Posted by Ame Sans Vie on July 24, 2003, at 9:35:35
Well, I took my first Xanax XR 3mg last night, and my second this morning. Wow, what a difference from Klonopin!! It lasts at least twice as long (for me, YMMV) and has that wonderful "Xanax effect" that I love so much (i.e. the motivating, antidepressant effect). In combination with Ultram it's a dream come true.
Anyway, I dropped the Desoxyn from my regime, and in case you haven't seen my posts from yesterday, my meds are now 100mg Ultram t.i.d. and 3mg Xanax XR qAM. The Xanax is going to be raised to 6mg in two weeks (if, when the time comes, I deem a dosage increase necessary... also possible I'll just try going up to 4mg or so).
So now that I've dropped the Desoxyn, the only thing I'm lacking is something to help keep my ADHD under wraps and give me that little added energy boost. I'm considering such things as Wellbutrin, Eldepryl, Strattera, Edronax, Meridia, Sanorex, and moderately-high-dose Provigil. Provigil has worked *unbelievably* well for me in the past (I'd honestly say it made me hypomanic, but I just felt so wonderful and outgoing, assertive, etc.), but at a dose of 1,000mg a day, which after a few days led to some horrible headaches. But then, I wasn't on anything for the depression and was being undertreated for anxiety, only on 4mg/day Klonopin and nothing else except the occasionall propranolol 20mg. So I'm thinking maybe 600-800mg would be a good idea, but before I decide, I'd kind of like your opinions of those other possibilities I've listed. Not to mention anything else you think may help.
I already take fish oil, l-tyrosine, l-phenylaline, P-5-P, niacinamide, lecithin, selenium, vitamin C, vitamin E, "Green Source" brand multisupplements, the Chinese remedy Xiao Yao Wan, occasional homemade herbal remedies (kava, chamomile, catnip, rosemary, scullcap, damiana, California poppy, blue lotus, betel nut, sceletium tortuosum, etc.), and I just began taking the homeopathic remedy Gelsemia sempervirens... so I think I have it covered in the supplement department, for the most part. I may consider adding a low dose of l-tryptophan and/or NADH, though. But of course, any other suggestions are more than welcome. (of course, my pdoc knows about all of these supplements and encourages their use--he's very knowledgeable in the areas of Chinese, Ayurvedic, homeopathic, and other supplementation in the treatment of mental disorders--in fact, if anyone would like any information regarding any of this, just let me know, and I'll ask him about it at my next appointment)
I also recently began working out again, after quite a long hiatus (a result of laziness). The Ultram just makes me feel so good, I feel like I *have* to exercise, lol. My pdoc has also recommended Yoga and Tai Chi, both of which I'm studying at the moment.
Finally, I see an acupuncturist for electro-acupuncture treatments biweekly, which are quite helpful. My acupuncturist is also a Chinese herbalist, and he's the one who has me taking the Xiao Yao Wan (see this post, http://www.dr-bob.org/babble/20030718/msgs/243732.html, for its ingredients).
Anyway, to get back to the topic at hand, I originally was also considering Prozac or Effexor as augmentation for this purpose, but 1.) they probably wouldn't work as well as something that works on the noradrenergic system, and 2.) there's a greater risk of serotonin syndrome combining an SRI/SNRI with Ultram.
My interest has also been peaked lately regarding Stablon (tianeptine), the serotonin reuptake enhancer. Though I'll surely add one of the medications I listed above, I'm seriously considering giving Stablon a trial in addition. Once again, my pdoc (whom I absolutely *love*, I don't think I say that enough, lol... he's so compassionate and understanding) is okay with all of this. He knows how thoroughly I research my medications, so he just told me to try to make a decision as to what I'd like to try before our next appointment (in two weeks).
Oh, and for anyone not familiar with my diagnoses, it may help to know that I have moderate ADHD, severe social anxiety, severe agoraphobia, moderate panic disorder, some obsessive-compulsive traits (O-C personality D/O?) and dysthymia, which fairly recently evolved into depression. The Ultram completely takes care of the obsessions, compulsions, depression, and, to a lesser extent, the social anxiety and agoraphobia. The Xanax XR, likewise, completely rids me of my symptoms of social anxiety, agoraphobia, panic disorder, and seems to synergize quite well with the Ultram, giving me more motivation and improving the Ultram's antidepressant effect.
I greatly appreciate any input you guys can give me on this. Peace out! :-)
~~Michael
poster:Ame Sans Vie
thread:244827
URL: http://www.dr-bob.org/babble/20030723/msgs/244827.html