Psycho-Babble Medication Thread 468293

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Re: Short-acting barbiturates » Ame Sans Vie

Posted by ed_uk on March 9, 2005, at 15:28:33

In reply to Re: Parnate 20mg, Day 6 » Phillipa, posted by Ame Sans Vie on March 9, 2005, at 15:03:07

Hi Ame,

>Yeah, it is pretty rarely prescribed these days, especially outside of pediatrics and veterinary medicine, it seems.

I've worked in a few pharmacies (in England). Most people who take Seconal are very old- I guess they've been on it for decades~! A lot of them are in nursing homes, often in their 90s or ever 100! The same goes for Amytal, Sodium Amytal, Tuinal and Soneryl.

Regards,
Ed.

 

Re: Kind of a downer

Posted by Dr. Bob on March 9, 2005, at 21:10:35

In reply to Re: Parnate 20mg, Day 6 » Ame Sans Vie » cubbybear, posted by Ame Sans Vie on March 9, 2005, at 14:53:41

> "soul without life", or "lifeless soul", in French. Kind of a downer, I know, lol, but everyone has known be by that name here and elsewhere on the net for ten years.

Maybe 10 years is long enough? How would one say "soul with life" in French? :-)

Bob

 

Re: Parnate 20mg, Day 6

Posted by cubbybear on March 10, 2005, at 1:24:19

In reply to Re: Parnate 20mg, Day 6 » Ame Sans Vie » cubbybear, posted by Ame Sans Vie on March 9, 2005, at 14:53:41

I have spoken with my doctor about this already, actually, to feel him out concerning how high he'd be willing to push the dose if required, as I know some people end up needing hundreds of milligrams per day. He says the sky's the limit, barring unwanted adverse reactions.
>
I'm always amazed at hearing how many people do well on doses in excess of 70 mg/day. My thinking has been (wrongfully) shaped by the patient insert which simply states therapeutic dose up to 60 mg/day, and Glaxosmith Kline evidently refuses to update the insert to reflect the liberalized diet restrictions and changes in thinking about high doses.
I still wonder, though, if you don't have insurance, wouldn't high doses get to be quite expensive? And if you are covered by insurance, hasn't the insurance company established a limit as to how high a dose they will pay for? Seems that these people have mastered the art of denying payment for every reason imaginable, so I wonder if they've set a maximum reimbursement vis a vis Parnate dosage. Just curious. cubbybear

 

Re: Short-acting barbiturates » ed_uk

Posted by Ame Sans Vie on March 10, 2005, at 10:39:35

In reply to Re: Short-acting barbiturates » Ame Sans Vie, posted by ed_uk on March 9, 2005, at 15:28:33

> >Yeah, it is pretty rarely prescribed these days, especially outside of pediatrics and veterinary medicine, it seems.
>
> I've worked in a few pharmacies (in England). Most people who take Seconal are very old- I guess they've been on it for decades~! A lot of them are in nursing homes, often in their 90s or ever 100! The same goes for Amytal, Sodium Amytal, Tuinal and Soneryl.

I was actually talking about chloral hydrate when I made the above remark -- you're certainly right that short-acting barbiturates are something of a dinosaur these days outside of hospital medicine and the elderly who've been dependent on them for 20, 30, 40+ years. Phenobarbital and Mebaral both seem to remain popular in pediatric use for epilepsy, however.

~Michael

 

Re: Kind of a downer » Dr. Bob

Posted by Ame Sans Vie on March 10, 2005, at 10:42:50

In reply to Re: Kind of a downer, posted by Dr. Bob on March 9, 2005, at 21:10:35

> > "soul without life", or "lifeless soul", in French. Kind of a downer, I know, lol, but everyone has known be by that name here and elsewhere on the net for ten years.
>
> Maybe 10 years is long enough? How would one say "soul with life" in French? :-)
>
> Bob

lol, perhaps you're right! I'm sure everyone would still recognize me with only a slightly altered name. :-)

I'll announce it in Admin and/or Social when I change it -- "soul with life" would be "Ame Avec Vie", which has a nice ring to it. :-)

~Michael

 

