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4 hours ago, mikl_pls said:

Thank you! :D

As for the addition of valproate, make sure you adjust your lamotrigine dosage if you're going to take valproate. Valproate slows the clearance of lamotrigine from your body, so you need to take half the normal dose of lamotrigine if you take it with valproate. In other words, you'd need to go down to 100 mg lamotrigine with the valproate. It's a small valproate dose, but still, the interaction can happen. I would actually say to wait to add that to your regimen until after you've discussed it with your pdoc—that's a very risky change to make on your own.

If zolpidem is too expensive, perhaps you could try something else? Have you tried trazodone? I take that with Seroquel and it works very well for my insomnia. Also, is zopiclone available in Mexico? Is temazepam?

Oh yes, i read something about the.interacción but didn't know was dangerous so it didn't matter at all. I will quit Valproate and stay with Lamotrigine, it's more helpful and i like the feeling, with valproate hardly notice something, but still we can considerado later i my next appointment.

As with those benzos, we don'"t find here in my country, just Triazolam (Halcion) a powerful hipnotic, Flunitrazepam (Rohypnol) just in the streets because they are banned. Oh, i forgot to tell you also Bromazepam (Lexotan) very mild bur effective and obbioisly we can't forget the goo olf Vslium.

The "z* drugs thst i know is it there is Zolpidem (Nocte, Ambien)/i would like to try but i" m without work right now, until october *fingers crossed*

 

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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 aripiprazole (Abilify) 20 mg

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 all

Cerberus, Curious if you've read Mind Fixers, by Anne Harrington?y That's not a trick or rhetorical question, and I'm not suggesting anything if you haven't OK, let me narrow this.  The

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So the plan Stan is to replace Abilify and add in rexulti instead. Here’s hoping it works! No other changes.


 

The AAP’s:

Zyprexa Zydis 20mg - treatment resistant psychosis and mood.......20 mg bedtime

Abilify 30 mg - mood stabilizer and treatment resistant psychosis......30 mg Bedtime (soon to be replaced by rexulti, if I tolerate rexulti)

Rexulti 1 mg for 3 more days, then 2mg - treatment resistant psychosis.......2 mg - 4 mg ultimately, bedtime (will replace abilify if I tolerate rexulti)

 

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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Current meds, just a little change:

Zolpidem (Notix) - 10 mg before bed. Finally i tried it, but not that sedative as i thought. Maybe some nights will take 20 mg but let's see how is still working. They said in other forums like bluelight that has hallucinating properties even at low doses like 20-30 even 10 mg but nothing at all at least not me. That was more interesting that made me go for a script, it helps, but nothing special.

Venlafaxine generic - 75 mg x 2 at morning when i wake up. I think is the antidepressant that has worked better for me, the social phobia has practically gone, also found it helps with my OCD and depression, more efective than SSRI's. Altough i read that the withdrawal is awful that scares me haha but just will focus in the present and later if i quit i'm gonna switch again to fluoxetine since is a long acting, easy to taper down.

Modafinil 200 mg, also when i wake up i LOVE the effect with my coffee in the morning and boost my mood to start my day.

Aripiprazole (Antremadin)/15 mg in the morning, helps f***ing OCD, my anxiety and mood swings, also tics disorder. Great atypical antipsychotic.

Methylphenidate XR (Tradea 54 mg) - At noon, for depression, adhd, sometimes use it as recreational the 10 mg IR. God i love/hate that substance, makes me feel euphoric and social, but i don't WANT a rehab again so i'm lowering down. Exercice helps a lot.

Atomoxetine (Strattera 40 mg) - At noon. Not am sure if it's effective for my adhd, maybe it helps in a subtle way, and i'm sure it helps depression also.

Clonazepam (Kriadex 2 mg) - ¼ at noon and ½ at bedtime, for anxiety, OCD off label but it helps, social anxiety, panic disorder and insomnia. LOVE it, never fails me all the time since 2005 it keeps effective.

