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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 27 to 51 of 57. Go back in thread:
Posted by Deneb on October 17, 2009, at 19:52:55
In reply to Re: What is the best med for lack of motivation? » Deneb, posted by emme on October 17, 2009, at 19:38:10
I've often wondered if my pdoc really knew what she was doing. We seem to focus so much on therapy that we never even discuss meds. Maybe I should ask for her rational for the meds I'm on. I've asked about the two SSRI thing online and so far most places have said it isn't useful to be on two SSRIs.
I don't know how to get a second opinion though. Should I just ask my pdoc to recommend someone? I have no idea how that works. I'm not even sure there are psychopharmacologists in Ottawa. That seems awfully specialized. We're not a super large city. We don't even have DBT here.
What medication helped you emme?
> Deneb,
>
> You've gotten several good suggestions in this thread. I am also wondering if you would benefit from a consulting opinion from a psychopharmacologist. I know you have a good relationship with your pdoc, but a fresh set of eyes might give you and your doctor some new ideas to work with.
>
> I believe there's a biological component to the whole apathy thing. I've experienced it strongly myself and have been amazed at how much the right medication can help. Like night and day. It simply should not be such a struggle for you to engage in ordinary living - I think you can have better.
>
> emme
>
Posted by Deneb on October 17, 2009, at 19:56:31
In reply to Re: What is the best med for lack of motivation?, posted by psych chat on October 17, 2009, at 19:36:19
I was diagnosed with an adjustment disorder while in the psych ward about 5 years ago. To my knowledge adjustment disorders are self limiting. I'm not sure if it is possible to have an adjustment disorder for 5 years, but I could be wrong.
I think it is possible there are many psychological factors at work here too. I know for sure I am scared about the future. My pdoc is my T, maybe I should explore this with her more.
Deneb
> d amphetamine..it's a stimulant/ADD type of medication.
>
> Maybe PDocs need to be more educated on the motivational issues and/or atypical depression, I'm not sure.
>
> Do you think maybe it's self sabatoge, being your almost at the graduation point? Or an adjustment disorder? Something to talk to a T about...
Posted by Phillipa on October 17, 2009, at 20:00:32
In reply to Re: What is the best med for lack of motivation? » psych chat, posted by Deneb on October 17, 2009, at 19:56:31
Hi Deneb known you for a long time. Your're a brilliant future scientist for sure. Some of the times you've posted I could never ever understand. You say your suicidality has gone done also and I watched you kind of blossom. Right now I think your T and you need a great talk. What do you think? Love Phillipa
Posted by Deneb on October 17, 2009, at 20:04:52
In reply to Re: What is the best med for lack of motivation? » Deneb, posted by Phillipa on October 17, 2009, at 20:00:32
Thanks Phillipa
I'm not sure about the brilliant part though. LOL I agree I need to talk to my pdoc/T. I'm going to write some of this stuff down as I always forget what to say.
> Hi Deneb known you for a long time. Your're a brilliant future scientist for sure. Some of the times you've posted I could never ever understand. You say your suicidality has gone done also and I watched you kind of blossom. Right now I think your T and you need a great talk. What do you think? Love Phillipa
Posted by Maxime on October 17, 2009, at 20:28:42
In reply to Re: What is the best med for lack of motivation? » emme, posted by Deneb on October 17, 2009, at 19:52:55
I'm positive that there is a psychopharmacologist at one of Ottawa's hospital. You should ask your pdoc for a referral.
Posted by Deneb on October 17, 2009, at 21:17:09
In reply to Re: What is the best med for lack of motivation? » Deneb, posted by Maxime on October 17, 2009, at 20:28:42
Thanks for that info Maxime.
I'm not sure a psychopharmacologist is needed at this point though. I haven't really tried a lot of meds. I feel like other people need a psychopharm more than me.
But then again, it will probably take a really long time to get an appointment so maybe I should start the process now.
