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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Chinaboy on January 4, 2015, at 6:22:03
I always keep the expectations high with high hopes from psychiatry.I keep jumping from one med to another without giving any one of them enough time. I know this is undesirable, but couldn't control it.Personally I don't think this is OCD. they are more like addictions. Yes, I'm addicted to the trial of medication for mental issues.
I'm just that kind of person who is prone to addiction. I would spend hours and hours studying Japanese or practising English listening ability, at the cost of job, other studies,family responsibilities. These apparently meaningful activities actually have ruined my life. I call it "hobby OCD". but it's not so simple a matter as OCD coz all the meds for OCD never helped.
What should I do with these addictions? Any input would be greatly appreciated!
Posted by vbs on January 4, 2015, at 12:56:03
In reply to Are there meds for addiction?, posted by Chinaboy on January 4, 2015, at 6:22:03
This sounds complicated. I would discuss it with your MD. I was once diagnosed with OCD. I would tinker with Linux at the cost of my computer science curriculum. I was ADD at one time. Now I'm insane. I hope you find help.
~vbs
Posted by Tomatheus on January 4, 2015, at 15:52:17
In reply to Are there meds for addiction?, posted by Chinaboy on January 4, 2015, at 6:22:03
Chinaboy,
What do you think are some of the reasons why you discontinue your medications too quickly? Do you find the medications to be just not effective enough in the time that you spend on them? Do they seem to produce a response that's inconsistent? Do the medications seem to help for a short period of time before becoming seemingly less helpful? Do the medications produce too many intolerable side effects? Finally, which medications, if any, have you had some success with?
I agree with vbs that it would be a good idea to discuss your thoughts about the addictive tendencies that you seem have with a mental health professional. A psychiatrist or therapist might be able to give you some insight about what you describe as being addictive tendencies that we might miss. I really don't know whether it would be best to look at the behaviors you've described here as being obsessive, related to a tendency toward distraction, related to a tendency toward addiction, or something else, and I think that it would take a good treatment professional (ideally one with a lot of knowledge and experience) to sort through all the possible explanations for the behavior that you describe and come up with a working explanation.
So, as tempting as it might be to self diagnose and look for treatments for the diagnosis that you've arrived at, I think that coming to a better understanding of what you're experiencing with a professional's help *before* looking for treatments would be most advisable.
I wish you luck and well being.
Tomatheus
Posted by Christ_empowered on January 4, 2015, at 22:28:22
In reply to Re: Are there meds for addiction? » Chinaboy, posted by Tomatheus on January 4, 2015, at 15:52:17
talk therapy? Meds only go so far.
Posted by ed_uk2010 on January 5, 2015, at 3:02:25
In reply to Are there meds for addiction?, posted by Chinaboy on January 4, 2015, at 6:22:03
>Personally I don't think this is OCD.
It isn't OCD, it's an obsessive-compulsive personality trait, which is very different. Some people with these symptoms are diagnosed with obsessive-compulsive personality disorder, usually if a wide variety of such traits are present over a long period of time, starting in childhood/adolescence. Other people do not fall into this category at all, and suffer predominantly impulse control and addictive disorders. All of the above may occur with or without actual OCD, but only OCD responds to SSRIs.... addictive and OC-personality traits do not. Psychological treatments are usually tried. Some impulse control disorders may respond to naltrexone.
Posted by Phillipa on January 5, 2015, at 9:35:05
In reply to Re: Are there meds for addiction?, posted by ed_uk2010 on January 5, 2015, at 3:02:25
I agree Ed I am a lot like above your description. PJ
Posted by rjlockhart37 on January 6, 2015, at 15:37:10
In reply to Are there meds for addiction?, posted by Chinaboy on January 4, 2015, at 6:22:03
for the OCD part a SSRI and/or buspar with a AP would help for over OCD, but still try to vary out some of the symptoms from OCD and addiction, addiction is more seeking for pleasure or cannot function without it, personally me i listen to music too much and if i don't listen to music i get depressed......
AP's espeically zyprexa lower the hypomanic symptoms to become intrested in various things that are ... like odd, or too much into it, but why don't ask the doctor about a short acting AP, because zyprexa lasts a vary long time and cause sedation and depression
higher doses of SSRI usally rid OCD symptoms but also can cause hypomania, so adding a AP would be a good choice
r
Posted by Chinaboy on January 7, 2015, at 6:52:48
In reply to Re: Are there meds for addiction?, posted by ed_uk2010 on January 5, 2015, at 3:02:25
> >Personally I don't think this is OCD.
>
> It isn't OCD, it's an obsessive-compulsive personality trait, which is very different. Some people with these symptoms are diagnosed with obsessive-compulsive personality disorder, usually if a wide variety of such traits are present over a long period of time, starting in childhood/adolescence. Other people do not fall into this category at all, and suffer predominantly impulse control and addictive disorders. All of the above may occur with or without actual OCD, but only OCD responds to SSRIs.... addictive and OC-personality traits do not. Psychological treatments are usually tried. Some impulse control disorders may respond to naltrexone.
>
I talked with my pdoc about what caused those OCD=like symptoms. With a careful analysis, he concluded that me spending too much time on hobbies is OCD personality trait but jumping from one med to another might be a hypomania episode triggered by the large dose of antidepressants Im on. That is because the longer SSRI Im on, the worse those symptoms become. Do you think his analysis makes sense?Also, for that reason, he decided to add 15Mg of Abilify to my antidepressant combo (Citalpram+Reboxetine+Buspar) since I do not react well to stand mood stablizers like Lamictal. He also mentioned that 15Mg of Abilify will augment those antidepressants. But isnt 15Mg of Abilify too much for an augmentation effect? For that effect, how much is too much?
