Posted by kavinsky99 on February 26, 2014, at 19:10:49
In reply to Re: Advice on which medication is best for my case » kavinsky99, posted by phidippus on February 26, 2014, at 18:12:31
> > I do have true racing thoughts when I'm very anxious, specially during a panic attack.
>
> I imagine the racing thoughts cause a lot of anxiety that then leads to panic.
>
More like the other way around. I think the physical anxiety sets in before the mind gets affect, on a course of a few days (with poor sleep nights in between). But without lithium or antidepressants (any I've tried), I usually tend to have not RACING, but constant endless mind chatter every day. Specially upon waking up. Mornings seem to be the worst part of my day regarding mood, thoughts and anxiety. Feels like my mind was busy thinking the same old traumas over and over again. Oddly, I also tend to wake up with a song BLASTING in my head, and stuck as the other thoughts. I wouldn't say they're racing thoughts, just repetitive, relentless and extremely attention draining. Everything feels like second-priority compared to them, according to my brain.
They're unpleasant in nature, mostly based on memories of bad things that happened and ruminations regarding them.> >endless mind chatter that I can't control and often give up and just "dialogue" with.
>
> I get the same nonsense at night when I'm trying to sleep. In some ways we have dissociated from the 'voices' inside our heads, making it out to be completely intrusive.
>
Yes, exactly. They're not MY thoughts. It's like my mind is playing to me a radio station. And it's very loud, with bad reception and it only plays the top 25 list of worst moments in my life.> >I have the odd day where I'm literally consumed by "flashbacks" and inner dialogue.
>
> What do you do to cope with these thoughts? Do you ever have fun with them?
>
I don't cope. I literally just try to not think. Other activites or "distractions" seem to actually worsen them. Benzodiazepines or really sit down quiet trying not to think is the best way to avoid it.> > Yeah, APs are great for managing anxiety (in lower doses. higher doses seem to worsen it)
>
> APs have that double edge: moderate doses can aleviate OCD symptoms and large doses can worsen them.
>
Yeah, from what I've read, higher doses tend to release norpepinephrine. I'm not sure that's why, but a lot of people get bad anxiety symptoms at higher doses of APs. And feel very sedated at the same time... Quite an unconfortable feeling.> >but create an specific kind of restlessness that is a lot like true ADHD.
>
> This is a side effect of neuroleptics called akathisia.
>
Yeah. Not able to sit, not able to lie down, not able to focus on anything. Just keep walking for no reason around the house. Terrible.> >Nothing sinks in, nothing feels rewarding, nothing gets caught in my mind.
>
> That's what happens when dopamine is supressed.
>
For depressed, anxious and bipolar people, is dopamine suppression the key-effect for the benefits received from APs? Never read anything about APs + Stimulants. Gonna check that out.
>
> > But I'm using tianeptine and feeling as stable as I have ever been, on 3mg to 6mg daily dose along with 600mg lithium.
>
> That's good. Are you still having symptoms you'd like to treat?
>
If things continue as good as they are as I increase tianeptine, then I'll just need to improve cognition and find something to sleep better. Currently using mirtazapine "crumbs" and I sleep great.
But I have to say, with depression and anxiety beat and the bad thoughts losing space on my mind, I'm noticing I'm living more freely, with more attention being given to studying. Gonna give time for tianeptine and then I'll see what I can do about my current awful cognitive performance.> >I do notice lithium "dulls" certain impulses and interests I used to have, that made me a more fun and outgoing person.
>
> This effect goes away after awhile.
>
Yeah. Today after my first dose of tianeptine, I felt a little TOO happy. Odd for me. Chatted more and interacted with teachers at my class.
By the way, it's nothing like mania.> >Doctor suggested Clomipramine for the intrusive thoughts, I haven't tried it yet due to the anti-cholinergic effects being possibly harmful to my already bad cognition.
>
> When I took clomipramine I hardly noticed the impact to my cognition, rather I'd say it was improved because so much of the intrusive and recurrent thinking got cleared up, thus uncluttering my brain.
