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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by LouisianaSportsman on October 11, 2014, at 22:27:40
I've been gone for awhile, I'm currently in a 90 day impatient treatment, and I am able to get online for this weekend. I go back without access Monday-Friday. I complete the program next Monday.
I've been on psychiatric medication for awhile now, and I've found a combo that is OK, but I feel like I can improve it.
I currently take:
Sertraline [Zoloft] 50mg.
Mirtazapine [Remeron] 30mg.
Lurasidone [Latuda] 40mg.
Bupropion SR [Wellbutrin SR] 450mg.
Topiramate [Topamax] 100mg.
Gabapentin [Neurontin] 2,400mg.
Propranolol [Inderal] 30mg.Suffering from chronic fatigue which I think is from the mirtazapine. Mirtazapine has been, hands down, the best antidepressant in terms of producing a response, but the weight gain and sugar cravings and the risk of prediabetes with the concomitant use of lurasidone worries me a lot-- the only reason I got on it is because I needed to be able to sleep in the treatment facility. I have gained 30lbs. on mirtazapine, but I'm not sure I want to give it up. Can the dosage increase reduce fatigue like I've read about? What about going down to 15mg.? Something has to give. I just really like the response it has on my MDD and GAD. Maybe I could switch to something in the tricyclic class since I've have such a good response...
I'm not sure what benefit I have gotten from sertraline, and I'm considering discontinuation or switching to Brintellix.
I'd like to switch the Bupropion SR 450mg. to Aplenzin 522mg.
The topiramate does nothing to curb my appetite nor seems to provide that energy or mood effect anymore. Would like to switch to Qudexy XR (topiramate extended release) 200mg.
The lurasidone has been effective, but I think Abilify 10mg. was better for me.
I think Lyrica 200mg. X 3 would be better than gabapentin 800mg. X 3
Propranolol was written for a minor arrhythmia, I think it would be good for GAD-- like the 80mg. XL.
My goal:
Brintellx 10mg.
Abilify 10mg.
Aplenzin 522mg.
Lyrica 600mg.
Qudexy XR 200mg.
Remeron 60mg.
Propranolol XL 80mg.Thoughts?
Posted by Lamdage22 on October 12, 2014, at 3:48:00
In reply to Review Of My Medication Regimen; Advise Needed, posted by LouisianaSportsman on October 11, 2014, at 22:27:40
That is a lot of medication!
So much that i don't know what advice to give you. Some of that medication cancels each other out i would imagine.
Maybe someone more knowledgeable can help. What does your doctor say about your plans?
And what is your diagnosis anyway?
Posted by oceansun on October 12, 2014, at 12:16:32
In reply to Review Of My Medication Regimen; Advise Needed, posted by LouisianaSportsman on October 11, 2014, at 22:27:40
> I've been gone for awhile, I'm currently in a 90 day impatient treatment, and I am able to get online for this weekend. I go back without access Monday-Friday. I complete the program next Monday.
>
> I've been on psychiatric medication for awhile now, and I've found a combo that is OK, but I feel like I can improve it.
>
> I currently take:
>
> Sertraline [Zoloft] 50mg.
> Mirtazapine [Remeron] 30mg.
> Lurasidone [Latuda] 40mg.
> Bupropion SR [Wellbutrin SR] 450mg.
> Topiramate [Topamax] 100mg.
> Gabapentin [Neurontin] 2,400mg.
> Propranolol [Inderal] 30mg.
>
> Suffering from chronic fatigue which I think is from the mirtazapine. Mirtazapine has been, hands down, the best antidepressant in terms of producing a response, but the weight gain and sugar cravings and the risk of prediabetes with the concomitant use of lurasidone worries me a lot-- the only reason I got on it is because I needed to be able to sleep in the treatment facility. I have gained 30lbs. on mirtazapine, but I'm not sure I want to give it up. Can the dosage increase reduce fatigue like I've read about? What about going down to 15mg.? Something has to give. I just really like the response it has on my MDD and GAD. Maybe I could switch to something in the tricyclic class since I've have such a good response...
>
> I'm not sure what benefit I have gotten from sertraline, and I'm considering discontinuation or switching to Brintellix.
>
> I'd like to switch the Bupropion SR 450mg. to Aplenzin 522mg.
>
> The topiramate does nothing to curb my appetite nor seems to provide that energy or mood effect anymore. Would like to switch to Qudexy XR (topiramate extended release) 200mg.
>
> The lurasidone has been effective, but I think Abilify 10mg. was better for me.
>
> I think Lyrica 200mg. X 3 would be better than gabapentin 800mg. X 3
>
> Propranolol was written for a minor arrhythmia, I think it would be good for GAD-- like the 80mg. XL.
>
> My goal:
>
> Brintellx 10mg.
> Abilify 10mg.
> Aplenzin 522mg.
> Lyrica 600mg.