Posted by delna on October 18, 2009, at 1:24:19
In reply to Re: What is the best med for lack of motivation?, posted by psych chat on October 17, 2009, at 19:24:50
> But my Tdoc wants me to try lamictal first. I'm really hesitant. Plus, has that helped anyone for motivation and/or atypical depression? He wants me to try it becaues it's something I've never taken in the past.
Frankly Lamictal had no effect on me whatsoever for atypical depression and certainly not for motivation.
I took it for dysphoric highs (agitation, severe anxiety, verbal aggression, ranting and raving etc.) It is a fabulous drug for that (for me at least)
If your pdoc says it may help, maybe it will. It helps with atypical depression (which is also nearly the same as bipolar depression) and there is alot of info about that (BP depression.
What is your hesitation? I have found it a really easy drug to tolerate (have been taking it for >5 years with no real side effects worth mentioning. Infact I am hard pressed to think of one- except perhaps blunting of emotions (but I was way to intense so this is a great thing for me) and a bit of dumbness (which may be depression speaking because when Geodon picked up my depression , I was sharp again).
Anyway, hope you decide on a good course of action
Good Luck
TC
D
Posted by delna on October 18, 2009, at 2:46:58
In reply to Re: What is the best med for lack of motivation? » Maxime, posted by Deneb on October 17, 2009, at 21:17:09
**Long post**
Deneb,
You sound frighteningly like me when I was at college! Firstly I too am a scientist and secondly I too had to prolong both my degrees.
>Starting my last year of high school I was put on Zoloft, whereby I started having very intense mood swingsOk, this is exactly what happened to me. I had depression and anxiety and was put on Paxil by a GP and went 'high' for a few weeks. Then I slumped into apathy. The doc kept increasing my dose and I started swinging mood wise. (more about that later)
>It is not just lack of motivation for studying that I have. I just seem to have a lack of motivation for most things in life. My favourite thing to do is sleep. I can sleep more than 14 hours a day.
>Just the other day I slept from about 3 AM to 3:30 PM, got up for a bit, grew tired again and went back to bed until 7:30 PM.
Sometimes I wake up early for class only to go home to sleep some more.Again this is just like I was. I'd come home from a lecture and pass out for many hours. I too had no motivation for anything.
>My room and my bathroom is completely disorganized and messy.
Me too
> I have mood regulation problems. I tend to get really excited and happy one minute and depressed and suicidal the next. It is probably my borderline personality.
Ok this is the scary part. Exactly like me. I too was diagnosed with borderline personality disorder. I'm not trying to diagnose you but I can tell you that eventually it turned out that I had bipolar disorder. Your depressions fit the atypical variety (seen in bipolar) and the fact that you swing makes me suspicious.
It took some years and a clever pdoc to look at my past and find that I did infact have a history of spontaneous hypomanias and mixed episodes plus all the other indicators of bipolar. Many bipolars are originally misdiagnosed as either depressed or as having BPD. Just to clarify I am not saying that you are actually bipolar- its just that I was, and my clinical picture looked more like yours but eventually the bipolar came out in a big way.
IMHO I think you need an expert diagnosis. It took years for my diagnosis to change from borderline to depression and anxiety to bipolar II rapid cycling and finally to the dreaded bipolar I rapid cycling.
I had a therapist too and she told me I was not bipolar (there was no such thing) and I was happy to believe her because it meant no harsh drugs. But actually she ruined things for me because it just delayed my treatment and now I am a pretty resistant case.
But from what I see you are already on some 'hardcore' drugs like antipsychotics which personally I only agreed to take when I was confirmed to be bipolar I because I was so terrified of them. A full diagnosis will really help because then you can be treated properly...
Sorry if I am confusing your already complex situation but I had to share this because our stories are too similar. It's only at 33 that I got a really thorough diagnosis and it turned out to be bipolar I, even though I spend nearly all my time in the depressive phase (which is common in BP)
Again I am not trying to diagnose you... I just
think an expert pdoc needs to review your history.
