Posted by Ritch on July 8, 2002, at 22:00:14
In reply to Re: Complex Medication Cocktails, posted by Peter on July 8, 2002, at 3:04:30
> > Firstly, thank you everyone for your useful and caring input. I think the main problem with my situation is that I've been on so many combos for so long that I really don't no if it's all working or not, or, for that matter, if I need any of it. What further complicates it for me as that my doctor believes that all of these symptoms I have which stem from various disorders are in themselves mild. As I mentioned before, he even supported my two decisions in the last year to taper off of various meds. On both occassions, I tapered slowly, one at a time. The first time I was on adderall, depakote and klonopin. I got off the adderall and depakote gradually, but before I could even start coming off the klonopin, I started experiencing real emotional discomfort-anxiety, restlesness, social phobia, etc..which made me run back to my p-doc for a new med combo. Another thing that further confuses all this is that in the mid 1990's a was a hardcore drug addict (heroin, cocaine, and anything I could get my hands on). It's true that many of my current mental problems were caused or exacerbated by my drug use, but the real catch is that I got off of heroin and cocaine in summer 1997, and since then my pdoc has had me on one drug regime after the next-from all the SSRI's to many different mood stabilizers to klonopin to dopamine agonists, beta-blockers, stimulants, u name it! So, essentially, my system has not been 'chemical free' (whether illicit drugs or pharmaceuticals) since the early 90's! So I can't tell if these meds work! What would I feel without them? I mean, the two times I tried tapering off everything, I freaked out and ran back to my doc, only to be placed on yet another slew of meds. I do recall at one point going to a second pdoc-a very well-known one in NYC, for an evaluation, like a second opinion. He said he doesn't think I have ADD (whereas my normal pdoc says I do!) and this second guy wanted to take me off everything and simplify it all down to lithium once a day. Well, I freaked out reading about the side-effects and the simple fact that anxiety and mild mood swings are more what I go thru than large Bipolar I episodes, which is what lithium seems to target best. So I didn't take it, and just went back to what I knew helped me be more social and less depressed - an SSRI. Yet, since the SSRI's in the past tended to make me crave alcohol because of dopamine-deficiency, I stayed on adderall for impulse control and my 'possible' ADD. Then, since I've been taking klonopin for 4 years, he told me to just continue it indefinitely, even though I feel nothing at all from it-I guess it just wards off panic for me now. And, of course, even though he says I sometimes have mild hypomania, he absolutely insisted that I not take an SSRI without a mood stabilizer, so I opted for depakote since I was used to it from being on it for years. And I'm a jazz pianist and composer, so the whole dulling effect that anticonvulsants can have on creativity is another issue for me, and therefore the pros and cons of if all of these meds are necessary. I'm really sorry for blabbering on and on-I just need to get it off my chest. But if anyone had the patience to trek through my boring self-absorbed essay here, I'd love to know what anyone thinks or advices. Thank you so much...all you guys are really the best.
> PeterHi there,
Your situation sounds a lot like mine. There have been flips in my diagnosis over the last few years, but what seems to stick for sure is bipolarII and panic disorder. I've tried stimulants for my ADHD symptoms and they will fix the attentiveness problems, but worsen the panic ones. Klonopin wards off panic, but too much makes me depressed and worsens attentiveness. Depakote quells my hostility and improves impulse control, but too much of that also worsens my attentiveness. So, I have kept the Depakote and Klonopin minimal (250mg+.5mg at nite), and added Effexor for ADHD and depression in the morning (just 25mg AM). So far, so good. A lot of my attentiveness problems are related to anxiety. If I can reduce anxiety without making me stupid it helps. The low-dose Effexor is having an antipanic effect as well. I get a *little* hypomania later in the day (when my Depakote levels are falling off), but it is manageable, and the Effexor is low enough at bedtime I can sleep OK without sleep help. I guess what I am trying to say is..that complex cocktails are fine IMO if you can tolerate them and they work. If you want to simplify things, you can, but it isn't going to be easy.
Mitch
poster:Ritch
thread:111691
URL: http://www.dr-bob.org/babble/20020628/msgs/111807.html