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Re: See my Pdoc today - PLEA for advice! PLEASE HELP

Posted by polarbear206 on June 18, 2007, at 9:25:37

In reply to See my Pdoc today - PLEA for advice! PLEASE HELP, posted by JerryPharmStudent on June 18, 2007, at 7:22:15

> Many of you know my med history and history with server treatment-resistant depression. It' just seem TOO weird to NOT being able to respond well enough on all these different meds, cocktails over the past 15 years. SOMETHING has to be causing my TRD. SOMETHING has to be causing my intolerance and resistance to meds. I NEED my life back. If I don't get it back soon I will die- I know this.
>
> So I BEG you - my friends on this board to lend me your opinions and advice. There HAS to be something that will bring me out of this darkness and let me return to life.
>
> Currently on BuSpar 30mg 2x daily
> Adderall 20mg 3x daily
> Klonopin 1mg 4x daily
> Hydrocodone 5g 4x daily
> Ambien CR 12.5 mg hs
> Lexapro 20mg
>
> My current symptoms:
> - Server lack of motivation (which hydrocodone help tremendously but is not a long term solotuion)
> - Severe anticipatory anxity/panic attacks/social discomfort
> - Extreme dysphoria
> - Periods of insomnia
> - Overwheling thoughts of all my stressors
> -Fatigue
> - weight gain
> -NO sexual pleasure at ALL
> - Feeling numb emotionally
> -hopelessness
> - Lack of stamina
> - VERY low self-esteem
> the list goes on and on
>
> I live in a small town with only ONE pdoc. He's an "effexor/antipsychotic " believer - meaning he prescribes Effexor for everyone and Antipsychotics like Geodon for everything from bipolar disorder to anxity, to insomnia to depression.
>
> Of course my case is different. He sees my 15 years of med trials and can't come up with anything creative.
>
> The bottom ALWAYS feels like it's going to or is falling out underneath me. There HAS to be something that will work - either a certain cocktail or a med used off label (although I'm on many offlabel treatments now).
>
> Choices:
>
> Abilify?
> Effexor + Lithium?
> SSRI + Tricyclic?
> Addition of Lamictal?
>
> If I am OFF stimulants - I sit on my couch staring at the wall. If someone were to (God forbid) die in my family I wouldn't "care." I NEED to /want to feel a sense of STABILIZATION - but those kind of meds only seem to add to my growing weight gain problems and cognitive impairment.
>
> I've recently started having problems with my short and long-term memory which really worries me. I almost feel as if all these meds over the years have simply burned out all my neurons in my brain.
>
> I have NO sexual desire and have not had an erection in 4 months.
>
> Sunny days make me MORE anxious and depressed compared to days that are rainy and/or overcast.
>
> I have a terrible intolerance to heat.
>
> Go off everything? I've tried that. Doesn't work.
>
> So PLEASE PLEASE - post your ideas - thoughts - suggestions - advice - ANYTHING. I NEED to return to life before I end it.
>
> I see my Pdoc today at 2:45PM central time USA
>
> If you are wondering what I have tried - I have tried EVERYTHING - every SSRI, benzo, MAOI, ECT, VNS, Testosterone and cortisol replacement therapies, vitamins, Fish oil, magnesium supplements - you name it.
>
> There HAS TO BE AN ANSWER. I am a 35 year old male and was diagnosed at 20. I have been in therapy for 15 years as well. I've seen endocrinologists who found out my testosterone levels were low along with my cortisol levels - but it was never followed up.
>
> What if there is a 'dysfunction" in my HPA axis? Hormones? Thyroid seems to be within limits. What if this has nothing to do with serotonin? What about problems with blood glucose levels?
>
> Depression, OCD, anxiety run VERy strong in my family - however no one has been treatment resistant like me.
>
> WHAT'S WRONG!?
>
> Please - anyone - maybe you see something that I've missed - something that could be helped or investigated- but be reminded I have NO health insurance and no access to public aid medical assistance as of yet - so complex testing is out of the question.
>
> I cannot continue unliving my life like this. PLEASE - anyone - help
>
> Thanks
>
>
> Jerry
>
>
>
>

Jerry,


I think the best thing IMO is to keep the number of medications you are taking to a minimum. The combination of all of these drugs is dramatically impairing and having an adverse reaction on you. I would ditch the stimulant and opt for a more activating AD like Effexor or an MAOI. Wellbutrin added on to Effexor has worked very well for me. Gardengirl has some very good suggestions about mood stabilizers. I can't say enough good things about Lamictal for mood stabilization. Start low and slow and try to see if you can keep it to 3 drugs at a time.

Polarbear 206

Lamictal 100mg
Effexor 75mg
Wellbutrin 150mg

P.S. I cut my Effexor back from 300mg to 75mg and cut Lamictal in half to 100mg since I added Wellbutrin. This has resulted in more energy, return of normal sex life, normal sleep cycle. I just feel a balance that I haven't experienced in a very long time. Hope this helps.


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poster:polarbear206 thread:763880
URL: http://www.dr-bob.org/babble/20070613/msgs/763891.html