Posted by Peter on September 21, 2003, at 19:24:24
Years and years of one med cocktail after the next. Years of different pdocs giving me different diagnoses, from 'BP otherwise unspecified' to 'depressive-anxiety' to adult ADHD to social anxiety to 'all of the above.'
After 7 years, my pdoc and I thought we might be getting close to helping my major symptoms. We ditched the AC 'mood stabilizers,' which I'd been taking for years to no effect, and narrowed everything down to klonopin + stim (adderall) + SSRI. I've tried every SSRI; they helped to differing degrees, but I always ended up having to come off them after a few months, usually because I became impulsive; whether this was a sign of mild hypomania or a down-regulation of dopamine which led to emotional-numbness which in turn led to my seeking stimulation and becoming impulsive, no doctor knows. But the fact that a stim+SSRI seemed to work better in the past than an SSRI alone or a SSRI+mood stabilizer made us tend to think that it was less an issue of SSRI-induced hypomania that caused the impulsivity that made me have to stop each SSRI, and more likely the dopamine down-reg/emotional numbness. Nevertheless, even though the SSRI worked better for me with a stim, my last trial of the combo was not a success, so we decided to try one more AC-lamictal, and we eventually ended up getting me on a pile of meds along with it (adderall, strattera, klonopin, temazepam, ambien), and ended up having to add Prozac in the end anyway. I was fairly stable on this cocktail for a few months but became too symptomatic and anxious, and we weaned me off 1 at a time (which sucked). Then we tried me on just a higher dose of klonopin + adderall, but my overarching anxieties and depressive tendencies were still there, so we decided, for the sake of geting me to at least somewhat of a functional level again, to just throw me back on an SSRI - the only one I hadn't yet tried - lexapro.
So that's what I'm taking now. Day 16 of lexapro 10mg (the first week was hell and now is not much better, maybe even worse) + 40mg adderall + 3mg klonopin. Usually I'm a fairly quick responder to SSRI's, even though they don't really work in the long run for me, but this lexapro doesn't seem to be doing a thing during week 3 of treatment except making me feel worse. My most recent overall mood characteristic has been dysphoria; just unable to be interested in anything, feel disgusted by everything, avoid everyone, etc.
I know a lot of people have had success with lexapro, and SSRI's in general, but I just really wonder if I should keep taking it and give it the full 6-8 week trial, or say screw it, taper off it, and try a med from the one existing med class I've never tried - an MAOI, like parnate or Nardil. I've been to anxious to even start an MAOI up in the past because of fear that I'll end up in an ER after having eaten something that I didn't know contained tyramine. But I can't tell you how sick I am of this never-ending pharmacological roller-coaster. I've tried everything else. Everything. I really feel like giving up. I was watching a movie tonight with my family, and the whole time I couldn't wipe this frown-even grimace-off my face. I was disgusted and depressed, and I'm so sick of feeling like this. I'm a musician, and I can't even try to approach the piano to play or compose. The adderall doesn't even help me feel more alert, gregarious, or motivated anymore. What can I say? I'm a miserable lump. Is it worth sticking with the lexapro through this with a chance, however slim, that it will end up helping me more than other SSRI's have? Or should I just go through what hopefully will be one last purge and withdrawal from my meds and begin an MAOI? BTW, I've tried a RIMA before - moclobemide; if it worked, I'd still be taking it. I've really held back from the MAOI's out of fear, telling myself I'd venture into MAOI-land only as a last resort if nothing else works. After all these years, maybe it's time to put the MAOI stigma aside in my mind and go for it. I really need, and would appreciate, some advice. Thanks.
Peter
poster:Peter
thread:262256
URL: http://www.dr-bob.org/babble/20030917/msgs/262256.html