Re: Parnate 20mg, Day 6 » cubbybear

Posted by Ame Sans Vie on March 10, 2005, at 10:55:12

In reply to Re: Parnate 20mg, Day 6, posted by cubbybear on March 10, 2005, at 1:24:19

> I still wonder, though, if you don't have insurance, wouldn't high doses get to be quite expensive? And if you are covered by insurance, hasn't the insurance company established a limit as to how high a dose they will pay for? Seems that these people have mastered the art of denying payment for every reason imaginable, so I wonder if they've set a maximum reimbursement vis a vis Parnate dosage. Just curious. cubbybear

At the moment I still rely on Medicaid to pay for any medications I take aside from clonazepam, meprobamate and Seconal, which I pay out of pocket for due to the three-prescription-per-month limit. Normally, though, at least in Texas, Medicaid won't reimburse for more than 100 tablets of Parnate in one prescription, which would mean 300 tablets per month (100mg / day) would be my upper limit. However, my new pdoc has worked with them to prearrange for the possibility of higher doses should they prove necessary, and Medicaid has agreed to pay for whatever is necessary considering my history of extreme treatment-resistance. After all, it is much less expensive than ECT or many other drugs I've been on, e.g., Provigil and Desoxyn!

Also, I of course do not want to rely on the State to pay for my drugs for the rest of my life, and I really struck gold the other day when I took an old computer monitor to a local repair shop for an extra $20 only to be offered a full-time position as server administrator for small businesses! Apparently they've been looking for someone who knows Linux and Unix for quite some time, so my switching from Windows to Linux and the resultant in-depth studying I've done into programming has really paid off! Parnate costs about $1 per tablet, and it (even at this early point in treatment) is worth more than its weight in gold to me and I'd be willing to pay however much it ends up costing me.

~Michael

 

Re: Short-acting barbiturates, Chloral etc... » Ame Sans Vie

Posted by ed_uk on March 10, 2005, at 11:07:16

In reply to Re: Short-acting barbiturates » ed_uk, posted by Ame Sans Vie on March 10, 2005, at 10:39:35

Hi ame,

>I was actually talking about chloral hydrate when I made the above remark.

Oops sorry, I didn't read your post that carefully :-S You're right about chloral, it's sometimes used as a paediatric pre-med, midazolam seems to be replacing it to some extent. Welldorm tablets (chloral betaine) are prescribed in a similar manner to Amytal, Seconal etc.

>Mebaral

We don't have mephobarbital here!

Best regards,
Ed.

 

Re: Kind of a downer » Ame Sans Vie

Posted by ed_uk on March 10, 2005, at 11:10:12

In reply to Re: Kind of a downer » Dr. Bob, posted by Ame Sans Vie on March 10, 2005, at 10:42:50

>I'll announce it in Admin and/or Social when I change it

No! Don't change it, it's a cool name, I like it! Are you secretly French?

Ed.

 

Re: Kind of a downer » ed_uk

Posted by Ame Sans Vie on March 10, 2005, at 11:50:19

In reply to Re: Kind of a downer » Ame Sans Vie, posted by ed_uk on March 10, 2005, at 11:10:12

> >I'll announce it in Admin and/or Social when I change it
>
> No! Don't change it, it's a cool name, I like it! Are you secretly French?

lol, no, I'm "secretly" Texan, actually... or Pennsylvanian... or Californian... depends on whether one defines that sort of thing by birth (California), childhood home (Pennsylvania), or current residence (Texas). :-)

I've just always been fascinated by languages and began to teach myself French at the age of 12, along with a multitude of other languages (e.g., Russian, Latin, Spanish, Italian, German, Kiswahili, Japanese, Mandarin, Arabic, Irish Gaelic) most of which I've sadly forgotten. My French is still pretty up to par, though, and currently I'm taking a step in another linguistic direction -- studying the evolution of the English language and learning the grammar and vocabulary of Chaucer's English (I've already gotten the pronunciation down -- *beautiful* language).

