Have any of you had or have read of gabapentin being of use as an adjunctive therapy for people with treatment resistant depression/anxiety/bipolar?
I have been doing research and some sources say it helps, others say there is no strong clinical proof. I think a lot of the conflicting reports I have seen has to do with it simply not being studied en mass.
Any advice/experiences regarding this? If so, what was your dosing?
So for seventeen years I've had pain depression. It especially feels like it's squeezing my heart. It hasn't historically been *about* anything. I've just chalked it up to biochemistry, heredity. And I've thought about suicide, most days, for at least fifteen years - because pain sucks. Ups-and-downs. Roller-coasters. Probably every person on here has done time at the worst torture theme park in the world.
Two years ago, my cocktail started working. There was some CBT and DBT in the mix too. I decreased my daily Ativan from 3mg to 2mg. Plus 20mg Latuda, 300mg Sertraline, 100mg Topamax. I actually felt happy, for about two years, until this October. Then it stopped working. And I stopped working. I work in a level I trauma center, where I identify cancer, anemia, and the effects of the coronavirus on the human body. I feel like I have a front row seat to human suffering, without being empowered to ameliorate it, and it's another kind of torture.
I am very tired of fighting. If there was a euthanasia travel agency, where I could just walk in, plan my funeral and end-of-life arrangements, plan my ideal death, and just call this thing at 38, that would be a somewhat attractive option (not telling, The Tallest Man on Earth, flaming-Viking-burial-at-sea.) I'm tired of fighting this disease, personally. And I'm tired of coming up against the tsunami of "world suck" (H/T Vlog Brothers) which seems to be hate-fucking itself ad astra.
So the strain theory, which I haven't read much on yet, is that we consider the termination of our lives when under one or more types of strain. I personally find this theory hopeful, as targeting the sources of strain, i.e. "world stuck," could reduce the inducements to terminate one's life. The General Strain Theory, according to one Wik I. Pedia cites loss of positive stimuli, addition of negative stimuli, or the inability to reach a desired goal, as three possible sources of strain. I will follow up on this with my tdoc on Wednesday. I think work is introducing negative stimuli, and I have a shit ton of unreached goals, but am starting to care about goals less and less. Basically, it pisses me off that I've had to dramatically reduce my goals due to my diseases, and it's kind of tempting to just leave the party. Please feel free to weigh in if you have personal and or academic experience with this.
I'm also meeting virtually with my pdoc tomorrow... to tweak the cocktail. Would love recommendations. My current rx mix, dxs and rx, failures are in my signature. Lamictal induces hives and vomiting. Depakote causes dyskinesia. Lithium ruined the thyroid and causes acute renal failure. Medicine. Ha ha. Organ roulette.
So the observation about different species of depression is that while for a decade-and-a-half I experienced what seemed like purely biochemical, chains-around-my-heart, tar-and-shark-filled, basements-beneath-basements depression. This feels more like a rational(?) depression, which has me concerned about whether it will be responsive to biochemical therapy.
"Clomipramine, Tryptophan and Lithium in Combination for Resistant Endogenous Depression: Seven Case Studies" - August 1987 | A. S. Hale (a1), A. W. Procter (a2) and P. K. Bridges (a3)By Skeletor
Unquestionably an extreme combination, but it seems to exhibit powerful antidepressant effects. Clomipramine on its own is regarded by many as maybe the most powerful non-MAOI antidepressant, at least in clinical practice and inpatient care, although the side effects can be quite rough, but combined with Tryptophan and Lithium it seems to be further boosted in its effect size and response rate.
Maybe worth trying before hopping on ECT / MAOIs...
One has to be careful because it is a small sample case "study", but nonetheless quite interesting to read. I encourage all those who have a view or experience to share it with us, regarding the aforementioned medications and especially the combination. Greetings!
Hi, all. I feel like a newb oldie: been on here a while, still feel dumb as shit with all the o chem breakdowns and acronyms.
Anyway- I've been maxed out on effexor xr for years now. I've taken it pretty consistently for...12 years? with a few breaks to try something new. There aren't many details I can remember well (always had a bad memory, now it's basically a vestigial feature), but here's what I've garnered:
*SSRIs and i seem to not mix. Not just some side effects, but all the side effects, and no or negative improvement.
*wellbutrin did nothing for me. Not good, not bad- just nothing.
*Effexor was good- great, even- before I tapped out. I've just been staying with it till I can figure something out.
*currently, I take 225 mg Effexor (and several doctors have told me now that they flat out won't go above that), 150 lamictal, and klonopin and Ambien as needed. (And as I've been mightily depressed lately...I've been "as needing" them a lot more.)
I've been wanting to change for a while now, and I've been studying up to see what might be some better options, but haven't had a tdoc or pdoc in the meantime. I'm meeting new ones shortly and I want to take some suggestions to them. Problem is that I'm allergic to a few things, with varying degrees of severity and type of allergic reactions. Any suggestions of SNRIs, TCAs, or MAOIs that aren't:
*sulfa-meds (full body hives. Like...full body- between my toes, in my buttcrack...😬)
*compazine (difficult breathing, light anaphylaxis.)
*darvocet, Vicodin (full-blown anaphylaxis.)
I have been given morphine with no reaction (so, what- does this mean that synethics cause issues, but cleaner natural versions don't?), and take imitrex regularly. I'm not smart enough to understand all of the individual components, and too ADD to have the patience to learn which causes what.
I feel like it's got be something pretty potent, since I've been middling- to severely-depressed pretty constantly (easily 8 out those 12 years), but I also don't need anything that's going to make me lethargic. Apathetic, fine- just please, no serious drowsiness.
I defer to you guys and gals and pals for what your thoughts are on what might be most effective, but also won't send me to the ER.
Any success or failures with rtms, tms, deep brain stimulation?
Meds just don't seem to work well for me. My depression is chronic with dips and peaks and my cognition is impaired heavily.
I do remember being knocked out violently at 5yo and 8yo, not sure if that caused some sort of brain damage. Ugh another day if this shit...