Psycho-Babble Medication Thread 1106610

Shown: posts 1 to 23 of 23. This is the beginning of the thread.

 

Having Mental Illness in Canada

Posted by Prefect on October 28, 2019, at 17:09:29

Canada is a wonderful country. Except when it comes to getting help for mental health. The idea of a steady psychiatrist who sees you a couple of times a month and counsels you on top of prescribing meds (like on Sopranos) is non-existent here.

It takes months to get to see a psychiatrist, post-referral. And when you do, it's usually one-time consults to review your meds and make suggestions. Family doctors, out of desperation, do most of the prescribing of psychopharmacology here due to this.

I'm having a lot of difficulty finding a steady psychiatrist. Today I had an appointment with a social worker who was reviewing me for CBT counselling sessions at CAMH (Toronto's biggest psych hospital). He told me due to the severity of my condition, I didn't qualify, as the program was more suited for milder cases.

I'm so frustrated.

I was wondering if people from Canada on this board had any suggestions? And do people on here from other countries experience the same thing?

 

Re: Having Mental Illness in Canada Prefect

Posted by jay2112 on October 28, 2019, at 19:07:28

In reply to Having Mental Illness in Canada, posted by Prefect on October 28, 2019, at 17:09:29

> Canada is a wonderful country. Except when it comes to getting help for mental health. The idea of a steady psychiatrist who sees you a couple of times a month and counsels you on top of prescribing meds (like on Sopranos) is non-existent here.
>
> It takes months to get to see a psychiatrist, post-referral. And when you do, it's usually one-time consults to review your meds and make suggestions. Family doctors, out of desperation, do most of the prescribing of psychopharmacology here due to this.
>
> I'm having a lot of difficulty finding a steady psychiatrist. Today I had an appointment with a social worker who was reviewing me for CBT counselling sessions at CAMH (Toronto's biggest psych hospital). He told me due to the severity of my condition, I didn't qualify, as the program was more suited for milder cases.
>
> I'm so frustrated.
>
> I was wondering if people from Canada on this board had any suggestions? And do people on here from other countries experience the same thing?

Hi fellow Canuckian :)

I am really sorry you are having such a tough time. I can relate, in my almost 30 years as a psychiatric patient. I am also a social worker, though, and think that this puts me at a bit of an advantage navigating the system.

Maybe I am lucky...I do have a regular psychiatrist whom I see once every 3 weeks, and is really quite an awesome, easy-going fellow. Ironically, I had his father as my first psychiatrist, back in the early 90's.

I am puzzled why they would deny you for CBT? I have a very severe case of Bipolar 2, and have gone through a few CBT sessions. It bothers me, though, that CBT is replacing more classic psychotherapy. We should have someone regular to talk about ALL of the past, today, and future with. The CAMH, though, is a bit cold and impersonal, like most large psychiatric hospitals.

Well, this board is a great place for support, chat, and feedback. Can I ask what meds you are on?

 

Re: Having Mental Illness in Canada jay2112

Posted by Prefect on October 28, 2019, at 20:11:25

In reply to Re: Having Mental Illness in Canada Prefect, posted by jay2112 on October 28, 2019, at 19:07:28

I suppose they denied me CBT because maybe that particular program was designed for milder cases? Not sure.

In any case I feel my mood disorder is endogenous and I would likely get little benefit from CBT, though it can't hurt. I'm suffering through this alone without getting to talk to someone about it regularly.

Currently on no meds since september 18 and reviewing options. Previously took Fluvoxamine, Zoloft, and Trintellix augmented with Abilify, in chronological order. No response to any of them.

Severe anxiety and depression. I start the day in absolute terror and gradually get better by evening.

I have a vague suspicion I suffer from some type of endorphin deficiency (because I have a positive immediate response to alcohol) but can't prove it. Been researching antidepressants that also act on opioid receptors as agonists, but haven't found any definitive info on that front.

 

Re: Having Mental Illness in Canada Prefect

Posted by jay2112 on October 29, 2019, at 12:42:59

In reply to Re: Having Mental Illness in Canada jay2112, posted by Prefect on October 28, 2019, at 20:11:25

> I suppose they denied me CBT because maybe that particular program was designed for milder cases? Not sure.
>
> In any case I feel my mood disorder is endogenous and I would likely get little benefit from CBT, though it can't hurt. I'm suffering through this alone without getting to talk to someone about it regularly.
>
> Currently on no meds since september 18 and reviewing options. Previously took Fluvoxamine, Zoloft, and Trintellix augmented with Abilify, in chronological order. No response to any of them.
>
> Severe anxiety and depression. I start the day in absolute terror and gradually get better by evening.
>
> I have a vague suspicion I suffer from some type of endorphin deficiency (because I have a positive immediate response to alcohol) but can't prove it. Been researching antidepressants that also act on opioid receptors as agonists, but haven't found any definitive info on that front.

