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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by pixiemagic on December 21, 2011, at 1:59:20
I know you guys aren't doctors, but could you please offer medication suggestions?
My main issues:
-irritability/anger
-can't control emotions/extremely sensitive
-lack of energy, but mind is always racing w/ thoughts
-no motivation
-phobias/fear
-sleep a lot
only formal diagnosis i've received is major depression, dysthymia, general anxiety, & traits of borderline personality disorder. :/ anyhow, usually i get triggered by something & then i get sad, which sends me into depression for a while (i dwell on things) or i get super angry & then super depressed (immediately after). the rest of the time i alternate day to day or week to week from having energy, being productive & happy (but not manic) to feeling low, lack of energy & irritable/angry. kind of like bipolar, but no real discernible cycle.
meds i've tried:
paxil (induced apathy, made cigarettes taste awful)
trileptal (no change after 2 weeks)
effexor + geodon (slept avg of 14 hrs, then was super anxious, brain fog, confusion, horrible!)
pristiq (no change after 2 weeks)
celexa (blissful, nothing could bother me, helped a lot with anger/irritability, slightly helped with phobias, still no motivation, eventually built up tolerance, but it worked again after a "break")
wellbutrin (some motivation, some anxiety, made my facial twitch in jaw worse, anxiety & muscle twitch became worse with higher dose)
celexa + wellbutrin (induced a little bit of mania, i was super happy, jittery, anxious, wanted to smoke & drink a lot)
currently taking wellbutrin 150mg SR once a day. i have a weird schedule & wellbutrin increases anxiety at a higher dose, so doc & i decided to try just one pill when i wake up. i wake up around noon on avg & wind down for the evening around 1am. go to sleep around 2am on avg. doc wants me to add celexa again in the evenings at a very low dose 5-10mg, but i haven't started yet. i'm thinking my problem is more dopamine & serotonin related, so celexa may work, but wellbutrin probably isn't the best choice for the dopamine. also, i think i might have too much norepinephrine anyways because i have a horrible tolerance to stress & i am super jumpy & easily startled, always have been.
Posted by Phidippus on December 21, 2011, at 17:07:05
In reply to med suggestions please?!, posted by pixiemagic on December 21, 2011, at 1:59:20
You seem to have mood issues/lability, so the first thing I'd work on is stabilizing your mood.
I see you've tried lots of antidepressants which seem to have mostly destabilized your mood at best. I think you should leave the ADs alone until you get your mood stabilized.
Depression seems to be a concern for you, so where I'd start is with Lithium, Lamictal or Zonegran, all mood stabilizers which show to improve depressive symptoms while treating mania (your racing thoughts, irritability).
Trust me, trying all these antidepressants is taking you down the wrong trail. Get on one once your mood is stabilized, otherwise you're just going to be riding on a rollercoaster.
Eric
Posted by creepy on December 21, 2011, at 21:12:45
In reply to med suggestions please?!, posted by pixiemagic on December 21, 2011, at 1:59:20
What about zoloft?
Sometimes it has an effect opposite of what youd expect. Helps me a lot with irritability.
I had the same reaction with celexa at high doses but it made me not care about anything and gain a lot of weight.wellbutrin SR only lasts about 6-8 hours. When it wears off do you get irritable and tired? Might want to ask about taking it 2x a day or going to XL.
Posted by SLS on December 21, 2011, at 23:15:11
In reply to Re: med suggestions please?!, posted by creepy on December 21, 2011, at 21:12:45
> What about zoloft?
> Sometimes it has an effect opposite of what youd expect. Helps me a lot with irritability.Zoloft seems particularly useful in treating anger/hostility issues. So are Tegretol and Trileptal.
- Scott
Posted by SLS on December 21, 2011, at 23:33:51
In reply to Re: med suggestions please?!, posted by SLS on December 21, 2011, at 23:15:11
> > What about zoloft?
> > Sometimes it has an effect opposite of what youd expect. Helps me a lot with irritability.
>
> Zoloft seems particularly useful in treating anger/hostility issues. So are Tegretol and Trileptal.I forgot to mention that Tegretol speeds up the metabolism of Zoloft, thus lowering Zoloft blood levels. I am pretty sure that this is not an issue with Trileptal.
- Scott
This is the end of the thread.
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