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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jay on December 26, 2005, at 7:53:28
OK...I am using a big dose of Prozac, along with clonazepam, nortriptyline, seroquel, Dexedrine, and zyprexa. (Ya, it sounds like a lot, but I am a big guy, and notice only large doses affect me.)My DX is somewhere along the BP2-3 spectrum, with my mania being dysphoric, agitated type. I have to be *very* careful with the Dexedrine. BUT...I have also added 500mg of Phosphatidylserine(PS), and left-over bromazepam prn. In all honesty, I'd actually like to cut down to PS as my main med, small doses of seroquel and dexedrine, and maybe even 5-10 mg of both Prozac and Nortriptyline. (My main problem with these meds are the sexual problems and the weight gain.) I know...you folks must think me "crazy"...heh...but isn't that the point??..lol.
Anyhow...comments please welcome...
Jay "The walking pharmacy" :-)
Posted by bart on December 26, 2005, at 13:10:54
In reply to My new cocktail..comments **PLEASE**, posted by jay on December 26, 2005, at 7:53:28
I was wondering if you ever feel like the zyprexa minimizes the effects from the dexedrine.
Posted by Phillipa on December 26, 2005, at 23:50:22
In reply to Re: My new cocktail..comments **PLEASE**, posted by bart on December 26, 2005, at 13:10:54
Quite a cocktail hope the experts come on. Fondly, Phillipa
Posted by yxibow on December 27, 2005, at 0:39:26
In reply to My new cocktail..comments **PLEASE**, posted by jay on December 26, 2005, at 7:53:28
> OK...I am using a big dose of Prozac, along with clonazepam, nortriptyline, seroquel, Dexedrine, and zyprexa. (Ya, it sounds like a lot, but I am a big guy, and notice only large doses affect me.)My DX is somewhere along the BP2-3 spectrum, with my mania being dysphoric, agitated type. I have to be *very* careful with the Dexedrine. BUT...I have also added 500mg of Phosphatidylserine(PS), and left-over bromazepam prn. In all honesty, I'd actually like to cut down to PS as my main med, small doses of seroquel and dexedrine, and maybe even 5-10 mg of both Prozac and Nortriptyline. (My main problem with these meds are the sexual problems and the weight gain.) I know...you folks must think me "crazy"...heh...but isn't that the point??..lol.
>
> Anyhow...comments please welcome...
> Jay "The walking pharmacy" :-)
I'm not too familiar with BP other than my aunt who passed away long ago due to BP-2. I'm not too clear on the studies of Phosphatidylserine -- it is after all, just a supplement, some consider a "smart drug". The supplement that is used today is largely derived from soy due to fears of mad cow disease, as the original experiments used bovine Phosphatidylserine and some claim the fatty acids are different in the soy version.You're no more a walking pharmacy than I... I can rattle off the 6.. 5? medications that I'm on, and I'm also a relatively big guy too although I've lost 33 lbs at the gym so far that Remeron gave me. Numerous people on here are on polypharmacy. The high dose Prozac plus the tricylic seems redundant, but I'm not second guessing your doctor. And indeed if one is agitated one certainly should be careful with Dexedrine. The Seroquel and Zyprexa are also somewhat redundant, although I have thought of returning to an addition of Zyprexa at one point, (I currently take Seroquel for a rare visual disorder) -- and the general comments were basically against returning to it (Zyprexa was effective but unfortunately caused pronounced pseudoparkinsonism).
tidings
Posted by med_empowered on December 27, 2005, at 1:33:26
In reply to Re: My new cocktail..comments **PLEASE**, posted by yxibow on December 27, 2005, at 0:39:26
hi! If its working, with minimal side effects, then good. But..could you maybe pick one atypical? I just ask b/c combining atypicals is usually a last-ditch effort in dealing with psychotic illness. With mood disorders, you might be better served by picking 1 atypical to deal with mood issues, and then using other medications to deal with stuff like sleep or anxiety.
I've done stimulant-atypical combos, and they were OK...how do you feel on it? It seems like you could possibly ditch the nortriptyline (which tends to be kind of stimulating) in favor of either Wellbutrin (stimulating, fewer side effects) or ditch the Prozac also in favor of Effexor or Cymbalta. Also, just for convenience and cost, could you go for Symbyax, instead of zyprexa and prozac separately? On my insurance, that would save about 15/month..I dont know how your system works, though.
Also, on a side note, adding metformin (glucophage, glucophage XR) to your atypical regimine **Might** help reduce weight gain and/or help you lose a little weight...at the very least, it will help prevent/treat "metabolic syndrome," which sometimes happens with atypical use. Metformin is very cheap and doesn't have too many side effects...some docs seem to think it helps improve mood, so patients need lower doses of medication...this may or may not prove true for you, but its an interesting theory nonetheless.
Anyway, I'm glad you found something that works well for you. Good luck, and plese keep us all posted!
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