Well, that is pretty awful of them, to deny you any kind of psychotherapy. I am a very powerful believer in medication, but talking with someone as an add-on does, and has been shown to, help.

But, the current medications deemed "psychiatric" are really, old news. A couple of thoughts, being in Canada.

-I am about to embark on a trial of CBD oil, the "Indica" strain. (Which is the one that is a relaxing kind.) Of course you know cannabis is perfectly legal here in Canada. This is very, very different than the stuff bought on the streets. It costs a bit, as it is not covered by most insurers yet. Here is the link to the government of Ontario cannabis website. https://ocs.ca/ You can order stuff online, and have it delivered to your door within 2 business days.

-Have you tried a mood stabilizer in combination with an antidepressant? On their own, I think mood stabilizers make depression and anxiety a bit worse, but experimentation seems to be key.

-I also find, again in combination, benzos like clonazepam and lorazepam seem also to help crush that initial blow of anxiety. But, over time, on their own, I don't think they are of much help.

Why so much experimentation? Well, everybody's metabolism of medications is unique. I found out I was a rapid metabolizer of certain meds, and I also have some kidney issues. So, some meds were deemed in and out of my system, more or less, before they could be effective.

 

Re: Having Mental Illness in Canada

Posted by Prefect on October 29, 2019, at 14:42:56

In reply to Re: Having Mental Illness in Canada Prefect, posted by jay2112 on October 29, 2019, at 12:42:59

I tried very low THC content CBD Oil last year (THC makes me very anxious) with no results, though it may have been because I was only on it for a couple of weeks. Perhaps didn't give it enough time?

I'm seeing my doctor in a couple of days, maybe Prozac augmented with Lamotrigine could be an option, or maybe a TCA? My liver is currently inflamed and fatty due to alcohol abuse, so I need to be careful which meds I take. My alcohol abuse has been a result of desperation induced by non-response to meds.

My doctor may be reluctant to prescribe benzos due to my history of alcohol abuse, but I'll ask her.

 

Re: Having Mental Illness in Canada

Posted by linkadge on October 29, 2019, at 18:22:19

In reply to Having Mental Illness in Canada, posted by Prefect on October 28, 2019, at 17:09:29

Hey, I am just 1 hour north of Toronto, but can concur with Canada's broken health care system.

We just waited 6 months to find a family doctor. We then found that the earliest appointment we can make for intake is in February!!!!

So, not only do I have no psychiatrist, I have no family doctor at the moment. The best I can do is go to walk in clinics.

On top of this (as mentioned in previous rants) people like me who have no insurance, have to pay for meds out of pocket (which severely limits options).

Walk-in clinics and the ER are no way to treat mental health problems.

Oh well. Doug Ford will fix it all up (not).

Linkadge

 

Re: Having Mental Illness in Canada jay2112

Posted by linkadge on October 29, 2019, at 18:30:31

In reply to Re: Having Mental Illness in Canada Prefect, posted by jay2112 on October 29, 2019, at 12:42:59

Hi Jay,

I currently take CBD (I went the medical route about 1.5 years ago). I take CBD:THC about 2:1.

I find it does help. It gives me a brain break / reset which lasts about 8-10 hours.

I make my own oil from the dry herb. I will also vape the dry herb about 2x a week (as needed). I also take lithium, mirtazapine and venlafaxine.

I find that some THC helps with appetite and sleep and with the 'reset' aspect.

The combination of CBD and THC has generally brought be to remission.

Linkadge


 

Re: Having Mental Illness in Canada Prefect

Posted by linkadge on October 29, 2019, at 18:33:41

In reply to Re: Having Mental Illness in Canada, posted by Prefect on October 29, 2019, at 14:42:56

That's very strange (individual differences in response). THC totally chills me out. I can literally forget all my problems for 8-10 hours. When it wears off, I have had enough of a mental break that I feel I can tackle my problems again.

