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Dangerously close to the end of the road. Help

Posted by delna on November 15, 2009, at 7:38:46

I fear I have exhausted all possibilities...but I am still looking at my final options (although now I am fearing the worst)

I tried the Effexor (which was my last real hope post Parnate) and it made me sleep for 4 days straight through, barely waking up to eat. I know sleepiness is a side effect but this was just ridiculous and despite my 200mg Provigil. I am so, so sensitive to sedation and somehow with me, it never passes nor is it ever transient. Add on's will not help sedation because I take 'ad-ons' when i am on non-sedating drugs just to stay awake (400mg provigil, 300mg wellbutrin, 200mg caffeine.) I need the 'base' drug to be activating.
So I stopped the effexor.

My last experience of Effexor was that it made me **really** high. But now the Lamictal (200mg) is blocking the switch, I assume.
My pdoc here said he wants to keep me 'slightly' hypomanic.(I'm not sure how he plans to do that as he is sick and won't be around for a week.) I think he was planning on using add-ons but if the 'base' drug is sedating me, no add-on will help (not even if ritalin is added to my already long list of ad-ons, from past experience).
I don't think he has any intention of touching the Lamictal dose, though.

I have some questions. I hope someone can please help me with some of them.

Question 1) Do you think lowering the dose of Lamictal is an option so that I get a *slight* high from the effexor?. Or is it plain silly because highs come crashing down, don't they? My last one lasted 8 months on Effexor (minus a mood stabilizer)but yes, it came crashing down eventually. But that was an uncontrolled 'manic episode' so maybe this would be different....?

The other option is a totally non sedating AD like Prozac. However...

Question 2) My anxiety is back with a bang (6-8mg Klonopin a day + 20mg inderall + today for the first time in 10 years, whiskey ), does that mean Prozac is out for me? I know Prozac can make anxiety much worse to begin with but then doesn't that settle down and finally Prozac acts as a anxiolytic? It's the only AD without sedation as a side effect so it seems like my final hope. Do you think it is worth a shot or does the anxiety never go?

My other option is to go to the States and go to one of the special hospitals for bipolar/ depression. I don't have insurance (travel insurance doesn't cover me) so I am not sure how much it would cost to be an inpatient. I tried looking it up but found nothing.

Question 3) Does anyone have a rough idea of cost of being an inpatient? Especially if you needed something funky like ECT or TMS?

Rosy Crucifiction came up with this list of the 'National Network of Depression Centers'

* Columbia University
* Duke University
* Emory University
* Harvard Brigham & Womens Hospital
* Harvard Massachusetts General Hospital
* Harvard McLean Hospital
* Johns Hopkins University
* Stanford University
* University of California, San Francisco Langley Porter Psychiatric Institute
* University of Colorado Denver Comprehensive Depression Center
* University of Cincinnati-Lindner Center of HOPE
* University of Louisville
* University of Michigan Comprehensive Depression Center
* University of Pennsylvania
* University of Texas Southwestern Medical Center
* Weill Cornell Medical College

Q4) Can anyone recommend one or comment on any? Or alternatively recommend something completely different?

Q5)Is this option even worth a try since I seem to have run out of drugs anyway? Also I have been told by 2 pdocs (one was an ECT specialist) that I am not a good candidate for ECT either- I am unlikely to respond. (Why? I don't know)

Any suggestions would really help

Thanks so much

Very desperate

PS: I also consulted a doc of internal medicine who having looked at all my reports (past and present) ruled out infections (active or occult)or deficiencies.




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