I really like my name too, but it certainly doesn't reflect how I feel inside anymore... perhaps I should initiate a poll on Social? What do you think? :-)

Of course, I'm also totally open to other suggestions, either in French or English that I could translate into French. :-)

Take care,
~Michael

 

Re: Short-acting barbiturates, Chloral etc... » ed_uk

Posted by Ame Sans Vie on March 10, 2005, at 11:57:29

In reply to Re: Short-acting barbiturates, Chloral etc... » Ame Sans Vie, posted by ed_uk on March 10, 2005, at 11:07:16

> Hi ame,
>
> >I was actually talking about chloral hydrate when I made the above remark.
>
> Oops sorry, I didn't read your post that carefully :-S You're right about chloral, it's sometimes used as a paediatric pre-med, midazolam seems to be replacing it to some extent.

Yes, I'd heard that about midazolam, and considering its strong propensity to induce anterograde amnesia I imagine it would be more helpful in a pre-surgical setting than any form of chloral.

I'd also heard that, primarily outside the U.S., midazolam syrup is often used pediatrically to treat more severe forms of certain parasomnias. Was I misinformed, or is this really a valid use? Just curious.

> Welldorm tablets (chloral betaine) are prescribed in a similar manner to Amytal, Seconal etc.

I've never had chloral betaine... are its effects/indications much different than those for chloral hydrate?

> >Mebaral
>
> We don't have mephobarbital here!

Oh, I wasn't aware of that -- ashamedly, I don't keep up as well as I should with international prescribing trends. :-)

~Michael

 

Re: Ame » Ame Sans Vie

Posted by ed_uk on March 10, 2005, at 12:45:19

In reply to Re: Short-acting barbiturates, Chloral etc... » ed_uk, posted by Ame Sans Vie on March 10, 2005, at 11:57:29

Hi ame!

I was born, brought up and live in three towns which are very close together. I don't have such an interesting background :-)

>I've just always been fascinated by languages and began to teach myself French at the age of 12, along with a multitude of other languages (e.g., Russian, Latin, Spanish, Italian, German, Kiswahili, Japanese, Mandarin, Arabic, Irish Gaelic) most of which I've sadly forgotten. My French is still pretty up to par, though, and currently I'm taking a step in another linguistic direction -- studying the evolution of the English language and learning the grammar and vocabulary of Chaucer's English (I've already gotten the pronunciation down -- *beautiful* language).

That's amazing! How on earth did you find time to learn all those languages?

I did French for a few years at school but it was always my worst subject. I wanted to be good at it but I just didn't have the ability. I was good at science but dreadful at foreign languages.

You are a very interesting person. You seem to have taken practically every drug in Pihkal, do you still experiment?

>I really like my name too, but it certainly doesn't reflect how I feel inside anymore... perhaps I should initiate a poll on Social? What do you think? :-)

Maybe you should just call yourself 'ame', then it wouldn't matter how you were feeling. I think I prefer ame sans vie though, it's more unique. Yes, I think you should start a poll on social.

>I'd also heard that, primarily outside the U.S., midazolam syrup is often used pediatrically to treat more severe forms of certain parasomnias. Was I misinformed, or is this really a valid use? Just curious.

Oral midazolam syrup is apparantly popular in some countries, we don't have it in the UK though, we've just got the injection (Hypnovel). As far as I know, oral midazolam is popular as a premedication for children, I'm not sure whether it's used outside the hospital setting. In some countries, oral midazolam is used to treat insomnia in adults, not sure about children.

>I've never had chloral betaine... are its effects/indications much different than those for chloral hydrate?

They're virtually the same, chloral betaine rapidly dissociates in the stomach to release chloral hydrate.

>ashamedly, I don't keep up as well as I should with international prescribing trends.

Lol, you seem to have been keeping up with plenty of other things.

Ed.

 

Re: Welldorm

Posted by ed_uk on March 10, 2005, at 12:57:21

In reply to Re: Ame » Ame Sans Vie, posted by ed_uk on March 10, 2005, at 12:45:19

BTW, chloral betaine 707 mg = chloral hydrate 414 mg.

 

Re: Ame

Posted by ed_uk on March 10, 2005, at 13:04:45

In reply to Re: Ame » Ame Sans Vie, posted by ed_uk on March 10, 2005, at 12:45:19

>You seem to have taken practically every drug in Pihkal, do you still experiment?

OK, maybe not while you're on Parnate!!

Ed.

