Posted by uncouth on October 3, 2011, at 19:17:30
In reply to Re: Tramadol, Oleptro for depression/bp ETC. » uncouth, posted by Phidippus on October 3, 2011, at 16:04:32
thanks so much phidippus, can you explain some of your rationale if you don't mind? would appreciate hearing the reasons why you chose what you chose, especially those infrequelty used TCAs. what is special about clomipramine and amytriptaline? i may have tried clomiprmaine before but it was a long time ago and not for very long. it's super serotoniny right...but what else?
do these TCA options sidestep the SSRI side effects that can occur like dopamine hypofunction and affective blunting and potentially amotivation, apathy, sexual issues? I don't know I Just swore i never would take effexor or cymbalta again, because while they did work, they made me a bit hypomanic (not necessarily bad) but i couldnt focus on the RIGHT thing to do at any one time...and i just seemingly stopped caring about real natural rewarding things like job success and relationships and achievement...all i cared about was what felt good in the immediate. or i dont know, maybe thats just a function of my bipolar disorder 2 and alcoholism genes.
anyway i'm interested in hearing more about clomipramine, amytriptaline. i was on tegretol which i may go back on, i went off of it becuase i was convinced it was tamping down my creativity and motivation and libido. i will probably be going back to vyvanse from adderall, as i agree the dextro form seems to be superior.
whats the logic behind memantine? i have tried it in the past. my biggest problem is its always been so hard to isolate med effects from life issues and the effects are always so subtle. nothing has ever knocked it out of the park. is the logic here the same logic behind ketamine, or is there something else you think its doing?
yes, bp depression is horrible...i dont even know anymore if i believe what i have is treatable with medicine. i feel like it's a character and spiritual issue some days, other days I feel like it's a real illness. i go to AA for previous addiction issues (phenylethylamine, if you can believe it) and i like AA because they talk about it being a disease AND a physical allergy that is fundamentally a spiritual problem. it's like all of the above but in a structured fashion. its intersting combination of CBT, support, spirituality, etc. although in the past they were very anti psych med, that has changed for the most part.
i don't know why God has given me this cup of suffering. it isn't for me to know i guess. yeah today is just an extra bad day. i can't seem to stay away from the supplements and f*ck around with them daily despite trying not to with my supplement regime, at least AA is keeping me on track with the drugs/alcohol and not screwing with my prescribed meds, but god i can't tell you how NON-SOBER I feel. and i feel so torn about the intense search for a solution via my own will and intellegence, and trying to let go (the AA way) and trust God and give up my life and will to the care of a power greater than myself. I literally feel this dialectical challenge on a minute by minute basis as I struggle to stay away from trying the next great miracle supplement / magic pill and saying STOP and doing something more productive / enjoyable.
the thing that is so hard is that what has become the primary rewarding thing in my life right now (i'm not working, looking for work, but this was a big problem even when I WAS working and had on paper a "great" job) is trying to fix myself, and how i feel. when it should be living life, and serving, and giving to others, and socializing. i feel so much shame in trying to take matters into my own hands at this point, simply becuase I know it is counterproductive, i know i'm not a doctor, i know my problem simply isn't solvable by my own efforts alone. and that in some cases the more i try the more I'm going to see myself as forever unfixable. i am not stupid, i know the answer is not in myself! I agree with what's written in The Big Book, in The Bible, in the DSM-IV, I do have ways of integrating them in my head, i mean despite my own struggles I know exactly what to tell a fellow sufferer, i know what to do, what not to do. i know what helps and i know what hurts. and yet like in Paul's great letter to the Romans Chapter 7 verse 14+:
"For we know that the law is spiritual, but I am of the flesh, sold under sin. For I do not understand my own actions. For I do not do what I want, but I do the very thing I hate. Now if I do what I do not want, I agree with the law, that it is good. So now it is no longer I who do it, but sin that dwells within me. For I know that nothing good dwells in me, that is, in my flesh. For I have the desire to do what is right, but not the ability to carry it out. FOR I DO NOT DO THE GOOD I WANT, BUT THE EVIL I DO NOT WANT IS WHAT I KEEP ON DOING. Now if I do what I do not want, it is no longer I who do it, but sin that dwells within me."