>
That's good to know. If tianeptine fails, I'll try clomipramine.> >What do you think of TCAs, at a low dose?
>
> Clomipramine is the only TCA that makes a real impact on OCD symptoms and its not useful at a low dose-i took 300 mg alongside 1200 mg of lithium.
>
Well, if it's good for my brain, screw my heart. He had it easy enough.> >dopaminergic drugs aren't a good option for me, as they worsen the agitation and anxiety a lot.
>
> Try Strattera - its a norepenephrine reuptake inhibitor that can help improve motivation and focus.
>
I'm definetely curious about those. Never tried a single Norepinephrine Reuptake Inhibitor before.
> > > Seroquel is not so good for cognitive dysfunction-it is more likely to cause it.
> > >
> > As will most APs, right? Damn you, dopamine...
>
> Not necessarily. Latuda has been shown to improve cognition.
>
For non-schizophrenics? usually APs improve their cognition, but people with schizophrenia can have really bad cognitive skills.> > Rilutek, did not know it could work for depression.
>
> A couple studies show it is efficacious in the treatment of ocd and bipolar depression
>
> >Never tried TCAs. What do you think of them?
>
> I've only taken imipramine and clommipramine. I had a good, clean experience with them. Imipramine felt a little sludgy, though.
>
I wish I could try the norepinephrine ones first... I suffer from really bad nerve pain on my spine. Don't know if that worsens anxiety and OCD, though.> >You think low dose of any of them could be effective for anxiety and neuropathic pain, without harm to cognition or other more bothersome side effects?
>
> I think so, the problem is OCD seems to only respond to high doses of antidepressants.
>
The anxious "circuit" in the brain is a bitch.> > SSRIs are so unreliable. Every two weeks or so my mood and side effect profile seem to shift to something else.
>
> Well, are you taking them without the lithium?
>
Yeah. Only one I took without lithium was Lexapro. I don't know if it was it or clonazepam that put me on such a bad mood. (By the way, benzos usually make me very agressive and depressed. I find it odd how most people like them for the good mood it gives.).
> >Keppra isn't very popular in my country, but I think we have it. i'm going to look into that one better before I comment on it.
>
> It works great for OCD and improves cognition. Its also an adequate mood stabilizer. Good dosage range was 2000-3000 mg.
>
What kind of side effects you had it on it?
> >I'll try one of these again when I have the time to deal with serious side effects and sleep 12-15 hours a day.
>
> Remember! A moderate dose of AP should suffice-and more importantly don't take without a serotogenic antidepressant on board!
>
Why is it important to have a serotonergic antidepressant on board? Thought APs usually had serotonergic properties of their own.> > The intrusive, repeating thoughts are by far the worst symptom of all. I don't know if they're the cause of a symptom or both, but they literally cripple my ability to live.
>
> You're fighting the thoughts tooth and nail. Maybe you just need to accept that you have these thoughts. Have you ever done any ACT?
>
Never had ACT. Honestly, therapy retraumatizes me even subconsciouslly. But I don't think I can have an approach to it that will solve them that isn't "real". I'm already taking care of that, though... Meaning I'm sueing a couple of places.
>
>
> > 900 Lithium + 30mg mirtazapine + 1mg risperidone or 600mg lithium + 50mg Zoloft + 6mg bromazepam were the best combos for that. However, Zoloft, risperidone, bromazepam and mitazapine tend to worsen my cognition.
>
> Try Brintellix + Latuda + Lithium
>
> > I never tried beta and alpha blockers. I'll look into it.
>
> They're studying Prazosin as an agent f0r treating OCD.
>
> > > Keppra, LAtuda, MEmantine, Riluzole
> > >
> > Can these drugs and nootropic drugs cause an increase on intrusive thoughts?
>
> They all decreased intrusive thoughts for me.
>
> >Focus on the garbage already on my mind.
>
> Maybe you can pick through it and find something useful.
>
> Eric
>
> ps. where are you from?
poster:kavinsky99
thread:1060760
URL: http://www.dr-bob.org/babble/20140214/msgs/1061401.html