Posted by jerryTRD on November 17, 2010, at 0:59:58
In reply to Re: I'll give you my symptoms, YOU Rx a med cocktail » jerryTRD, posted by Jay_Clockwork_Angels on November 17, 2010, at 0:51:29
> > Diagnosis:
> > Major Depressive Disorder - Treatment resistant w/ Generalized anxiety disorder.
> >
> > Main complaints:
> > No motivation - cannot get out of bed
> > Extremely Lethargy
> > Decreased stamina, strength
> > Crying occasionally
> > Severe insomnia - takes 2-5 hours to get to sleep but then I just keep on sleeping.
> > Hopelessness
> > Low self-esteem
> > loneliness
> > Dysphoria
> > No joy from previously enjoyable hobbies, listening to music, etc
> > Severely decreased sex drive and sexual function. NOTHING turns me on.
> > Fleeting suicidal ideation from time to time
> >
> > HAS HAD:
> >
> > ECT treatments
> > Vegal Nerve Stimulator both failed.
> >
> > Now here's what I'm taking:
> >
> > Lexapro 10mg
> > Effexor XR 150 - weaning off (although I had more sexual drive with the Effexor)
> > Adderall 20mg IR 3x daily
> > Klonopin 1mg 3x daily & 2 at bedtime
> > Seroquel 400mg at bedtime for sleep
> > Ambien 10mg
> >
> > Synthroid for under-active thyroid and after taking ti for 3 months has yet to help with depression and/or fatigue. Dosage increased today to 150mcg.
> >
> > AndroGel - for low testosterone. Been on it a month and no help with sexual problems, libido, stamina, energy,
> >
> > Problem:
> > Adderall 20mg IR 3x daily works great - but BIG crash about 2-3 hours after my last dose (3pm). Feel much more depressed due to the crash. But without the Adderall, I can't get out into life - participate in social activities, etc. It's just the crash!
> >
> > Insomnia - I've been on EVERYTHING for sleep -the best being Nembutal (a barbiturate) - gave me the BEST! sleep in my life!
> > I just want to feel naturally sleepy at night and not have my thoughts racing, etc.
> >
> > So you guys & gals - what would you do? change? swap out? remove entirely?
> >
> > I have Medicare Part-D and Medicaid, but it usually won't cover off-label uses like memantine for stimulant crash.
> >
> > SO WWYGD? (so what would you guys do?)
> >
> > I desperately want to get a part-time job and I can't function like this - especially with the crash from Adderall IR (and no my ins doesn't cover the XR).
> >
> > I'll take any and all suggestions -maybe there's a "solution" within your answers?
> >
> > Thanks!
> > Jerry
> >
>
> Hey Jerry,
>
> I am just tossing some ideas since we seem to be similar in some symptoms. There are a few different avenues you can take, but I might suggest that you are in need of some more GABA and serotonin-acting meds. This is just my quite mild guess, of course..so YMMV, etc..lol.
>
> There are a couple of meds that unfortunately are very expensive but newer. And no, these are no magical cure either...but I know that you know that.
>
> First, I'd say add a small amount of both Lyrica and Abilify. I know antipsychotics are no *miracle*, but I have found them best taken with an anti-histamine anti-cholenergic drug as simple as Benadryl, daily.
>
> Lyrica feels a lot more 'consistent' than Neurontin,(IMHO) but again, costs quite a bit.
>
> What I am thinking is Abilify seems to have a positive effect on dopamine, increasing or decreasing it, and Lyrica will help work alongside the clonazepam you take. I found Lyrica to be one of the most important drugs in my pill regime. Abilify may also decrease your need for Adderall, for the sake of preventing your dopamine ups and downs so much.
>
> The Androgel, I have found it honestly to have a very, very subtle effect which seems to come around about the 2 month mark. I know, waiting again...sucks..lol. With the other meds, it seems to have a synergistic effect. But, it's not like I am getting massive erections constantly every day. But, if I let a sweet gal take control of my zipper, then things come alive!! lol. Also, this may not be noticeable, but the Androgel helps replace your body's fat with lean muscle. Muscle also weighs more than fat, so after a few months, try on a smaller waist size pants, and even if your scale doesn't show much, you will be able to tell with the waist measurement.
>
> Oh ya, and also, I have found two 5mg packets of Androgel works better than one 5mg packet. See, what is happening is the Androgel is a complete *replacement* of your testosterone. First, it decreases your body's natural testosterone, but then needs a few months to build up the Androgel.
>
> PHEW..okay, I touched on a few things, what do you think?
>
> Take care,
> Jay
>
>
>
>
Hey jayI appreciate you replying. I'll take a look more close;y tomorrow - cause it's way past my "bedtime."
Along with your suggestions - I feel my reward system is malfunctioning. 7 Years ago when I live din Minneapolis I saw a team of high ranking pdocs and they finally agrees to augment my current meds with hydrocodone. This went on for 3 years or so until I moved home - well I shouldn't say that because when i saw my pdoc here (my hometown) he read the note from the U of MN pdos on why I was on the hydrocodone and he had no problems prescribing it. it helped SOOOOOOOOO MUCH!!!!!
I never abused it nor did I ever become tolerant to it.
However about a year or so ago my pdoc just decide to take me off of it because they stopped making the brand I was on (stupid reason) but I think my pdoc was a bit nervous with me on it especially being the only pdoc in our town.
BUt hell I dunno if I'll even see another pdoc who would be willing to add the hydrocodone back into my mix.
Major Depressive Disorder, treatment-resistant w/GAD. Meds: Lexapro 10mg, Adderall IR 20mg 3x daily, Klonopin 1mg 5x daily, Seroquel 300mg, Ambien 10mg, Synthroid 125mcg, Androgel
poster:jerryTRD
thread:970543
URL: http://www.dr-bob.org/babble/20101107/msgs/970568.html