Posted by jerryTRD on October 26, 2010, at 12:44:42
In reply to Re: so tired and fatigued even on Adderall, posted by linkadge on October 26, 2010, at 7:34:12
> Bottom line: You're on too many medications! You're probably metabolically.....not good, very not good. I wouldn't be suprised if there aren't a whole load of other hormones out of whack too.
>
> With all the antidepressants and the klonazepam, your body probably can't get any form of restorative sleep.
>
> **Consolidate your medications:
>
> - reduce lexapro to 5mg or less?
> - half the seroquel or get off?
> - replace seroquel and effexor with low dose
> amitriptyline?
> - or, better yet, replace effexor and seroquel with amoxapine (if some dopamine antagonism is desired).
>
> How about just adderall, amoxapine, lexapro?
> As for the anticonvulsants, if you want to keep the clonazepam get off the lamortrigne (lamotrigine will screw your sleep up - and the antidepressant effect has probably long since pooped out for you). If the lamotrigine is providing some AD effect, then replace lamotrigine and clonazepam with say xanax.
>
> So, say lexapro, amoxapine, xanax, and adderall.
>
> Also, reassess your diet, and perhaps do a course of night of sleep deprivation.
>
> Bottom line is that once you get above a certain number of meds, you just gum the metabolism up, and you start to feel worse.
>
>
> Linkadge
>
>Hi LInk - thanks for replying
I agree I'm on too many medications. I'm all for your plan but here's the deal - I need something sedating at night and I need something for anxiety.
I also think you have mistaken lamotil (for diarrhea) for lamotrigine. I'm not on lamotrigine.
But back to the subject - here's why I'm on the meds I'm on:
Effexor: - had good success with it in the past but isn't helping this time around. Doc switched to 10mg Lexapro and cut the Effexor down to 150mg to reduce any withdrawal until I see him next
Lexapro - has helped in the past with depression and anxiety but only to a moderate degree. Seems to work the best out of all the SSRIs
Adderall - helps tremendously with my social functioning, motivation, concentration and focus. Also helps with depression.
Seroquel - the only thing powerful enough to get me to sleep at night. Problem is once I'm asleep I tend to sleep for days at a time on this stuff. I would GLADLY go off of it if I knew there was something else out there that could help.
Klonopin - for anxiety and panic but I believe I've built up a tolerance to it. When I was seeing doctors at the U of Minnesota they would routinely switch my benzo around to get past any tolerance. So, say 6 months I'd be on Klonopin and 6 months I'd be on Ativan, etc or Xanax. I would GLADLY switch to either Ativan or Xanax.
Ambien - to be discontinued - not much help at all for sleep -grown to much of a tolerance.
Synthroid - hypothyroidism
Lamotil - IBS-D (diarrea)
AndroGel - low Testosterone
Here's my ideal concoction:Basic SSRI
Adderall
Benzo
Perhaps a tricyclic that will help augment the combo and also help with sleep (amitriptyline does NOT make me sleepy).So like you said -
Lexapro
Adderall
Ativan?
AmoxapineHere's what's happening now:
Mood is ok except is now being affected by physical symptoms including ongoing diarrhea, nausea, fatigue.I take my Adderall IR at 8am, Noon and 2:30-3pm. And it helps tremendously - I wouldn't be up writing this if it didn't. However, after all these years of being on it - it seems to be acting longer than usual - thus I'm still having stimulation in the evening -sometimes up until 3am and I don't know why? Before I've been able to take Adderall and take a nap if I wanted too. Now it's causing insomnia - which leads me to sleep in the next day and screw up my med cycle and sleep patterns.
But I want to keep the Adderall - too many benefits to ignore.
I just don't know what's going on here. People have posted they think I'm exhausted (which I do feel as though I am), am needing various supplements for digestive health, etc etc - but I don't know how to talk to my family doctor or my pdoc about all this.
I really need some help. My day to day functioning is falling rapidly.
Any further advice would be greatly appreciated.
Thanks
Jerry
Major Depressive Disorder, treatment-resistant w/GAD. Meds: Lexapro 10mg, Adderall IR 20mg 3x daily, Klonopin 1mg 5x daily, Seroquel 300mg, Ambien 10mg, Synthroid 125mcg, Androgel
poster:jerryTRD
thread:966941
URL: http://www.dr-bob.org/babble/20101020/msgs/967042.html