Psycho-Babble Medication Thread 1079762

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 14, 2015, at 16:22:39

Last night, I did it. My PDOC said I could if I wanted I took my last pill of 30mg. Mirtazapine. That's my first step in the right direction, IMO. I'm thinking about coming off Latuda next. I suffer from unipolar major depression and generalized anxiety disorder.

AM:

Pristiq 50mg.
Wellbutrin XL 300mg.
Topamax 200mg.
Gabapentin 1,200mg.
NAC 1,200mg.
Fish Oil 1,000mg.
Zinc 150mg.
Caffeine 400mg.
Prilosec 20mg.
Aspirin 81mg.
B-Vitamin Complex with Folic Acid ~g.

PM:

Latuda 40mg.
Topamax 100mg.
Gabapentin 1,200mg.
Valerian Root 1,000mg.
Melatonin 3mg.
5-HTP 200mg.
NAC 1,200mg.
Fish Oil 1,000mg.
Zinc 150mg.

My PDOC meds are:

Pristiq 50mg.
Wellbutrin XL 300mg.
Latuda 40mg.
Topamax 300mg.
Gabapentin 2,400mg. (Actually taken as 600mg X 4)

Thinking about adding Buspar to capture back Latuda 5-HT1A partial agonism without the heavy duty antipsychotic action. It would also provide that action mirtazapine would give there when it antagonized the 5-HT receptors save that one without the weight gain and sedation side effects. Good idea?

Am I taking too many supplements? Which ones do I need to not take and which ones am I not taking that I need to take?

Any advice regarding my regimen would be greatly appreciated. Before you warn me about serotonin syndrome with combing 5-HTP with a SNRI, find me one case report in the literature where a normal 5-HTP added to someone taking a therapeutic dosage of a SSRI or SNRI suffered serotonin syndrome. BTW, I think it helps my depression 10% and curbs my appetite 20% so it's worth it for me lol.

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 14, 2015, at 16:46:35

In reply to Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 14, 2015, at 16:22:39

I'm taking a look at my zinc gluconate which is 300mg/day equal to 42mg of elemental zinc. Will reduce to 200mg. for 28mg. of elemental zinc and look into taking copper with it.

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Christ_empowered on June 14, 2015, at 18:31:01

In reply to Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 14, 2015, at 16:22:39

The 5htp w/ pristiq makes me nervous, personally. I hear ya on loads of supplements...I do what I call "Orthomolecular Deluxe," so I'm loaded up, too.

Anyway...how are things going? What are you aiming for?

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 14, 2015, at 21:08:41

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by Christ_empowered on June 14, 2015, at 18:31:01

> The 5htp w/ pristiq makes me nervous, personally. I hear ya on loads of supplements...I do what I call "Orthomolecular Deluxe," so I'm loaded up, too.
>
> Anyway...how are things going? What are you aiming for?

I'm getting retested by this psychiatrist, actually, in order to get ADHD meds which may entail stimulants. My performance at work is going down the drain. I meet with therapist Tuesday after this coming one to schedule it. He'll have my ADHD-PI diagnosis confirmed by computer testing and the whole nine yards by a previous psychiatrist who had me on Adderall IR 60mg. divided TID. with Nuvigil 250mg. I sorta miss the focus and stimulatory effects I got from these medications. It makes me tempted to order adrafinil online.

My depression is better enough for me to go off mirtazapine and Latuda when it comes time for my next visit. I just want Buspar to provide me with a substitute effect from both drugs so to speak.

I'm just now getting crazy about supplements. I don't think the 5-HTP and Pristiq are going to cause serotonin syndrome. Once again, show me the evidence. I would have noticed by now if anything malicious was going on.

I want the supplements to provide me with an antidepressant boost in a more natural way than the prescription meds. I think it's good to use the supplements as a way to maximize the effectiveness of prescription medicine and get off of some of it by reaching into its wealth of resources to provide your body with key tools. I like advice regarding what to take within my regimen to maximize effectiveness and antidepressant charge. Ashwaghanda looks promising as well as agmatine. What do you take?

