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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by porkpiehat on November 1, 2016, at 15:08:58
I have GRE on Thursday Afternoon and a grad school interview Saturday. on my current mix of effexor/lamictal I can't really stay focused or relaxed enough so It's too late to fiddle with that.
I have been taking small amounts of vyvanse and it brings my brain up to speed but then a little too speedy, which could break either situation.
I'm left considering propranolol and/or klonopin in addition but I don't want to impair my cognition...any thoughts on these mixes?
Gracias
Posted by rjlockhart37 on November 1, 2016, at 16:40:43
In reply to Testing interview combo needed!, posted by porkpiehat on November 1, 2016, at 15:08:58
propranolol blocks norepinephrine, it does take the edge off and feel back down to earth but it can cause cognitive slowing, klonopin is just calm down, but sometims it can cause mental depression at moderate doses.....
maybe ask about like lyrica or something, it doesnt really seem to have much cognitive impairment
Posted by rjlockhart37 on November 1, 2016, at 16:42:20
In reply to Re: Testing interview combo needed!, posted by rjlockhart37 on November 1, 2016, at 16:40:43
i would go with klonopin by itself, it takes anxiety away pretty well
Posted by linkadge on November 1, 2016, at 20:02:14
In reply to Re: Testing interview combo needed!, posted by rjlockhart37 on November 1, 2016, at 16:42:20
I would do your best to stay in 'the zone' yourself and only take a med if you are way out of the zone.
Stick to meds you are prescribed. If you do take a beta blocker start with very low does and only take what you need to stop tremor / heart racing.
Stimulants can oftentimes be counterproductive in stressful situations, but its really hard to tell.
If you have word finding difficulty, I find that cholinergic agonists (such as small doses of choline or even simply black tea) can be helpful.
Eat well too (i.e. omega-3 eggs in the morning)
Good luck,
Linkadge
Posted by porkpiehat on November 1, 2016, at 21:48:43
In reply to Re: Testing interview combo needed!, posted by linkadge on November 1, 2016, at 20:02:14
I am prescribed all these meds, I just seem to feel so different throughout the day (on a regular schedule, and unfortunately morning and after lunch are the worse. I feel much better in the late afternoons and early evenings.
I've never allowed myself to take more than .25 mgs of klonopin at a time. Alone, unless I'm having severe anxiety beyond cloudy thinking and disorganization a full .5 mgs can be too sedating.
However, today, I felt crappy and disorganized before I sat down for a mock interview after just taking effexor and lamictal. Realizing I wouldn't be able to keep track of myself I took 10mgs vyvanse (super low dose) and for the first two hours I was engaged. then taking a practice test I did OK but started feeling speedy.
To experiment I took a full .5 mg klonopin and it almost took me past speedy. I took my afternoon lamictal and it seemed to even everything out completely.
I don't think it's unfair to take a full .5 mg of klonopin given that that's half of what I was originally prescribed. The Vyvanse probably did its part also.
It feels dodgy to pair two of the "worst" drugs to feel normal. But I'm going to try it at the start of the day tomorrow and see if I feel interview-worthy in the morning, and competent to test at 1pm and go from there.
Posted by SLS on November 2, 2016, at 6:00:54
In reply to Re: Testing interview combo needed! » linkadge, posted by porkpiehat on November 1, 2016, at 21:48:43
Hi.
Your reaction to clonazepam (Klonopin) is interesting and paradoxical. It may be a form of disinhibition that sometimes occurs with benzodiazepines. There might be a clue in there somewhere. Do whatever you need to in order to deal with your current demands. I wouldn't want to encourage you to do something that would make you feel worse at this time.
Q:
I am curious if ADD/ADHD has ever been considered as a comorbid condition. Have you ever tried a tricyclic? If so, which ones? Have you ever tried Focalin or some other form of methylphenidate (Ritalin, Metadate, Concerta)? What dosages of Lamictal and Effexor are you taking? How does caffeine affect you?
I'm sure Linkage has a few good ideas.
- Scott
Posted by porkpiehat on November 2, 2016, at 8:06:37
In reply to Re: Testing interview combo needed! » porkpiehat, posted by SLS on November 2, 2016, at 6:00:54
My effexor is 37.5 mg and lamictal is about 100-150. It's not the best combo but I can't change it during a busy semester. Effexor is more helpful at lower doses than celexa was, which made me easily aggitated/hard to concentrate at lower doses. After 10 years it started reacting funny with the lamictal.
Although I think my ability to read smoothly and comprehend is much better at a full dose of Celexa (40 mgs) or Buspar...indicating my problems are much more anxiety-based, there are major drawbacks to those.
Ive been relying on low-dose SSRI (effexor currently) to keep my suicidal depths at bay, social anxiety down, and keep away night terrors.
Focus and motivation is coming thanks to a low dosse stimulant. Interestingly, when I go to organic chemistry class without taking it, I struggle with my professor's Indian accent and can't understand what he's saying, and struggle to keep up in general.
I think there's a comorbidity ADD/GAD that affects my concentration. And we know that extreme distraction and dissociation is a hallmark of trauma.
Current problems are the mix of effexor and vyvanse over time has led to some very mean thoughts, and a feeling like I'm detatching emotionally from the rest of humanity. It's also nearly impossible for me to sleep soundly since starting effexor.
Ambien, Benadryl, melatonin, and now ativan barely scratch the surface. Ativan and Nyquil was working but the mornings were rough. Any suggestions on the sleep end of things?
After admissions I'll have to investigate something else. I'm not a big fan of the effexor but I've been in worse places before.
Posted by Porkpiehat on November 2, 2016, at 10:53:10
In reply to Re: Testing interview combo needed! » SLS, posted by porkpiehat on November 2, 2016, at 8:06:37
I'm finding a lot of mornings that I'm in kind of a foggy druggy feeling after taking the Effexor lamictal combo and the stuns don't clear I out until noon or so. Bad for morning interview. Maybe take Effexor at night I'm not sleeping anyway
This is the end of the thread.
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