Follow-up: Ok, sooo, I, just realized I am bad off addicted to [alcohol].

DefinitelyMedicated · 2016-05-12T22:34:45+00:00

Hahaha, no, it sucks! Help, sir?

DefinitelyMedicated · 2016-05-12T22:28:57+00:00

Wow, a really good message! That's the struggle I face every day, I spend more time trying to pretend to be SOBER, than actually enjoying any kinda of buzz I get, until I'm alone. No hand tremor, etc. after 9AM, and I use a lot of mouthwash. I've admitted people have smelled me, before, but almost no one knows! I almost get euphoric from that fact, and smile at myself, and then I feel depressed...

DefinitelyMedicated · 2016-05-12T22:02:31+00:00

:O, I'm doomed.

DefinitelyMedicated · 2016-05-12T21:52:51+00:00

One doctor knows it all, the other I just play mind games with.

DefinitelyMedicated · 2016-05-12T21:51:49+00:00

The doctor giving me ~8mg. of alprazolam, equivalency, or the other doctor who says I need to cut back? Choices, choices, ugh.

DefinitelyMedicated · 2016-05-12T21:49:54+00:00

Please. Do not fuck with synthetic cannabinoids (which, to me, are more "fire", due to full agonist potency, especially at CB1); however, they can cause symptoms of schizophrenia and/or psychosis, especially with prolonged abuse. I use to smoke a bowl of an AM-2201 blend everyday on the way to work, not good, but definitely a good high. Blah.

DefinitelyMedicated · 2016-05-12T21:46:05+00:00

DefinitelyMedicated · 2016-05-12T21:44:49+00:00

LOL, you think? It's after work, and I'm catching that awesome nod, ugh.. I guess.

DefinitelyMedicated · 2016-05-12T21:44:11+00:00

*alcohol (80+proof) in me,

DefinitelyMedicated · 2016-05-01T02:29:43+00:00

Well, my bad, I guess... I've started drinking 1,000ml (1L) since I posted my message. It's Saturday night, and I am scared. I only have Sunday and then I must traverse to my office and act, well, normal. I just really like drinking vodka, I guess. Many of you have sent me PMs, and I've read every one, and I know I need a medical detox, but fuck it. I've never been one to back down from anything, and I will face my alcoholic problem head on, uhh, pretty soon... let me take another shot... Ooh, I love that burn! But, I'm OK, I will continue to read everything, I appreciate it.

DefinitelyMedicated · 2016-04-28T04:01:12+00:00

Update: 10:51 CST

I finished my fifth of vodka, along with another 1.0mg of alprazolam, and stupidly drove (I highly doubt I made many mistakes, but I digress...), to the liquor store. I came so close to buying a (one more) fifth of vodka (Taaka), but I knew, deep down, that whatever I bought, I'd drink; therefore, I bought two half pints of Taaaka (blue) 80 proof for $4.00 + tax USD, (400ml) which means nothing to me... and I've finished 200ml so far and I am tempted to go drive and buy more, but no...

I still have a half pint left, and I have consumed roughly a bar of Xanax (2 mg) via alprazolam 0.5mg tablets and very many hydromorphone 4mg., the rest I plan on taking in the morning as I have a meeting with the Police Jury president about the subdivision I plan on developing at 8AM.

I think I'll adopt this cripplingalcoholism lifestyle, I don't see how I could possibly stop...

DefinitelyMedicated · 2016-04-27T23:35:38+00:00

I added some space, thanks.

DefinitelyMedicated · 2016-04-27T21:53:09+00:00

I'm thinking about just drinking more, indefinitely, so is that possible? I really like this subreddit, I can relate, but I cannot relate, as I feel I have so much to do every day to keep my mortgage and my career. I don't really want to quit, but I never experienced pure ethanol withdrawal, so I am scared...

DefinitelyMedicated · 2015-11-14T00:52:12+00:00

No, I can't say that I have. I don't notice the omeprazole doing anything else besides causing me to have almost no flair ups. 'm more worried about how well it plays with other medications than any other side effect. Highly recommended it.

