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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sometimesblue on October 12, 2007, at 13:19:44
I was on Bupropion and it was great as far as depression and motivation were concerned [had some side effects, but they went away with time]. I started having terrible mood swings and bacame very quickly irrated by the smallest things [not good when you have kids] so doc gave me Prozac to even out the moods. That worked fine.
But now all the motivation is gone again. I felt it dwindling while on both, then i stopped taking the bupropion for almost a week [not intentionally] and so i thought once on the BP i'd be fine again. And NOTHING!
Not sure what to tell my doc? Is it me? I hate to say it but the most focused I've ever been was when i used to dabble in coke. And now that's not an option...so where does that leave me?
I can't seem to finish anything...sometimes i can't even start.
SB :(
Posted by Netch on October 12, 2007, at 13:56:24
In reply to Lost Motivation + Focus???....now what?, posted by sometimesblue on October 12, 2007, at 13:19:44
sometimesblue, have you tried lamictal?
It's the most effective med for bipolar depression. It can be combined with ssri or lithium.Some people with motivational issues are helped with abilify.
/Netch
Posted by sometimesblue on October 12, 2007, at 14:09:41
In reply to Re: Lost Motivation + Focus???....now what? » sometimesblue, posted by Netch on October 12, 2007, at 13:56:24
OK, 3 questions:
1. Lamictal w/ Bupropion & Prozac? I like the Bupropion because it fixed all the sexual side effect i had from the numerous SSRI's i have ben on.
2. Amblify: energy & focus? Those are major problems for me, as long as i can remember they have been.
3. Any sexual side effects from Amblify or Lamictal?
thanks for your help,
SB
Posted by sometimesblue on October 12, 2007, at 14:11:50
In reply to Re: Lost Motivation + Focus???....now what? » sometimesblue, posted by Netch on October 12, 2007, at 13:56:24
I also take Carisoprodol on & Off & most recently ultram for chronic back pain.
How do you think these can be addressed?
-SB
Posted by Netch on October 12, 2007, at 16:03:08
In reply to Re: Lost Motivation + Focus???....now what?, posted by sometimesblue on October 12, 2007, at 14:09:41
> OK, 3 questions:
>
> 1. Lamictal w/ Bupropion & Prozac? I like the Bupropion because it fixed all the sexual side effect i had from the numerous SSRI's i have ben on.
>
> 2. Amblify: energy & focus? Those are major problems for me, as long as i can remember they have been.
>
> 3. Any sexual side effects from Amblify or Lamictal?
>
> thanks for your help,
> SB>I also take Carisoprodol on & Off & most >recently ultram for chronic back pain.
>How do you think these can be addressed?
A problem with SSRI is that it can blunt emotions, including motivation.
Lamictal do not cause sexual dysfunction and it may stabilize your mood on Bupropion.
If a med distabilizes your mood it could be a sign that your bipolar or mixed state.
That would indicate that you should try lamictal first... and then add prozac/Bupropion if you need additional AD effect. An option is to add lithium.Abilify is an atypical neuroleptic that is used for bipolar/schizofrenic symptoms. It addresses issues with motivation, fatigue, paranoid thoughts (delusions/psychosis), isolation, instable mood, social fears/hostility/aggressivity.
The med does not work for everybody, some become fatigue from it, but I know many schizofrenics/bipolars who've been helped with abilify. The secret is to find the right dose. Too much may cause fatigue, anxiety or insomnia.
Since you're using ultram for chronic back pain I assume your pain is severe. I would try to get a MRI scan to exclude any problem that could be addressed surgically. If it's an issue with muscle pain maybe a naprapat/chiropractor/osteopath could help you out. If the pain is more complexed like in fibromyalgia maybe lyrica could address your problem.
If you're overweight and/or eat high sugar diet it may also worsen your pain condition./Netch
Posted by sometimesblue on October 15, 2007, at 10:19:05
In reply to Re: Lost Motivation + Focus???....now what? » sometimesblue, posted by Netch on October 12, 2007, at 16:03:08
> If a med distabilizes your mood it could be a sign that your bipolar or mixed state.
> That would indicate that you should try lamictal first... and then add prozac/Bupropion if you need additional AD effect. An option is to add lithium.I guess the best person to diagnose this is a therapist/psychatrist? Unfortunately, I have to mental health coverage with my insurance. And so, it's been a case of trial and error with my Physician to determine what combo works best for me.
> Since you're using ultram for chronic back pain I assume your pain is severe. I would try to get a MRI scan to exclude any problem that could be addressed surgically.I did have an MRI which showed a bulging disk. The Ultram doesn't do much for the pain anyway. I'm seeing an orthopedic doctor and hopefully physical therapy to strenghten the muscle around the disk to ease the pain.
What do you think of adding Ephedra to the mix for energy/focus? It used to work for me, but i stopped taking it because i figured i wouldn't need it anymore once I was on Buproprion. But since the BP isn't working for that anymore, i thought maybe i should go back on it.
I know if i were seeing a therapist i would get better help, unfortunately, that isn't an option, and so i look to you guys for help. You seem to be well versed on the subject, more so than my doctor.