but then, some days, i feel better, sometimes, some meds seem to just click, or I find a substance that offers me relief even if temporarily. or I read something online that is like an "a-hah!" moment, like reading about LDN and endorphin deficiency syndrome. and i say, why should I feel shame for trying to allieviate my suffering...if i had brain cancer, wouldn't i be applauded for trying to NOT GIVE UP? i mean the first time I tried PEA, and everything lifted, I knew i was right for thinking before that this is NOT how i should be feeling and thinking and living in the world. or was I right? or did the PEA Just make me high?
all I know is i'm spending HOURS Per day researching, i get a high when I read abstracts, it makes me feel better I guess, i'm putting my life and my will in the care of MEDICATIONS as I *THINK* I undertsand them. i go to whole foods almost every day and am tempted to pick up the next supplement that i think i want to try. i'm always emailing my poor doctor saying i want to make a change. then i feel like sh*t about it, and feel frustrated that i'm continuing the same habits i'm trying to change, the things that are keeping me bound up in a life that i don't want and that I almost lost. but the problems still remain, so does that mean I give up and just accept my fate and go off all medications, withdraw, become "sober" as per AA from everything? certainly AA or CBT or psychotherapy has been enough to treat people who are depressed or even bipolar. or do i keep at it, recognizing that i'm still unhappy, this is still a substandard life i'm living, and keep searching for the next potential 'magic bullet'? I know something is wrong. I just don't know what normal is anymore, what I should expect as being 'my normal', and how much i should try to optimize before i start overoptimizing and the marginal cost exceeds the marginal benefit.
i pray for wisdom here constantly but i'm not getting it. and yes, i have another doctor's appointment this monday. but how the doctor even do his job when i'm doing stuff behind the scenes myself (even if it ell him) with supplements. i think i need a new doctor...or now am i just endulging my illness even more, now doctor shopping, trying to find the pdoc that will try even more experimental med combinations.
anyway, i can't wait! (literally, i'm excited for pdoc appointment because that means i get to try a new drug! can you believe that, excited for a doctors appointment I need because i'm suffering from an intractable condition...like it's fun for me...AA is right, this disease lives in our heads, and it's a disease of selfishness and self-absorbtion and...now i'm once again putting my faith in something other than God) because this time we get to talk about the following, along with the list you wrote above which I will get his feedback on. but wow, how fun!!! and exciting!!! it will be because I get to ask him about:
tramadol! <--
low dose buprenorphine! <--the treatment nobody will prescribe because of the f*ck*ng DEA and fear of malpractice lawsuits and the paranoia about opioids and that only has one study on it despite it having anecdotally relieved some of the most intractable depressions.
low dose naltrexone! <--the miracle treatment for everything
tianeptine! <--not available in USA! which means its better!
disulfiram! <--super fun because super-off label and it would be a rare use case
lamictal! <--would be i think trial number FIVE of it over the past 7 years
rilutek! <--$1000+ month medication for ALS as you guys know
ketamine! <--i was able to snag some and wanted to keep it for a rainy day, but last month tried a little bit of it and realized my ketamine tolerance is still way way high, and also realized that this was a seriously non-sober act and killed my 28 days of sobriety in AA...so in a grand flourish and in a grand gesture of "giving up control" and trusting in God and not my own diseased self will, i flushed it all. now i wish i hadn't.
psilocybin! or lsd! <--tried two months ago, also killing off about 25 days of sobriety. but maybe what i need is a spiritual experience! that's what AA says! so let's just accelerate it and use my own will and intellegence to rationalize the use of an illicit substance that could seriously conflict with my current meds. but hey there are tons of anecdotal evidence and even a few scientific studies showing that it's caused profound life changes in people
let's see what else am I super excited to talk to him about! oh yeah...