Linkadge

 

Re: Having Mental Illness in Canada linkadge

Posted by Prefect on October 29, 2019, at 18:44:24

In reply to Re: Having Mental Illness in Canada Prefect, posted by linkadge on October 29, 2019, at 18:33:41

Yeah I'm very jealous of people who do well on THC. It makes me very disoriented, paranoid, and panicky. The only thing that calms me down is goddamn alcohol and now I have an inflamed fatty liver. And once it wears off I feel like crap.

I wish I could get my hands on morphine to see how I would respond to low dose treatment. I have a feeling I have an endogenous mood disorder with a dysfunctional opioid system. I actually get depressed after exercise, rather than euphoric.

In ancient times opium was regularly used by doctors to treat mood disorders. Modern times have brought on a serotonin fetish that I don't respond to.

 

Re: Having Mental Illness in Canada Prefect

Posted by linkadge on October 30, 2019, at 7:10:44

In reply to Re: Having Mental Illness in Canada linkadge, posted by Prefect on October 29, 2019, at 18:44:24

Some studies show that THC has an inverted 'U' shape type effect on serotonin release. Lower doses increase it, whereas higher doses decrease it. I don't do well on higher doses of THC alone. However, my tolerance of THC improves dramatically with added CBD.

You can't really use THC in the same way you would an antidepressant. I can't use it during the day (obviously, for a variety of reasons).

I also have a strain that is high in CBN (not THC or CBD). CBN is also good for anxiety / sleep. If you leave the plant longer the THC will covert to CBN.

It's not an exact science, but I would say that cannabis has virtually eliminated all of the physical symptoms of my depression (insomnia, pain etc).

Linkadge

 

Re: Having Mental Illness in Canada

Posted by Christ_empowered on October 30, 2019, at 20:14:30

In reply to Re: Having Mental Illness in Canada Prefect, posted by linkadge on October 30, 2019, at 7:10:44

hi. if its worse in the AM, then I would think a tca would be worth bringing up to a doctor. Tofranil was OK(ish) for me...2nd time around, kinda rough...but it seemed less apathy-inducing than cymbalta.

is tianeptine available in canada? it isn't in the US, but...after amineptine got banned or whatever, tianeptine came out...some people love it, other people find it ineffective.

if a tca isn't on the table, sometimes starting out with 2+ drugs is...sadly... the least horrible option. i mean...if it works, you'll get some relief, faster...better than waiting out 1, then 1, then another 1+1...

effexor+remeron is fairly well established as a valid option, in some cases. other antidepressant+antidepressant combinations that might help: cymbalta+remeron, remeron+wellbutrin, (insert ssri HERE)+wellbutrin, ssri or ssnri + buspirone (buspar)....

have you ever tried 'atypical' tranquilizers, aside from Abilify? olanzapine works nicely with Prozac (symbyax...generic, now, in the US), but the metabolic probs and the usual from neuroleptics (read: eps, akathisia, td) are something to be concerned about...

low dose risperidone has been used to boost antidepressants, but i find that kinda scary, because risperidone is on the rougher end of atypicals, plus...prolactin elevation, big concern...

cymbalta can be dosed up to 120mgs/daily, I think...as long as your liver is OK and you can get some blood work now and then, that seems like it be a less harsh option than Tofranil or the other tca drugs...

im not a huge fan of mood stabilziers, personally. lots of people swear by them, but I personally have found a lot of them to function as glorified sedatives. true story.

hope this helps, somewhat. :-)

 

Re: Having Mental Illness in Canada Christ_empowered

Posted by Prefect on October 30, 2019, at 20:39:45

In reply to Re: Having Mental Illness in Canada, posted by Christ_empowered on October 30, 2019, at 20:14:30

Tianeptine us not available in Canada either. I would have been interested in trying it due to its opioid agonism. Sometimes I wonder if there's a conspiracy in western countries against French and Russian pharmaceuticals.

I have much more anxiety than depression. It's a severe visceral type of anxiety that makes me subconsciously check out and disengage from reality and almost enter an altered state for the whole day. I'm very sensitive to sensory stuff (sounds, light) and can even get agitated watching a show or having a conversation. I'm more able to watch a show when it's late at night and I'm almost getting sleepy, so I suspect neuro-excitation.

I'm curious about TCAs that help with sleep maintenance with little liver toxicity; I've got an inflamed liver from alcohol abuse so I need to be careful.