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Christ_empowered on June 14, 2015, at 21:36:42

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 14, 2015, at 21:08:41

I'm into Hoffer-style Orthomolecular, plus stuff I just put together in an attempt to to de-stress and augment the core Orthomolecular stuff. So, here's the line up: 12 grams time release C, 2 b-100 caps, 3 grams niacinamide, 400mcg selenium, 12mgs astaxanthin, 50,000 IU natural form beta carotene, 30mgs optizinc, 1,000 iu natural form E plus mixed tocopherols, 100mgs coq10.

There's random other stuff I take when I think about it, but that's the always, all the time, daily line up.

 

Re: Thinking of Tweaking My Combo. Thoughts Please? Louisiana Sportsman

Posted by SLS on June 15, 2015, at 12:17:49

In reply to Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 14, 2015, at 16:22:39

MDD and GAD


> Pristiq 50mg.
* 100 mg/day?

> Wellbutrin XL 300mg
* Exacerbates anxiety and insomnia?

> Topamax 200mg.
* Why?
* 200 mg/day maximum (for psychiatric)?

> Gabapentin 1,200mg.
* Why?

> NAC 1,200mg.
* works better with Lamictal?

> Caffeine 400mg.
* Ruins sleep?

> Folic Acid
* Deplin or L-methylfolate instead?

> Latuda 40mg.
* Generally ineffective?

> Melatonin 3mg
* What time do you take it?

> Thinking about adding Buspar to capture back Latuda 5-HT1A partial agonism without the heavy duty antipsychotic action.
* Don't exclude Abilify or Viibryd from consideration as adjuncts. Both act as 5-HT1a partial agonists.


* How did you react to Nardil or (Nardil + Klonopin)?
* How did you react to Paxil?

Focalin PRN for mental energy and concentration?


- Scott

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 15, 2015, at 20:16:03

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please? Louisiana Sportsman, posted by SLS on June 15, 2015, at 12:17:49

> > Pristiq 50mg.
> * 100 mg/day?
>

It's definitely worth exploring although it has been shown that 100mg. offered no superiority to 50mg. in testing.

> > Wellbutrin XL 300mg
> * Exacerbates anxiety and insomnia?
>

I really don't think so. I don't have insomnia, I just like to be chilled out at night via antihistaminergic effects or things like valerian. I like the sleep both routes give.

> > Topamax 200mg.
> * Why?
> * 200 mg/day maximum (for psychiatric)?
>

For weight control and mood. Didn't respond until I go to 300mg.

> > Gabapentin 1,200mg.
> * Why?
>

Anxiolysis.
> > NAC 1,200mg.
> * works better with Lamictal?
>

Definitely something worth thinking about. I've been on it and got off of it and I wonder now if I did better on it.
> > Caffeine 400mg.
> * Ruins sleep?
>

Nah. And the stimulation in the morning is mandatory.

> > Folic Acid
> * Deplin or L-methylfolate instead?
>

Would be more effective but not cost effective and would stall time when I'm trying to make more urgent changes. Definitely would prefer.

> > Latuda 40mg.
> * Generally ineffective?
>

Yeah, Abilify was better for me overall.
> > Melatonin 3mg
> * What time do you take it?
>

7pm when there is still light out. Hours before bed.
> > Thinking about adding Buspar to capture back Latuda 5-HT1A partial agonism without the heavy duty antipsychotic action.
> * Don't exclude Abilify or Viibryd from consideration as adjuncts. Both act as 5-HT1a partial agonists.
>

Yes, true. Viibyrd would be difficult for my PDOC to add with the Pristiq. I can see him being more open to Brintellix. This PDOC just isn't like my old one who would let me exercise freedom and let me write the scripts myself so to speak... I'm not sure if you remember some of my cocktails.
>
> * How did you react to Nardil or (Nardil + Klonopin)?
> * How did you react to Paxil?
>
> Focalin PRN for mental energy and concentration?
>
Will definitely explore this option.
>

Thanks so much for your valuable input, Scott. Got me thinking about Lamictal. May just need 100mg. if it's just for depression although I would likely target 200mg. regardless. I'm still looking at Buspar since I've never tried it and I'm always looking for the magic bullet.