> Qudexy XR 200mg.
> Remeron 60mg.
> Propranolol XL 80mg.
>
> Thoughts?
>
I wish I could help. I have some of the same questions as you, such whether tricyclics could be a replacement for Remeron.I guess I wouldn't discontinue Zoloft right now if you're not in a good place only because of discontinuation symptoms. Going higher on propranolol may help anxiety more, but you risk sedation, though you could find out in a matter of days. Lyrica might be better than gabapentin in that it's supposed to be "stronger" but I don't know what benefits you're getting from it. It can cause weight gain, supposedly more than gabapentin. You could go higher on Topamax for the weight control, but it has pretty nasty side effects the higher you go. Abilify did cause prediabetes in me.
Have you ever tried Lamictal? It seems to help a lot of people with everything. Or another standard anticonvulsant?
I wish you the best in your search and in your stay.
Posted by LouisianaSportsman on October 12, 2014, at 13:57:53
In reply to Re: Review Of My Medication Regimen; Advise Needed, posted by oceansun on October 12, 2014, at 12:16:32
> I wish I could help. I have some of the same questions as you, such whether tricyclics could be a replacement for Remeron.
>
> I guess I wouldn't discontinue Zoloft right now if you're not in a good place only because of discontinuation symptoms. Going higher on propranolol may help anxiety more, but you risk sedation, though you could find out in a matter of days. Lyrica might be better than gabapentin in that it's supposed to be "stronger" but I don't know what benefits you're getting from it. It can cause weight gain, supposedly more than gabapentin. You could go higher on Topamax for the weight control, but it has pretty nasty side effects the higher you go. Abilify did cause prediabetes in me.
>
> Have you ever tried Lamictal? It seems to help a lot of people with everything. Or another standard anticonvulsant?
>
> I wish you the best in your search and in your stay.
>
>I have tried lamotrigine a long time ago and stayed on 200mg. for awhile as a maintenance dosage because I was prescribed maxed out dosages of amphetamine salts and modafinil (as well as clonazepam) and my PDOC at the time would only write that if I was on lamotrigine 200mg. I ate it everyday and was titrated off of it by my next PDOC (complicated situation with DEA arose with me (see treatment)) I felt better coming off of it, honestly. I can no longer be prescribed stimulants or benzos and I'm not sure about pregabalin due to my situation.
You shared very crucial information and advise, BTW. I will definitely take it into consideration. I appreciate your post and insight.
DX:
Substance Use Disorder Without Physiological Dependence - In A Controlled Environment
Attention Deficit Hyperactivity Disorder - Predominantly Inattentive Presentation
Bipolar Disorder NED with Mixed Features
* Characteristics of Antisocial Personality Disorder
* Characteristics of Autism Spectrum Disorder - A3 - Level 1
--
I should have added this to my original post, amateur mistake.
Posted by linkadge on October 12, 2014, at 18:51:23
In reply to Review Of My Medication Regimen; Advise Needed, posted by LouisianaSportsman on October 11, 2014, at 22:27:40
You're on too much.
Linkadge
Posted by Christ_empowered on October 12, 2014, at 20:28:27
In reply to Review Of My Medication Regimen; Advise Needed, posted by LouisianaSportsman on October 11, 2014, at 22:27:40
Seroquel XR PM, Adderall XR or Focalin XR AM plus neurontin.
Posted by phidippus on October 20, 2014, at 20:33:22
In reply to Review Of My Medication Regimen; Advise Needed, posted by LouisianaSportsman on October 11, 2014, at 22:27:40
almost 2 of everything!
Had you tried Brillentix?
What is your dx anyway?
ERic
Posted by Lamdage22 on October 23, 2014, at 17:34:16
In reply to Re: Review Of My Medication Regimen; Advise Needed » LouisianaSportsman, posted by phidippus on October 20, 2014, at 20:33:22
> almost 2 of everything!
>
> Had you tried Brillentix?
>
> What is your dx anyway?
>
> ERicHe said it:
DXses:
Substance Use Disorder Without Physiological Dependence - In A Controlled Environment
Attention Deficit Hyperactivity Disorder - Predominantly Inattentive Presentation
Bipolar Disorder NED with Mixed Features
* Characteristics of Antisocial Personality Disorder
* Characteristics of Autism Spectrum Disorder - A3 - Level 1
Quite heavy.
Posted by phidippus on October 24, 2014, at 14:00:53
In reply to Re: Review Of My Medication Regimen; Advise Needed, posted by Lamdage22 on October 23, 2014, at 17:34:16
How well controlled is your ADHD?
What mood stabilizers have you been on for your bipolar disorder?
What characteristics of antisocial personality disorder do you harbor? (you can't really medicate that)
When were you diagnosed autistic?
Isn't autism sometimes mistaken to be antisocial personality disorder?
Eric
This is the end of the thread.
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