 

Ame, Re: Clomipramine, sedation, anhedonia » Ame Sans Vie

Posted by temoigneur on March 10, 2005, at 21:41:49

In reply to Re: Short-acting barbiturates, Chloral etc... » ed_uk, posted by Ame Sans Vie on March 10, 2005, at 11:57:29

Hey Michael how are you doing. Are you in school right now, I remember your french, perhaps you're launched in a carreer. How is your family, mine is good, I'm going to the Anxiety Disorder Conference in Seattle next month, should be informative:)
I haven't been on the anxiety boards that much recently, so i don't know if you are still in contact, but I have severe anxiety and moderate – heavy OCD.... I was asking you about tramadol while i was trying nardil. I went on Tramadol, but I thing the NRI properties it shares with effexor were making me quite anxious. As explained below, I'm on Clomipramine now, but tricyclics, feel similar to zyprexa to me, it certainly has controlled my OCD well, but I sleep most of the day, and have little/no ambition to do much of anything, I’m numb, and have lost much of my creativity.
I was wondering, with your knowledge of anxiolytics and drugs, is there anything you might recommend addiing to or as an alternative to clomipramine. I wrote this message in Feb. before I saw your post on Parnate, that’s about the only drug available in Canada I haven’t been on. Below I've explained some of the complications I've had with stimulants/SSRI's …
After, ridiculous anxiety - being almost driven to suicide numerous times in the past year, I've come upon clomipramine for OCD/Anxiety. It has all but abolished the horrible OCD/Anxiety along with clonazepam, 3mg t.i.d. but I'm tired all the time, I just want to sleep all day; my mind is relatively dull, and I can see sleeping my way into my sixties, if I don't get something that would give me some inertia. I have little/no ambition, or drive to do very much and as I'm on disability, I can just sleep all day and ponder what life would be like without the disease. But I had a good mind, got my ARCT in piano, I'd like to be a Nurse-Practitioner, but this is impossible being so dull and drowsy.
Anyway, is there any conceivable combo Clomipramine + SSRI or bromocriptine that may allow me to retain clinical gains, and start living again. Basically looking for something to give me my energy and creativity without the torment of Anxiety and OCD. Has anyone observed that their anxiety is aggravated by SNRI's or Stimulants. I cannnot tolerate any stimulants, On Ritalin I displayed bipolar symptoms, Dexadrine made me extremely anxious, as did provigil.
My psychiatrist has noted that noradrenergic medications cause an increase in anxiety for me. Does anything strike you that might help with energy/cognition, I found all SSRI's to be stimulating, to the point where I couldn't sleep, which is why I'm somewhat interested in some combination of SSRI + Clomipramine. The SSRI's alone helped for 4 months, then did little for my anxiety, but it's hard to compare because while on the SSRI's I was in university school, under a good deal of pressure – now on clomipramine, I have no significant commitments. I came off clomipramine cold turkey three days ago, and I’m starting to get anxious, I feel this forboding brewing, I think I’ll go back on it tonight. Thank’s Michael,, also I understand if your busy, catching up on what your illness has taken from you, and can’t answer.
Ben Je te souhaite toutes reussites avec parnate.

 

what is this? » ed_uk

Posted by cubbybear on March 11, 2005, at 3:17:30

In reply to Re: Ame » Ame Sans Vie, posted by ed_uk on March 10, 2005, at 12:45:19

> Lol, you seem to have been keeping up with plenty of other things.
>
Would someone tell me what this "lol" stands for, that is infecting everyone's E-mail like a virus?

cubbybear

 

at least it's not sans merci

Posted by up'n'down on March 11, 2005, at 3:24:37

In reply to Re: Kind of a downer » ed_uk, posted by Ame Sans Vie on March 10, 2005, at 11:50:19

