Psycho-Babble Medication Thread 1096457

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

Prozac + ? = Good

Posted by Ruuudy on December 27, 2017, at 12:27:07

I'm a long-time Prozac (fluoxetine) connoisseur - been taking it approximately 27 years.

Added on some low-dose Anafranil (clomipramine) a few years after having been on the Prozac to try to some more umph out of the Prozac it seemed to work wonders on my OCD component, but the side effects were too much.

Briefly took a few months hiatus 20 years ago to participate in a double-blind Paxil study. Came to find out I was taking the active Paxil, and I was pretty sure at the time anyway because of the extreme constipation.

Sometime between 10 to 15 years ago, I discovered that Klonopin (clonazepam) had a beneficial effect on my anxiety. Didnt get a prescription for it until a few years later. Started out taking on a per needed basis, but eventually added it in to my daily regime.

And here we are today.
I just had the discussion with my psychiatrist the other week as to whether he or I think the fluoxetine is even providing any benefit after all these years.

I have lifes stressors coming at me at all angles, it seems, with several major life events over the past two years my fathers death (he was the family rock the one that kept everyone at peace; he was also my boss, later my business partner,,, basically my everything, mentor & best friend).
The resulting family disputes (my sister is bipolar) have beaten me down, the pressure & stress of trying to maintain our family retail business (of which Im now the sole owner) is wearing on me.

I am in research mode trying to find an augmenting agent to add to my fluoxetine.
I do truly believe the fluoxetine is providing a neuro-protective measure that has kept me from having one of my double-depression week-long bouts; I havent had one of those in close to 15 years.

Im 50 now I need something thats going to help restore some zest in my life.

My current picks:
Wellbutrin (though my doctor is concerned it might increase anxiety)

Modafinil

Pristiq (low-dose)

My biggest complaints are anhedonia, lack of motivation, lack of self-esteem, no sex drive.
I think I need something thats going to hit the norepinephrine and dopamine systems.

Sincerely,
Rudy

 

Re: Prozac + ? = Good

Posted by joe f on December 27, 2017, at 20:04:36

In reply to Prozac + ? = Good, posted by Ruuudy on December 27, 2017, at 12:27:07

Going back to anafrinal ...what were the side effects...and how about a low dose of abilify

 

Re: Prozac + ? = Good

Posted by rjlockhart37 on December 28, 2017, at 0:11:52

In reply to Prozac + ? = Good, posted by Ruuudy on December 27, 2017, at 12:27:07

modafnil is good for being alert, help mood a little, but its not like other stim, safer in profile

 

Re: Prozac + ? = Good

Posted by Christ_empowered on December 28, 2017, at 7:14:43

In reply to Prozac + ? = Good, posted by Ruuudy on December 27, 2017, at 12:27:07

hi. wellbutrin, provigil, nuvigil. stimulants (ritalin, focalin, the various amphetamines) can also be used, and there's some indication that stimulants help -some- people with ocd.

remeron is sometimes used w/ ongoing antidepressant treatment. lower doses are more sedating (and can cause more weight gain). my undestanding is that the higher doses are more effective, less sedating, and cause less weight gain.

now and then, mirapex is used in mood disorders. helps low end in bipolar disorder, sometimes helps "negative symptoms" in chronic schizophrenia. does something to dopamine receptors, so I guess it'd be a non-euphoric stimulant, also.

have you tried any other benzodiazepines? Klonopin -is- effective, but its more likely than many other benzodiazepines to dampen mood, even cause straight up depression. xanax is now regarded with some suspicion, -but- its been used to boost antidepressants and in higher doses as treatment for some forms of depression. there's a xanax xr or er (I forget..) that's supposed to give all day coverage with 1 pill, which should keep dosage escalation and interdose anxiety to a minimum. of course, depending on your dose, there's also good ole Valium, which also has more pronounced muscle relaxant properties and is more sedating (at equivalent doses) than xanax, klonopin, or ativan.

low dose zyprexa has been studied w/ prozac. the combination is called "symbyax," and there's a generic now. its definitely not stimulating, but it does help w/ ocd for some people, anxiety, agitation, and can lift severe depression (For some people..).

these days, I would imagine that a low(ish) dose of Abilify might also be on the table. it can be somewhat stimulating, far fewer metabolic problems than zyprexa. over the long haul, no one seems to have a good idea of the td risk for abilify, so...there's that, unfortunately. in animal studies, aripiprazole doesn't cause as much D2 upregulation and other brain changes one sees with tranquilizers, so that's potentially a good sign. if your doctor opts for abilify, remember that prozac messes with the metabolism of abilify, so some prescribers go for 1/2 the usual abilify dose, something like that.