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 15, 2015, at 20:18:07

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 15, 2015, at 20:16:03

Never been on a MAOI, but I've thought about it. Klonopin helps but this PDOC won't write me a benzo like my old one. Always avoided paroxetine due to sedation side effect.

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 15, 2015, at 20:24:09

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by Christ_empowered on June 14, 2015, at 21:36:42

> I'm into Hoffer-style Orthomolecular, plus stuff I just put together in an attempt to to de-stress and augment the core Orthomolecular stuff. So, here's the line up: 12 grams time release C, 2 b-100 caps, 3 grams niacinamide, 400mcg selenium, 12mgs astaxanthin, 50,000 IU natural form beta carotene, 30mgs optizinc, 1,000 iu natural form E plus mixed tocopherols, 100mgs coq10.
>
> There's random other stuff I take when I think about it, but that's the always, all the time, daily line up.

Very interesting. Some of that stuff I feel like I would benefit from as well.

Is it true that your body can only absorb so many supplements? Taking a handful of things is worthless because those nutrients compete for the same uptake sites. Like theoretically if I took 750mg. of zinc then try to take copper, the zinc has consumed all of the room for the copper?

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by SLS on June 15, 2015, at 20:43:25

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 15, 2015, at 20:16:03

> > > Pristiq 50mg.
> > * 100 mg/day?

> It's definitely worth exploring although it has been shown that 100mg. offered no superiority to 50mg. in testing.

I can't stress enough the utility in taking 100 mg/day of Pristiq. It works in real life. Drug companies like to keep their recommendations low in an effort to reduce reported side effects post-marketing. If you recall, the maximum dosage for Effexor was initially recommended by the drug company to be 225 mg/day. It is now 375 mg/day.

How does Topamax affect you at 300 mg/day that it doesn't at 200 mg/day? Carbonic anhydrase inhibition is dosage-dependent. Be careful not to develop kidney stones.

You'll get well. Continue to be persistent.

:-)


- Scott

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 16, 2015, at 19:34:43

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by SLS on June 15, 2015, at 20:43:25

I'll see about having the Pristiq increased then. I would like to think that I could benefit from the 100mg dose. I will also see if I can retain the same appetite suppressant effects with 100mg. BID Topamax. Thanks for calling the risk of kidney stones to my attention.

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by bleauberry on June 20, 2015, at 14:02:18

In reply to Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 14, 2015, at 16:22:39

....just an opinion and only because you asked....too many meds, not enough supplements, and the current supplements are on the weak side...

 

Re: Thinking of Tweaking My Combo. Thoughts Please?

Posted by Louisiana Sportsman on June 20, 2015, at 15:09:46

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by bleauberry on June 20, 2015, at 14:02:18

> ....just an opinion and only because you asked....too many meds, not enough supplements, and the current supplements are on the weak side...

Well, what supplements would be better for me to take then?

Thanks.

 

Tweaked It-- Please Read Update

Posted by Louisiana Sportsman on July 4, 2015, at 10:43:56

In reply to Re: Thinking of Tweaking My Combo. Thoughts Please?, posted by Louisiana Sportsman on June 20, 2015, at 15:09:46

I decided to minimize as much as possible. I'm off the Remeron completely and the Latuda and reduced my Topamax to 200mg. per SLS' suggestion. I'm also taking less supplements, no more valerianr root and things I can get from a multivitamin; so at the present, I am taking:

Pristiq 50mg. QD
Wellbutrin XL 300mg. QD
Topamax 100mg. BID not TID anymore total 200mg.
Gabapentin 600mg. QID total 2,400mg.
NAC 600mg. QID same time as I take the gabapentin total 2,400mg.
Fish Oil DHA/EPA 960mg. QD (haven't even taken this a month straight to assess benefit yet, almost have taken NAC for a month with no side effects for both fish oil and NAC)
Multivitamin
Melatonin 3mg. QHS
Prilosec 40mg. CF

I'm in remission, I believe of MDD/GAD with this cocktail that is working for me. I've been in and out of PDOC offices and this is the best I've come up with in awhile.