>I often wonder if it is necessary to take two SSRI's at the same time. It seems like SSRI overkill to me.I have never in my life heard of such a treatment rationale. Infact 2 at once is not safe. SSRI's definitely promote apathy- they are infamous for it! You usually augment the first SSRI with Wellbutrin or Provigil or another agent. I know alot of people are taking nortryptiline with success but personally (with no disrespect to others) I would not take it. Firstly if you are indeed bipolar it might make you swing madly as TCAs are infamous for that. But ofcourse if you are not, it can work wonders!
Now I am on a mood stabilizer (lamictal), provigil and have just started a MAOI (since the SSRI just didn't work and I crashed into depression despite it.)
I was torn between Parnate (MAOI which is supposed to be the last word in atypical depression) and Effexor (SNRI, which helped in the past with mood, motivation, anxiety, OCD etc)but chose parnate in the end. The reason being that effexor has a very difficult and long withdrawal period and if it didn't work well I could not switch to Parnate for ages . But SNRI's DO tend to work (at high enough doses) much better than SSRI's- especially for those with motivation problems.
parnate is not scaring me at all in terms of food interactions and drug interactions (you just have to be extra careful) but then I have only been on it for 15 days....For me the only side effect that sucks is sedation but I believe that gets better in time and at the right dose. Haven't seen much benefit yet..
Incidentally, what REALLY helped my mood, motivation whilst keeping me stable was low dose Geodon. It was miraculous! Like waking up from a coma. But sadly, I had to give it up (after 2 years) because i had a bizarre reaction to it.
My pdoc (a psychopharmacologist in NYC) said Abilify was the next best thing (especially if you are sensitive to sedation)But I didn't try it because of fears of TD (which I think I had on Geodon- not sure)Well I hope I haven't rambled on too much and caused confusion......Please forgive me if I have. Your story just hit home for me.
I hope you find some decent help and find a good drug (or combo) that works for you.
Good luck
Take care
Love
DPS: Sorry if I went off on a tangent. If I did please ignore this post.
Posted by emme on October 18, 2009, at 7:25:51
In reply to Re: What is the best med for lack of motivation? » emme, posted by Deneb on October 17, 2009, at 19:52:55
> I've often wondered if my pdoc really knew what she was doing. We seem to focus so much on therapy that we never even discuss meds. Maybe I should ask for her rational for the meds I'm on. I've asked about the two SSRI thing online and so far most places have said it isn't useful to be on two SSRIs.
Yeah, I've wondered about the two SSRIs. If she focuses mostly on therapy, she may not be as skilled with use of medication - it's hard to do it all. As someone else suggested, you might start by asking at the hospital if they know of anyone. Your pdoc might know someone. You can do some creative googling.
> That seems awfully specialized.
It's not as much as you think. It simply means a psychiatrist who specializes in psych medications.
> What medication helped you emme?
Well, Abilify for one. Effexor helped motivation, but I did not tolerate the drug well (YMMV of course). Provigil helped motivation quite a lot, but it annoyed me by making me feel overstimulated sometimes. But many people swear by Provigil.
emme
Posted by Deneb on October 18, 2009, at 13:48:26
In reply to Re: What is the best med for lack of motivation? l » Deneb, posted by delna on October 18, 2009, at 2:46:58
> >Starting my last year of high school I was put on Zoloft, whereby I started having very intense mood swings
>
> Ok, this is exactly what happened to me. I had depression and anxiety and was put on Paxil by a GP and went 'high' for a few weeks. Then I slumped into apathy. The doc kept increasing my dose and I started swinging mood wise. (more about that later)I remember the mood swings were quite severe. I swung very high and very low. When I was high I thought the world was my oyster and that I could do anything. I had thoughts of changing the world. When I was low I was suicidal. There was also some weirdness going on because at some points I was very suicidal, but I was high at the same time.
I also remember awful horrible paranoia my last year of high school. I don't know what was up with that, but I thought all my teachers were talking about me behind my back and I remember I would hide from them when I saw one walking down the hallway. I don't know if it was just a bad case of social anxiety or what.
I tend to have these periods where I zone out and think I am not in reality. Sometimes I will hide or go mute. It is probably anxiety though.
