Psycho-Babble Medication Thread 913470

Shown: posts 1 to 16 of 16. This is the beginning of the thread.

 

Help please. I need to make some changes.

Posted by zana on August 22, 2009, at 10:37:43

I am now taking 8 meds. I am feeling better than I was at my worst. I am out of bed and not suicidal. But I am not great. I have bouts of weeping every day. I am apathetic, afraid to go out of the house myself, can't get started on things, feel energized but unable to do much with the energy. I am not really depressed. But there really isn't any happiness in my life.
My husband is convinced that I need to get off the meds I am on. I have tired just about everything exceot Parnate and Nardil. Before I was on this regime I was headed for ECT.
So maybe this is as good as it gets. Maybe this is as much help as I can expect from medication and I just have to live with the negative effects. My husband keeps saying you don't know what anything is doing and you need to closer to your native state. What if my native state is bed-ridden, suicidal depression?
I just don't know what to do. Eight meds seems crazy and I am not as well as I'd like be. My experience has been that when I try to decrease a med, like seroquel, I feel worse. I got down to 100mgs of seroquel from 150 over a couple of weeks and I felt much more weepy. I went back up and I felt better. What does that tell me? I need 150mgs of seroquel or I didn't give it enough time?
And if I decide to try to reduce my meds, how do I know where to start?
Right now I am embarassed to say, I'm on:
45 mg Remeron
300 mg Wellbutrin
100 mg Pristiq
150 mg Seroquel
1 mg Respridal
3 mg Klonopin
600 mg Gabapentin
200 mg Provigil
Any and all suggestions will be very much appraciated. By the way I have MDD, no msnia, no psychosis, nothing else.
Thank you.
Zana

 

Re: Help please. I need to make some changes. zana

Posted by Phillipa on August 22, 2009, at 10:51:57

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

Zana that is a lot of meds. Have you had a second opinion? Hard to know what to say when you don't know the person in real life. All I can offer is support and say that two antipsychotics, klonopin (which was very depressing for me) and it just seems like a lot of downers. I'm so sorry you feel so bad. But I tend to agree with your husband he's med free right? Didn't know things were so bad for you thought the pristiq had helped. Love Phillipa

 

Re: Help please. I need to make some changes.

Posted by stargazer2 on August 22, 2009, at 11:22:22

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

zana,

who is ordering all the meds for you? what is their level of expertise? How long have you been seeing this doctor? have you ever gotten a second opinion? I don't know where to begin to make any suggestion... all i can say is get another opinion from an expert, who can get you weaned off of this combination and work with you to find out exactly what is helping you.

where do you live? US or other. Perhaps one of the users here can suggest a doc.

i feel for you...there has to be a better, less complicated combination of meds to use. I don't think even a real psychopharmacologist would combine that many meds, it doesn't seem like you could know what med is doing what for you.

What med did you start on, how long ago and what was the sequence of when each medication was added and why? did you keep any record of this?

I have MDD and nardil was what one doc gave me many years ago as only the second med tried, and it lifted my depression like magic. that was before all of the SSRI's were developed. I have a rule for myself, 3 meds is the top number of meds i will combine, it might have been 4, but i was not comfortable with that.

More meds always makes the situation more complicated to figure out, not to mention knowing what each med could be doing to your brain or organs, that are responsiblefor the elimination of the drugs from your body, i.e. liver or kidneys.

is your doctor that skilled that he or she is unconcerned about this combination of meds that has been prescribed, presumedly, by this one doctor?

Second opinion, sooner, rather than later.

 

Re: Help please. I need to make some changes.

Posted by sam K on August 22, 2009, at 11:40:40

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

I am doing my best on a drug called metformin. Its for diabetes, and I dont even have diabetes. Ive never been diagnosed with any blood sugar problems, although I have noticed them for a while now. Asked for metformin and doing better than I ever ever have. I feel way more normal. check thi sout. sorry if i sound like a robot advertiser sometimes i feel like i do.

http://en.wikipedia.org/wiki/Insulin_resistance

and plus, metformin can be used for wieght control for all those anti psychotics/anticonvulsants your on. So it'd be worth a try.

 

Re: Help please. I need to make some changes.

Posted by linkadge on August 22, 2009, at 11:55:28

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

45 mg Remeron
300 mg Wellbutrin
100 mg Pristiq
150 mg Seroquel
1 mg Respridal
3 mg Klonopin
600 mg Gabapentin
200 mg Provigil

Holy shitaki mushrooms. You definately may want to cut something. How about the remeron first?

 

Re: Help please. I need to make some changes. zana

Posted by maxime on August 22, 2009, at 12:23:23

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

Have you ever been on less meds and felt better than you do now? That's a lot of meds to be on to only feel marginally better.

I think you should try Nardil and Parnate and get off all those meds. Would your doctor be willing to prescribe an MAOI?

 

Re: Help please. I need to make some changes.