 

Re: Having Mental Illness in Canada linkadge

Posted by jay2112 on October 30, 2019, at 20:42:25

In reply to Re: Having Mental Illness in Canada jay2112, posted by linkadge on October 29, 2019, at 18:30:31

> Hi Jay,
>
> I currently take CBD (I went the medical route about 1.5 years ago). I take CBD:THC about 2:1.
>
> I find it does help. It gives me a brain break / reset which lasts about 8-10 hours.
>
> I make my own oil from the dry herb. I will also vape the dry herb about 2x a week (as needed). I also take lithium, mirtazapine and venlafaxine.
>
> I find that some THC helps with appetite and sleep and with the 'reset' aspect.
>
> The combination of CBD and THC has generally brought be to remission.
>
> Linkadge
>
>
>
>
>

Hey thanks Linkadge..

I am on a very similar med list as your's, and am hoping that the CBD oil will really help. The stuff I am eyeing has 2.5 mg of thc, and 4 mg of cbd. That little bit of THC seems to help many as well. I tried some of the edible at a friend's place last week, and it completely melted away a really bad knot I had in my back and neck. I have read many amazing stories of this stuff, so shelling out a little extra for it is not a problem. My pdoc is 100 percent behind me too, which is an added bonus. Am going to see my pdoc tomorrow, so going to try combining nabinol with the cbd. Should be interesting! I will report back.

Jay

 

Re: Having Mental Illness in Canada

Posted by Christ_empowered on October 30, 2019, at 20:59:08

In reply to Re: Having Mental Illness in Canada linkadge, posted by jay2112 on October 30, 2019, at 20:42:25

me again.

surmontil...i think its trimipramine, maybe?...is a more modern tca that is supposed to help sleep, help anxiety, and help lift the spirits with a different adverse effect profile...

i would like to say that its not as harsh, overall, as other tca-drugs, but could be wrong about that...if nothing else, it is (supposedly) a safe(ish), effective sedative that doesn't destroy sleep quality.

hope things get better in your world. :-)

 

Re: Having Mental Illness in Canada Prefect

Posted by jay2112 on October 30, 2019, at 21:05:59

In reply to Re: Having Mental Illness in Canada Christ_empowered, posted by Prefect on October 30, 2019, at 20:39:45

You might be interested in Lyrica. It seems to work great when used with an antidepressant, for anxiety, but will start working the day you start it. And I too only responded to opiates and benzos. And Lyrica has seemed to help.

And the indica-dominant strain of cannabis I have tried, the government grade, really relaxed me, unlike much of the stuff I used to smoke off the street. The sativa-dominant strain is supposed to be more activating. I will have to experiment with this stuff, and report back.

But, like said above, it is also very much individual to body chemistry.

Jay

 

Re: Having Mental Illness in Canada jay2112

Posted by Prefect on October 30, 2019, at 21:20:56

In reply to Re: Having Mental Illness in Canada Prefect, posted by jay2112 on October 30, 2019, at 21:05:59

The difference between pregablin (lyrica) and gabapentin has always eluded me. I tried gabapentin once and I couldn't concentrate, though this may been psychosomatic.

I'm seeing my MD tomorrow maybe I'll bring it up.

I'm so desperate I've even thought about trying benadryl. I jolt awake way too early every morning and freak out (knot in stomach, palpitations), unable to go back to sleep. I end up having ten cigarettes in a row just to calm down a bit.

 

Re: Having Mental Illness in Canada

Posted by linkadge on November 1, 2019, at 16:10:49

In reply to Re: Having Mental Illness in Canada Christ_empowered, posted by Prefect on October 30, 2019, at 20:39:45

You might look at some good quality milk thistle. It is good for your liver and has some antidepressant qualities.

Linkadge

 

Re: Having Mental Illness in Canada

Posted by linkadge on November 1, 2019, at 16:22:06

In reply to Re: Having Mental Illness in Canada linkadge, posted by jay2112 on October 30, 2019, at 20:42:25

Dosing of CBD can be a bit tricky. I need ~10-20mg a day for a decent therapeutic effect. In terms of costs, I find its cheapest to make CBD oil from the dry herb.

I get 10g of 'tower' (which has 11-13% CBD potential). I heat it (at 240C) for one hour and then another hour heated in oil. I use olive oil as a carrier oil (which seems to have good support for absorbency - and contains oleic acid, which converts to oleamide, which itself has cannabimimetic properties). Under ideal circumstances, this would produce 130mg of CBD. I can get 5-7 days worth of CBD for this. It's a little over a buck a day. If I wasn't paying out of pocket I would probably take 2-3x this. However, I hear there is some cumulative effect in that the effect strengthen over time (?)