Quetiapine (Aretaeus 100 mg) - 50 mg evening, 100 mg bedtime. Again ocd, mood stabilizer, insomnia, anxiety, depression. My favorite AAP, helps a lot of conditions.

Lamotrigine generic 100 mg - Two (200 mg) at evening, for mood disorder, anxiety and depression. I quit valproate though, this is better.

 

So that's it my current cocktail, what do you think? Thanks for reading, greetings!

 

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@Equilibrium022x Are you making these new changes with the help of your psychiatrist? You admitted in the past to making your own changes which can be dangerous. It doesn’t matter how much people on this board may seemingly know about meds, we are not doctors here. It is okay to take the advice you get here and consult your doctor about it, that’s fine, just don’t go making changes on your own based on online advice. 

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5 minutes ago, saintalto said:

@Equilibrium022x Are you making these new changes with the help of your psychiatrist? You admitted in the past to making your own changes which can be dangerous. It doesn’t matter how much people on this board may seemingly know about meds, we are not doctors here. It is okay to take the advice you get here and consult your doctor about it, that’s fine, just don’t go making changes on your own based on online advice. 

I'd made them by my own research, i read a lot about mental health, but i consult him via whatsapp before i make the changes and he agree with me most of the time, not always, i then don't do them. I actually have my appointment this wednesday octubre 2th to reafirm my meds, switch them, low or up doses, and he rather gradually quit most of them, tapering of or switch me to another, he gives me also psychoterapy. So nothing to worry about. 😊

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@Equilibrium022x You are not a psychiatrist and are not qualified to make your own medication changes. Specialists like psychiatrists go to school for many, many years to be able to prescribe psychiatric medication. It is not just a little research at home that gives them a degree. If I’m not mistaken, please someone correct me if I’m wrong, this board does not encourage people to change and add their own medications without the supervision of a trained doctor. 

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1 hour ago, saintalto said:

@Equilibrium022x You are not a psychiatrist and are not qualified to make your own medication changes. Specialists like psychiatrists go to school for many, many years to be able to prescribe psychiatric medication. It is not just a little research at home that gives them a degree. If I’m not mistaken, please someone correct me if I’m wrong, this board does not encourage people to change and add their own medications without the supervision of a trained doctor. 

I'm sure, most doctors make trial and error. Every brain is different, they could be wrong for my own experience don't always prescribe what we need, and may be wrong but almost sure like many of the users here are being either self medicated or trying another drug, maybe abusing them...i'm not saying everyone ok, thanks for your concern, i appreciate that, see you later my friend! ;)

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I agree completely with @saintalto.  It's one thing to be an informed participant in your treatment (that's the goal of many people here, I'd wager).  It's another thing to play around with things ad hoc and decide on your own accord what to take and not take.  That's just plain dangerous.  There's a reason pdocs are involved--they have years and years of training.  I'm not saying to follow one blindly--I'll ask my pdoc for a med change if I think it's a good idea or I'll decide on a course of action if she presents me with two or more options).  But she's in charge, not me.

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Then why people here keep asking here and there for medications! Making threads of this med is better than this one and so on..we aren't doctors! Maybe some of them can't even pay one! We have the liberty of making our own research and make an opinión to others even more preparated than some "doctors".

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On 9/30/2019 at 7:56 PM, Equilibrium022x said:

We have the liberty of making our own research and make an opinión to others even more preparated than some "doctors".

No. The difference between you and me and the “doctors” is 8+ years of study in an accredited medical institution under the guidance and supervision of experienced professionals, which has earned them the title of Doctor of Medicine as well as other specialized degrees. Part of their rigorous study involved obtaining a comprehensive understanding of human biochemistry, and of the action of pharmaceuticals, so that they would be qualified to prescribe them to patients.

A doctor’s “trial and error” is nothing like yours or mine. The doctor makes careful, judicious decisions based on a depth and breadth of knowledge across his discipline, and on a knowledge of the specifics of your individual case. He has an ethical imperative to ensure that any treatment of uncertain effect will at least do you no harm.