Posted by ricker on August 22, 2009, at 12:24:02

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

Hi Zana,

I would stop the remeron, your sleep should be okay with the seroquel on-board. I'd also drop the risperdal/gabapentin and add lamictal. Not sure if you have tried lamictal before, but, if you have and failed, were you taking seroquel then? If not, the two work quite well together.

Best of luck, Rick

 

Re: Help please. I need to make some changes.

Posted by zana on August 22, 2009, at 14:09:44

In reply to Re: Help please. I need to make some changes., posted by ricker on August 22, 2009, at 12:24:02

Thank you everybody for your thoughts.
I have had a bunch of second opinions here in the Boston area and the pdoc I am seeing now is quite experienced. He didn't want me to drop the remeron because it's supppsed to be California Rocket Fuel in combination with pristiq.
I originally started remeron for sleep. It never seemed to have much AD effect. Seroquel had a very modest AD effect at 300mgs. Provigil helps my mood and energy but has a nasty down side. I think we added the gabapentin to take the edge off the provigil.
The pristiq was added next. At first it was like magic. Then that pooped and we went up from 50 to 100 on it. Then the respirdal. Then we added Wellbutrin trying for improved mood and energy again, still. I have been on the klonopin forever.
I was thinking of trying to decrease the seroquel or the respirdal again. And I think I'll decrease the Wellbutrin as 300mgs makes me feel pretty wound up.
The pdoc, every pdoc I've ever seen, always says to change just one thing at a time. But with so many uppers and downers it seems like it hard to drop an upper without balancing it by dropping a downer.
Sigh...

 

Re: Help please. I need to make some changes. zana

Posted by SLS on August 22, 2009, at 14:10:25

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

You have a lot of work ahead of you to strip down this mixture of drugs. I don't recommend that you stop any of them abruptly. Some will take longer than others to taper.

Which drugs do you feel are important to stay on, and why?


- Scott

 

Re: Help please. I need to make some changes. zana

Posted by SLS on August 22, 2009, at 14:29:10

In reply to Re: Help please. I need to make some changes., posted by zana on August 22, 2009, at 14:09:44

> He didn't want me to drop the remeron because it's supppsed to be California Rocket Fuel in combination with pristiq.

Well, it would seem silly to discontinue something that is working. Is it also silly to continue something that is not working? Actually, I would have increased the Remeron up to 75mg just to be able to say that you gave it a fair chance of working. Otherwise, as has already been suggested, Remeron might be the first drug to discontinue using a taper.

I am trying not to second guess your doctor here. He is either brilliant or he is cavalier with his use of drugs. You might want to check out the TRD program at Harvard / Mass. General. I sent you some Babble-Mail regarding this.


- Scott

 

Re: Help please. I need to make some changes. ricker

Posted by SLS on August 22, 2009, at 14:34:04

In reply to Re: Help please. I need to make some changes., posted by ricker on August 22, 2009, at 12:24:02

> Hi Zana,
>
> I would stop the remeron, your sleep should be okay with the seroquel on-board. I'd also drop the risperdal/gabapentin and add lamictal. Not sure if you have tried lamictal before, but, if you have and failed, were you taking seroquel then? If not, the two work quite well together.

That's pretty good advice.

:-)


- Scott

 

Re: Help please. I need to make some changes.

Posted by bleauberry on August 22, 2009, at 14:41:41

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

As SLS said, there is a lot of work to do. Plan on 6 months, buckle up the seat belts, and hold on.

I dunno, I guess you could stay where you are or add yet something else. I don't like either of those options. If these meds are doing it, what does that tell you? They are missing the target maybe?

I'm glad you are better than you were. My hunch is that it is only one or two of those meds responsible for that. The others are either doing nothing or working against you. For sure they are putting a tremendous undue strain on the liver and immune system, further weakening you and strenghening whatever enemy is working against you.

As you reduce the dose of any of them, a worsening of depression can probably be expected. It is probably not a return of the original depression, but rather a withdrawal induced depression as your brain needs time to adapt to less of whatever the drug was doing. For example, if I take a serotonin med, it doesn't help me feel better, and then I wean off, well, guess what, I will get depression coming off it. My synapses cannot adapt instantly to the decreased amount of serotonin overnight, even though the previously increased amount of serotonin did not help. Make sense?

I think your best longterm prognosis is here:
1. Wean off as much as possible to allow the introduction of Parnate first choice, Nardil second choice.
2. Find out why the depression is there. It is easier and cheaper than people think. It is probably something that the neurotransmitter modulaters (psych drugs) don't touch.
3. Try oddball things. The previous post on the diabetes med is a shining example. Just because someone doesn't test positive for diabetes doesn't mean their insulin receptors aren't clogged up. And how do you know the thyroid receptors aren't clogged up without trying T3 to competitively remove what is clogging them? Of forskolin to competively remove whatever is clogging the adrenal/cortisol receptors. How do you know you don't have a common yeast or bacterial infection? How do you know you haven't accumulated heavy metals in your brain? These things are all easy to test for and dirt cheap.

