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I feel like I'm in a bind.  ECT/TBI wrecked my brain.  Vicious circle-- need support/intensive therapy, but currently too unstable/impaired to make appointments or to leave the house.

I'm terrified of A/AP's, as I already have neurological damage-- tics, dystonia, spasms, dyskinesia, etc.  Plus, I get akathisia and restless legs on everything.  But I've got psychosis and severe agitation/aggression going on.

Pdoc stopped lithium due to cognitive impairment.  Propranolol at sufficient doses causes severe bradycardia.  Lamictal makes me manic/restless titrating up.  Allergic to Trileptal/Tegretol.  Depakote hugely sedating.

Any creative ideas?  I hate that I'm desperate enough to be obsessing about meds again.  It's a sickness all it's own.

 

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4 hours ago, lifequake said:

I hate that I'm desperate enough to be obsessing about meds again.  It's a sickness all it's own.

I know what you mean by this, I do this too.

What is/are your diagnosis/diagnoses?

4 hours ago, lifequake said:

I'm terrified of A/AP's, as I already have neurological damage-- tics, dystonia, spasms, dyskinesia, etc

This is bad as this eliminates a lot of potentially useful medications.

Have you tried Topamax or Zonegran for a mood stabilizer?

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5 hours ago, BrianOCD said:

Benzos always got me out of the house and moving, in emergency situations, do they work for you?

I'm supposed to be taking Klonopin round the clock, but it makes me more confused/memory-less/depressed.  I do have severe panic and obsessive thoughts that keep me trapped 24/7 from being present.  It's like I am *never* in the moment.

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They're apparently not really effective in monotherapy, but may be worth giving a shot... I'm going to throw Topamax and Zonegran out on the table. I personally had a good run with Zonegran for several years. I had to switch anticonvulsants because I started having seizures and it wasn't controlling them adequately.

Here's a study on using primidone (Mysoline) as an adjunct mood stabilizer in treatment refractory bipolar patients (I'm assuming that's what your diagnosis is).
https://www.ncbi.nlm.nih.gov/pubmed/10440522

Here's a case report of using tiagabine (Gabatril) in a patient with bipolar disorder with severe anxiety. Other than that, the evidence doesn't look good for this one...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000180/

Vimpat (lacosamide) may be a good candidate, but some of its serious adverse reactions are PR prolongation, AV block, and atrial fibrillation/flutter, as well as suicidality (as with all AEDs) and SJS, and one of its common adverse reactions is depression.
Here's a promising study in bipolar patients over 30 days: https://www.ncbi.nlm.nih.gov/m/pubmed/30251375/
But then again, here's this: https://www.seizure-journal.com/article/S1059-1311(13)00008-3/fulltext

I know you're afraid of antipsychotics, but I've personally had heaps of success with both trifluoperazine (Stelazine), a first-gen antipsychotic, and aripiprazole (Abilify). They both have practically given me my life back. The former, Stelazine, in the lowest dose of 1 mg twice daily, allowed me to leave the house when I was house-bound with anxiety and resume simple daily life. Abilify stopped my psychotic depression that I was having around this time last year that was pretty much about to take my life. I know meds are not by any means one-size-fits-all, and YMMV, but I figured I'd throw those out on the table as well.

I hope this helps, and I hope you find the help you need and deserve. Best of luck to you! Keep us posted.

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What kind of instability are we talking about here? Both poles? Just depression? Just mania? Mixed?

i suppose if we want to get further out of the box, some sort of cbd or cbd/thc product. Closest thing I can think of without getting into completely unproven supplement territory.

my experience so far is mixed..feels like a small add on vs game changer. It’s small enough that it could very well be placebo.

otherwise, perhaps it’s lesser of two evils with an aap. Think of it as a bridge to then kick off the therapy process that can hopefully take you the rest of the way. Not something permanent.

 

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