Your own research, unless you happen to also be an advanced graduate student in the field of medicine, biochemistry, and/or pharmaceuticals, is not going to provide the kind of information needed to make the kind of safe and fully informed decisions that would allow you to experiment with your own meds cocktail.

You said it yourself - you’re not a doctor. You’re not qualified to make such decisions. Do you have the right to? Sure, it’s your brain, you have the right to fuck it up as badly as you can. But in the end, you know where you’ll end up? At the doctor’s. And do you know what you’ll do at that point, once you’ve finished train-wrecking your own brain with your ill-informed experiments? You’ll do what he would have told you to do to start with.

Listen up, all you lot - here at CB we ask a lot of questions of each other about our meds and our personal experiences with them not so we can go all Doc Brown and shit trying to cure ourselves, but so we can better assess how our meds are affecting us, so we can take more informed questions and suggestions back to our care teams, and so we can make better decisions as active participants and advocates in our own care.

So knock off all this rubbish about making wild changes to your meds on your own without talking to your docs. That’s not what we’re about here, and we don’t support it. While we’re at it, we take a very dim view of members telling everybody they’ve decided to just come off all their meds altogether, for whatever reason, without their doctor’s sanction. Because we don’t do stupid around here.

 

Cerberus

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Cerberus,

Curious if you've read Mind Fixers, by Anne Harrington?y

That's not a trick or rhetorical question, and I'm not suggesting anything if you haven't

OK, let me narrow this.  The essential premise of the book is that only severe mental illnesses should be treated by psychiatrist.

So, let's narrow that.  My MI of BP1 w/ psychosis would qualify as a severe mental illness.  Altho therapy has been of tremendous benefit to me.

OK, let's narrow that.  Nope, about to get testy so I'll stop

-----------

I should put this in the books read section of the board, as it relates to that.  And, in any event, I agree with the last paragraph of your post Cerberus although I'm not going to read the entire thing because it's long

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4 hours ago, Will said:

Cerberus,

Curious if you've read Mind Fixers, by Anne Harrington?y

That's not a trick or rhetorical question, and I'm not suggesting anything if you haven't

OK, let me narrow this.  The essential premise of the book is that only severe mental illnesses should be treated by psychiatrist.

So, let's narrow that.  My MI of BP1 w/ psychosis would qualify as a severe mental illness.  Altho therapy has been of tremendous benefit to me.

OK, let's narrow that.  Nope, about to get testy so I'll stop

-----------

I should put this in the books read section of the board, as it relates to that.  And, in any event, I agree with the last paragraph of your post Cerberus although I'm not going to read the entire thing because it's long

Will - I am not familiar with that book, but if its core premise is as you suggest, I doubt I would agree with it. I do believe that not every upset of the human mind is the result of mental illness, and not every upset needs pharmaceutical treatment.

The trick, however, is determining what is and what isn’t a case of bona fide mental illness, and for that you need the aid of a qualified psychiatrist or psychologist.

Let’s say a person is suffering from a case of Major Depressive Disorder, though not debilitating. Should the person be treated, or not? He certainly should not attempt to treat himself without the assistance of a specialist, would have difficulty getting the meds without a prescriber in any case, would likely find “alternative” treatments disappointing, and if he chose a therapy-only route, would find that relief took longer.

But there’s this to consider also - it is well-documented that relapse of MDD significantly increases the likelihood of further episodes, until repeat episodes become a certainty. If it is possible to gain control of this patient’s condition early, in a moderate state, and prevent relapse, is that not a sound argument for treatment before the mental illness becomes severe?

There may be times when we feel frustrated that we are not making better progress, and feel that our pdocs are slow or unwilling to try new strategies. That is why we encourage all our members to become as informed as possible about their own conditions and the available treatments - not so you can strike out on your own, but so you can go into that next pdoc appointment loaded for bear, and get your pdoc to discuss your treatment plan to a point that you’re satisfied.

 I’m not sure if this replies directly to the point you were trying to make in your post, but I hope it helps.