OK. oh, one final option...deplin. insurance coverage can be tricky for it, because its considered a "Medical food," not a drug, or something like that, but...it -can- boost antidepressants, without adding another drug to the line up.

hope this helps. good luck to you.

 

Re: Prozac + ? = Good

Posted by Ruuudy on December 28, 2017, at 11:24:33

In reply to Re: Prozac + ? = Good, posted by Christ_empowered on December 28, 2017, at 7:14:43

> hi. wellbutrin, provigil, nuvigil. stimulants (ritalin, focalin, the various amphetamines) can also be used, and there's some indication that stimulants help -some- people with ocd.
>
> remeron is sometimes used w/ ongoing antidepressant treatment. lower doses are more sedating (and can cause more weight gain). my undestanding is that the higher doses are more effective, less sedating, and cause less weight gain.
>
> now and then, mirapex is used in mood disorders. helps low end in bipolar disorder, sometimes helps "negative symptoms" in chronic schizophrenia. does something to dopamine receptors, so I guess it'd be a non-euphoric stimulant, also.
>
> have you tried any other benzodiazepines? Klonopin -is- effective, but its more likely than many other benzodiazepines to dampen mood, even cause straight up depression. xanax is now regarded with some suspicion, -but- its been used to boost antidepressants and in higher doses as treatment for some forms of depression. there's a xanax xr or er (I forget..) that's supposed to give all day coverage with 1 pill, which should keep dosage escalation and interdose anxiety to a minimum. of course, depending on your dose, there's also good ole Valium, which also has more pronounced muscle relaxant properties and is more sedating (at equivalent doses) than xanax, klonopin, or ativan.
>
> low dose zyprexa has been studied w/ prozac. the combination is called "symbyax," and there's a generic now. its definitely not stimulating, but it does help w/ ocd for some people, anxiety, agitation, and can lift severe depression (For some people..).
>
> these days, I would imagine that a low(ish) dose of Abilify might also be on the table. it can be somewhat stimulating, far fewer metabolic problems than zyprexa. over the long haul, no one seems to have a good idea of the td risk for abilify, so...there's that, unfortunately. in animal studies, aripiprazole doesn't cause as much D2 upregulation and other brain changes one sees with tranquilizers, so that's potentially a good sign. if your doctor opts for abilify, remember that prozac messes with the metabolism of abilify, so some prescribers go for 1/2 the usual abilify dose, something like that.
>
> OK. oh, one final option...deplin. insurance coverage can be tricky for it, because its considered a "Medical food," not a drug, or something like that, but...it -can- boost antidepressants, without adding another drug to the line up.
>
> hope this helps. good luck to you.


Thank you so much for that in-depth discussion!

2017 has been a year of lots of exploration.

I had phone consultations with a highly-regarded psychiatrist,,, one of those astute doctors that performs & writes all these publications on various drug trials. I sent him my DNA samples via the Genomind test. Discovered I have the MTHFR mutation, so I did try the Deplin for probably 12 weeks - nothing!
Other blood work suggested I needed to add Vitamin D to my daily regime.

Fluoxetine 20mg40mg qam
Clonazepam 0.5mg .5mg or 1mg prn
Folate 5,000 Plus 10mg qam
Vitamin D3 VESIsorb® 2,000IU 1 cap qam
DL-Phenylalanine tid
NAC 900mg tid
Magnesium (glycinate) tid
Renew Life Extra Care Probiotic, Ultimate Flora, 150 Billion 1 cap qam
Pure Encapsulations NeuroMood Multi-Pak

I'm going to request some bloodwork in the new year to get a measure on various levels.
I can't tell you I'm really feeling any better mentally having been taking these supplements for the past year.
I just know they're allot of pills to take everyday!!!

I AM getting worried the scientific community is going to start release negative reports on the long-term use of SSRI's, specifically fluoxetine!

And I think you're right on the Klonopin possibly causing depression. I've been taking it for a couple of years now and I think it might have lost its zing. So, I try to take holidays from taking it.

Thanks for the conversation!

Rudy

 

Re: Prozac + ? = Good

Posted by Christ_empowered on December 28, 2017, at 11:33:28

In reply to Re: Prozac + ? = Good, posted by Ruuudy on December 28, 2017, at 11:24:33

hi. your klonopin dose is relatively low. have you ever tried valium? I think the going conversion is klonopinx20-diazepam equivalent. I don't know that it will help with drug-induced depression, but it works quickly and has a long half life, and a night time dose can help lull some people to sleep.

valium is also easier to taper than klonopin, should you and your doctor decide to stop benzodiazepine treatment.