> > >I'll announce it in Admin and/or Social when I change it
> >
> > No! Don't change it, it's a cool name, I like it! Are you secretly French?
>
> lol, no, I'm "secretly" Texan, actually... or Pennsylvanian... or Californian... depends on whether one defines that sort of thing by birth (California), childhood home (Pennsylvania), or current residence (Texas). :-)
>
> I've just always been fascinated by languages and began to teach myself French at the age of 12, along with a multitude of other languages (e.g., Russian, Latin, Spanish, Italian, German, Kiswahili, Japanese, Mandarin, Arabic, Irish Gaelic) most of which I've sadly forgotten. My French is still pretty up to par, though, and currently I'm taking a step in another linguistic direction -- studying the evolution of the English language and learning the grammar and vocabulary of Chaucer's English (I've already gotten the pronunciation down -- *beautiful* language).
>
> I really like my name too, but it certainly doesn't reflect how I feel inside anymore... perhaps I should initiate a poll on Social? What do you think? :-)
>
> Of course, I'm also totally open to other suggestions, either in French or English that I could translate into French. :-)
>
> Take care,
> ~Michael
>
>
I like Will Shakespeare and the Elizabethan english [best known in the King James version of the Bible.]
When I see "sans," I think of Will's seven stages of man, the last of which he says we end up"...sans teeth, sans hair, sans everything."
Both of your names are intriguing, but the positive one probably would be most encouraging to those who are not doing so well, right now.:-) U'D

 

Re: what is this? » cubbybear

Posted by KaraS on March 11, 2005, at 4:06:00

In reply to what is this? » ed_uk, posted by cubbybear on March 11, 2005, at 3:17:30

> > Lol, you seem to have been keeping up with plenty of other things.
> >
> Would someone tell me what this "lol" stands for, that is infecting everyone's E-mail like a virus?
>
> cubbybear


LOL = laughing out loud


 

Re: what is this?

Posted by ed_uk on March 11, 2005, at 8:24:07

In reply to Re: what is this? » cubbybear, posted by KaraS on March 11, 2005, at 4:06:00

>Would someone tell me what this "lol" stands for, that is infecting everyone's E-mail like a virus?

Sorry :-S

Ed.

 

Re: Ame, Re: Clomipramine, sedation, anhedonia » temoigneur

Posted by ed_uk on March 11, 2005, at 8:36:45

In reply to Ame, Re: Clomipramine, sedation, anhedonia » Ame Sans Vie, posted by temoigneur on March 10, 2005, at 21:41:49

Hello,

>My psychiatrist has noted that noradrenergic medications cause an increase in anxiety for me.

That's intesting. Although the clomipramine molecule itself is predominantly serotonergic, desmethylclomipramine - an active metabolite of clomipramine, is a norepinephrine reuptake inhibitor.

-Ed.

 

Re: what is this? » KaraS

Posted by cubbybear on March 11, 2005, at 9:12:54

In reply to Re: what is this? » cubbybear, posted by KaraS on March 11, 2005, at 4:06:00

> > > Lol, you seem to have been keeping up with plenty of other things.

H-m-m- You're very tactful. I guess you mean to ask if I've been living in a vacuum. Maybe so, but don't forget that I live in Asia where trendy E-mailspeak is not necessarily keeping pace with the Western world
Anyway, lol = laughing out loud? So, what letters would you use for the sarcastic/snide utterance, lots of luck?
> > >
> > Would someone tell me what this "lol" stands for, that is infecting everyone's E-mail like a virus?
> >
> > cubbybear
>
>
> LOL = laughing out loud
>
>
>
>
>

 

Re: what is this? » KaraS » cubbybear

Posted by KaraS on March 11, 2005, at 14:45:01

In reply to Re: what is this? » KaraS, posted by cubbybear on March 11, 2005, at 9:12:54

> > > > Lol, you seem to have been keeping up with plenty of other things.
>
> H-m-m- You're very tactful. I guess you mean to ask if I've been living in a vacuum. Maybe so, but don't forget that I live in Asia where trendy E-mailspeak is not necessarily keeping pace with the Western world
> Anyway, lol = laughing out loud? So, what letters would you use for the sarcastic/snide utterance, lots of luck?
> > > >
> > > Would someone tell me what this "lol" stands for, that is infecting everyone's E-mail like a virus?
> > >
> > > cubbybear
> >
> >
> > LOL = laughing out loud
> >

I think you meant this post for Ed instead of me.

