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Your Cocktail Deconstructed

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17 hours ago, Wonderful.Cheese said:

So, no more anti-drooling pill, no more clozapine, no more vraylar, and hoping to make zyprexa zydis 10 mg part of my regular cocktail (I have been taking it daily anyway), also I take Flonase for allergies I forgot about that 

 

The AAP:

 Abilify 35 mg - mood stabilizer and psychosis......30 mg Bedtime and 5 mg AM

 

The anti anxiety:

 Klonopin 3 mg - severe anxiety (GAD)........1 mg AM, 1 mg afternoon, 1 mg evening/bedtime

  

The mood stabilizer:

Lamictal 300 mg - mood stabilizer......300 mg bedtime

  

 Birth control:

  Yaz - birth control and heavy period control.......one pill AM

 

Sleep disorders:

  Nuvigil 200 mg - sleep disorders/wakefulness.....200 mg AM

 

Hashimoto’s disease:

Synthroid 50 mcg - hashimoto’s disease.....50 mcg AM

  

 Weight control:

Metformin 2000 mg - weight gain prevention from psych meds.......1000 mg AM and 1000 mg evening

Topamax 200 mg - weight management/loss, controlling overeating.....100 mg AM and 100 mg afternoon

 

Allergies:

Flonase - allergies.....spray in the morning

  

The as needed med (PRN):

 Zyprexa Zydis 10 mg - as needed for breakthrough psychosis.....5 mg twice daily

Glad you're down to one AAP regularly, and just one prn! :D 

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My cocktail is slimming down a bit as I become more and more stable! Was able to get rid of the PRN antipsychotic. Now I have a stockpile of Zyprexa and Geodon!! lol

  1. aripiprazole (Abilify) 20 mg 1 PO q AM: bipolar II, antidepressant adjunct
  2. clorazepate (Tranxene T-Tab) 15 mg 1 PO tid (45 mg): anxiety, panic attack prevention (I'd like to eventually get rid of this and just have PRN Xanax)
  3. desipramine (Norpramin) 50 mg 1 PO q AM: bipolar II depression
  4. MethylPro L-Methylfolate 15 mg 1 PO q AM: bipolar II depression, MTHFR gene mutations
  5. phendimetrazine (Bontril-PDM) 35 mg 2 PO tid (210 mg): obesity, and off-label for ADHD and idiopathic hypersomnia
  6. sertraline (Zoloft) 100 mg 1.5 PO q AM (150 mg): bipolar II depression, OCD, panic disorder
  7. vitamin D3 (cholecalciferol) 50,000 IU 1 PO q wk: hypovitaminosis D
  8. oxcarbazepine (Trileptal) 600 mg 1 PO bid (1,200 mg): bipolar II, nocturnal epilepsy
  9. propranolol (Inderal) 40 mg 1/2 PO bid (40 mg): essential tremor, and happens to help anxiety a little

+ PRNs (see signature)

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6 hours ago, mikl_pls said:

Glad you're down to one AAP regularly, and just one prn! :D 

Thank you! Although I am probably going to be put on zyprexa zydis 10 mg daily in addition to the abilify at my pdoc appointment in about 10 days. In the future I'd like to decrease the Abilify to 30 mg, but for the moment I'm wanting to enjoy semi stability for a while longer. I have been taking the PRN zyprexa daily 5-10 mg for about 3 weeks I think at least now.

6 hours ago, mikl_pls said:

My cocktail is slimming down a bit as I become more and more stable! Was able to get rid of the PRN antipsychotic. Now I have a stockpile of Zyprexa and Geodon!! lol

  1. aripiprazole (Abilify) 20 mg 1 PO q AM: bipolar II, antidepressant adjunct
  2. clorazepate (Tranxene T-Tab) 15 mg 1 PO tid (45 mg): anxiety, panic attack prevention (I'd like to eventually get rid of this and just have PRN Xanax)
  3. desipramine (Norpramin) 50 mg 1 PO q AM: bipolar II depression
  4. MethylPro L-Methylfolate 15 mg 1 PO q AM: bipolar II depression, MTHFR gene mutations
  5. phendimetrazine (Bontril-PDM) 35 mg 2 PO tid (210 mg): obesity, and off-label for ADHD and idiopathic hypersomnia
  6. sertraline (Zoloft) 100 mg 1.5 PO q AM (150 mg): bipolar II depression, OCD, panic disorder
  7. vitamin D3 (cholecalciferol) 50,000 IU 1 PO q wk: hypovitaminosis D
  8. oxcarbazepine (Trileptal) 600 mg 1 PO bid (1,200 mg): bipolar II, nocturnal epilepsy
  9. propranolol (Inderal) 40 mg 1/2 PO bid (40 mg): essential tremor, and happens to help anxiety a little

+ PRNs (see signature)

I'm so happy to hear you are becoming more stable! Yay! Great news! 

