What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?By Adolf
"Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?
Can antipsychotics be an alternative to "conventional" antidepressants? What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.
Have a strong itch to drop Effexor...(I won't go cold turkey). It stopped my dysphoric crying spells, but now, 10 months later, I'm feeling increasingly flat, apathetic, numb, no motivation (even after dropping to 75mg). I hate how all A/Ds have this lobotomy effect on me longterm. It's initially fine in acute episodes, I'm not sad now, but I can't function properly, and I continue to score Moderate-Severe on the depression scale.
I think it's counteracting my Ritalin (which I increased to 30-40mg)? I don't want to increase Effexor above 150mg, I'd never be able to go off.
I'm trying dosing at night instead, will this make any difference @mikl_pls ? I skipped yesterday's morning dose (then came the intense nausea, over stimulation & brain slosh awfulness @10 hours later) and I took my dose with dinner.
I'm seriously considering going on low-dose mild SSRI instead (Prozac?) I'm sensitive to meds & side effects, and I'm also VERY worried about withdrawals. Especially from Effexor, they are the WORST, and I just read study that Effexor withdrawal syndrome is not dose-dependent:
Forgot to take Lamictal yesterday (I took my other meds). Holy Hell, I took my dose today (on schedule) and I STILL feel awful!! I've only been on 100mg....I thought Lamictal had a super-long half-life? Yesterday went like this:
10am - up, had breakfast
11am – slight Brain “swishes” started (was out the entire day)
12pm – Stronger Brain zaps start
1:30pm – Lunch (meat, salad/veg)
2:30pm – Sudden extreme exhaustion
4pm - more brain zaps => ZAP ZAP ZAP! 🤯
7pm - Irritability starts
11pm – Tea, bedtime, could not fall asleep (I haven't had insomnia in 2+ years)
...Night sweats…Restless legs.....
12am – Ruminations, feel weepy
..Insomnia ensues…(Toss & turn, sweaty/achey all night)
It's now 12pm,and I am STILL having brain zaps! I worry I’ll never be able ever taper, switch from, or withdraw from this med. You probably think well, with MI, WHY would you ever go off it? For me, longterm, these meds are band-aids. There is always a price. Ok, maybe great at preventing acute/severe depression, but as a result, they rob me of any spark, joy, elation, happiness, libido, sexual sensation/response, feelings of reward, love.... This disturbs me. I used to know what positive emotions felt like…
So I’m stable, existing.....but still lacking will or any interest in living....
I apparently have very treatment-resistant OCD. My pdoc hasn't said it, but I have gathered this from my profound lack of insight into my obsessions, psychotic preoccupations, and the fact that OCD is not only interfering with life, but treatment as well.
I have tried novel strategies like memantine (30 mg), lamotrigine (400 mg), zonisamide (400 mg), topiramate (400 mg), etc. I've tried somewhat high doses of SSRIs (my pdoc hates prescribing anything at max dose) (fluoxetine 80 mg, fluvoxamine 100 mg (nightmare), escitalopram 10 mg (nightmare), sertraline 200 mg), SNRIs (venlafaxine XR 825 mg!!, duloxetine 120 mg, desvenlafaxine 150 mg, Fetzima (joke...)), Viibryd 40 mg, Trintellix 20 mg, etc., clomipramine 225 mg. I've tried various antipsychotics (typical and atypical) alongside SSRIs: fluphenazine 1 mg tid, perphenazine 4 mg tid, trifluoperazine 5 mg bid, haloperidol 1 mg tid to 5 mg x1, pimozide 2 mg bid, etc. Nothing seems to really help. Basically, if there's a way to treat it, I've probably tried and failed it or tried it partially due to conservative prescribing habits of my pdoc.
I have not tried low-dose clomipramine + SSRI, supratherapeutic doses of SSRIs (pdoc won't hear of it...), higher doses of typical antipsychotics (for acute psychotic preoccupations), certain antipsychotics (thioridazine, clozapine, etc.). I'm thinking about seeking a second opinion from another pdoc soon because my current pdoc is no longer helping me. She just keeps me on the same useless regimen and never wants to change anything, pats me on the back saying "you're better than you think you are," and sends me on my way. The office staff are severely understaffed, and one of them in particular always bitches me out after my sessions because it's so late, but it doesn't matter if I take 5 minutes or 55 minutes... she's going to bitch me out no matter what about it. She never says anything to the people who go back there and take two hours though. Just me, because I'm at the end of the day. It royally pisses me off and I'm about to snap at her, and I really don't want to (the office staff person). I'm also about to snap at my pdoc and ask if she'd rather the meds kill me or me kill me due to inadequate medication. I know meds aren't all there is in treatment, but she seriously has to budge for something to change.
I am seeing a therapist, but he's new and still getting to know me, so nothing has been done yet. He's taking notes and asking thorough questions though. I like him so far. He actually has a white dry-erase board in his office that he uses to illustrate things he's trying to convey to patients, and he's the only therapist with one in that whole office. I wish I could see my original therapist though. She's known me since I was 9 years old... She knows me like no other mental health practitioner knows me, and has the most extensive history on me. Last I saw her, she was in "partial retirement," which meant she blocked off half her office to this new guy (ex-pastor gone family counselor), disposed of all her notes on all her patients, sent half of her patients to this new guy, and kept the other half of her patients (mostly younger patients she said). I saw her twice or 3 times during that time, and she dismissed me after that. I wasn't really seeing her for my own purpose, but because of a problem I had I didn't know how to deal with. I tried calling her semi-recently when I was looking for a counselor several times, texting her, everything, and never got an answer, so I assumed she fully retired.
Anyway, I didn't mean to digress so much in this post.