> > I have mood regulation problems. I tend to get really excited and happy one minute and depressed and suicidal the next. It is probably my borderline personality.
>
> Ok this is the scary part. Exactly like me. I too was diagnosed with borderline personality disorder. I'm not trying to diagnose you but I can tell you that eventually it turned out that I had bipolar disorder. Your depressions fit the atypical variety (seen in bipolar) and the fact that you swing makes me suspicious.I attribute my mood swings to the borderline personality. My swings seem dependent on situations most of the time. My mood swings have gotten a lot better now. I think the Risperdal helped me the most. But also my pdoc says I've made a lot of progress in therapy. I don't know whether it was mostly the therapy or the meds. I think one reason why I think my illness is not bipolar disorder is because I don't stay up for days without needing sleep. I've had periods where I don't feel like sleeping for a day and a half, but I always get tired eventually and need to sleep.
> It took some years and a clever pdoc to look at my past and find that I did infact have a history of spontaneous hypomanias and mixed episodes plus all the other indicators of bipolar. Many bipolars are originally misdiagnosed as either depressed or as having BPD. Just to clarify I am not saying that you are actually bipolar- its just that I was, and my clinical picture looked more like yours but eventually the bipolar came out in a big way.
I hope I am not bipolar, as it means I will probably need to be on meds for life. I know my pdoc doesn't think I am bipolar and she has seen me for years. I will keep that possibility in the back of my mind though. Maybe I need a second opinion.
> IMHO I think you need an expert diagnosis. It took years for my diagnosis to change from borderline to depression and anxiety to bipolar II rapid cycling and finally to the dreaded bipolar I rapid cycling.
I think it would be a good idea for me to have a second opinion. I will start about seeing someone else.
>
> I had a therapist too and she told me I was not bipolar (there was no such thing) and I was happy to believe her because it meant no harsh drugs. But actually she ruined things for me because it just delayed my treatment and now I am a pretty resistant case.Sorry to hear that. Does delay in treatment cause treatment resistance?
>
> But from what I see you are already on some 'hardcore' drugs like antipsychotics which personally I only agreed to take when I was confirmed to be bipolar I because I was so terrified of them. A full diagnosis will really help because then you can be treated properly...My pdoc actually did not start the Risperdal. When she was on maternity leave, I saw another pdoc and he started me on Risperdal after I inquired about an antipsychotic to add to the mix.
>
> Sorry if I am confusing your already complex situation but I had to share this because our stories are too similar. It's only at 33 that I got a really thorough diagnosis and it turned out to be bipolar I, even though I spend nearly all my time in the depressive phase (which is common in BP)Sorry to hear of your diagnosis, but it is good you got the right diagnosis finally. Do you have a better time functioning now with the new meds?
>
> Again I am not trying to diagnose you... I just
> think an expert pdoc needs to review your history.
>
>
> >I often wonder if it is necessary to take two SSRI's at the same time. It seems like SSRI overkill to me.
>
> I have never in my life heard of such a treatment rationale. Infact 2 at once is not safe. SSRI's definitely promote apathy- they are infamous for it! You usually augment the first SSRI with Wellbutrin or Provigil or another agent. I know alot of people are taking nortryptiline with success but personally (with no disrespect to others) I would not take it. Firstly if you are indeed bipolar it might make you swing madly as TCAs are infamous for that. But ofcourse if you are not, it can work wonders!Looks like I will need to do some experimenting on myself. I just hope that it doesn't disrupt my life too much.
>
> Now I am on a mood stabilizer (lamictal), provigil and have just started a MAOI (since the SSRI just didn't work and I crashed into depression despite it.)
>
> I was torn between Parnate (MAOI which is supposed to be the last word in atypical depression) and Effexor (SNRI, which helped in the past with mood, motivation, anxiety, OCD etc)but chose parnate in the end. The reason being that effexor has a very difficult and long withdrawal period and if it didn't work well I could not switch to Parnate for ages . But SNRI's DO tend to work (at high enough doses) much better than SSRI's- especially for those with motivation problems.I read about the awful Effexor withdrawals and I would be hesitant to try it out for that reason too.