Edited by Wonderful.Cheese

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On 5/12/2019 at 2:31 AM, Persona_Is_Life said:

Holy polypharmacy. How are you feeling on this cocktail? Also, welcome!

Congrats! That must feel amazing! Also, much less to worry about. 

I'm great..no not really, but i'm stable. The only problem is very hard to wake up in the mornings, that's a little price, i hope my psychiatrist take me one antipsychotic (quetiapine i hope so) and also i think i'll be fine with just one antidepresant, i would like to keep the fluoxetine since it is more antiobsesive, and makes good synergy with the Ritalin. The las three ones (diazepam, amitriptyline and perphenazine) is just one pill with three substances at those dosage, that one i self medicate :D is very peaceful mind and doesnt knock me like quetiapine, i also self medicate with pregabalin and lamotrigine, surprising helpful both of them, by reading here and other forums, i decided to try those, i dont know if i tell him the next appointment, lets see how it goes, he is openly when i suggest one med..i'll update later :D and thanks for the welcome! Greetings from Mexico!

Edited by Equilibrium022x
Greetings

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Well, yesterday...sorry on thursday two days ago had my appointment with my psychiatry. He really did some changes and thanks God is working good.

1. Quetiapine √ out!

2. Escitalopram... √ out

So he add me a substance unknown from me, and is very peaceful mind thoughts clean and every thoughts are more clear, so here is my coctel:

1. Brexpiprazol 0.5mg (the new one) 

0-0-1 

2. Aripiprazole 15 mg....0-0-1

3. Fluoxetine 20mg.....2-2-0 (the only change was divide doses, still 80mg) - ocd, depression, anxiety √ great medicine, best ssri i've taken.

4. Modafinil 200mg....1-0-0/ from two i've taken, he dropped it just one for wakefull me, lerhargy, adhd

5. Methylphenidate LA/30mg....1-1-0

(Adhd, depression)

6. Olanzapine 10mg (drooped it instead of 10mg just half pillz very hard to cut it but fortunely i have a pill razor)/- 0-½-0. Eventually he will put me off my favorito antipsychotic 😕

7. Clonazepam 2mg....0-0-1/ he will make me quit also my favorite benzo but fuck it i'll use ir prn as well the olanzapine. Ok for this one two weeks i will take the entire pill, then two week pill, them keep me tapering two weeks ¼ pill (0,5mg)/them drop it 😕hopimg wont b hard to quit

 

Ok thanks for reading and sorry my bad orthography this damn phone is very slow working. Greetings!

 

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One change and two additions...

  1. alprazolam (Xanax) 1 mg 1/2-1 PO tid (1.5-3 mg)
  2. aripiprazole (Abilify) 20 mg 1 PO q AM
  3. desipramine (Norpramin) 50 mg 1 PO q AM
  4. sertraline (Zoloft) 100 mg 1 1/2 PO q AM (150 mg)
  5. oxcarbazepine (Trileptal) 600 mg 1 PO bid (1,200 mg)
  6. pindolol (Visken) 5 mg 1 PO q AM
  7. phendimetrazine (Bontril-PDM) 35 mg 2 PO tid (210 mg)
  8. quetiapine (Seroquel) 25 mg 1 PO qhs prn
  9. trazodone (Desyrel) 100 mg 2 PO qhs prn (200 mg)

+ Many more meds for non-psychiatric conditions.

Tranxene is out and replaced with regular doses of Xanax.

Swapped Inderal for Visken to help with depression, probably not so much for tremor (going to have to see my neurologist about what to take for that...)

Bontril will likely be going back to Dexedrine in the next week or so but at a much lower dose than I was taking (60 mg), and probably as the ER capsules.

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Upping the lamotrigine. Correcting the gabapentin dose.

Bupropion XL 150mg / 300mg (alternating days) qam

Gabapentin 400mg tid

Trazodone 50mg qpm

Lamotrigine 150mg qpm

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(yet another) new cocktail:

Sertraline 50mg - Anxiety & OCD

Bupropion XR 300mg - Depression

Clonazepam 0.25mg - Anxiety

Abilify 5mg - Intrusive thougts & Tics

Lamictal 200mg - Cosmic balance

 

Fingers crossed, I think I am approaching "normal", again.

