![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by brynb on May 27, 2013, at 12:24:12
Hi All-
I've been doing pretty well after a few months of Ketamine, 5 weeks of TMS (this is my last week) and a regimen of Lexapro, Tramadol, Ativan and Seroquel. I only take the Ativan at night to sleep along with the Seroquel (which I take as needed, if I feel like I can't sleep). Truthfully, Seroquel seems to be enhancing my AD effect quite a bit, so although it makes me very tired in the morning, I'm not dropping it just yet.
I don't do well on stimulants (they make me anxious, moody and irritable), so my pdoc suggested Nuvigil for fatigue and motivation.
I've taken Provigil before with success, but I already feel like I'm on too many meds. I've made great strides from an a episode that began last November, and have been doing well for the most part, but I just took a part-time job and I want to keep moving toward remission. I also still have bad days and don't necessarily feel totally "right" yet. Although I'm not nearly as fatigued as I was in the depths of my depression, I am still completely unmotivated and find myself sleeping a lot of the time. It takes a lot for me to get out and socialize, too. I know I need to work out/exercise/run, but I just can't. It sounds like laziness, but it's more like a block.
So, Nuvigil: feedback? Good idea? Too many meds?
Thanks in advance.
-b
Posted by brynb on May 28, 2013, at 12:03:14
In reply to Lack of motivation, posted by brynb on May 27, 2013, at 12:24:12
Is it good for motivation?
Posted by rjlockhart37 on May 31, 2013, at 0:19:36
In reply to Or, Nuvigil anyone?, posted by brynb on May 28, 2013, at 12:03:14
it wakes you up, motivation is increased but not like amphetamine type stimulation. More of caffeine without jitters and slight better mood elevation
talk to your doctor about fatigue and depression....that's what my doctor gave for me....and also some cognitive impairment in the mornings from zyprexa
Posted by Englishman006! on June 1, 2013, at 10:58:35
In reply to Lack of motivation, posted by brynb on May 27, 2013, at 12:24:12
Did you not get a robust response from Ketamine? That would be my choice, via intramuscular injection every ten days or so.
It is difficult to tell what's doing what with the number of meds and treatments you are receiving. Certain meds can actually keep you from getting completely well. SSRIS often cause emotional blunting and apathy, this is preferable over being clinically depressed but ultimately they tend to hinder full remission.
Most people who undergo radical new treatments are told to remain on their current meds at stable dosages throughout the trial. But I can't help thinking that staying on them may ultimately interfere with the patient's chances of complete remission.
Just my thoughts...
Posted by brynb on June 1, 2013, at 11:33:56
In reply to Re: Or, Nuvigil anyone?, posted by rjlockhart37 on May 31, 2013, at 0:19:36
thanks, rj. it definitely helps get me up in the morning, but i'm afraid it's getting too stimulating (i feel hypomanic) and then i crash hard from it.
i realize i need to push myself to run/exercise and once i can do that (hopefully), it will become routine. i just have such a mental block that's preventing me from actually doing it. and, i'm tired from my meds!
thanks again.
-b
Posted by brynb on June 1, 2013, at 11:44:04
In reply to Re: Lack of motivation, posted by Englishman006! on June 1, 2013, at 10:58:35
> Did you not get a robust response from Ketamine? That would be my choice, via intramuscular injection every ten days or so.
>
> It is difficult to tell what's doing what with the number of meds and treatments you are receiving. Certain meds can actually keep you from getting completely well. SSRIS often cause emotional blunting and apathy, this is preferable over being clinically depressed but ultimately they tend to hinder full remission.
>
> Most people who undergo radical new treatments are told to remain on their current meds at stable dosages throughout the trial. But I can't help thinking that staying on them may ultimately interfere with the patient's chances of complete remission.
>
> Just my thoughts...hi englishman006,
during my ketamine trial, i did remain on the same meds. ketamine provides an initial robust response, and is great as a quick fix for really bad funks/acute situations, but i didn't find it to be a sustainable option. while it definitely helps lift mood, i run into trouble with stability on it.
i just finished 5 weeks of tms. i'm hoping to keep feeling the effects of it even now that treatment ended. my pdoc said i would. naturally, my regular meds (lexapro as my main AD) are still in the picture, however i now take 10mg instead of 20mg. i'm hoping that'll make a difference in the anhedonia/motivation department.
thanks for your feedback.
-b
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.