>
> parnate is not scaring me at all in terms of food interactions and drug interactions (you just have to be extra careful) but then I have only been on it for 15 days....For me the only side effect that sucks is sedation but I believe that gets better in time and at the right dose. Haven't seen much benefit yet..I eat a lot of weird foods so I am not sure at all that I should try an MAOI. It would mean my Mom has to know I am on a med with serious side effects and she would definitely not like that. She already tells me to cold turkey the meds I am on. She told me to bear through the withdrawal symptoms because meds are bad for you. She likened my meds to narcotics.
>
> Incidentally, what REALLY helped my mood, motivation whilst keeping me stable was low dose Geodon. It was miraculous! Like waking up from a coma. But sadly, I had to give it up (after 2 years) because i had a bizarre reaction to it.
> My pdoc (a psychopharmacologist in NYC) said Abilify was the next best thing (especially if you are sensitive to sedation)But I didn't try it because of fears of TD (which I think I had on Geodon- not sure)Does Abilify have a high incidence of TD? I am looking to maybe try Abilify too. My pdoc doesn't seem to like to change my meds though (I've been on the same meds for years) so I am not sure how she would react to the thought of a new combo. I find what really helped me a lot is the Risperdal. I have a lot fewer severe mood swings now. When I reduce my dose of Risperdal or forget to take it I often start acting up.
>
> Well I hope I haven't rambled on too much and caused confusion......Please forgive me if I have. Your story just hit home for me.Oh no, not at all. Thanks for sharing your story. It was very helpful to me. I need to look at all the possibilities and if I have been misdiagnosed, then it is crucial for me to find my right diagnosis.
Posted by Deneb on October 18, 2009, at 13:52:42
In reply to Re: What is the best med for lack of motivation? » Deneb, posted by emme on October 18, 2009, at 7:25:51
> Yeah, I've wondered about the two SSRIs. If she focuses mostly on therapy, she may not be as skilled with use of medication - it's hard to do it all. As someone else suggested, you might start by asking at the hospital if they know of anyone. Your pdoc might know someone. You can do some creative googling.
All pdocs here in Ontario need to be referred by a doctor here. Even if I did my own Googling, I don't think I would be able to see that doctor. I could be wrong though. I have worried about my pdoc not being skilled with the use of medications for a long time now.
> > What medication helped you emme?
>
> Well, Abilify for one. Effexor helped motivation, but I did not tolerate the drug well (YMMV of course). Provigil helped motivation quite a lot, but it annoyed me by making me feel overstimulated sometimes. But many people swear by Provigil.
>
> emmeProvigil is another med that sounds like it might help me because I have a lot of trouble not sleeping the day away. I don't know if we have it in Canada though.
I am interested in Abilify too.
Posted by Maxime on October 18, 2009, at 14:29:51
In reply to Re: What is the best med for lack of motivation? » emme, posted by Deneb on October 18, 2009, at 13:52:42
> Provigil is another med that sounds like it might help me because I have a lot of trouble not sleeping the day away. I don't know if we have it in Canada though.
>
> I am interested in Abilify too.
>
>We have Provigil in Canada. It's called Alertec. Abilify has only just become available in Canada and you might have some trouble locating a pharmacy that has it yet. But if the Risperdal works so well for you, why would you want to change to Abilify?
Posted by bleauberry on October 18, 2009, at 14:40:22
In reply to What is the best med for lack of motivation?, posted by Deneb on October 17, 2009, at 14:13:54
Too many posts here for me to read. So maybe I am repeating something already said.
Motivation is usually in the dopamine/norepinephrine circuits. Things that worsen motivation are SSRIs such as Celexa Prozac.
Things that can help:
1. Add the supplement Tyrosine to your cocktail.
2. Add Provigil (must try both generic and brand before making a judgement on this drug)
3. Add Ritalin.
4. Add Adderall.
5. Lower the SSRI doses.
6. Lower an antipsychotic dose.
7. Keep one SSRI replace the other with Nortriptyline.
8. Keep one SSRI replace the other with Desipramine.
9. Emotionall and physically do battle with the motivation monster...in other words, feel like it or not, get up and do it. Win a battle. Then win another one. It helps retrain the mind and brain chemistry.I would start with Tyrosine because it is easy and cheap and effective often enough as to not ignore it. It will beef up the NE/DA circuits that the SSRIs are keeping silenced.
