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Re: Meds to improve task initiation

Posted by NKP on April 24, 2022, at 18:14:41

In reply to Re: Meds to improve task initiation, posted by NKP on April 8, 2022, at 4:21:14

I feel as though I have gone as far as is reasonably possible with medication. My current regimen is (a) venlafaxine 225 mg/day and (b) lamotrigine 100 mg/day.

(*) Stimulants: I'm reluctant to use them because of concerns about addiction, tolerance, downregulation of dopamine receptors, and the "zombie"-effect that some users report. Moreover, my psychiatrist is unlikely to prescribe them since I don't have ADHD (see below about my psychiatrist).

(*) Low dose flupentixol (in the form of Fluanxol): I'm concerned about the loss of brain volume reportedly caused by typical antipsychotics (though flupentixol is sometimes called an atypical typical), tardive dyskinesia, and diabetes. I saw a post on another forum wherein a Fluanxol user got diabetes and when they went to fetch their diabetes medicine from their pharmacy, their pharmacist told them that he had noticed over the years that all Fluanxol users seem eventually to get diabetes. On the plus side, my psychiatrist has said that he is open to the possibility of prescribing Fluanxol, which I've taken in the past, but he first wants to try other things (possibly quietiapine, which I really don't want to use).

(*) Aripiprazole: Sounds like a less effective form of flupentixol with more weight gain. Plus, my psychiatrist seemed to pour cold water on this possibility when I once mentioned it.

(*) Pramipexole: I'm worried about side-effects, and highly unlikely that my psychiatrist would prescribe it (see below about my psychiatrist).

I should also mention that my psychiatrist is quite conservative and does everything "by the book". He doesn't seem to do off-label prescribing. He'll only prescribe a drug if there is an algorithm or study that supports its use.

So it feels like I've gone as far on medication as I can, and short of re-introducing Fluanxol, I'll either have to conquer my lack of motivation with therapy, or I'll just have to accept my lot and live life this way if therapy doesn't work.

My wife is worried that I'm going to lose my job.


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poster:NKP thread:1119129
URL: http://www.dr-bob.org/babble/20220128/msgs/1119558.html