Posted by Christ_empowered on July 26, 2016, at 10:32:08
The older literature on the neuroleptics recommends reducing to a dose below the initial dose for many/most patients. Even the newer literature mentions looking for the "lowest effective dose" with any neuroleptics, "atypical" or otherwise.
I go to a community/public mental health clinic. They're nice enough to me, and the treatment is fully covered by disability, so...yeah. Problem is...it seems that they're all about as much as you can tolerate. I mean, it could be worse...I'm not on injections or a court order, so that's good. I'm not any old school AP (they seem to use Haldol an awful lot there...).
Still, my symptoms have improved over time, and now I'm much, much better in terms of my level of functioning and all that good stuff. Quality of life has improved dramtically, too. Thing is...I"m starting to feel kinda...too calm, too tranquilized, etc.
When I was agitated and had been sick for years, I think the meds at the current doses made a lot of sense. Problem is...the meds just get piled on at this clinic, because dosage reductions and tapering seem to be foreign concepts, as best I can tell. I've read that happens at a lot of places, especially the community mental health clinics.
--sigh-- I'd like to see a reduction in my Abilify and a reduction or complete taper with the Trileptal. One reason I need wellbutrin is because the other 3 meds (Abilify, Trileptal, and Lamictal) are sedating and made my depression worse because of sedation and concentration difficulties. My doc also insists on always writing for as-needed gabapentin and keeping me stocked with a low dose of risperidone (2mgs tablets). I feel like...well, I feel like they really, really want me tranquilized, lol.
The doses are: 30mgs/Abilify, 1200mgs/Trileptal, 100mgs/Lamictal, and 400mgs/Wellbutrin SR. I think my main problem is severe, recurrent, sometimes psychotic depression. I did have 1 psychotic manic episode, but...there was a lot of psychosocial stuff feeding into that, too.
Any advice?!?! I don't think I can get to another doctor. My parents have resources, so I suppose I could get to a private practice doc and do self-pay for the sessions and use disability for the meds, but...I filed a medical board complaint years ago against a shrink, so now I've kind of been black balled with the private practice docs around here. Maybe somebody would take me...I dunno...
I just think I could probably do better on a lower dose of the Abilify and a lower dose (or complete elimination) of the Trileptal. Maybe bump the lamictal up to 150-200 or so...it has more solid data behind it than Trileptal, anyway.
Ugh. And the shrinks are weird. Maybe all shrinks are weird. Before this one prescribed Wellbutrin, he asked if I'd ever had a seizure. I told him that I thought I'd had one during Klonopin withdrawal, and his face turned red and he muttered something under his breath, then terminated the appointment a little bit early. I get the sense that everything's cool...as long as you "know your place."
ugh.
poster:Christ_empowered
thread:1090874
URL: http://www.dr-bob.org/babble/20160713/msgs/1090874.html