Posted by phidippus on February 26, 2014, at 18:12:31
In reply to Re: Advice on which medication is best for my case » phidippus, posted by kavinsky99 on February 24, 2014, at 19:08:14
> I do have true racing thoughts when I'm very anxious, specially during a panic attack.
I imagine the racing thoughts cause a lot of anxiety that then leads to panic.
>endless mind chatter that I can't control and often give up and just "dialogue" with.
I get the same nonsense at night when I'm trying to sleep. In some ways we have dissociated from the 'voices' inside our heads, making it out to be completely intrusive.
>I have the odd day where I'm literally consumed by "flashbacks" and inner dialogue.
What do you do to cope with these thoughts? Do you ever have fun with them?
> Yeah, APs are great for managing anxiety (in lower doses. higher doses seem to worsen it)
APs have that double edge: moderate doses can aleviate OCD symptoms and large doses can worsen them.
>but create an specific kind of restlessness that is a lot like true ADHD.
This is a side effect of neuroleptics called akathisia.
>Nothing sinks in, nothing feels rewarding, nothing gets caught in my mind.
That's what happens when dopamine is supressed.
> But I'm using tianeptine and feeling as stable as I have ever been, on 3mg to 6mg daily dose along with 600mg lithium.That's good. Are you still having symptoms you'd like to treat?
>I do notice lithium "dulls" certain impulses and interests I used to have, that made me a more fun and outgoing person.
This effect goes away after awhile.
>Doctor suggested Clomipramine for the intrusive thoughts, I haven't tried it yet due to the anti-cholinergic effects being possibly harmful to my already bad cognition.
When I took clomipramine I hardly noticed the impact to my cognition, rather I'd say it was improved because so much of the intrusive and recurrent thinking got cleared up, thus uncluttering my brain.
>What do you think of TCAs, at a low dose?
Clomipramine is the only TCA that makes a real impact on OCD symptoms and its not useful at a low dose-i took 300 mg alongside 1200 mg of lithium.
>dopaminergic drugs aren't a good option for me, as they worsen the agitation and anxiety a lot.
Try Strattera - its a norepenephrine reuptake inhibitor that can help improve motivation and focus.
> > Seroquel is not so good for cognitive dysfunction-it is more likely to cause it.
> >
> As will most APs, right? Damn you, dopamine...Not necessarily. Latuda has been shown to improve cognition.
> Rilutek, did not know it could work for depression.
A couple studies show it is efficacious in the treatment of ocd and bipolar depression
>Never tried TCAs. What do you think of them?
I've only taken imipramine and clommipramine. I had a good, clean experience with them. Imipramine felt a little sludgy, though.
>You think low dose of any of them could be effective for anxiety and neuropathic pain, without harm to cognition or other more bothersome side effects?
I think so, the problem is OCD seems to only respond to high doses of antidepressants.
> SSRIs are so unreliable. Every two weeks or so my mood and side effect profile seem to shift to something else.
Well, are you taking them without the lithium?
>Keppra isn't very popular in my country, but I think we have it. i'm going to look into that one better before I comment on it.It works great for OCD and improves cognition. Its also an adequate mood stabilizer. Good dosage range was 2000-3000 mg.
>I'll try one of these again when I have the time to deal with serious side effects and sleep 12-15 hours a day.
Remember! A moderate dose of AP should suffice-and more importantly don't take without a serotogenic antidepressant on board!
> The intrusive, repeating thoughts are by far the worst symptom of all. I don't know if they're the cause of a symptom or both, but they literally cripple my ability to live.
You're fighting the thoughts tooth and nail. Maybe you just need to accept that you have these thoughts. Have you ever done any ACT?
> 900 Lithium + 30mg mirtazapine + 1mg risperidone or 600mg lithium + 50mg Zoloft + 6mg bromazepam were the best combos for that. However, Zoloft, risperidone, bromazepam and mitazapine tend to worsen my cognition.
Try Brintellix + Latuda + Lithium
> I never tried beta and alpha blockers. I'll look into it.
They're studying Prazosin as an agent f0r treating OCD.
> > Keppra, LAtuda, MEmantine, Riluzole
> >
> Can these drugs and nootropic drugs cause an increase on intrusive thoughts?They all decreased intrusive thoughts for me.
>Focus on the garbage already on my mind.
Maybe you can pick through it and find something useful.
Eric
ps. where are you from?
poster:phidippus
thread:1060760
URL: http://www.dr-bob.org/babble/20140214/msgs/1061394.html