Posted by softheprairie on December 19, 2008, at 23:41:29
In reply to Re: How high are the chances venlafaxine might wor » softheprairie, posted by Onestone on December 19, 2008, at 16:47:25
> > Venlafaxine/Effexor could give you partial relief, and in a while you may be able to talk the doctor into adding a stimulamt to augment it, which would be very reasonable for someone who has tried several first- and second-line meds to no avail. I was on Effexor plus Concerta for a few years.
>
> May I ask why? What did you need it for?
>(I'm in the US, by the way. I guess I had assumed you were also, which I know is foolish, so I don't know the prescribing culture in your area.)
Well, I'm a bit unclear myself in my memory of the timeline that answers your question.
My first psych meds were just for depression, starting my first year of college (tho' I had been depressed even before that, but didn't seek medical attention for it specifically until college). It started pretty conventionally, with just one SSRI, then a switch to a different SSRI, then broadening out to other pharma classes and combining more than one med at a time. I got through college with a lot of difficulty, two years later than the ones I started with, as I left school for a while and had some incompletes, and was part-time when I returned. My OCD wasn't diagnosed at the time, or maybe just with a notation of "has obsessive traits." I am also very overweight and have had complaints of fatigue for many years, and was diagnosed w/ sleep apnea during college, and despite C-PAP complaince, I still have severe fatigue.
Slowness on exams and perfectionism were becoming increasing problems in school.
Anyways, I was able to get into a law school in my state that allowed me to go at less than the full # of hours at a time, because I knew I didn't have the energy to carry a full load. Then, in law school my depression and OCD got worse, and I went to new psych providers in my new town. There was some disagreement on if I actually have ADD or not, tho definitely not the hyperactive variety. I had some psych testing that officially said I had some attention problems, but didn't qualify as ADD. But, I was miserable at law school with depression and OCD. I complained about my terrible time concentrating, and asked about adding ADD medication to my depression treatment, if I recall correctly, and the nurse practioner who was my prescriber allowed it. I'm not sure if she marked it down as being for ADD or depression primarily. Then, that office moved, and my prescriber got a different job, and I switched to a new Dr., this one an MD that does med management and talk therapy both. I had declining functioning and left school with one incomplete in a writing class, and not such good grades in the ones that were mostly based on a final exam, because I was too slow in writing the test and didn't finish in time. It was supposed to be a leave of absence, but I didn't finish the incomplete writing class, and it turned into an F and I didn't try to go back, since I couldn't really say what I had changed about myself to be able to keep up if they let me back.
I was last in school in 2001. I had over five years of working full-time after that, but there was a new supervisor at my place of employment who was giving me bad job reviews for slowness, and I was doing my best, but couldn't please her. I ended up resigning rather than get fired. That was in early 2007. I haven't been employed since; I am on disability.
I have had my current psychiatrist since 2001. Somewhere in there he changed my first-listed/most prominent diagnosis from depresion to OCD. He now has my diagnoses in this order: OCD; major depressive disorder; and attention deficit disorder (I know the latest DSM puts the H in there with the ADD even if one isn't hyperactive, but my dr. used the old term, I guess). Some of my stimulant Rx's had the notation "for ADD," while I remember at least one saying "for depression, attention." At least with the most recent pdoc I have seen since 2001, I was honest in saying I was interested in stimulants not just for ADD, but for depression and energy. I'm not sure if it's legal for the DOCTOR to say stim. Rx is for energy or weight-loss in my locality, or just really looked down upon, but I do know it's allowed legally here to be used off-label for depression. There's a lot more to the story, having to do w/ stims being discouraged when the problem is OCD, with the general psych opinion being that stims promote obsessiveness, and whether to tread my depression or OCD first, but I sense I've writen a bunch already.
poster:softheprairie
thread:869422
URL: http://www.dr-bob.org/babble/20081214/msgs/869780.html