 

lol

Posted by up'n'down on March 11, 2005, at 23:36:25

In reply to what is this? » ed_uk, posted by cubbybear on March 11, 2005, at 3:17:30

> > Lol, you seem to have been keeping up with plenty of other things.
> >
> Would someone tell me what this "lol" stands for, that is infecting everyone's E-mail like a virus?
>
> cubbybear

I was told it meant "lots of love." Am I a lettuce leaf-like green??? U'D

 

Re: Linux » Ame Sans Vie

Posted by gromit on March 12, 2005, at 9:47:02

In reply to Re: Parnate 20mg, Day 6 » cubbybear, posted by Ame Sans Vie on March 10, 2005, at 10:55:12

Congratulations that's great, who say's there is no money in Free Software.

 

What happened to selegiline? » Ame Sans Vie

Posted by cache-monkey on March 15, 2005, at 23:43:28

In reply to Parnate 20mg, Day 6, posted by Ame Sans Vie on March 8, 2005, at 14:48:55

Hi there,

Glad to hear that you are doing well. I seem to remember from last year at some point that you were on low-dose selegiline plus possibly DLPA, and that it was working pretty well for a while. Did the combo poop out or something? Or were there side effects?

I'm particularly interested since the selegiline helped you quit (? reduce?) smoking, since I'm shopping for a new AD that might help me with the same.

In any case, good to have you back on the board.

Best,
cache-monkey

> First, my apologies for being away from the board for a few days without an update -- I've just been having so much fun getting out with friends and truly enjoying myself for once! I mean, I thought Adderall was great for my depression, but it did cause me to eventually begin to isolate myself a bit. Parnate, on the other hand, is already a dream come true. I think I may even put off going up to 30mg for now (though I'll have to talk with my pdoc about it Friday)! The only side effect I've experienced is moderate insomnia, which responds very well to 300mg secobarbital or 1,200mg meprobamate (I'm switching back and forth as I've found it prevents a tolerance from developing to either drug).
>
> I've also found the dietary restrictions, thusfar anyway, to be more "forgiving" than they were with Nardil. I'll continue to remain vigilant on this matter, though, as I know full MAO inhibition hasn't yet been reached.
>
> All in all, I'd describe my current state of being as a *true* complete remission, and I have past experiences with 50+ drugs to back that assertion up. There's a mild-moderate noticeable stimulation, but it's purely mental for me and much less coarse than amphetamines.
>
> I have to run, but I'll actually try to keep up with the board this time, lol -- I'll check back later on tonight.
>
> ~Michael

 

Re: Ame, Re: Clomipramine, sedation, anhedonia » temoigneur

Posted by Ame Sans Vie on March 17, 2005, at 8:22:22

In reply to Ame, Re: Clomipramine, sedation, anhedonia » Ame Sans Vie, posted by temoigneur on March 10, 2005, at 21:41:49

> Hey Michael how are you doing. Are you in school right now, I remember your french, perhaps you're launched in a carreer.

Hi, Ben! LTNS!

Well, I haven't launched a career utilizing my French, but Parnate has allowed me the confidence to accept an amazing job offer programming an all -new computer system! :-)

> How is your family, mine is good, I'm going to the Anxiety Disorder Conference in Seattle next month, should be informative:)

My family's hanging in there, you know... I'd be very interested to hear how that conference goes!

> I haven't been on the anxiety boards that much recently, so i don't know if you are still in contact, but I have severe anxiety and moderate – heavy OCD.... I was asking you about tramadol while i was trying nardil.

Yes, I remember talking with you quite well! :-)

> I went on Tramadol, but I thing the NRI properties it shares with effexor were making me quite anxious. As explained below, I'm on Clomipramine now, but tricyclics, feel similar to zyprexa to me, it certainly has controlled my OCD well, but I sleep most of the day, and have little/no ambition to do much of anything, I’m numb, and have lost much of my creativity.

Ah, the cruel jokes serotonin reuptake inhibitors play upon us... :-(

> I was wondering, with your knowledge of anxiolytics and drugs, is there anything you might recommend addiing to or as an alternative to clomipramine.

I'll certainly try my best . . .

