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Re: Need Advice on Med Cocktail. Please help!

Posted by dcruik518 on June 17, 2008, at 21:42:20

In reply to Need Advice on Med Cocktail. Please help!, posted by elbee on June 16, 2008, at 13:06:35

> Hi,
> I was wondering if anyone can weigh in on what drugs would be helpful for me. Also, if there's anyone who can help me understand what my problems are symptoms of or if they have similar symptoms that'd be great! I currently take zyprexa 7.5 and Lamictal 400 for BP1. I would probably not be changing these much.
> I mostly have low energy and motivation. I have trouble getting started with anything. I also have a mental hangup about doing anything because I feel like first I must have the appropriate mind set or be mentally organized. It's hard to explain--maybe it's a little obsessive. Finally I ruminate a lot about negative things. I guess I'm also "rejection sensitive" and worry about people are judging me (but not in a psychotic sense).
> I'm open to any drug. My psychiatrist said to think about luvox, anafranil (clomipramine), nardil, buspar, and zyprexa/prozac combination but she is open to other things.
> Thanks so much!

Hi Elbee,

Nice to meet you. Hope you're doing well.

I have to say: You don't really sound obsessive compulsive to me! The fact you ruminate a lot is not enough; it's common with most forms of depression, and sometimes has more to do with personality than illness. I've taken both Anafranil and Luvox and they both made me really groggy and dull and apathetic--not exactly what you want if you're having trouble getting started on things.

My guess is that you're more of a thinker than a doer, and may be a bit of a loner--an introvert, in other words. You also say you have rejection sensitivity and low energy and motivation. All that together sounds to me like Atypical Depression and/or Dysthymia, which is what I have, in addition to Social Phobia.

Nardil is sort of the gold standard for Atypicals/Dysthymics, but you may gain quite a bit of weight on it. However, the huge relief you may feel might easily be worth it, at least until you're back on your feet. Another possibility is mixing a stimulant like Adderall with a good social anxiety drug like Neurontin. The Adderall will help with your energy, motivation, concentration, and probably boost your mood some, and the Neurontin should take care of that "rejection sensitivity", possibly boost your mood a little more, and take away a lot of anxiety you may feel, especially concerning other people.

Best, D.R.C.




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