 

Re: Prozac + ? = Good » Ruuudy

Posted by beckett2 on December 30, 2017, at 20:12:53

In reply to Re: Prozac + ? = Good, posted by Ruuudy on December 28, 2017, at 11:24:33

> > hi. wellbutrin, provigil, nuvigil. stimulants (ritalin, focalin, the various amphetamines) can also be used, and there's some indication that stimulants help -some- people with ocd.
> >
> > remeron is sometimes used w/ ongoing antidepressant treatment. lower doses are more sedating (and can cause more weight gain). my undestanding is that the higher doses are more effective, less sedating, and cause less weight gain.
> >
> > now and then, mirapex is used in mood disorders. helps low end in bipolar disorder, sometimes helps "negative symptoms" in chronic schizophrenia. does something to dopamine receptors, so I guess it'd be a non-euphoric stimulant, also.
> >
> > have you tried any other benzodiazepines? Klonopin -is- effective, but its more likely than many other benzodiazepines to dampen mood, even cause straight up depression. xanax is now regarded with some suspicion, -but- its been used to boost antidepressants and in higher doses as treatment for some forms of depression. there's a xanax xr or er (I forget..) that's supposed to give all day coverage with 1 pill, which should keep dosage escalation and interdose anxiety to a minimum. of course, depending on your dose, there's also good ole Valium, which also has more pronounced muscle relaxant properties and is more sedating (at equivalent doses) than xanax, klonopin, or ativan.
> >
> > low dose zyprexa has been studied w/ prozac. the combination is called "symbyax," and there's a generic now. its definitely not stimulating, but it does help w/ ocd for some people, anxiety, agitation, and can lift severe depression (For some people..).
> >
> > these days, I would imagine that a low(ish) dose of Abilify might also be on the table. it can be somewhat stimulating, far fewer metabolic problems than zyprexa. over the long haul, no one seems to have a good idea of the td risk for abilify, so...there's that, unfortunately. in animal studies, aripiprazole doesn't cause as much D2 upregulation and other brain changes one sees with tranquilizers, so that's potentially a good sign. if your doctor opts for abilify, remember that prozac messes with the metabolism of abilify, so some prescribers go for 1/2 the usual abilify dose, something like that.
> >
> > OK. oh, one final option...deplin. insurance coverage can be tricky for it, because its considered a "Medical food," not a drug, or something like that, but...it -can- boost antidepressants, without adding another drug to the line up.
> >
> > hope this helps. good luck to you.
>
>
> Thank you so much for that in-depth discussion!
>
> 2017 has been a year of lots of exploration.
>
> I had phone consultations with a highly-regarded psychiatrist,,, one of those astute doctors that performs & writes all these publications on various drug trials. I sent him my DNA samples via the Genomind test. Discovered I have the MTHFR mutation, so I did try the Deplin for probably 12 weeks - nothing!
> Other blood work suggested I needed to add Vitamin D to my daily regime.
>
> Fluoxetine 20mg40mg qam
> Clonazepam 0.5mg .5mg or 1mg prn
> Folate 5,000 Plus 10mg qam
> Vitamin D3 VESIsorb® 2,000IU 1 cap qam
> DL-Phenylalanine tid
> NAC 900mg tid
> Magnesium (glycinate) tid
> Renew Life Extra Care Probiotic, Ultimate Flora, 150 Billion 1 cap qam
> Pure Encapsulations NeuroMood Multi-Pak
>
> I'm going to request some bloodwork in the new year to get a measure on various levels.
> I can't tell you I'm really feeling any better mentally having been taking these supplements for the past year.
> I just know they're allot of pills to take everyday!!!
>
> I AM getting worried the scientific community is going to start release negative reports on the long-term use of SSRI's, specifically fluoxetine!
>
> And I think you're right on the Klonopin possibly causing depression. I've been taking it for a couple of years now and I think it might have lost its zing. So, I try to take holidays from taking it.
>
> Thanks for the conversation!
>
> Rudy
>

Hi Rudy, wishing you a happy new year. I'm sorry about the loss of your father and the difficult past two years. I imagine your coping skills must be really good, keeping yourself above water through this.Vit D helps me and could be really helpful for you. How great you were able to consult with what sounds like a psychopharmacologist. I've added some armodafinil, and that's helped with apathy. No cure, though.


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