Posted by Christ_empowered on January 7, 2015, at 7:39:09
In reply to Re: Are there meds for addiction?, posted by Chinaboy on January 7, 2015, at 6:52:48
15mgs/Abilify is full on antipsychotic dose. 10-15 is where the AP effects hit full on for most people. That said...you can go higher. I take 30 per day because I'm Mr.Agitation. So...15 isn't bad. I'd watch the drug-drug interactions to make sure it isn't building up in your system.
15 used to be the standard starting and target dose. More calming than 10, but can still be somewhat "activating," with good control of (hypo)mania and psychosis, at least for a lot of people.
Good luck!
Posted by Chinaboy on January 7, 2015, at 7:57:15
In reply to Re: Are there meds for addiction?, posted by Christ_empowered on January 7, 2015, at 7:39:09
> 15mgs/Abilify is full on antipsychotic dose. 10-15 is where the AP effects hit full on for most people. That said...you can go higher. I take 30 per day because I'm Mr.Agitation. So...15 isn't bad. I'd watch the drug-drug interactions to make sure it isn't building up in your system.
>
> 15 used to be the standard starting and target dose. More calming than 10, but can still be somewhat "activating," with good control of (hypo)mania and psychosis, at least for a lot of people.
>
> Good luck!
Thanks for your reply! Yes, I understand that 15mgs/Abilify has a good good control of (hypo)mania and psychosis, but how about its effect on augmenting antidepressants? Does this effect begin to disappear at 15mg?
Posted by ed_uk2010 on January 7, 2015, at 8:41:15
In reply to Re: Are there meds for addiction?, posted by Chinaboy on January 7, 2015, at 6:52:48
>a hypomania episode triggered by the large dose of antidepressants Im on. That is because the longer SSRI Im on, the worse those symptoms become. Do you think his analysis makes sense?
It depends whether you have any symptoms of hypomania eg. elevated mood, overexcitement, out of character impulsive behavior, reduced need for sleep, excessive talkativeness, rapid thoughts etc. What symptoms exactly become worse with SSRIs?
>Also, for that reason, he decided to add 15Mg of Abilify to my antidepressant combo
15mg is rather a lot to start with, for a non-psychotic condition. Initial side effects include nausea and restlessness.
>But isnt 15Mg of Abilify too much for an augmentation effect? For that effect, how much is too much?
It's above average. More common to start with around 5mg (if not taken before) and increase to 10mg if tolerated.
>Lamictal
Lamictal isn't like any other mood stabiliser. So don't rule out others because of poor response to Lamictal. This is assuming you need a mood stabiliser at all.
Posted by Christ_empowered on January 7, 2015, at 9:48:29
In reply to Re: Are there meds for addiction? » Chinaboy, posted by ed_uk2010 on January 7, 2015, at 8:41:15
ummm....antidepressant augmentation is a tricky thing. Like, some people need that full strength tranquilizer. Back in the day, they'd use perphenazine or thorazine at varying doses, especially when agitation, phobias, anxiety, and psychotic symptoms were present.
So...yeah...Abilify. Maybe your shrink just thinks you need the extra tranquilizing action of 15mgs/day. I would think that 15mgs/day to start would cause less activation than a lower dose, since that dose is more tranquilizing. Also, shrinks sometimes Rx based on personal experience, not data, and 15mgs used to be the standard and starting dose...maybe your doc just knows what to expect from that starting dose?
AP/AAP drugs are used for...everything, lol. The older AP drugs were also widely used until the TD lawsuits and anti-psychiatry movements kinda put a damper on that.
Just think of it this way...Abilify @ 15mgs is an effective tranquilizer, plus it can elevate mood in some people.
Posted by Chinaboy on January 9, 2015, at 6:31:09
In reply to Re: Are there meds for addiction?, posted by Christ_empowered on January 7, 2015, at 9:48:29
Many THanks to the helpful guys who offered me opionions. My pdoc insisted on me having bipolar depression/mixed state.
Tomorrow I'm going to replace 300Mg of Seroquel with 10Mg of Abilify. Partly because Abilify has synergistic reactions with Lamictal. Besides, 300Mg of Seroquel does little to my paranoid thinking. Hopefully 10Mg of Abilify can help with my thinking pattern and nagetive symptoms of schizoid personality disorder.
And I also added 100mg of Amisulpride for the residual nagetive symptoms of schizoid personality disorder. It's said that Abilify can help reduce the rise of prolactine raised by Amisulpride.
AND Lamictal remains at 200mg.
What do you think of this combo?
Posted by burial on January 9, 2015, at 8:07:51
In reply to what do you think of this combo?, posted by Chinaboy on January 9, 2015, at 6:31:09
> Many THanks to the helpful guys who offered me opionions. My pdoc insisted on me having bipolar depression/mixed state.
>
> Tomorrow I'm going to replace 300Mg of Seroquel with 10Mg of Abilify. Partly because Abilify has synergistic reactions with Lamictal. Besides, 300Mg of Seroquel does little to my paranoid thinking. Hopefully 10Mg of Abilify can help with my thinking pattern and nagetive symptoms of schizoid personality disorder.
>
> And I also added 100mg of Amisulpride for the residual nagetive symptoms of schizoid personality disorder. It's said that Abilify can help reduce the rise of prolactine raised by Amisulpride.
>
> AND Lamictal remains at 200mg.
>
> What do you think of this combo?
could you please elaborate more on this lamotrigine-aripiprazole synergy? I've taken both and they were definitely activating, but maybe there are some pharmacological properties that exoplains this?
This is the end of the thread.
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