> I wrote this message in Feb. before I saw your post on Parnate, that’s about the only drug available in Canada I haven’t been on. Below I've explained some of the complications I've had with stimulants/SSRI's …

Well you know, I've heard of wonderful success stories involving Parnate used to treat OCD (as well as other comorbid conditions, i.e., depression, other anxiety disorders, eating disorders). I've heard anecdotal evidence to support Nardil's use in treating OCD, but nowhere near enough to convince me that it is truly effective, unlike the case with Parnate (and perhaps Marplan as well).

> After, ridiculous anxiety - being almost driven to suicide numerous times in the past year, I've come upon clomipramine for OCD/Anxiety.

Oh wow, I'm so sorry to hear you've had such a rough year... :-(

> It has all but abolished the horrible OCD/Anxiety along with clonazepam, 3mg t.i.d.

Well, that's a start!

> but I'm tired all the time, I just want to sleep all day; my mind is relatively dull, and I can see sleeping my way into my sixties, if I don't get something that would give me some inertia. I have little/no ambition, or drive to do very much and as I'm on disability, I can just sleep all day and ponder what life would be like without the disease. But I had a good mind, got my ARCT in piano, I'd like to be a Nurse-Practitioner, but this is impossible being so dull and drowsy.

Oh believe me, I can relate, as can many others on this board.

> Anyway, is there any conceivable combo Clomipramine + SSRI or bromocriptine that may allow me to retain clinical gains, and start living again. Basically looking for something to give me my energy and creativity without the torment of Anxiety and OCD.

An SSRI would almost certainly exacerbate your lethargy and lack of drive on its own, so I imagine combining one with a relatively selective serotonin reuptake inhibitor like clomipramine would just add to the problem.

Bromocriptine could help things out, though it may not give you your energy back. Dopamine agonists tend to work very well for lack of ambition and anhedonia, but it's the noradrenergic meds that seem to provide the most useful boost in energy.

> Has anyone observed that their anxiety is aggravated by SNRI's or Stimulants. I cannnot tolerate any stimulants, On Ritalin I displayed bipolar symptoms, Dexadrine made me extremely anxious, as did provigil.

I found just the opposite with stimulants -- they made me more sociable and easy-going, even without Klonopin. SNRIs have never helped me at all though, but neither did they ever cause any side effects (which I understand is rare).

> My psychiatrist has noted that noradrenergic medications cause an increase in anxiety for me. Does anything strike you that might help with energy/cognition, I found all SSRI's to be stimulating, to the point where I couldn't sleep, which is why I'm somewhat interested in some combination of SSRI + Clomipramine. The SSRI's alone helped for 4 months, then did little for my anxiety, but it's hard to compare because while on the SSRI's I was in university school, under a good deal of pressure – now on clomipramine, I have no significant commitments.

Hmmm... I really have very few suggestions, but here they go:

1. Augment with low-dose fluoxetine (perhaps least likely of the SSRIs to cause anhedonia/apathy, and it has an indirect dopamine-enhancing effect)
2. A very low dose of Provigil, Dexedrine, etc. (if you can find a dose that is somewhat helpful without many side effects), perhaps combined with either Parlodel, Symmetrel, Mirapex or Requip.
3. A CNS stimulant in a low-moderate dose along with either a beta-blocker (e.g. propranolol, nadolol, atenolol) or alpha-2 agonist (e.g. guanfacine, clonidine) to keep your noradrenergic system from overfiring.
4. A CNS stimulant in a low-moderate dose, perhaps a decrease in your Klonopin dose, and the addition of a more "anti-depressant" benzodiazepine, such as alprazolam or lorazepam.
5. A good sleeping pill that allows you to wake up feeling refreshed (e.g. Imovane, Ambien, Sonata, Lunesta, Restoril).
6. Xyrem, though I'm not sure that it's available in Canada... I imagine a couple doses at night could be great for the fatique you describe, though.
7. Parnate

> I came off clomipramine cold turkey three days ago, and I’m starting to get anxious, I feel this forboding brewing, I think I’ll go back on it tonight. Thank’s Michael,, also I understand if your busy, catching up on what your illness has taken from you, and can’t answer.

Sorry it took so long to reply, but I'm just so busy during the days now that I actually *feel* good! :-)

> Ben Je te souhaite toutes reussites avec parnate.

~Michael Je te remercie infiniment! :-)


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