Posted by michael on May 8, 2008, at 17:17:11
In reply to Re: SLS - Scott, question for you..., posted by SLS on May 8, 2008, at 15:41:01
Hi Scott,
Thanks for getting back to me so quickly. I put my answers to you questions directly below each question... hope that makes sense.
> Hi Michael.
>
> Thanks for the kind words.
>
> Yes, the URL for my drug page has changed. You can find it at:
>
> http://www.slschofield.com/medicine/psychiatric_drugs_chart.html
>
> I have been a bit neglectful about adding new drugs to the list. Maybe I'll work on that over the weekend.
>
> What is your diagnosis?
Dysthymia
> How does it manifest?
Largely fatigue, lack of energy, lethargy, sleeping a lot, lack of motivation or ambition or interest in doing anything generally, somtimes cognitive difficulties (focus & concentration - maintaining a train of thought, or memory issues). General difficulty getting things done, and even just getting things started (even simple tasks - like laundry for example), Etc.Without any meds, in addition to feeling run down (both physically and mentally), I also feel somewhat "flu-ish" - or generally ill, or a general malaise... Between the fatigue and the malaise, it often feels like it's something physical, rather than something mood-related - but they can't find anything wrong physically, and insist that it's dysthymia.
> How are you doing with your treatment?
Fairly well, I guess... over the last few years, I tried a number of different meds (duloxetine, parnate, a TCA - seems like there were others, but perhaps not? In any case, they're not coming to mind at the moment). They generally did the opposite of help...Now I'm back to wellbutrin, which seems to be the best base med for me (parnate was also helpful) and it also keeps me from smoking. It helps with the feeling ill. The dexedrine helps w/energy, motivation, ambition, thinking, and amount of sleep - though I can still easily take a nap, even just after taking it. The sulpiride is subtle, but seems to help lift my mood a touch - it makes the whole thing a little bit lighter, or brighter - if that makes any sense.
> How would you compare yourself to when you were not responding to anything?
While I wouldn't say that I feel great, with this combo, I feel like I'm largely functional - at least I think so... I'm not working at the moment, (I'm looking) so that'll be a better test of just how well I can "function" these days. For a while there, I felt like I might not be able to function well enough to support myself (i.e. not able to work) - kind of a helpless, and depressing feeling. But things seem to be getting better again with this combo... time will tell.
>
> I have had some success with having added Deplin to my treatment regime. I am currently taking:
>
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 20mg
> Deplin 7.50mg
>
>
I'm glad to hear that you've had at least some success to report, in your quest! I hope things will improve even more in the future.I'm not familiar with Deplin... I've been out of the PB loop for a long time. I'll have to do a little research, and take a look at it.
> If you don't feel like you are continuing to improve, you might consider taking Abilify. It is an activating antipsychotic that is sometimes touted as being a "dopamine system stabilizer" (DSS).
>
Abilify is one of the meds that I forgot in my list above - oh, yeah, also mirapex, and another antipsychotic that I can't think of just now - maybe seroquel?In any case, you had recommended that I try abilify a while ago, and I did. I liked the activation, but had difficulty sleeping, or getting on a regular sleep schedule. I believe it synergizes with welbutrin, so I started out with just 2.5 mg per day. When I went up to 5 mg, it was like someone flipped a switch, and rather than being stimulating, it became VERY sedating - and it stayed sedating even when I went back down to 2.5 mg again. It really knocked me out, so I moved on at that point. Have you heard of that kind of reaction to abilify?
I may experiment a bit with abilify again, down the road a bit. If I could substitute that for the dexedrine, that might be an appealing mix - particularly since the dexedrine has such a short, fixed window during which it works. It'd be nice if abilify could give me enough stimulation around the clock, without giving me too much stimulation & messing with my sleep... Ironically, I found abilify to be much more stimulating than dexedrine - until it flipped and knocked me out.
> Have you tried Lamictal? Wellbutrin + Lamictal can make for a useful combination.
>
I tried adding lamictal to wellbutrin a number of years ago - didn't seem to have any noticeable effect at all, for me... Just my luck.Thanks, as always, for your thoughts and suggestions. I always value your feedback.
I hope all of this is coherent... let me know if I missed anything, or if anything was unclear, or if you have any further questions, etc.
Michael
p.s. thanks for the link to your chart!
>
> - Scott
>
>
poster:michael
thread:827957
URL: http://www.dr-bob.org/babble/20080430/msgs/827990.html