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I don't know that I need your post to help.  And I don't mean that snidely... too terribly much. The focus of the board on meds has remained unchanged since I joined it.  I have always understood that.  And I largely agree w/ that as it applies to me, insofar as I am "free" to make my own judgments on that.  My sig used to spell out my drugs and precise dosages, but I no longer view that as particularly relevant.

I think the thing that makes me bristle as to your position is rooted somewhat in your role as a moderator.  And, I think I understand myself well enough to figure out why that is so.  I have had better exchanges with CNS and others.  Ours have not been so happy because our exchanges have been played out on the board and not by DM.  Yes, you tried to reason with me, but in 2012 or thereabouts I felt really badly burned by some of the mods.  You were not the worst in that.

We can agree, I think, that the human mind is a frontier.  Which neither you nor I fully understand.  I liked the book.  I liked its focus on therapy.  I understand that therapy does not work as successfully for everyone.  I understand why it works for me so well.  There are few things I truly understand.

I don't even know what a Gallifreyan is, Cerberus, and I don't have the interest in finding out.  Let me say that I respect your position. That's enough, don't you think?

I do like the way the board is not as "hard ball" as it seemed to be when I first joined.  But maybe that is just my perception as I have gotten more comfortable with it. 

My tendency is to minutely review my posts for clarity and then to edit.  This time I will not.  Hopefully.

One edit for the sake of honest dealings:  I did not read the entire thread.  I zoomed to yours.  Because I was interested.

 

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Dx: Major Depressive Disorder, recurrent, in full remission, Chronic Insomnia, ADHD-PI, Temporal Lobe Epilepsy featuring complex partials and generalized Tonic/Clonics, Dyspraxia, Nocturnal Hypoxemia, Diabetes II, Chronic pain

Psyc meds: Bupropion XL (Wellbutrin XL) 450 mg, Aripiprazole (Abilify) 15 mg, Mixed Amphetamine Salts (Adderall IR) 90 mg in a divided dose, generally 30 mg t.i.d.,  Propranolol (Inderal) ER 60 mg, Eszopiclone (Lunesta) 6 mg  qhs., Clonazepam (Klonopin) 1 mg, always qhs. Levetiracetam (Keppra) 2,000 mg in a divided dose, b.i.d.

PRN: Propranolol 20-40 mg, Lorazepam (Ativan) 1-4 mg,  Belsomra (Suvorexant) 20 mg, Ondansetron (Zofran) ODT 8 mg, Provigil 200 mg, 3:1 CBD/THC tincture (I have a medical cannabis card), Norco 10/325.

Supps: Multi vit/min as needed, Vit. D-3 3,000 IU, Hemp seed oil 2 g for the essential fatty acids alpha-linolenic acid (ALA) 900 mg, and linoleic acid (LA) 260 mg, providing the last essential fatty acid are omega-3-acid ethyl esters (Lovaza) 4 g, EPA 1,856 mg/DHA 1,500 mg,  CoQ10 200 mg, N-acetyl cysteine (NAC) 1,800 mg, Alpha GPC (glycerophosphocholine) 300 mg, Acetyl L-Carnitine 500 mg, Piracetam 1.5 g, 2 liters/minute oxygen by nasal cannula qhs

Dosages are a daily total.

NAC, ALA, and CoQ10 are precursors to L-Glutathione, the major cellular antioxidant that protects against amphetamine neurotoxicity. Animals predosed with these precursors and given neurotoxic doses of amphetamine did not experience amphetamine neurotoxicity. See study link below.

CoQ10 is an essential cofactor to several biological processes that make human life possible. (see "ATP to ADP cycle") Statins lower CoQ10 levels. I take Crestor (rosuvastatin).

Acetylcholine is a major neurotransmitter affecting many systems. Acetylcholine causes muscles to contract, activates pain responses, regulates endocrine and REM sleep functions, memory and cognition. It may reduce inflammation. People over 50 or those who take anticholinergics (e.g. Benadryl, sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; disopyramide and others) have a reduced level of it. I take a choline supplement, Alpha GPC (Alpha-glycerophosphocholine), to assure proper acetylcholine levels.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/  "Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review."  

https://www.ncbi.nlm.nih.gov/pubmed/27766914 "N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects".  "The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways."