I do not like the trap of adding med on top of med, because at some point it seems too common to see someone in real bad shape who has a laundry list of 8 meds or so. It is a slippery slope, one med at a time, and you don't see it coming.
Whenever I see people in total remission, it is usually with 1 to 3 substances. More is not usually better. It just means the ones that were added to were not doing their job and probably should have been eliminated rather than added to.
Posted by Deneb on October 18, 2009, at 15:12:06
In reply to Re: What is the best med for lack of motivation? » Deneb, posted by Maxime on October 18, 2009, at 14:29:51
Thanks for that info Maxime. I just read that Abilify is good for motivation and I don't want to be taking two antipsychotics.
There is just a ton of info in this thread and I don't know much about meds at all. This will take some time to sort though and research. I am honestly feeling a bit overwhelmed with so much info. I think maybe a second opinion might be a good start.
> We have Provigil in Canada. It's called Alertec. Abilify has only just become available in Canada and you might have some trouble locating a pharmacy that has it yet. But if the Risperdal works so well for you, why would you want to change to Abilify?
>
Posted by Deneb on October 18, 2009, at 15:17:48
In reply to Re: What is the best med for lack of motivation?, posted by bleauberry on October 18, 2009, at 14:40:22
Thanks for that very useful list Bleauberry. It is a good starting point for me and you really organized the info well.
I think my pdoc likes the last option the most. I've been in therapy with her for 7 years though and I have not improved with my motivation much. In fact, I think it is getting worse. My issues with suicide however, are much much better. My mood swings are better too. I don't know how much of it is due to the therapy and how much is due to the Risperdal. I know know I slide down into crisis pretty quickly when I drop the dosage of Risperdal.
My pdoc seems to think it is the progress in therapy that has helped the most. She does acknowledge that the Risperdal really helps me though. I think she believes it is controlling my anxiety.
Is Tyrosine a supplement? I've heard of it, but I don't know what it is really.
I don't want to fall into the trap of adding one med over the next again and again. I agree it is a slippery slope.
Posted by Deneb on October 18, 2009, at 15:35:03
In reply to Re: What is the best med for lack of motivation? » bleauberry, posted by Deneb on October 18, 2009, at 15:17:48
I do wonder how much of my problems are just due to psychological issues. For example, I seem to have a lot of motivation in answering posts right now for some reason. Usually I tend to start threads and not reply to them. I guess because I like the attention, but recently I have been replying to a lot of threads. Now if I really did have an all encompassing motivation problem, wouldn't I have trouble posting replies to threads as well?
Sigh. I am just really confused. It is probably a complex mix of biology and psychology.
Then again this sudden increase in replying to post is a recent thing. I usually have to pretty much force myself to answer posts.
Posted by ColoradoSnowflake on October 18, 2009, at 16:21:45
In reply to Re: What is the best med for lack of motivation?, posted by bleauberry on October 18, 2009, at 14:40:22
Hi BB:
Can a person on Parnate take Tyrosine?
What is the best form/brand to get?
Thanks a lot,
Gayle
Posted by bulldog2 on October 18, 2009, at 16:42:53
In reply to Re: What is the best med for lack of motivation? » bleauberry, posted by ColoradoSnowflake on October 18, 2009, at 16:21:45
> Hi BB:
>
> Can a person on Parnate take Tyrosine?
>
> What is the best form/brand to get?
>
> Thanks a lot,
>
> GayleI would be very cautious with tyrosine as you could have a hypertensive crisis.
Posted by Deneb on October 18, 2009, at 17:34:50
In reply to Re: What is the best med for lack of motivation?, posted by bulldog2 on October 18, 2009, at 16:42:53
Thanks so much for contributing to this thread everyone. There is a lot of info to sort through. I'm taking notes and going to ask pdoc about them.
