - boom! Down I go. Sleep doc wants me off zyprexa (thinks it is causing sleep walking) but clozapine is next. Which I have heard is AWFUL for OCD. So I don't know what to expect/do. I see pdoc tomorrow. I have been very stressed about work too, which is suffering in part BECAUSE of all this, and then contributing to my mental health too. I feel like I need to take some time off, but sometimes I'm fine.