 

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Cocktail is undergoing re-construction... Cross-titrating from Zoloft to Prozac (after taking Zoloft for almost 2 years or so). Added Wellbutrin(s), added pindolol (Visken). Swapped out a long-acting benzo to just taking Xanax tid.

  • alprazolam (Xanax) 1 mg 1/2-1 PO tid as directed (1.5-3 mg/day) (mostly taking 1/2 due to sedation): anxiety, panic attacks, etc.
  • aripiprazole (Abilify) 20 mg 1 PO q AM: "brain glue," helps me not go crazy, I'm more myself than ever on this medicine and been on it for about 2 years
  • bupropion (Wellbutrin) 75 mg 1 PO q PM: re-added Wellbutrin to the mix, is keeping me from suicidality and the bottomless void
  • bupropion (Wellbutrin) 100 mg 1 PO bid: ^ ^ ^
  • bupropion SR (Wellbutrin SR) 150 mg 1 PO q AM: ^ ^ ^ (total bupropion = 425 mg)
  • desipramine (Norpramin): held together my combo of Zoloft and Abilify, may not need it after a while if I stay on Wellbutrin (but Wellbutrin causes seizures in me so... we'll see...)
  • dextroamphetamine (Dexedrine) 1/4-2 PO tid (5-60 mg): back on this, titrating up from a tiny dose to wherever my "sweet spot" is, hopefully less than 60 mg so I have somewhere to go...
  • fluoxetine (Prozac) 20 mg 1-4 PO q AM as directed: cross titrating from Zoloft to this. 20 mg P + 100 mg Z x1 week, 40 mg P + 50 mg Z x1 wk, 60 mg P + 25 mg Z x1 wk, then 80 mg P + 0 mg Z; for bipolar depression, binge eating, impulse shopping (seriously, it's becoming a major problem), OCD, etc.
  • MethylPro L-Methylfolate 15 mg 1 PO q AM: abnormal folate metabolism due to genetic mutations in MTHFR genes
  • pindolol (Visken) 5 mg 1 PO q AM: supposed to disinhibit serotonin release by blocking 5-HT1A autoreceptors, but I think Abilify has this beat on receptor binding affinity, so who knows if this is going to help, also for tremor, but since this is a beta-blocker with intrinsic sympathomimetic activity (ISA) (IOW, partial agonist or functional antagonist of beta receptors), it may actually make my tremor worse, but at least it doesn't mess with triglycerides and cholesterol or cause bronchospasm...
  • sertraline (Zoloft) 100 mg 1 PO q AM: see cross-titration schedule at Prozac
  • vitamin D3 50,000 IU 1 PO q AM: I need this to keep from going into hypovitaminosis D so I don't feel like a 92 year old man
  • quetiapine (Seroquel) 25 mg 1 PO qhs prn: adjunct sleep med to trazodone
  • trazodone (Desyrel) 100 mg 2 PO qhs (200 mg): sleeeeeeeeeeeeeeeeeeeeeeep plz thx
  • oxcarbazepine (Trileptal) 600 mg 1 PO  bid (1200 mg): seizures, anxiety, bipolar mood stabilizer, etc.
  • levothyroxine (Synthroid) 150 mcg 1 PO q AM 1h ac: hypothyroidism, depression, etc., dose increased from 125 mcg to 150 mcg because despite TSH being normal, T3 and T4 were low (probably partially a result of Trileptal)

Plus much more! (see signature)

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19 minutes ago, Lapis.Lazuli said:

I don't have a huge cocktail like everyone else here, but I guess it's a combo of meds...

(I am going to start my new meds either today or tomorrow)

  • Aripiprazole - 5 mg a.m. / 5 mg p.m.
  • Clomipramine - 25 mg p.m.
  • Klonopin (Brand due to generic not working as well) - 1 mg a.m. / 1 mg p.m.
  • Lorazepam - 1 mg PRN for breakthrough anxiety and/or panic attacks and/or agitation

@mikl_pls How on earth do you keep track of all those meds? Do you use a med box and phone alarms and such? I couldn't do it. I'd have to have an in-home health aide come to my home to help me with my meds if that were the case. Very interesting seeing all the combos you've been on!

I definitely have to use a phone app, spreadsheets, and pill organizers, etc., to help me keep track of all my meds.

You're lucky you get by with such a trim cocktail! :) 

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On 4/13/2019 at 9:59 PM, dancesintherain said:

Lithium - 150mg IR in am; 450 ER in pm - mood-stabilization, predominantly antimanic (dosage recently decreased because of kidney concerns)

Lithium - 250mg in am - mood-stabilization, anti-depressant

Zyprexa - 5mg - recently returned from this after a trial with Fanapt, which ended up not working out sleep-wise

Ativan - 0.5mg in am and 1mg in pm - dosage has been changed around a bit while handling the Fanapt sleep issues

Prazosin - 2mg for PTSD-related nightmares

Luvox - 100mg for OCD-related obsessive and intrusive thoughts

Significantly changed dosages and a few changed meds because of the manic episode with psychosis.

