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Re: Let's play psychofarmer! (Test your dx/rx chops)

Posted by TemporarilyBob on September 7, 2012, at 1:03:27

In reply to Re: Let's play psychofarmer! (Test your dx/rx chops), posted by schleprock on September 7, 2012, at 0:25:38

> I would keep it simple and mayber start with clomipramine and seroquel, might take care of depression\GAD and make you sleep. Wouldn't know what to take for ADHD (ritalin?). I'd probably hire a butler for the rest.
>
> You really should mention how you did on those previous medications and why you discontinued them for so long. Was it Lou Pilder who told you to stop taking them?
>
> Well Lou, is this the kind of mess you want us all to fall into? This is where your "narrow road" leads?

Now, now .... Names not to be named.

Vyvance is almost identical to Ritalin. Without going into details, it has an "inert" isomer attached in such a way that it can only be broken down by gastric fluids, thus greatly reducing the potential for abuse that Ritalin has (through inhalation or injection).

As for why the break? I was fired because of my disability. Unemployment doesn't pay enough to cover close to $800/month of medications. Even if Social Security had not turned me down twice, you need to be on SSD for two years before you get medical benefits. And states only help the "destitute," which apparently means less than $100 to your name and your bags already on the street.

Don't want to give too much away, but since you asked. TCAs were the first meds I responded to, Nortriptyline far more than imipramine. Benzos gave me the first relief I ever had from anxiety ... only took 35 yrs to find that out. Atypical antipsychotics lifted my baseline mood considerably (another indicator for the BPSD dx if you buy it), but some like Zyprexa shot my triglycerides up so high that the figures were meaningless (outside of having a triglyceride index > 900 meaning "impending heart attack"). I know it's a dirty little secret but Vyvance may have acted as much as a mood stabilizer as an aid to cognition and memory ... no one likes to talk about how dopamine-altering meds might be good for one's mood. Lamictal? Abilify? Lamictal came first and at first it was a breath of fresh air. Then Abilify and I got into that zone I'm sure a lot of you know where you're not quite certain if you feel good or blah, or maybe you could feel better, but there's so much haze you can't see any signposts to look for progress.

There, I've done it, said way too much. To put it succinctly, in gravitational Newtonian physics there is something called the Three Body Problem. You see, when you have two bodies you can precisely determine the gravitational effects they will have on one another. Introduce a third body and it goes to hell in a handbag. This is, in effect, a Six Body Problem.


Great wits are sure to madness near allied,
And thin partitions do their bounds divide.

 

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poster:TemporarilyBob thread:1025036
URL: http://www.dr-bob.org/babble/20120830/msgs/1025045.html