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Re: more on concerta Krazy Kat

Posted by Ritch on June 5, 2002, at 23:41:36

In reply to Re: more on concerta Ritch, posted by Krazy Kat on June 5, 2002, at 13:58:24

> Heh Mitch. How are you?

Well.. springtime hypomania is definitely over. I can tell because I am not buying any new music. I am listening to old vinyl instead. The imipramine is helping (good for generalized anxiety), but seems to have too much antihistaminic fog compared to nortiptyline. I still need to wait another full week to see though. Desipramine had zero effect until about 10 days into it and then things started "sharpening up". What starts to happen with the NE meds (for ADD symptoms), is a shift in perception of details. I start noticing things I hadn't noticed before, and I start marking times/dates on calendars and PLANNING things. The present moment seems to be a wider, more forgiving "space" to use my short-term memory and it doesn't feel like such a huge EFFORT to process ordinary tasks. Moderate seasonal depression will be kicking-in by the end of the month and be in full bloom by mid July.

> Re: the 27 mg. - my pdoc and I discussed this. I had been up to 25 mg. before on Ritalin and hadn't noticed a big difference between 20 and 25, so he felt that 36 would be an o.k. jump. I'm o.k. with it because I would have had to wait for yet another script if we went to 27 first.

That seems fairly logical-he probably didn't want to wait and go through another bump in dosage.

> First day, so I'll let you all know about the possible extension of benefits into the evening tomorrow. He didn't feel it would affect that and mentioned the same thing Chris did as a solution - taking 5 mg at, say, about 4:00. He said no later than that, though.

Chris's suggestion makes a lot of sense-you use the same med, but just "fill-in" the last few hours of the day.

> My sleep patterns are still wacky, so I imagine he wants me to try it at this level for a little while before adding any at the end of the day. Of course, I am getting impatient and want it all fixed now!!! :)

Have your sleep "patterns" always been "wacky"? Or is this a phenomenon of stimulant use? Can you explain the "wackiness"? I noticed during major depression that Adderall stabilized and made my sleep *more* consistent*. However, with dexedrine I noticed an overall reduced sleeptime (but no interruptions), Focalin did the same thing. But those two trials were during my hypomanic time of year. The Adderall was tried during a major depressive episode-I slept 7 hrs a day instead of the typical 10hrs. at that time of year.

> I have not tried Effexor.

I wouldn't be excited about trying it-if I were you. The only thing I really liked about it was-if I was experiencing a very major depressive dip, I could take just 12.5mg and snap out of it in a matter of hours and that would last for a few days! But, it was just too destabilizing overall, and made me itch.

> Re: "Serzone settled me down, but I was very confused (like trazodone). Wellbutrin makes me very panicky and grouchy."
> Boy, both of those affect me the same way. I find it fascinating that we have quite a few similarities because of our sex and age difference.

I liked Serzone because it didn't send me pacing all around like SSRI's did. In fact, I felt physically rested and calm sitting still. I just had trouble focusing mentally and I also have trouble with my eyes crossing and difficulty keeping them both aimed straight (exotropia). Interestingly, meds that help with *mental* focus also keep my eyes straightened out. Serzone also made me itch, too!

> Re: "mood SAMENESS"
> That would be a goal, IF, that anxiety/jitteriness can be controlled. So again, it seems as if we react similarly here.
> Perhaps a small amount of something else can control that? It couldn't be sedating for me. How many meds does it take? Ug. ;0

That's what I am hoping the imipramine will do for me. I know it has been effective for ADD symptoms, and panic/generalized anxiety.

> Also, after I am on 36 mg of Concerta for a few days, I will try your suggestion of taking the Depakote at even more spaced out intervals - maybe 500 mg in the morning, 500 in early afternoon, 1000 at night.
> And my mood chart/journal is a big goal...
> - kk

I saw some guidelines for Depakote dosing (can't remember the source) that mentioned that you should avoid single doses greater than 500mg. In your case you would need to take 500mg tabs 4x daily. Are you taking the Depakote ER 500mg instead of the regular Depakote CR 500mg? You just *might* be able to take get by with 1500mg Depakote a day instead if you were taking 500mg ER 3x daily-possibly. You can ask your pdoc if you aren't already taking the ER version.





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