Psycho-Babble Medication | about biological treatments | Framed
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Long time no see...

Posted by Ame Sans Vie on August 5, 2004, at 11:25:17

Hi all! Decided to take a much-needed computer holiday (for the most part), but the time has come once again for me to beseech your wisdom on a particular matter.

Last I posted here, I was taking:

--Klonopin 3mg AM, 2mg noon, 3mg PM
--Fluoxetine 40mg
--Adderall 30mg BID-TID
--Delsym (dextromethorphan polistirex) 30mg BID

... that's the best I can remember, anyway. And for those who aren't familiar with me, a "quick" rundown of my problems would include dysthymic disorder, atypical depressive disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive disorder (mild), social anxiety disorder, panic disorder w/agoraphobia, adult attention deficit disorder w/o hyperactivity (primarily impulsive type)... yeah, I'm just a big mess, lol. I'm a 21 year-old male, btw.

So obviously I wouldn't be begging for advice if everything were going well with my meds. The fluoxetine (Prozac) worked wonderfully for a while in conjunction with the other meds, but not even all that amphetamine could allay one side effect which didn't appear until just over a month ago -- horrible weight gain. Sure, I was feeling mentally well, but I'm at a point where I'm very focused on my *physical* health now that I've just about got the mental thing under control. So the Prozac was dropped like a bad habit four weeks ago and I've dropped twelve pounds since (it's a start!).

After quitting the Prozac I developed another symptom -- sleeplessness. Of course, most people would admonish me for my high stimulant dose at this point, but it turns out amphetamine wasn't the problem, but the solution. An extra dose *before bedtime* and I sleep like a baby!

Finally, just prior to quitting the Prozac my doctor increased my Klonopin dosage to counteract some agitation the antidepressant was causing. So my new regimen is as follows:

-Klonopin 5mg q8h
-Adderall 30mg 7AM, noon, 5PM and 10PM

I also switched recently from Delsym (to prevent amphetamine tolerance) to Dexalone -- a considerably less vile-tasting alternative, lol. It's OTC and comes in packages of 10 or 30 capsules, each containing 30mg DXM HBr.

Here's the deal: I go back to see my pdoc Wednesday, and at our last appointment he suggested adding Wellbutrin XL to the mix. I've been on Wellbutrin before but never really gave it a chance to work because the dry mouth at the beginning of treatment was pretty awful. Still, I'm willing to try it again.

Does anyone know of any documented cases and/or studies concerning the concomitant use of amphetamines with bupropion? I realize that going forth with this proposed plan means I may re-experience that insomnia/agitation, but with all this Klonopin, *that* I can deal with, lol. MAOIs are out of the question because of Medicaid's ridiculous limitations on prescription amounts (Parnate - 100 x 10mg monthly; Nardil - 100 x 15mg monthly; Marplan - not covered; Eldepryl - gives me hallucinations).

Or should I just wait for Cymbalta to hit pharmacies and give it a go instead? (if I can wait that long!)

Thanks!

~Michael


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poster:Ame Sans Vie thread:374353
URL: http://www.dr-bob.org/babble/20040805/msgs/374353.html