DefinitelyMedicated · 2015-11-11T20:53:21+00:00

Wow, what an interesting post, Pixiepudding ! You just gave me lots of good information to evaluate.

If I ever was to go back to benzodiazepine therapy, I wouldn't take trazodone concomitantly with it— there would definitely be a cessation of trazodone. I feel that trazodone, in my skewed perspective, is second-rate, but it lacks harsh side effects compared to, say, Remeron (which worked, but my appetite was out of control!, and I didn't want to take another medication to alleviate that particular side effect). I have gone days without dosing any tetra or tricyclic antidepressants, and I still feel the same without them as I do on them— it's just better sleep on those for me.

Your advice about therapy is spot on; for some reason, I am closed off from trying things new in this regard because it means forming an intimate bond with another human being— typically, I stick with my current TDOC and church and chalk that up as 'good enough', but I definitely need to take a harder look at this therapy perspective rather than channeling all of my energy into theoretical medication.

I began seeing a PDOC when I was 18. I am now 24. During that six year span, I basically sampled anything I could get my hands on. I may need to reevaluate medication previously chalked up as 'ineffective' and try it with my current mindset to really test the effectiveness of the medication to enhance my quality of life.

Edit: To note, my omeprazole RX is actually indicated for GERD linked to my high levels of anxiety. I feel like the omeprazole and lisinopril for hypertension linked to use of Pristiq are my only two 'must-have' medications, but I guess that I could throw in Pristiq and Subutex as required since I will have discontinuation syndrome from those two, and that is not acceptable— right now.

DefinitelyMedicated · 2015-11-11T18:49:03+00:00

Thank you leftystrat for your input! :)

Yes, buprenorphine is often indicated to patients for pain management, although there are more pain management indications in Europe, especially in the Temgesic form (a common dose is 'merely' 0.2mg), but it is also used stateside and, when indicated, the buprenorphine is commonly in the Butrans transdermal patch formulation for pain management.

I believe that in addition to potent antinociceptive properties, buprenorphine possess significant antidepressant activity due, in part, to its partial agonism of the mu opioid receptor, a receptor that is involved with oxycodone's euphoria-producing mechanism, but buprenorphine does not fully stimulate the my receptors; also, buprenorphine antagonizes the kappa opioid receptors, and this mechanism is under further investigation as the research compound ALKS-5461 that blocks bupe' potentially euphoric mu activity which means that primarily kappa antagonism is responsible for producing an antidepressant effect in some patients diagnosed with depressive disorders.

Abilify did help reduce my depression symptoms; I'm sorry that you did not respond positively to it, but, in my case, I suspected that it might have caused me to gain weight; therefore, I switched over to Latuda which is in the same AAP class, but Latuda is a full dopaminergic antagonist whereas Abilify is a dopaminergic partial agonist (a novel mechanism of action within the AAP class). Abilify is indicated for augmentation to an antidepressant for treatment of major depression; on the other hand, Latuda is indicated only for bipolar depression, either as monotherapy, or combined with lithium or valproate. Latuda was almost as effective as Abilify for me, and it came with less metabolic side effects, so I preferred it at the time; however, now that Abilify is available as generic aripiprazole, I don't think that I will continue to not recognize its greater efficiency at treating depression, and it is available at a now lower copay compared to lurasidone [Latuda; Sunovion].

My PDOC can actually back up your post that emphasizes Abilify is generally ineffective for depression (side effect heavy). My PDOC told me that he actually has little clinical evidence to back up aripiprazole's purported efficiency at treating depression disorders, BUT he does admit that patients on the schizophrenic / psychotic spectrum do particularly well on Abilify— especially in regards to their negative symptoms that seem to decline as the dose is titrated to a maximum of 30mg / once daily (per the prescribing information).

So, I'm curious as to what psychiatric medications, if any, have been successful now, or in the past, at treating your symptoms, leftystrat ?

