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PDOC appointment Friday first time in years

Posted by kadykat on April 10, 2014, at 1:07:56

Hey, everybody!

Right now, I guess you could say that I don't have an official dx as of now; however, if I were to guess:

MDD - anergic depression
Very minor anxiety "stressed out" feeling. I also get social anxiety pretty bad, but not in places I'm comfortable.

I am in pain management; therefore, the only psychiatric medication I take is duloxetine 60mg. I mean, I suppose I responded OK to it, for it to take me this long to get to this point.

I have already tried and hated: Lexapro, Zoloft, Effexor, Wellbutrin, Gabapentin, Lyrica.

I have a very supportive husband, thank God. It's sad that I'm home nearly everyday yet still we have to hire a maid to clean the house. I own a small business that I micromanage as much as I possibly can.

I sleep anywhere from 12-16 hours a day. I am literally too tired to get out of bed. I have a very supportive son that takes care of me, and I try to do my best for him, but I feel like all I can do is feed him money since I'm hardly there in any many other ways.

Let's go ahead and take my health into account. I am slightly overweight (really, I don't look like an ogre and I'm my family is surprised I don't since I don't get out too much) and have type II diabetes that runs in the family. I don't think Zyprexa is a good idea for me.

I think it might be a good idea to double the Cymbalta to 120mg. and augment with an atypical antipsychotic? I was thinking Abilify, but I'm not sure if it is appropriate considering my health. I was thinking Latuda.

I also think that Nuvigil (I think Focalin would be better but I take medication for high blood pressure) makes sense as well to combat my constant fatigue.

I think I need something for my anxiety. Of course benzodiazepines pop up first, but I know about their reputation.

I'm not sure if I'd really like to even stay on Cymbalta. I'm not sure it's doing anything or not. My body is immune to the stuff, it's been so many years. I believe I stuck with it just because it helped with my fibro. I mean, I didn't like Effexor, after all?

I don't think the duloxetine helps my fibromyalgia.

I'm really liking the idea of the idea of this Latuda stuff more than anything I've read about about. (can't be on anything that will cause weight gain, but this looks like the most weith neutral AAP) Same thing with Nuvigil, I really like the sound of this drug. Would prefer Focalin, but I take blood pressure medication, so I'm not sure if the PDOC would want to prescribe this out. I feel like the stimulant would help my social anxiety in a way too.)

A good first visit?:

Cymbalta 60mg. --> 20mg. titration downwards
Lamictal titration
Latuda 40mg.
Nuvigil 150mg.

Second visit: Find an AP that works assuming that lamictal/latuda/nuvigil doesn't work completely?

I think Lamictal would be great for mood stabilization (something I may have an issue with), apparently one of the best mood stabilizers for anxiety-- effects the N-type calcium channel just like Lyrica and gabapentin (the only other anticonvulsant I believe that does this is Keppra).I think it's an overall good robust antidepressant effect in terms of mood stabilizers as well.

Does anyone have any ideas? I feel like I like someone good ideas going into my target visit. I've been doing a lot of reading on here. ;)




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