Posted by dove on December 3, 2004, at 10:13:48
In reply to Re: Help - AD for ADHD guy? other drugs?+long rant :-(, posted by King Vultan on December 3, 2004, at 9:19:46
Since being "dumbed down" isn't an issue ;-)
I have found a combination of the following meds to help with the symptoms you're discussing:
Effexor (150-225 mgs per day--depends on severity of depression and anhedonia. Also helped social anxiety once I was used to it, initially caused extra anxiety--happily it was merely transient.),
Klonopin (0.5-3 mgs--for panic, anxiety, and social phobia/anxiety, although, my other meds must be controlling these symptoms as I haven't needed to take any in over 4 months.),
Remeron (45 mgs at night--helps with going to sleep when I'm suppose to and gaining worthwhile energy the next day. Another plus is that it puts my over-active brain asleep when its being self-destructive. I think it helps smooth over some of my social anxiety also.),
Prozac (10-40 mgs--helps focus energy and curb impulsive behavior as well as numbing depressive emotions--is that good? Sometimes it's needed in my case.)
Adderall (0.5-40 mgs per day--helps enormously with scatter-brain behavior, getting mundane jobs "finished"--not just started. Helps tremendously with focus, and helps in small dosages with social phobia. However, this med does cause me to become irritable and gives me muscle tension--especially in my jaw. Has also acerbated depression at times.)
I have been on this combo for almost two (2) years now, with a few bad episodes interspersed, but overall, a very positive response.
If I should suddenly deteriorate on this combo I would then start considering Cymbalta to replace Effexor. Parnate (or Nardil, MAOI's) and one of the activating old TCA's would be next on my list, although they would require a good wash-out period. I have taken just about everything except for the MAOI's, so they are my "big gun" hold-outs should worse get much worse.
Stimulants can cause a worsening of depression, and can be very useful in self-destructive behaviors. Next time you visit with Pdoc and/or Nurse, and you feel strongly that the ADD meds will enable you to thrive, do not tell them you are having suicidal ideation. Perhaps it would be more helpful to explain how you are feeling overwhelmed and unable to get anything done, and this is what is fueling some of your other negative symptoms. Just a thought...
Hope this helps!
dove
poster:dove
thread:423698
URL: http://www.dr-bob.org/babble/20041201/msgs/423848.html