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9 hours ago, Will said:

I don't know that I need your post to help.  And I don't mean that snidely... too terribly much. The focus of the board on meds has remained unchanged since I joined it.  I have always understood that.  And I largely agree w/ that as it applies to me, insofar as I am "free" to make my own judgments on that.  My sig used to spell out my drugs and precise dosages, but I no longer view that as particularly relevant.

I think the thing that makes me bristle as to your position is rooted somewhat in your role as a moderator.  And, I think I understand myself well enough to figure out why that is so.  I have had better exchanges with CNS and others.  Ours have not been so happy because our exchanges have been played out on the board and not by DM.  Yes, you tried to reason with me, but in 2012 or thereabouts I felt really badly burned by some of the mods.  You were not the worst in that.

We can agree, I think, that the human mind is a frontier.  Which neither you nor I fully understand.  I liked the book.  I liked its focus on therapy.  I understand that therapy does not work as successfully for everyone.  I understand why it works for me so well.  There are few things I truly understand.

I don't even know what a Gallifreyan is, Cerberus, and I don't have the interest in finding out.  Let me say that I respect your position. That's enough, don't you think?

I do like the way the board is not as "hard ball" as it seemed to be when I first joined.  But maybe that is just my perception as I have gotten more comfortable with it. 

My tendency is to minutely review my posts for clarity and then to edit.  This time I will not.  Hopefully.

One edit for the sake of honest dealings:  I did not read the entire thread.  I zoomed to yours.  Because I was interested.

 

Will - I understand, and agree that the tone I sometimes take when I reply to posts in "moderator mode" sometimes gives the impression that I have a stick shoved farther up my ass than I actually do. It's because in those times I'm speaking not only for myself but for the entire Moderating Team and the site owner.

That said, I never say anything I don't stand behind, but I may not say everything that I believe. I am right there with you in support of therapy. When I beat back my first round of MDD, I did it entirely with therapy, without any meds at all. That had the benefit of giving me a very solid base of Cognitive-Behavioral Therapy skills that have really carried me through the rough patches as time has progressed. But in subsequent bouts of my treatment-resistant Double Depression, I realized there was no reason to suffer (or take a risk with suicidal ideation knocking at the door with a battering ram) when help was at hand in the form of meds.

I personally believe therapy should be the first line of defense for MI that can respond to rational self-intervention. I personally detest taking medication of any kind, and view it as a necessary nuisance. But not all MI fits this description. Those suffering from schizophrenia, delusion, persistent OCD, PTSD, DID, and other disorders where normal rational function is confused or preempted, usually need the help of chemical adjustment to "level their mental playing field" before they can gain the full benefit of therapy.

You're right - the human mind is a grand frontier, a mystery waiting for exploration, and I am the first to say that my ignorance of it feeds my fascination with it. Because of that, I try to glean as much understanding from the varied positions held by all our members, including yours, and I respect your position and the thought you put behind it. I'm glad you have found therapy that works well for you.

(Gallifrey, by the way, is a planet in the British science fiction programme Doctor Who. The Gallifreyans who inhabit the planet are known as the Time Lords.)

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OK

My temper is something I'm working on thru therapy.  When manic I don't have much of a fuse.  As in none almost.  And there was one mod who jerked my chain way too hard, again not you, but this was even when I had come back in '14 to try and redeem myself (more so to try and explain myself) for crossing mod boundaries.

And then 2014, even with that going rather well, got too intense for me for other reasons and I flipped out and had to go into the hospital for a week.  Tempted to go on about 2014, but I'll leave it at that.  Thanks  

Edit:  And one final thing here is that my sig used to say BP1 with psychosis, and when you add the psychosis to it that helps explain things some.  But again I'm not much into labeling myself now.

 

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