Posted by antennastoheaven on June 25, 2013, at 17:43:18
In reply to Re: Bipolar DX based only on SSRI hypomanic response? » antennastoheaven, posted by SLS on June 25, 2013, at 15:45:55
> Wellbutrin can also be taken with a MAOI, despite official labeling to the contrary. Combining Nardil with Wellbutrin would offer you the possibility to adequately treat anhedonia. I will say that Wellbutrin makes a good adjunct to Pristiq.
Seems it would be difficult to get someone to prescribe a MAOI and Wellbutrin, although I'd be willing to try it. I have personally taken Adderall and Emsam together safely. It would be possible to get two different pdocs prescribing different things, but then I'd have to lie to each of them and I don't want to do that. Or get one of the drugs some other way, but that's also not something I want to do.
Emsam (selegiline) was rather sedating for me. I never went past the 6mg dose officially, but I left up to 3 patches on (still adding a new one daily) and felt no improvement. It didn't do anything for ADD symptoms and I found it more difficult to focus then usual, even though I didn't feel any cognitive deficit. From what I have read Parnate would be less likely to be sedating than Nardil or selegiline.
Because of the importance of being able to focus on sustained cognitively demanding tasks, I am reluctant to take any combination that would result in me not being able to take a stimulant or get a steady supply of them. However, right now is the time for me to try new things while I'm on disability.
> Regarding Lamictal, a sizable percentage of people experience cognitive side effects with it. Common complaints are related to memory impairment and brain fog. It seems to me unusual that Lamictal should produce a biologically induced state of suicidality as might a drug like Prozac. Perhaps the brain fog and lack of positive effect frustrates and demoralizes you to the point of precipitating a psychogenic suicidal state. This might indicate a need for some form of psychotherapy.
Lamotrigine has been linked to suicide. Here is one article: http://onlinelibrary.wiley.com/doi/10.1002/pds.1932/abstract
The drug made me feel so empty that I wanted the feelings to end, and drugs as a form of escape from those feelings were insufficient. When I made the connection that the feelings started with an increased dose of Lamictal, the suicidal thoughts subsided. This seems like something the prescriber of the drug should have figured out, as increased suicide risk is known to be an issue and the FDA requires it to be labelled: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm100190.htm Yet I had to make the connection on my own,.
I have seen a therapist for a while and am currently in a partial hospitalization program. http://www.dr-bob.org/babble/psycho/20130309/msgs/1045521.html
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URL: http://www.dr-bob.org/babble/20130617/msgs/1045882.html