Posted by Quintal on April 19, 2008, at 14:04:39
I'm thinking of asking for it at my next appointment. I'd also like to ask for buprenorphine of course, but I doubt he'd wear it. I mentioned it in hospital though and he didn't seem all that perturbed by the idea, but told me not to bother with "those American drugs". I doubt bringing in the studies would make much difference, especially since they come from the internet. Anyway, lofepramine seemed like a good choice to add to my Lamictal because of my previous response to TCAs, that and it's mild side effect profile. I'm not sure what else to suggest since I've tried almost all of them and only a few have worked. The only new one on the market since then is Cymbalta and I'm very wary of it because I can't usually tolerate strongly serotenergic drugs, and the strong NA reuptake puts me off too - reboxetine was awful and Effexor made me suicidal, as well as causing a hell of a withdrawal syndrome. I suppose cyproheptadine would help offset some of the serotonin side effects though, if I actually get it.
The other big idea was to try Parnate again, but to be honest I'm wondering if I need such a powerful AD effect now I've got Lamictal on board, and if it's worth all the dietary/drug restrictions right now. I suspect it isn't. I was having a good response to tianeptine, but my supply ran out on Sunday and my mood has dropped somewhat since then. I'm also starting to feel much more uneasy in social situations. That all-pervading fear is starting to creep back in. About the only problem with tianeptine is that it's so expensive. I wonder if I could talk my pdoc into importing it for me on the NHS? A professor once offered to try and get hold of a supply of melatonin for me because it isn't available here, so maybe that's an option, but a very remote one.
I'm also considering Wellbutrin, but I'm wary of anything that could make me even more irritable or give me insomnia or anxiety. Also, it's only licensed for smoking cessation here and getting my pdoc to prescribe it off-label feels like too much of a pain in the *ss, especially considering it might not really be suitable for me. At the last appointment he said "We're not going back to the days where you're trying a new drug every month", so I have to be carfeul what I ask for. I'm on rations.
I'm not sure what to do. Maybe it's easier to list what I'm looking for and see what people suggest as fitting the bill?
* More energy and motivation. I feel lethargic, don't want to get out of bed on a morning, and I'm tired all the time.
* Something to help with anxiety. I suppose it's more generalized anxiety these days, with a bit of agoraphobia mixed in.
* Not to disturb sleep too much.
* Something to help sleep if possible (but not cause daytime sedation).
* Something 'rewarding' if possible, something that will tice me to get out of bed on a morning and take it.
* Help with neuropathic pain/fibromyalgia symptoms.
I'm currently taking 50mg lamotrigine and 50mg amisulpride (p.r.n.) with moderate results. Diagnosis Bipolar I and borderline personality disorder.
Q
poster:Quintal
thread:824278
URL: http://www.dr-bob.org/babble/20080412/msgs/824278.html