I'm not sure pdoc would be receptive to this though, as she is very very therapy oriented. I also don't know if I would hurt her feelings to get a second opinion.
Posted by Maxime on October 18, 2009, at 18:35:39
In reply to Re: What is the best med for lack of motivation?, posted by Deneb on October 18, 2009, at 17:34:50
Remember that your pdoc works for YOU. If she doesn't want you to get a second opionion, then that is her problem. You always have the right to a second, third and fourth opinion. Although having said that, it looks like she has done some very good therapy with you and that's hard to find.
Posted by Deneb on October 18, 2009, at 18:45:38
In reply to Re: What is the best med for lack of motivation? » Deneb, posted by Maxime on October 18, 2009, at 18:35:39
Yeah, you're right Maxime. I do have a right to other opinions. She is really professional though, maybe she would be OK with it. I've never seen her lose her cool and she is very empathetic. I've made a lot of progress with her in terms of therapy. I just don't think she is the best pdoc for meds.
> Remember that your pdoc works for YOU. If she doesn't want you to get a second opionion, then that is her problem. You always have the right to a second, third and fourth opinion. Although having said that, it looks like she has done some very good therapy with you and that's hard to find.
Posted by Phillipa on October 18, 2009, at 19:49:36
In reply to Re: What is the best med for lack of motivation? » Maxime, posted by Deneb on October 18, 2009, at 18:45:38
Deneb you can tell in your threads when your're not taking the resperidol so it must be working for you. I think your're doing a great job of greeting people also on babble. Love Phillipa
Posted by psych chat on October 18, 2009, at 21:29:35
In reply to Re: What is the best med for lack of motivation? » psych chat, posted by delna on October 18, 2009, at 1:24:19
> If your pdoc says it may help, maybe it will. It helps with atypical depression (which is also nearly the same as bipolar depression) and there is alot of info about that (BP depression.
>
> What is your hesitation? I> Anyway, hope you decide on a good course of action
> Good Luck
> TCTC, my hesitation is becoming worse off with a trial of Lamictal than I am now. I'm barely getting through school with a demanding course load-but it could be worse. Last major med trials nearly incapacitated me, and the effects lasted months..now a year later. I have to weigh the risk/benefit. Lamictal causes cognitive problems for some; others it doesn't. It's still a risk. I already have cognitive problems from the depression. I couldn't imagine such problems becoming even worse.
Yes, I've done a lot of reading about atypical depression-I agree it is much like the depression component of bipolar.
Never had much of a problem with agitation or mood swings, though it's happened, more recently with initiating psychotherapy. Only felt dysphoria from Prozac, and anxiety has been completely under control-I hardly even notice it anymore.
I think PDoc brought up Lamictal before we discussed atypical depression. Still weighing the options, but I do have to make a decision soon.
Thanks
Posted by emme on October 18, 2009, at 22:28:57
In reply to Re: What is the best med for lack of motivation?, posted by Deneb on October 18, 2009, at 17:34:50
> Thanks so much for contributing to this thread everyone. There is a lot of info to sort through. I'm taking notes and going to ask pdoc about them.
>
> I'm not sure pdoc would be receptive to this though, as she is very very therapy oriented. I also don't know if I would hurt her feelings to get a second opinion.
I think you can certainly express how much you value the work you've done with her and how much you've benefited (and will continue to benefit) while explaining that you want to hear some fresh ideas on your medication to help you deal with the apathy. IMO, use of the right medication doesn't devalue good therapy.I wouldn't worry about hurting her feelings. A good professional should respect your wish for extra input.
Good luck.
emme
Posted by metafunj on October 19, 2009, at 10:58:35
In reply to Re: What is the best med for lack of motivation?, posted by bleauberry on October 18, 2009, at 14:40:22
From my understanding, supplements like L-Tyrosine are best used on an empty stomach so that it does not have to compete with other amino acids in the protein of the foods you are eating. I wonder how much brand matters here with amino acid supplementation?
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