Depression in lat afternoon - meds?

[doghappy]

I know this is a longshot but wondered if anyone else has been on similar meds and had a simiilar experience. I am very stable from about 8:00 am to 4:00 pm. Overall, I'm the most stable I've been. But @4:00 pm, like clockwork, depression starts to set in. My pdoc seems to think it's something that can be dealt with CBT but I do CBT all day - this decidely feels like a chemical problem. My meds are:

Morning:

Celexa - 80 mg

Geodon - 40 mg

Provigil - 400 mg

Adderall - 40 mg

Early Afternoon:

Adderall - 40 mg

Provigil - 200 mg

Night:

Lithium - 1200 mg

Seroquel - 200 to 300 mg (I take this earlier if I feel really labile)

Would changing how or when I take a med(s) help, do you think? Thanks so much!

- Kel

[Bueler]

This may or may not make a difference, but I take 1200mg Lithium, and divide it between morning and night (600mg each). Maybe you don't have enough lithium in your system by the afternoon?

It's worth a shot... the other thing I could think of would be to split your Geodon dosage between morning and afternoon, but if you have a 40mg capsule, this may not be possible.

Do you use immediate release lithium, or Extended Release? I use extended and still split it up, and it works pretty well for me.

[dancesintherain]

Is there anything life-wise that could be causing a 4 o'clock crash. The only reason I'm asking is that I was sure mine was medication related (usually around 6)....when I realized that it was the time that I'd usually get off work and be on the metro on the way home, walking to my apartment, etc. In other words, lots of time to think and worry and stress about everything, which I hadn't had during the day because I'd had to be functional for the job.

If there's nothing life-wise that would seem logical...maybe a med split could help. One other option would be celexa, but I don't know how long the half-life is on that one. That might be worth checking--looking at the half-life of the varous drugs and seeing if something could be wearing off.

[CrazyBabs]

Provigil can cause the 4o'clock crash. Do you get mini (and I mean tiny) hi-lows all day? That was my experience with Provigil.

P.S. I am new - first post.

[doghappy]

Thanks so much for the responses. They're all helpful. CrazyBabs, great first post!

danceinthe rain: It is certainly relevant to consider the possibility it's something that happens at that time that causes it. I don't think so, though, as it doesn't seem to depend on what I'm doing (my schedule varies). But I'll watch for that.