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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by porkpiehat on October 14, 2016, at 13:33:37
Coming up on Month 2 of effexor. Ive ended up on quite the combo that doesn't seem super sustainable:
Effexor 37.5
Lamictal 100mg
.5 mgs Klonopin
10-30 mgs propranolol
10 mgs VyvanseThe day before I started effexor I was just sooo sad and socially uncomfortable, with occasional disociative and panic episodes at night. No drive. Could connect emotionally with television but not people.
Effexor immediately made me feel zoned out but the intense sadness started to lift. I started taking the propranol to help take the edge off the irritability that came in the afternoons. Sex drive gone.
up to about 60 mgs I felt so frigid and annoyed by other people it was creating its own kind of social anxiety because I hate having to deal with them. Also tired all day and unable to sleep through the night
Added Vyvanse to help brighten my mood and engage me and it helps, but I need to keep up with the propranolol, lamictal, and klonopin to keep me from getting too overstimulated and drinking/fiending.
I can concentrate and read in a way I can't remember and talk with self possession (I can actually see myself handling an interview for grad school). I'm afraid to f*ck with the this but Gosh darn do I feel COLD and intolerant of everything. I would say I'm not "depressed" and suicidal, but I don't feel like I'm an active part of humanity and I never feel lighthearted. Frankly everyone could burn and I probably wouldn't care. Even music, which I live for, kind of gets under my skin.
But I am very good at work and homework and I'll probably crush the GREs...but I don't see myself getting through grad school feeling so detatched, almost sociopathic.
I'm also not sure if this combo is terribly safe.
I tried "just lamictal" sometimes with wellbutrin, for 6 months or so but it didn't cut it after 8 years of celexa.
I probably feel about as numb on 37.5 mgs of effexor as I did a high dose of Prozac, but there was a sense of happiness then at least.
People keep suggesting other NE-active drugs to replace the effexor (cymbalta, etc), but based on my experience with others (WB, Serzone, desipramine and cymbalta for about two days), I think that might be responsible for the detatchment and gray feeling. And the irritability. And the focus, unfortunately.
Trauma and/or bipolar II may complicate.
has this been anyone elses' experience?
Posted by SLS on October 14, 2016, at 15:38:51
In reply to Effexor combo/update, posted by porkpiehat on October 14, 2016, at 13:33:37
What were you originally prescribed Vyvanse for? Is there a ADD/ADHD component to your condition? Have you ever tried Focalin?
> Effexor 37.5
> Lamictal 100mg
> .5 mgs Klonopin
> 10-30 mgs propranolol
> 10 mgs VyvanseHow high have you gone with Effexor?
When you combined Wellbutrin + Lamictal, what dosages were you taking, and for how long? What were the results?
Have you tried adding Abilify?
Perhaps you would do better without a serotonergic antidepressant. For example, you might feel better with Lamictal 200-300 mg/day + Abilify 5 mg/day + Wellbutrin 300 mg/day.
I wasted a lot of time taking 200 mg/day of Lamictal with only minimal results. Whenever I tried moving up to 300 mg/day, I would experience moderate impairments of memory and some brain-fog, so I would very quickly return to 200 mg/day. However, I realized that the depression was improved at the higher dosage. I decided to push the 300 mg/day to see what would happen with these side effects over the course of time. I can't remember how long it took, but I think it was less than a month.
Sometimes, a low dosage of lithium can help. It has been used with TCA, MAOI, and SSRI. I am taking 300 mg/day. I actually feel better at 300 mg/day than I do at 450 mg/day.
Perhaps it is time for a MAOI?
- Scott
Posted by porkpiehat on October 15, 2016, at 11:34:27
In reply to Re: Effexor combo/update » porkpiehat, posted by SLS on October 14, 2016, at 15:38:51
pdoc gave me trazodone to help with sleep and possibly to brighten the effexor. I didn't sleep so well (I never do on trazodone) but after taking my morning effexor, lamictal, and vyvanse I'm in a strange fog, maybe like the first time I took an effexor. I didn't feel like this when I woke up. Lamictal always seems to give me cognitive problems when taken with some serotonergics. I think both the effexor and and traz together with that have knocked me around. Can't do much right now but mood is good lol.
I'll have to get back to the complicated Lamictal/Wellbutrin experience when I can think
Posted by rjlockhart37 on October 19, 2016, at 18:30:46
In reply to Effexor combo/update, posted by porkpiehat on October 14, 2016, at 13:33:37
your on a combination that looks well-put together, your on the lower doses of it though....but sometimes that's the best, effexor is a good antidepressant, but i think it's max dose is 225mg-300mg and usally will skyrocket someone but also can excaserbate mood disorder (mood swings, schizophrenia related mood swings, anxiety)
irritablity can be improved with increased benzo, different benzo, or adding both zyprexa or other anti-psychosis medications, mainly because they reduce dopamine in certain sections of the brain
i was lamotragine 400mg, it stablized me but blunted some of my natural emotions....lithium you could but that's up the doctor
switching benzo's may help, but some doctors don't like to move to ativan or xanax, klonopin seems to be favorite with doctors because it produces less euphoria than others.....
maybe work with the doses, add more trazadone, or remeron to effexor
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