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Just searching for a good medication


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Hello!

I'm going to give the run down of everything and hopefully someone will have a suggestion for me. I am going to see my psychopharmacologist on Friday, and I am in need of a little something. My psychopharmacologist is very good about prescribing things off-label and has (on a few occassions) prescribed me medications from outside the US. There is apparently some "bill" or "act" that says its okay in certain circumstances to prescribe a medication to someone in a country its not available in. Does anyone know the name of this act????

Anywho, I was taking Selegiline HCL 5mg 2x a day for quite a while and it worked wonders, and I mean WONDERS. Anyone who says it isn't effective as an anti-depressant is wrong, it may not have worked for them but it sure did for me. I was very happy on Selegiline, not euphoric, just happy and content with life. I experienced no side effects at all except for one, and thats the reason I had to stop taking it. Selegiline causes "confusion" in a large percentage of the people who take it. That may not seem like a big deal, but when you are a full time student, its really shitty to be confused all the time, so I had to stop taking it. I am currently waiting for the EMSAM patch to come out since my psychopharmacologist thinks it won't pose the confusion side effect that plain old Selegiline does.

Anywho (again), I would like to suugest something to my psychopharmacologist, because he appreciates it a lot when his patients have done the research on drugs themselves. He feels that this helps the patients to stay motivated to stay on the drugs, and in turn makes remission of depression more likely.

So yeah.... I'm going to tell you a few things that are wrong with me (physically) and mentally and hopefully someone will be able to suggest what might be best.

1) I have Liver Damage (due to the Cymbalta I was taking), and would like to minimize the possiblity of it getting worse.

2) I have an Eating Disorder (although I am recovering), so weight gain can't be a side effect (and preferably not weight loss either).

3) I am a full time student who wakes up at 12pm everyday and works until 4 am every morning, so I can't be falling asleep at work or school. I also can't really deal with a "confusion" side effect since I need to be alert and focused and cognisant, in both my job and my school work.

4) SSRI's (from what I remember) had ZERO effect on me, and I would seriously have been better off without them.

5) My current diagnosis (and have been for awhile) are (Severe) Reccurent Major Depression, and Generalized Anxiety Disorder, and Bulimia Nervosa (purging type and nonpurging type, in Remission).

So.... any med combo, either on label or off, or from the USA or not, would possibly be of great help to me. I am also very open to supplements.

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Hello!

I'm going to give the run down of everything and hopefully someone will have a suggestion for me. I am going to see my psychopharmacologist on Friday, and I am in need of a little something. My psychopharmacologist is very good about prescribing things off-label and has (on a few occassions) prescribed me medications from outside the US.

1) I have Liver Damage (due to the Cymbalta I was taking), and would like to minimize the possiblity of it getting worse.

<{POST_SNAPBACK}>

One of the few organs that will heal itself if you are nice to it for a while... But in the meantime the

depression won't go away by itself, so I'll not suggest non-medication. Wellbutrin is fairly weight-

neutral, but not the kindest on your liver, and usually a bad idea with bulimia.

2) I have an Eating Disorder (although I am recovering), so weight gain can't be a side effect (and preferably not weight loss either).

<{POST_SNAPBACK}>

This makes any suggestion very much harder. Most psych meds that work for depression alter the

balance of the neurotransmitters involved in appetite and satiety. Plus, no really knows how much

weight they stand to gain/lose until on the meds.

3) I am a full time student who wakes up at 12pm everyday and works until 4 am every morning, so I can't be falling asleep at work or school. I also can't really deal with a "confusion" side effect since I need to be alert and focused and cognisant, in both my job and my school work.

<{POST_SNAPBACK}>

And a number of them cause problems here. 

4) SSRI's (from what I remember) had ZERO effect on me, and I would seriously have been better off without them.

<{POST_SNAPBACK}>

That's really unusual - no side-effects even?

5) My current diagnosis (and have been for awhile) are (Severe) Reccurent Major Depression, and Generalized Anxiety Disorder, and Bulimia Nervosa (purging type and nonpurging type, in Remission).

So.... any med combo, either on label or off, or from the USA or not, would possibly be of great help to me. I am also very open to supplements.

<{POST_SNAPBACK}>

Maybe look to the stimulating tricyclics, moclobemide (the MAOI diet isn't required but my bet is

that it's very useful), risperdal (way left field, but so far you've described benefit from altering

NA/DA levels but not from increasing serotonin - which is supposed to help bulimia and most

depressions).

If the cymbalta works, but is increasing your liver enzyme levels (which is usually interpreted as

damage, and usually *is*, but *could* mean it's just working way hard), what about lowering

the dose and adding selegiline back in?  BTW, methionine supplements are supposed to be

liver-supportive (not kind to people down-wind though) in case you need to stay on the cymbalta.

(Maybe something like Valdoxan or one of the NMDA antagonists?)

There, that's some options to research very carefully and talk over with your doctor. The

cocktail ideas are off the top of my head and could be very bad ideas in reality.

Oh! And one that doesn't need a presciption - morning (or whatever morning is for your

schedule) exercise. That should really help with the "confusion" issue, and with luck

help keep your appetite legitimately up.

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Null0Trooper,

Thank you very much for your reply. I'm going to the Inner Harbor today, but as soon as I get back I will do some more research on Moclembide. I was actually thinking about it before hand ;) What a co-inky-dink. hehe. Thanks. Does anyone know where I can find the side effects and pharmacological stuff about Moclembide?

Sorry if I spelt Moclembide wrong, I just woke up and I'm still very groggy.

:)

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For recurrent depression, a mood stabilizer can help.  Lamictl has some AD properties but there are all kinds of potential side effects.

Focalin is an isomer of Methyphenidate (Ritalin).  While it won't do a ton for ADD, it's possible that at lower doses it could have an effect on mood and not have many of the side effects usually acociated with stimulants.

Weren't you on Provigil for a while?  What was the problem with it?

There is no such thing as a perfect med, BTW.  Many of us have to deal with side effects that are nearly as disabling as what we're taking them for. In future semesters you might want to rethink your school/work schedule to accommodate for the fact that even when meds work like they are supposed to they still suck ass a lot of the time.

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Weren't you on Provigil for a while?  What was the problem with it?

There is no such thing as a perfect med, BTW.

<{POST_SNAPBACK}>

Provigil, in the opinion of my psychopharmacologist, only made the liver damage done by Cymbalta worse. The liver is supposed to help metabolized things, as well as filter out toxins, and many other functions. With my liver as damaged as it is (or more so WAS back when I was on the med combo) the Provigil wasn't being metabolized properly either. The same goes for the Reboxetine I was also taking.

Yeah I know there is no PERFECT med, but Selegiline came damned near close to it. I am just waiting for the EMSAM patch to come out.

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