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Re: Is your apt. messy? How to clean when.... » jerrympls

Posted by Keith Talent on June 10, 2004, at 8:26:50

In reply to Is your apt. messy? How to clean when...., posted by jerrympls on June 8, 2004, at 19:29:40

> Effexor XR 375
> Valium 10mg/4x daily
> Concerta 56mg am/18mg late afternoon
> Seroquel 200mg (for insomnia and nighttime anxiety)
> Ambien 20mg (in case I wake up and can't get back to sleep)
> Synthroid 0.0125mcg

> I've told all this to my pdoc - but it's in one ear out the other.

New psychiatrist time?

> when I was on nortriptyline, dextroamphetamine and alprazolam I always kept my apt. clean even though I was severely depressed!

What doses of these three drugs were you on?

What is/are your diagnos(i/e)s?

If the main problems are depression and anxiety, then I would:

- substitute clonazepam (about 4 mg twice daily) for the diazepam

- drop the quetiapine

- drop the synthroid unless it's for a thyroid hormone deficiency

- substitute dexmethylphenidate (Focalin) for Concerta and take it every two waking hours until you finish work for the day (I know that's a pain, but it will have a rapid onset of action and keep smooth benefits throughout the day), or go back to dextroamphetamine (immediate release) taken three times daily

- try avoiding the stimulant in the few hours before bed, or as soon as you finish work for the day

- if still depressed, increase the venlafaxine extended-release to 300 mg twice per day (but only if you've wound up the stimulant dose to a really high level already, because the stimulant will augment the antidepressant's beneficial effect - especially relating to drive/motivation)

- if the venlafaxine still doesn't help enough, change to another antidepressant

- continue using the zolpidem 20 mg as needed

I'm sure that you can find a combination that serves you much better than your current one, Jerry.


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URL: http://www.dr-bob.org/babble/20040608/msgs/355345.html