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Dr. Kramer-med cocktail questions [LONG]

Posted by dove on April 2, 2002, at 15:32:33

In reply to Re: Dr. Kramer-med cocktail questions, posted by Dr. Kramer on April 2, 2002, at 9:50:29

Some more med cocktail questions from the peanut gallery. The questions are at the bottom with my med history preceding them.

I have had my share of revolving P-Doc's and Therapists, as well as many different dxes. Started with a dx of Epilepsy, then Migraineur, then ADHD, then ADHD w/ BP (ultra rapid cycling), GAD, PTSD, Panic Disorder, Agoraphobia, and PMDD.

My last diagnosis (I can hope-the only one left that might fit is "Borderline") is in this order: ADHD, Major Depression possibly coupled with double depression (also dysphoria), PMDD, Panic Disorder, GAD, Classical Migraineur w/ syncope-like aura, SAD, mild OCD, and clinical mild hypoglycemia. I have been directed/advised to remain on a moderately high lean protein diet with moderately low carbs (preferably complex rather than simple). I have done extensive light therapy for two years with the only benefits being that I get half-an-hour of personal time away from my husband and five children. I have tried fixing myself with Natural Remedies (although, our refined chemical "Remedies" are merely their descendants), to no avail.

I am not as hopeless as I once was and am trying to give my children laughter and love despite the emptiness or pain I feel inside. Not one day passes that suicide does not enter my mind at least once, or my negative "talking to myself" appears. I am attentively working on those behaviors, but the suicidal thoughts really do pop out of nowhere, like a quick tap on the shoulder and there's no one there and you turn back just in time for a slap across the cheek.

I feel like I'm on a kiddy roller-coaster, the ups and downs aren't too extreme, and the underlying sadness and hopelessness never quite fades. Things that used to trip my happy wires offer me very little zap, maybe two days at the most. I have so many interests, compelling diversions, things I love to do, make, write, read... yet I feel frozen and unable to enjoy the very things that give me life and vitality.

My husband is no longer able to emotionally support me, and my best friend's husband has forbidden me to enter their lives due to my depressed crying jags that last all of 10-15 minutes (She is the only person I am able to talk with--and she with me.).

Currently, I'm in a place that appears very bleak to me. My latest P-Doc has been very supportive, working with me, not on me. He is in the process of finding a "talk-therapist" who might click with me, as so many others have not. I've had CBT, Desensitization for my agoraphobia and panic attacks, and plain old talk therapy with many a provider, but it seems to backfire for some reason. The meds are the only stability in my life, but I fear that my extreme tolerance to TCA's and the SSRI's will eventually lead to the loss of that minor but critical stability.

I am currently taking:
Adderall (40 mgs p/day),
Serzone (400 mgs p/day),
Amitriptyline (100 mgs p/day),
Neurontin (1800-2400 mgs p/day),
Prozac (40 mgs p/day), and
Klonopin (3 mgs p/day).
I have also taken Ativan for tortuous dental visits, but not in the last 5 months.
This has been my most successful med cocktail thus far.

I have never had any blood work/Lab work done since beginning this quest years ago. Below, are all the meds I can clearly remember taking in the past. The only meds that were ever taken alone were the Adderall and the Amitriptyline. Adderall slowed me down quite a bit and caused a mild increase in my depressive state until my body adjusted to its one-task-mind effects.

Mood Stabilizers:
Verapamil [Calan SR]

CNS Stimulants:



Natural Remedies:
Kava Kava
Valerian Root
Saint John's Wort
Omega 3s
Gingko Biloba

1.) Is there a need for lab or blood work to be done when taking 6 or more psychopharmacological meds?

2.) My Dr. says I have a very high tolerance to these meds, including the fact that I have very few side-effects - unless I ramp too fast. Is that normal, to be taking that many meds and still feel depressed? Is there something we're completely missing?

3.) Can I take Gingko Biloba w/ my med-mix (my Dr wasn't sure but said he'd investigate)?

4.) What's your advice regarding a glass of wine or a beer every once and again when attending social-family events?

5.) Apathy, fatigue, hebetation, disinterest in things that I treasure, absolutely no motivation, that waxes and wanes throughout the day, week, month, and year. Any advice as how to jump this hurdle?

6.) Lastly, I've had 6 UTI's in the past 5 months, and have taken four different antimicrobial meds that seem to temporarily stall the infections. These UTI's just happen to coincide with upping my Prozac by another 20 mgs, any connection? And do antibiotics have any effects or interactions with all the other meds?

I know this is really long, but I've never pulled out all the stops before and I need to. Thank you for your precious time, I appreciate it immensely.





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