Trying to treat a possible glutamate-GABA imbalance with high dose NAC/gabapentin since most neurotransmitters are GLU/GABA. GABA-B, which gabapentin acts on, is indicated in MDD. Wellbutrin XL now without the Latuda is giving me some dopaminergic action, and it is working hand-in-hand with Pristiq's effect on NE. Pristiq is a good maintenance medicine for my MDD. Topamax is somewhat effective to ameliorate my binge eating disorder, mood instability and substance abuse liability.

Going off the Remeron has given me some increased energy, and I think I'm doing better without it in regards to my weight. Also I'm not bipolar, but my previous dx was bipolar depression; therefore, Latuda was indicated. I really don't need dopaminergic antagonism in my life right now and going off of it has not exacerbated my depressive symptoms.

I will get retested for ADHD sometime in the future and be put on something for it, but I'm not sure what it will be. But, in terms of my non-ADHD symptoms, they are being treated as best as I think they can. The only thing I'm thinking about adding will be nootropics/supplements, but I'm going to assess this regimen first.

Thanks for the advice given in this thread. If anyone has any thoughts, please, please share I'd love to hear from you!

 

Re: Tweaked It-- Please Read Update Louisiana Sportsman

Posted by SLS on July 4, 2015, at 12:45:57

In reply to Tweaked It-- Please Read Update, posted by Louisiana Sportsman on July 4, 2015, at 10:43:56

Nice!

So far, I haven't seen Latuda do anything positive for people with respect to depression. Some people actually get worse with it, including me.

I wish you continued success.


- Scott


> I decided to minimize as much as possible. I'm off the Remeron completely and the Latuda and reduced my Topamax to 200mg. per SLS' suggestion. I'm also taking less supplements, no more valerianr root and things I can get from a multivitamin; so at the present, I am taking:
>
> Pristiq 50mg. QD
> Wellbutrin XL 300mg. QD
> Topamax 100mg. BID not TID anymore total 200mg.
> Gabapentin 600mg. QID total 2,400mg.
> NAC 600mg. QID same time as I take the gabapentin total 2,400mg.
> Fish Oil DHA/EPA 960mg. QD (haven't even taken this a month straight to assess benefit yet, almost have taken NAC for a month with no side effects for both fish oil and NAC)
> Multivitamin
> Melatonin 3mg. QHS
> Prilosec 40mg. CF
>
> I'm in remission, I believe of MDD/GAD with this cocktail that is working for me. I've been in and out of PDOC offices and this is the best I've come up with in awhile.
>
> Trying to treat a possible glutamate-GABA imbalance with high dose NAC/gabapentin since most neurotransmitters are GLU/GABA. GABA-B, which gabapentin acts on, is indicated in MDD. Wellbutrin XL now without the Latuda is giving me some dopaminergic action, and it is working hand-in-hand with Pristiq's effect on NE. Pristiq is a good maintenance medicine for my MDD. Topamax is somewhat effective to ameliorate my binge eating disorder, mood instability and substance abuse liability.
>
> Going off the Remeron has given me some increased energy, and I think I'm doing better without it in regards to my weight. Also I'm not bipolar, but my previous dx was bipolar depression; therefore, Latuda was indicated. I really don't need dopaminergic antagonism in my life right now and going off of it has not exacerbated my depressive symptoms.
>
> I will get retested for ADHD sometime in the future and be put on something for it, but I'm not sure what it will be. But, in terms of my non-ADHD symptoms, they are being treated as best as I think they can. The only thing I'm thinking about adding will be nootropics/supplements, but I'm going to assess this regimen first.
>
> Thanks for the advice given in this thread. If anyone has any thoughts, please, please share I'd love to hear from you!
>


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.