 

Re: Help please. I need to make some changes.

Posted by doxogenic boy on August 22, 2009, at 17:59:29

In reply to Re: Help please. I need to make some changes., posted by zana on August 22, 2009, at 14:09:44

> Seroquel had a very modest AD effect at 300mgs.
---

Maybe it can work at higher doses?

My experience with Seroquel (quetiapine) is good. Of course, nothing is good for everyone, but sometimes we haven't had the persistence to try for instance high-dose therapy. Endurance is needed to wait for side effects go down, and then, if there was no effect, try a higher dose etc.

But it is difficult to say when it is enough, especially if the pasient is thinking of suicide.

In a hopeless chronic depression where I thought I had tried everything and I thought there was _nothing_ left to try, December 2006 Seroquel was added to the combination of escitalopram (Lexapro/Cipralex), Lyrica (pregabalin) and trimipramin, gradually up to Seroquel 600 mg, the latter I still use in the same dose.

Seroquel took up to months before the side effects faded out, but I am glad that I had patience to maintain it. It didn't lead to remission, but it had a good effect for sleep, against anxiety and it was mood-elevating.
The antidepressant effect of Seroquel took at least a month to show.

"Efficacy, safety and tolerability of quetiapine augmentation in treatment resistant depression: an open-label, pilot study."
-->
http://www.ncbi.nlm.nih.gov/pubmed/19171384
++++++++++


http://www.ncbi.nlm.nih.gov/pubmed/17288688

"[...] In the Montgomery-Asberg Depression Rating Scale (MADRS) analysis, the difference between the quetiapine and lithium group was significant from day 28 onwards (p < 0.05), with subjects improving more in the quetiapine group than the lithium group[...]."
+++++++++++++++

My recommendation:

100 mg Pristiq
700 mg Seroquel - slowly increase, during months
300 mg Wellbutrin
600 mg Lyrica (300 mg twice a day)
and the others...

45 mg Remeron
1 mg Risperdal
3 mg Klonopin
600 mg Gabapentin
200 mg Provigil:

...so slow as possible, taper down and quit.

doxogenic

 

Re: Help please. I need to make some changes. SLS

Posted by ricker on August 22, 2009, at 18:41:40

In reply to Re: Help please. I need to make some changes. ricker, posted by SLS on August 22, 2009, at 14:34:04


> That's pretty good advice.
>
> :-)
>
>
> - Scott

Thanks Scott, I guess it pays to read your post's...I've learned lots from your insight here on the Board. I should have added in my original post "under doctors supervision" ;)

Have a good day,

Rick

 

Re: Help please. I need to make some changes. zana

Posted by Fred23 on August 22, 2009, at 20:44:27

In reply to Help please. I need to make some changes., posted by zana on August 22, 2009, at 10:37:43

> I am now taking 8 meds.

> And if I decide to try to reduce my meds, how do I know where to start?

Have you kept a log of when what medication was started, at what dosage, and when any effect was experienced, whether good or bad?

Some meds may take weeks or months to reach the intended effect. If it doesn't have a benefit, then it may not be worth the money paid for it, and whatever complications it can cause by side effects or interactions with other drugs. (In other words, has the med proven its worth the money?)

Doctors or studies can't really know how the meds affect you as an individual.

 

Re: Help please. I need to make some changes.

Posted by sam K on August 22, 2009, at 22:21:22

In reply to Re: Help please. I need to make some changes., posted by bleauberry on August 22, 2009, at 14:41:41

yes, Im glad you saw that. I mean I didnt just try metformin because this or that. Ive tried almost every drug there is. Ive tried every class of drug (no maois/remeron/typical APS), every supplement, synthroid, doxycycline, tetracycline, lithium orotate, blah blah blah.
No exageration, i am very treatment resistant. But as this time went on trying all these meds and supplements, I noticed i was having reactions to them like hypoglycemia and hyperglycemia. It never hit me until more examples kept happening.
I drank coffee for a few weeks, no meds, and gained 20 pounds. I didnt understand at all. I honestly didnt. Then I figured out that it messed with my blood sugars, i was eating every hour, big meals, I mean I felt starved all the time.
Then finally as the med train has ended, I put 2 in 2 together and it finally made sense. I got metformin and have been doing good for about a week or two now. (and im garenteed it wont end, Im hitting what is causing most of my symtoms)
Im pretty sure I have insulin resistance, although no tests, partly because they cost alot and I show so many symptoms anyway.
I was obese as a child and throughout most of my teen years. And I never meant to eat alot, but i was always hungry. I was self medicating with food really. And that leads to obesity.
So anyway, Im glad I finally have found a good treamtnet for myself. I feel way more normal in every aspect. Although Ive always been a Bipolar/grandiose person. So I might have to get that treated if I get too crazy.
But the depression is gone. Gone gone gone. no more tears for me, no more laying on the floor of my house thinking of dying and suicide. No none for me, thank god.


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