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Re: Best med for complex-PTSD? TriedEveryMedication

Posted by SLS on February 18, 2020, at 12:06:37

In reply to Re: Best med for complex-PTSD? SLS, posted by TriedEveryMedication on February 17, 2020, at 16:34:04

Hi.

> > One of the main contributors to mood illness is childhood adversity. I'm sure it was for me. Awhile back, a few psychologists used the term "development PTSD" to describe the effects of chronic trauma during childhood. I had success with prozosin (Minipress) 30 mg/day (10 mg. b.i.d.). I might go back to it. I stopped taking it in an effort to streamline my regime. Prazosin was first used for PTSD as a treatment for nightmares as a single 3 mg dose immediately before bedtime. However, a few doctors have reported that taking higher dosages (up to 40 mg/day) throughout the day effectively treated daytime depression and anxiety.
> >
> > Prazosin must be started as a single 1-2 mg dosage at bedtime to prevent vertigo.


> Interesting about prazosin for depression. I was given it to combat anger and insomnia from despiramine, but I was warned it could make depression worse.
>
> Just curious, what is your current regimen?

Right now, I am still in the process of discontinuing Effexor (venlafaxine). I was hopeful there for a little while. I experienced significant improvements, but they lasted for about 3 days immediately after a dosage increase of decrease. I tried Trintellix (vortioxetine) immediately prior to beginning Effexor. It seemed to produce a long-lasting strange zombie state and a worsening of my baseline depression. It made Effexor do some crazy things as a result.

It's back to MAOI + TCA for me.

I am having a difficult time deciding between Marplan and Parnate. Parnate is a dead end for me. I function better on it than off it, but mental energy is really the only aspect of my depression that is significantly improved. Anhedonia and amotivation persist. I can't get myself to do things, and nothing feels good. There is no mood "brightening", and cognitive and memory impairments are improved only moderately.

Here is what I am currently taking:

Nortriptyline 100 mg/day
Lamictal 300 mg/day
Lithium 300 mg/day

In the past, adding Abilify and prazosin have helped, but I want to establish how much of an improvement I can obtain without them. Abilify = weight gain + high triglycerides. Prazosin is a remarkably clean drug at 30 mg/day. My only complaint is that it can kill sex-drive. Since discontinuing it 2 years ago, I can't say whether or not it has recovered. It's hard to know when reduced sex drive is a component of the illness.

My plan is to begin taking either Marplan or Parnate. I'm leaning towards Marplan since I tried it only once and stopped taking it after only 2 weeks. I was frustrated and impatient. I was stupid, but my stupidity was 35 years in the making by that point. I'm not kicking myself in the *ss too hard over this.


- Scott



Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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