Posted by phidippus on May 6, 2014, at 19:58:42
In reply to Reduction of Meds; Symptoms Persist, posted by Louisiana Sportsman on May 5, 2014, at 15:30:25
> * lack of motivation to progress my life
> * chronic lazinessThese two sound more like psychological issues that would best be addressed with therapy. Unless you want to take on a cocaine habit.
> * emotional outbursts over minor things
Some DBT could help here.
> * lay in bed on the computer during complaisant days outside
Is this the problem or your guilt about it?
> * "weird, nervous" anxious feeling arises, solicitous and disquieted-- tachycardia present, randomly on certain days that stops me from doing anything (not caused by methamphetamine, tested it)
May be a limited symptom attack. Topomax can cause anxiety.
> * thoughts about death...Now, when I drive, for instance, I'll think about crashing into the median or something; whereas, before, it didn't bother me as much.
Intrusive and recurrent thoughts form the basis of OCD. Brintellix should be treating these symptoms or at least reducing their frequency. Often times, OCD requires treatment with antidepressants at higher doses that would normally be used for depression. You can always try and increase the Brintellix and see how you respond.
Another possibility is the replacement of Desoxyn with dextroamphetamine, which has been used as augmentation in the treatment of OCD.
> 1. Switch Latuda to Geodon 80mg. or lessGeodon is worthless at an 80 mg dose. At 160 mg it does all its supposed to do.
>It would give less dopamine occupancy (60% or <) at this dosage which may allow the Desoxyn to work better to improve motivation.
Geodon will be hitting D2 receptors while the desoxyn works primarily on D1 receptors. There should be little competition between the agents.
>I would get the similar AAP serotonergic activity that Latuda provides.
You would get 5ht1a partial agonism, 5ht1b partial agonism, plus serotonin reuptake inhibition.
>Also concomitantly add Aptiom
Are you bipolar with adhd and ocd? I don't think you've ever told me your diagnosis.
>I think this would help with...the negative thoughts.
No.
>For emotional outbursts, switch Xanax XR to Ativan SL 1mg.
I thought benzos only helped with anxiety...How does GABA-A agonism influence behavior?
> Alternative idea to switching Latuda to Geodon is to add Protriptyline at about 30mg.
Adding Vivactil to your regimen sounds like a fine idea what with you taking methamphetamines.
> NortriptylineMay be useful for depression.
> Oleptro ER
Ha ha.
> Clomipramine
Sure, instead of Brillantix.
> Ideas? Thoughts? Opinions? Inputs?
I think you're obsessed with trying out drugs. Remember, the more drugs you take, the more mucked up things get.
Eric
poster:phidippus
thread:1065262
URL: http://www.dr-bob.org/babble/20140419/msgs/1065309.html