 

lithium - 150 am and 600 pm (liver is now cooperative)

lamictal - 250

zyprexa - 15 mg

fanapt - 6 mg

xanax - 0.25 twice per day

klonopin - 1 mg

prazosin - 2 mg (wow I love this drug)

 

luvox dropped because of fear it was making me manic, back on fanapt because it apparently was doing something (we didn’t think that was the case), higher dose of xyprexa because I was hearing things, Ativan dropped because it wasn’t playing well with other meds and Xanax added instead.  This was over two ish month period.  We had to make switches quickly enough to make a difference and end the episode, but slowly enough that we could tell what was happening.

 

i May switch to Xanax XR and drop Klonopin if the trial of Xanax goes well.

Edited by dancesintherain

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30 minutes ago, mikl_pls said:

I definitely have to use a phone app, spreadsheets, and pill organizers, etc., to help me keep track of all my meds.

You're lucky you get by with such a trim cocktail! :) 

Thank goodness for those phone apps, right? And pill organizers! And don't feel bad for the number of pills you need for MH stability or your physical health too. You gotta do what you gotta do! Your drs prescribed the meds for a reason, after all.

What phone app do you use for med reminders, if I can ask? I use a health storylines one and I have an Android phone. I like it pretty well. 

5 hours ago, HydroCat said:

(yet another) new cocktail:

Sertraline 50mg - Anxiety & OCD

Bupropion XR 300mg - Depression

Clonazepam 0.25mg - Anxiety

Abilify 5mg - Intrusive thougts & Tics

Lamictal 200mg - Cosmic balance

 

Fingers crossed, I think I am approaching "normal", again.

 

Good to hear that you are approaching “normal” again! And I love the Lamictal as “Cosmic balance”! :) It is a good one. 

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Well off vraylar which broke my gut and brain and back onto my “miracle med” (zyprexa zydis) at a lower dose (5 - 10 mg now vs 20 mg long ago) daily. The zyprexa squashed a “on my way to a full blown manic episode” from vraylar insomnia. Flonase was added a while back as recommended by my GP.

 

The AAP’s:

Zyprexa Zydis 5 mg or 10 mg - treatment resistant psychosis.......5 mg - 10 mg bedtime

Abilify 35 mg - mood stabilizer and treatment resistant psychosis......30 mg Bedtime and 5 mg AM

 

The anti anxiety:

 Klonopin 3 mg - severe GAD........1 mg AM, 1 mg afternoon, 1 mg evening/bedtime

 

The mood stabilizer:

Lamictal 300 mg - mood stabilizer......300 mg bedtime

    

Birth control:

Yaz - birth control and heavy period control.......one pill AM

 

 Sleep disorders:

Nuvigil 200 mg - sleep disorders/wakefulness.....200 mg AM

 

Hashimoto’s disease:

Synthroid 50 mcg - hashimoto’s disease.....50 mcg AM

  

 Weight control:

Metformin 2,000 mg - weight gain prevention from psych meds.......1,000 mg AM and 1,000 mg evening

Topamax 200 mg - weight management/loss, controlling overeating.....100 mg AM and 100 mg afternoon

 

Allergies:

Flonase - Allergies.....Sprays in the AM

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1 hour ago, Wonderful.Cheese said:

What phone app do you use for med reminders, if I can ask? I use a health storylines one and I have an Android phone. I like it pretty well. 

I use both Medisafe and Med Helper.

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7 hours ago, Wonderful.Cheese said:

Thank goodness for those phone apps, right? And pill organizers! And don't feel bad for the number of pills you need for MH stability or your physical health too. You gotta do what you gotta do! Your drs prescribed the meds for a reason, after all.

What phone app do you use for med reminders, if I can ask? I use a health storylines one and I have an Android phone. I like it pretty well. 

Good to hear that you are approaching “normal” again! And I love the Lamictal as “Cosmic balance”! :) It is a good one. 

Thanks Cheese :)

Maybe it is just me, but Lamictal feels like it fits right into place.

(They should start paying me for this PR)

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9 hours ago, Wonderful.Cheese said:

Thanks. I’ll have to look into those two!

Emoods is pretty good too. It’s primarily a mood tracking app, but has built in alerts/alarms

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