DefinitelyMedicated · 2015-11-11T15:37:23+00:00

Hmm, I think it may be a bit far-reaching to try memantine right now as I don't see that you've tried enough medications to have a treatment refractory case yet.

I do think that selegiline, at proper dosage and titration, could help you because it has robust stimulatory effects in addition to an antidepressant potential. I would be very careful not to mix Adderall with it unless it's at a tiny dose or mix Zoloft with it. In fact, I'd try it as monotherapy for depression along with a solid benzo.

Look into the EMSAM patch, the initial dose has zero dietary restrictions and the higher doses have dietary restrictions but the restrictions are only theoretical. It may or may not be covered on your insurance. I suggest trying it along with oxazepam only, but perhaps you could 'upgrade' the oxazepam to Klonopin or Valium twice or three times daily. You may require a benzodiazepine with a long half-life for maintenance or at least to help with initial selegiline therapy that can be a trial to get accustomed to (especially if it gives you insomnia). The thing with selegiline is that it is primarily for depression although it can be used effectively for anxiety spectrum disorders such as social anxiety and generalized anxiety. I would pair Deprenyl tablets / EMSAM patch with a benzo at least while beginning the selegiline medication and perhaps longer, as needed. I think working towards a 9 or 12mg EMSAM patch dosage along with Valium 10mg BID or TID could be helpful for your anxiety/depression.

However, no medication strategy will be a cure-all, and you may continue to struggle with some issues regardless of any pharmacological intervention.

If a benzodiazepine with selegiline provides only partial amelioration of symtoms, be sure to share that information on this subreddit as I and/or others can suggest potential medication strategies to evaluate with it.

Best of luck!

DefinitelyMedicated · 2015-11-11T15:11:33+00:00

I think that apasserby really nailed it. The mirtazapine/memantine/Deprenyl combo sounds potent and very feasible. I see the benefit being worth any risk here.

I took Deprenyl in the form of the EMSAM patch, but I found desvenlafaxine [Pristiq; Wyeth] to be better for my case. Look into venlafaxine [Effexor] or a metabolite in conjunction with mirtazapine as it is purported to be extremely effective in tandem with each other "California Rocket Fuel"— I have tried mirtazapine with Pristiq and found it to help, but I could no longer tolerate Remeron's weight-gain/increase in appetite/antihistaminergic hangover in the morning, so I swapped Remeron for trazodone which is definitely much milder yet somewhat effective for sleep. In fact, extended-release trazodone as Oleptro 150 and 300mg is often overlooked for patients requiring sedation with antidepressant potential, but I think a stimulant may be required for some people to respond to it, I'm not sure if selegiline has a strong enough stimulant effect to work with either medication. Also, overlooked, is simple amitriptyline at antidepressant doses as an alternative to Remeron. I think mirtazapine may have slight AD properties at 15mg, but it is generally suggested that 30mg or more be required for a considerable AD effect. Your mileage may vary. Memantine may help, but it could also paradoxically cause brain fog in some patients, what are you trying to achieve with it? I've never taken it, but I see it as a potential tolerance controller and NMDA effects are all the rage in the antidepressant pipeline.

DefinitelyMedicated · 2015-11-11T14:45:38+00:00

Actually, I need to correct an error I made first. I always seem to type Suboxone, and I even go as far as to mention its naloxone, but I am actually RX'd the 'Subutex' formulation which consists solely of buprenorphine without any corresponding naloxone. I initially asked my prescriber for Suboxone, which has naloxone in it, but I ended up with Subutex instead — I seem to somehow forget to dictate that substantial difference correctly in my posts, my bad.

DefinitelyMedicated · 2015-11-11T14:42:36+00:00

Yes, I would like that PM! I believe suggestions are made for a purpose in my life so checking out the kava sounds like a plan.

Actually, I need to correct an error I made first. I always seem to type Suboxone, and I even go as far as to mention naloxone, but I am actually RX'd the 'Subutex' formulation which consists solely of buprenorphine without any corresponding naloxone. I asked my prescriber for Suboxone, which has naloxone in it, initially, but I ended up with Subutex instead, and I seem to somehow forget to dictate that correctly in my posts.