-SB
Posted by Dr. Bob on October 15, 2007, at 20:16:43
In reply to What about EPHEDRA?? » Netch, posted by sometimesblue on October 15, 2007, at 10:19:05
> What do you think of adding Ephedra to the mix for energy/focus?
Sorry to interrupt, but I'd like to redirect follow-ups regarding Ephedra to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20070923/msgs/789470.html
Thanks,
Bob
Posted by psychobot5000 on October 18, 2007, at 17:16:01
In reply to Re: Lost Motivation + Focus???....now what? » sometimesblue, posted by Netch on October 12, 2007, at 16:03:08
I would note that Lamictal has failed numerous large-scale studies on its antidepressant potential. It typically gives a boost in mood when initially taken, which then fades away over the next six weeks, back to baseline or even below - with the addition of side-effects, of course. Thus, I would respectfully suggest that it's not a good idea for motivation and focus. For me, it was ultimately counterproductive in both those areas.
Posted by sometimesblue on October 19, 2007, at 9:22:32
In reply to Re: Lost Motivation + Focus???....now what?, posted by psychobot5000 on October 18, 2007, at 17:16:01
So, what did work for you? After the lamictal, did you get on anything else?
-SB
> I would note that Lamictal has failed numerous large-scale studies on its antidepressant potential. It typically gives a boost in mood when initially taken, which then fades away over the next six weeks, back to baseline or even below - with the addition of side-effects, of course. Thus, I would respectfully suggest that it's not a good idea for motivation and focus. For me, it was ultimately counterproductive in both those areas.
>
Posted by psychobot5000 on October 19, 2007, at 13:21:05
In reply to Re: Lost Motivation + Focus???....now what? » psychobot5000, posted by sometimesblue on October 19, 2007, at 9:22:32
> So, what did work for you? After the lamictal, did you get on anything else?
>
> -SB
I have been on a few other things, none of which really work perfectly for me, unfortunately. But, I'll make you a few suggestions for motivation and focus.You mentioned dabbling in coke, and that this worked for you. I hesitate to suggest this, but...if you didn't find that abusing it or addiction was a problem, then the most effective treatment for motivation and focus problems is often a stimulant: concerta or ritalin, or else adderall or dexedrine. A lot of docs are uncomfortable with these meds because they're abusable, however, so, be warned. They're all somewhat similar to coke, -and- more similar to ephedra. One option is 'Vyvanse' which is a special formulation of dexedrine, that needs to be filtered slowly through your liver in order to be activated--thus, you can't get 'high' and it's less abusable. I don't know if your doc would be familiar with it, but it might be a good option if he were. In any case, I bet that one of those would help--though you might have to be off the bupropion if you take them.
Another option might be desipramine, which is an older antidepressant that focuses on noradrenaline, and so can make people more alert.
Abilify is probably a good idea, though. There are some people on this board that have gotten motivation out of it, though for some it doesn't work as well.
There's also mirapex, and requip, which are somewhat similar to Abilify (they all act on D2 receptors, though Abilify does it differently than the other two, and has other actions as well). They might help with motivation, too. All three are expensive, though, and all three can have undesirably side-effects, though (fatigue, digestive troubles...). So just warning you.
Sorry I can't be of more help! Have you tried cruising through the archives on this site? A search for 'motivation' or 'focus' would probably bring up a lot of posts on the subject. ...Have you tried black tea or coffee? They can help!
Psychbot
Posted by sometimesblue on October 19, 2007, at 14:13:21
In reply to Re: Lost Motivation + Focus???....now what? » sometimesblue, posted by psychobot5000 on October 19, 2007, at 13:21:05
> You mentioned dabbling in coke, and that this worked for you. I hesitate to suggest this, but...if you didn't find that abusing it or addiction was a problem, then the most effective treatment for motivation and focus problems is often a stimulant: concerta or ritalin, or else adderall or dexedrine. A lot of docs are uncomfortable with these meds because they're abusable, however, so, be warned.
I've often thought about suggesting this to my doctor because I KNOW it will help...I came to the same conclusion you did (if coke worked, a legal stimulant would work as well). And I never had an addiction problem with it, when i stopped, i just stopped, no problems [i don't remember even going through withdrawls]. But, I do know that straight out *asking* for it will raise a red flag. It's gotten such a bad rap because of people that do abuse it...so i'm leary to approach the subject. I can't very well tell her "listen, coke worked for me in the past, how about something simular, eh?" I figure I'll keep trying other stuff until she comes to the same conclusion as me.
> Abilify is probably a good idea, though. There are some people on this board that have gotten motivation out of it, though for some it doesn't work as well.That might be something worth suggesting.
> Sorry I can't be of more help! Have you tried cruising through the archives on this site? A search for 'motivation' or 'focus' would probably bring up a lot of posts on the subject. ...Have you tried black tea or coffee? They can help!Coffee doesn't do too much for me, even red bull doesn't seem to have the same affect on me as it does on others (i will try black tea though, that i haven't tried before). I don't know what's wrong with me, maybe i just have a high tolerance for these things...In any case, you have been great help! Thanks so much for your detailed post :)
-SB
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