I could honestly benefit from a bit more. I have taken higher doses and they help. Hopefully, a synthetic CBD becomes available for treatment of anxiety or related disorders. This could bring costs down further.

However, I am in much better shape overall than I was 1.5 years ago. It has improved my anxiety and insomnia dramatically (in combination with THC) and side effects are minimal, if that.

Linkadge

 

Re: Having Mental Illness in Canada Prefect

Posted by linkadge on November 1, 2019, at 16:29:04

In reply to Re: Having Mental Illness in Canada jay2112, posted by Prefect on October 30, 2019, at 21:20:56

I assume you've tried mirtazapine?

Mirtazapine and CBD work well together. Some of my insomnia 'stack' includes:

- mirtazapine
- magnesium
- gaba
- CBD / THC
- lithium
- niacin
- co-q10 (supposedly blocks glutamate release)

Just to add. There may be some synergy between CBD and gaba precursors. CBD apparently increases the brain's sensitivity to gaba (as does lithium).

Linkadge


 

Re: Having Mental Illness in Canada Prefect

Posted by beckett2 on November 7, 2019, at 19:42:09

In reply to Having Mental Illness in Canada, posted by Prefect on October 28, 2019, at 17:09:29

> Canada is a wonderful country. Except when it comes to getting help for mental health. The idea of a steady psychiatrist who sees you a couple of times a month and counsels you on top of prescribing meds (like on Sopranos) is non-existent here.
>
> It takes months to get to see a psychiatrist, post-referral. And when you do, it's usually one-time consults to review your meds and make suggestions. Family doctors, out of desperation, do most of the prescribing of psychopharmacology here due to this.
>
> I'm having a lot of difficulty finding a steady psychiatrist. Today I had an appointment with a social worker who was reviewing me for CBT counselling sessions at CAMH (Toronto's biggest psych hospital). He told me due to the severity of my condition, I didn't qualify, as the program was more suited for milder cases.
>
> I'm so frustrated.
>
> I was wondering if people from Canada on this board had any suggestions? And do people on here from other countries experience the same thing?

Lyrica has been terrific for GAD. That's how my BPll can manifest. I started at a high dose when I was really ill and came off of Xanax. Over time I've reduced my dose. Because it's formulary (I think that's the word), the price is stupidly high. Which is a shame because it's different than gabapentin. Gabapentin makes me dull and tired in addition to anxious.

Oddly enough, a little adderall helps tons. I have ADD but this didn't bother me too much until the BPll.

trintellix 20mg
lamotrigine 200mg
lyrica 100mg
adderall 10-15mgs

one cup coffee per day :)

Best wishes from the US.

 

^^ Re: Having Mental Illness in Canada Prefect

Posted by beckett2 on November 9, 2019, at 19:05:40

In reply to Having Mental Illness in Canada, posted by Prefect on October 28, 2019, at 17:09:29

Just to add that Lyrica (pregabalin) is available in generic. Received my refill in generic today.

 

Re: ^^ Re: Having Mental Illness in Canada

Posted by linkadge on November 23, 2019, at 8:01:05

In reply to ^^ Re: Having Mental Illness in Canada Prefect, posted by beckett2 on November 9, 2019, at 19:05:40

Given my response to phenibut for anxiety, I would like to try pregabalin. However, I feel that if I asked for pregabalin, this might be considered 'drug seeking behavior'. Apparently pregabalin is moving on the 'bad list' because some yahoos abuse it.

Linkadge

 

Re: ^^ Re: Having Mental Illness in Canada linkadge

Posted by beckett2 on November 26, 2019, at 17:11:30

In reply to Re: ^^ Re: Having Mental Illness in Canada, posted by linkadge on November 23, 2019, at 8:01:05

> Given my response to phenibut for anxiety, I would like to try pregabalin. However, I feel that if I asked for pregabalin, this might be considered 'drug seeking behavior'. Apparently pregabalin is moving on the 'bad list' because some yahoos abuse it.
>
> Linkadge

You've likely demonstrated responsibility to your care provider, but I understand. It is abusable in large amounts, and I've heard it is a larger problem in Europe, but maybe that's changed. As I said above, it works whereas gabapentin did not.


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