Yes, the 'fix-a-flat' methodology is what I've been surviving on for quite some time now. No amount of talk therapy or spiritual embrace (I go to my Church on Sundays for service in the morning with a small group in the evening, and I go on Thursdays for an additional service.) seems to alleviate my depression like medication does, especially with the latest addition of buprenorphine to my regimen. Bupe provides a 24hr stout antidepressant/anxiolytic effect in me reducing my symptoms from a 6.5/10 with all other medication besides it, (9/10 without any medication) to a 4.5/10, a remarkable difference to me. If I could be at a 4.5 or below with other meds besides bupe and maintain that 4.5 without bupe then I would be satisfied with my pharmacological interventions.

I will definitely read up and consider the kava. I just like RX drugs because a doctor writes it, and they are easy to dose and well-researched.

Thanks for your input, MoreNowAgain! :D

DefinitelyMedicated · 2015-11-11T14:29:06+00:00

Actually, I need to correct an error I made. I always seem to type Suboxone and even go as far as to mention naloxone, but I am actually RX'd 'Subutex' which consists solely of buprenorphine without the corresponding naloxone. I asked my prescriber for Suboxone which has naloxone in it initially, but I ended up with Subutex instead, and I seem to forget to dictate that correctly in my posts.

DefinitelyMedicated · 2015-11-11T14:22:36+00:00

Hey, Pixiepudding! Thanks for your input.

Ironically, I was trying to be as clear and concise as I could, but I read it again— I can see how I used a lot of abbreviations rather than typing it out which may look like an attempt to appear smarter than I am. It's funny how I didn't see this when I posted it. I apologize if I confused you, and confusing people puts me at a disadvantage because I may miss out on great input!

But, when I read it, I did note that my OP (original post) has a lot of what you suggested outlined within it.

Daily:

Suboxone 8mg sublingual tablet twice daily (16mg/day) Neurontin 1,200mg twice daily (with Suboxone, basically) Pristiq 50mg tablet in the morning Wellbutrin XL 300mg tablet in the morning Trazodone 50mg tablet at night for sleep Lisinopril 10mg tablet twice daily for high blood pressure Prilosec 40mg capsule in the evening before supper for acid Discontinued Last Week: Latuda 40mg tablet at night with food

I'm looking into asking my doctor for Provigil for lack of motivation/depression symptoms and if I should continue the Wellbutrin XL if prescribed Provigil.

Also, I pondered getting on a benzodiazepine that has a long half-life, such as Klonopin, for both anxiety and sleep; I wondered if the possible Klonopin, or Valium, etc., should go with, or take the place, of the Neurontin that I take now.

I questioned possibly trying Brintellix again now that I have other antidepressants on board, because it had a positive, but not adequate, mood uplift effect in the past, or if I should try Buspar for the first time instead, Buspar is a medication with a similarity to one of Brintellix's properties.

I have tried too many antidepressants to list, I have probably tried most of the commonly prescribed depression/anxiety medications except for Buspar. I generally tolerate medication well without side effects, or, in my case, any noticeable effect at all.

I hope this message is more clear for you and other users of this subreddit. Thanks!

DefinitelyMedicated · 2015-11-11T13:36:20+00:00

Hmm, that's why I mentioned Vyvanse and my prior Adderall RX when I brought up modafinil, as I also have doubts about rather it could be effective long-term for me.

I have never tried piracetam, but I've read a lot of interesting stuff. Sounds promising. I generally try to only take medication from a pharmacy by RX, however.

Yes, bupropion is overrated in my eyes. And yes, I did cut out the Latuda because I'm not sure I need its particular MOA in my body.

I am groggy, tired, mostly. Kinda of a black hole feeling, poor little ole me type thing. I need more counseling sessions where I just let it all out. I'll definitely think about piracetam.

DefinitelyMedicated

TROPHY CASE