Posted by delna on September 28, 2009, at 3:42:15
I really need help and advice. I really don't trust psychiatrists anymore (with good reason). This is a bit long so I really appreciate it if you do manage to read it!!
-I have bipolar I (with disabling depressions and very rare mixed states)
- I have terrible OCD (which can become psychotic)
-I have severe fatigue/sleepiness (unless I am high)
My problem is this; I was put on Geodon after every drug had failed to lift my depression and get me out of my own world (sitting in bed all day)
It really worked like magic and for the first time ever in my life I felt normal- I even had a job and a life. It stimulated me (even though paradoxically it knocked me out at night and left me comatose)
But then I developed severe pain on it and had to give it up. It turned out to be tardive pain syndrome (which no doctor picked out including 4 psychiatrists, 5 neurologists and 2 pain specialists). After trying every nerve pain killer, I was in fact going to have a pudendal nerve block and restart Geodon despite excruciating pain because it made me feel so good. It was by pure chance that I stumbled upon an article on tardive pain syndromes which i showed to my pdoc who agreed that this is what the pain was. So basically this means that atypical antipsychotics are out for me (because my brain is already sensitized and I am prone to full- fledged TD)
When I was on Geodon I was on:
Lexapro (for OCD)
Provigil (for sleepiness- I always need this whatever the drug regime)
Geodon withdrawal was excruciating and I was out for 4-5 months. Finally I settled on Lamictal 200, High dose Provigil (400-600mg) and Wellbutrin and Lexapro.
Unfortunately my depression has returned with a bang. I dont get out of bed. I am so close to suicide (which I have told my doctor)
I am out of choices.
-SSRIs only help my OCD not the depression.
-Effexor has worked in the past at high doses but that is because it made me high (I dont how it will work now that I am on a mood-stabilizer)
-Lithium has no effect on me at all
-I have tried unconventional drugs like Mirapex as well
-I am a TCA non-responder and because I have inherent sleepiness I cant tolerate them
My pdoc has suggested Parnate (which I have tried before and sedated me a lot) but I am willing to give a try (since he promised it would become stimulating at the right dose) but it is supposedly not good for OCD. My OCD only responds to SSRIs and SNRIs (not even antipsychotics). And since SSRIs are dangerous with MAOIs they is no option of adding one to Parnate. Dose anyone have actual experience with Parnate and OCD?
He also suggested Clozapine(!) but from what I have read it has no antidepressant properties.
I really feel out of choices and because I am very sleepy by nature sedating ADs are not an option for me.
I am reconsidering high dose Effexor or duloxetine (which I tried but did nothing in particular)
Am I missing anything?
Any suggestions greatly appreciated
Thanks for reading.