Posted by phidippus on March 12, 2014, at 17:16:54
In reply to Re: Phidippus. - Med Regimen, posted by LouisianaSportsman on March 11, 2014, at 23:59:06
> Adderall IR (amphetamine salts) 60mg.;
I'm a big fan of amphetamines. They help with executive function, mood and even some anxiety disorders (OCD). If anytyhing, I'd recommend 70 mg of Vyvanse, which just lasts longer.
> Aplenzin (bupropion hydrobromide) 522mg.;Odd number there. With the amphetamines on board it gets difficult to recommend bupropion, but there's no denying it can help with mood. I'd do a quick check and go off it for a bit to see if it really makes a difference.
> Brintellix (vortioxetine) 10mg.;
I made it to 20 mg before I started puking all over the place. This is an awesome drug for anxiety - 5ht1d antagonism, 5ht3a antagonism, 5ht1b agonism, 5ht1a agonism, 5ht7 antagonism. I had an amelioration of my OCD about 4 weeks into the drug. However, it didn't seem to impact my mood in 6 weeks. Maybe if I'd stayed on it longer...
> Latuda (lurasidone) 80mg.;
I like Geodon more-it has a lot of the same mechanisms of action as Brintellix and is an SNRI to boot. BUT, Latuda gets the job done and helps with anxiety at higher doses (120-160 mg).
> Nuvigil (armodafinil) 250mg.;Fun, fun. What do you need this for?
> Lamictal (lamotrigine) 200mg.;
> Neurontin (gabapentin) 1,200mg.;
> Trokendi XR (topiramate extended-release) 100mg.That's a lot of anticonvulsant and I'd be worried about what depressive effects the some total is having. Topamax is probably only contributing side effects at that dose (and maybe preventing migraines).
If your looking for more mood stabilization because you're taking more antidepressant, I would first look at increasing your antipsychotic. That will reduce mania and OCD symptoms.
Otherwise, I'd go for 400 mg on the Lamictal-the higher you go with lamictal the better the mood stabilization. Something to do with the potentials of sodium channels...I had a cool pdf around her somewhere...
Neurontin will provide some mood stabilization and some relief from anxiety-as a glutamate antagonist it will also reduce your OCD. Can you tolerate it at 2400 mg?
> I'm planning on increasing Brintellex to 20mg.
good
>Lamictal to 300mg.
try 400, unless your moving that way slowly.
>Neurontin to 1,600mg
The difference between 1200 and 1600 mg is nil. You really need to double it to feel results.
>and Trokendi XR to 200mg. at some point.
I'd just drop the Tokendi XR
>there are studies that suggest that you can use lower doses of the mood stabilizer you're augmenting to another mood stabilizer.
This is true, but we're talking about Dopomax here.
> I would love to trial Oxtellar XR (oxcarbazepine extended-release tablets) in place of my lamotrigine.
Trileptal just doesn't have the 'zing' of Lamictal.
Eric
poster:phidippus
thread:1062167
URL: http://www.dr-bob.org/babble/20140307/msgs/1062360.html