I've posted on this topic before, because I'm really wondering why this is happening to me, but not on other people that have been on higher-dose stimulants (without breaks) for MUCH longer....
I re-instated Ritalin (after a 4 month break) due to increase in work cognitive tasks. Pdoc increased the dosage because previous dose was starting to not cut it, wearing off early. I Was told I could experiment, but to take weekends/breaks off in order to "rest" . In the last 3 weeks, I've noticed drastic improvements in my mood, motivation, ability to focus on intellectual tasks/reading, and a positivity, calmness in general.
Problem is, I am psychologically addicted. When I try to break on the weekends, I can't get out of bed, barely prepare food for myself (despite hunger), and shower, basically, these symptoms are MUCH worse than before I was taking it! I'm concerned that I'll need to keep increasing the dose, take it everyday, and eventually, it will make my condition/functioning worse in the long run (exacerbating the problem). I had old pdocs that would not prescribe me stimulants for exactly this reason.....(I am not ADD.....it is for TRD.)
Any ideas guys? I'm very compliant, and have no inclination to abuse the dosage. This is the only thing that's made a dent in my mood and functioning and does not seem like a long-term solution!
I can't remember a time when food wasn't THE main focus in my life. Even when I'm so full and can't eat another bite...my thoughts wander to what else I'll eat later. Diets, eating plans, Weight Watchers Summer Camps, gastric bypass, journaling what I eat and/or exercising will START to give results the first few weeks and then my body just basically says "F you" and shuts down. No more weight loss. If I can't get the gratification of weekly seeing measurable change in my efforts...I'm right back to food.
Overeating has ruined my life. Whoever I COULD have been when I started out a sweet little girl was squandered when I somehow started using food to placate myself VERY YOUNG. Then it became a horrible guilty, shameful and "what's wrong with me" set of glasses I looked at life through. I was constantly pushed by my mom to stop eating, go on a diet and exercise. She tried EVERYTHING until well into my adult life. She too had weight/eating issues and knew what life would be like for me. She tried to help the only way she knew how but it set up a terrible vicious cycle of sneaking food to make myself feel better and loved and treated special...that's what food feels like to me. When I look at my family dynamics I can see all the ways life in general contributed to this addiction. But breaking out of it has been a constant struggle. Now for the last 2-3 years I've literally given up. I'm 58 now and it feels like, short of a miracle, I'll die fat. My hips, spine and knees are in terrible shape (of course they are).
Being fat set up a way of thinking and acting in all relationships with people that I also am exhausted with. I honestly with all my heart and fiber of my being think and feel that pleasing someone else will keep them in my life and they'll pay what little attention to me they are willing to give me. Not all people have been horrible, I've had some great friends over my life...but of course, THEY HAD LIVES and I was never the center of anyone else's life. I would have done anything through my mid forties to make someone else the center of my life in hopes of finally finding someone who wanted to team up and walk through life together. Now? I'm too old. I'm too set in my ways. It's just not as important. I'm past the age of finding someone to "be a couple" with...no I'll never define who I am that way. I'm too old for kids and of course at this point I should've had grandchildren. There will be no one to take care of me as I get older. I literally hope God takes me out while I can still walk and am living on my own. I never want to be institutionalized in an assisted living/nursing home type of situation.
Thanks for reading this.
My pdoc and I have finally found something that works for my impulsivity/compulsivity (mainly impulse buying, which I've always had an issue with, but may or may not have been exacerbated by Abilify) and my binge eating: Memantine (Namenda). For those who haven't heard of this medicine, it's an Alzheimer's disease medicine, but it is gaining use in psychiatry for many off-label uses, including binge eating, impulse control disorders, ADHD, etc.
After I was prescribed Abilify almost a year ago, I started piling up some serious credit card debt because I was impulse buying, and soon both my credit cards were beyond their credit limit. I have also dealt with binge eating for several years. My I asked my pdoc about memantine, to see what she thought about it, and if it would be worth trying for these things (I told her about my debt, and she knew about my binge eating, as we have tried several things for it). She agreed to try me on a starting dose of 5 mg 2x/day. I responded very well, as I found myself able to stave off urges to impulse buy a lot easier! I also noticed my appetite has diminished, my binge eating has subsided, and I have lost 10 lb in about the span of a week (which is starting to slow down).
My next visit (my most recent visit), I told her the results, and she agreed to increase to the maintenance dose of 10 mg 2x/day, and I'm noticing the therapeutic effects are markedly increased. Next time I see her, I may consider switching to Namenda XR, which has a dose of 27 mg, which is taken just once a day.
I figured I would write this post in case anyone who is dealing with these issues and might be searching for any answers.
National Public Radio recently ran a story covering a Standford University study that found that Ketamine may act as an opioid, and therefore may have the potential to cause addiction. See? It's like I always say: Glass half empty. But this is a preliminary study, and the findings will have to be duplicated by others.
Listen to the story.