MAOIs parnate and marplan! <--trial number 2. but hey i'm using my head on this one, i could replace my bupropion and mirapex and adderall with just one drug and get some SE action to boot!
zonegran! <--wow i can't believe it, i actually got excited today because i had never heard of this med before. a different mood stabilizer! Tegretol worked pretty well (just went off it this week...maybe not a good idea) so maybe I should try zonegran instead of lamictal
vyvanse! <--for replacing the adderall
amantadine! <--for replacing the mirapex and getting some NMDA antagonism action to boot
and thats just what i'm excited about talking about today. so yeah most def i'll need a full hour.
do you now understand what these substances have become for me in my life? i'm in love with them because i'm in love with myself and can't break free from the bondage of self (an AA phrase) despite praying for the relief every day, and my own self concern drowns out the concerns of others in my life and has casued isolation and despair I cannot even describe. and if you saw me you would see this is near irrational and nobody seems to understand because on the outside I seem normal, upper class, sociable, good looking, very well educated and talented, which makes feel even more guilty and personally responsible for the suffering, like i just can't seem to "get it together" like others can.
i know i'm not unique in having these feelings, they are just incredibly strong today and i am so f*ck*ng frustrated with not being able to control my use of meds and supplements despite going to rehab and doing AA. i can't give up my desire to control myself, of playing God. but i dont want to live like this anymore, I just can't, the suffering will just continue and get worse. seeing my peers pass me by was one thing, that was hard enough when its tarted to happen a few years ago, now everyone is marrying , will start to have kids soon, but i can't even extract daily pleasure out of life.
ok, im sorry for this rant. i just had to write it out. i don't know what i'm asking for if anything in terms of help. maybe i shouldnt have tried to use seroquel last night instead of my prescribed saphris. maybe i should have skipped to my planned up taper of 25mg pregnenolone bid that i started two days ago instead of taking an extra 50mg this morning. maybe i shouldn't have gone off of tegretol last week and this is a side effect of that. or maybe i'm just feeling like sh*t because i spent time at a amazing, healthy, doctor friend of mine's house yesterday and had to experience a man living with engagement and drive for for life and God and family and responsibility.
i have prayed for relief from the obsession to use drugs and obsess about meds and supplements for months now, as per AA instructions. and yet I still am making myself crazy and can't stop, won't stop, or am incapable of knowing how to stop. i go to almost a meeting a day, some days more than one. and then once i go home i'm back at it. and we haven't even talked about the fact that that's not even my only obsession.
maybe i should just go off of everything. someone who knows a lot about mental illness wrote to me the other week and suggested that i withdraw from everything, go away for a while and work on something meaningful, outside, with people around me, and try to see if i can rewire my brain naturally via hard work, meaning, and positive social interactions. i'm beginning to think maybe this is the right answer, but know with certainty that once i came back from that situation to real life, i'd be back at the psychiatrist office because the root cause of my desire to be and feel something different will always be there. and the relief from suffering i read about people experieincing from getting on the right med....i don't know.
what do i put my hope in? i've gotten worse over the years since i started taking meds. but how do i know where i would have been otherwise. maybe i'd be dead now? and now that things have gotten where they are, walking around with insurmountable shame and despair, anger and frustration and resentment, pessimism and self-hatred. punctuated by times of lust and self-confidence and insomnia and stimulant induced internet addiction and going back and forth to my bathroom multiple times a day to pop a supplement that i think will relieve my immediate dysphoric feelings, and not even being conscious of what i'm doing until it's already been done. now that things ahve gotten where they are now, do I or don't i need medication to function?
but i'll let my doctor make the decisions. at least i have 22 days of technical sobriety as of today...hah, what a joke...i certainly don't feel sober.
anyway, i didnt expect this to be an hour long mixed-state rant i just really needed to write out my thoughts today. i feel better, i'm not in any immediate danger, but i definitely am irritable and dysphoric and depressed and frustrated. tonight i will get to sleep early, take enough saphris to ensure i sleep well, and tomorrow i will stick to the assinged pregnenolone up-taper. i have doctor's appt next monday and am in communication with him.
thanks everyone, i really love you for being here. you've been here with me for years now, although I come and go from activity on this board. and phillipa what would we all do without your punctuation-less yet loving first posts.
responses about meds listed in this message appreciated...and of course everything else. i'm going to go lay down and listen to some duduk music and pray and maybe read some AA big book and figure out what AA meeting i'm getting to tonight.
-uncouth in a sleep-deprived stimulant induced hormonally imbalanced mixed state.
poster:uncouth
thread:998639
URL: http://www.dr-bob.org/babble/20110925/msgs/998658.html