# anecdotal med combinations?



## fattmik (Jun 15, 2007)

I'm fairly new to this board, so first of all, hi to everyone. It was only about a month ago that I realized - or was led to the realization - that this "shut down" and yet strangely agitated state I've been in for over three years now has a recognizable and diagnosable name. Which is frustrating, because I've spent the majority of that time in therapy trying to a) accurately describe the feeling of losing nearly everything internally, and b) looking for a quick fix cure, or hoping that a switch would go off returning me to my formerly fluid state of mind and being. Luckily, the therapy has helped me realize that this condition was not something that merely "happened" - that the signs were there, that I was losing myself maybe long before I began to acutely feel it. I am also no longer looking for a silver bullet, although that is not always the case.

I took a year off from medication after a lengthy trial of varied drugs did nothing to alleviate the dislocation (at the time, it was just considered depression). I was also told at the time that a job would rescuscitate me, but it only made things worse. Unfortunately, I continued to feel shut down and out of it (and became unemployed, I might add), so recently, with a little more patience and knowledge of my condition, I've decided to go back on meds. The Wellbutrin I've been on has agitated me further - it exacerbates the brain fog, and brings some dormant irritability to the surface. On the flip side, it has made me more energetic. But the last two days has brought a rather extreme depression, brought on at least partially by the drug's agititation.

Anyway, all of that is preface. I'm reading Feeling Unreal, and it mentions an anecdotal "hidden pearl that can really help DPD" - a combination of an SSRI and provigil. Has anyone tried this combination? Has it worked for you? Senior members...are there any other anecdotal combinations that have consistently worked? I know people are different, but I'm just wondering what has proven effective as a cocktail for different people. Any stories/thoughts would be appreciated.


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## comfortably numb (Mar 6, 2006)

I don't think there is any special med cocktail that is going to be a hidden pearl in curing this disease for everyone. Basically the cause of most peoples dp/dr is anxiety so i doubt a ssri mixed with provigil would help much as provigil is a weak stimulant. Abit more stimulating then wellbutrin i think but ive only taken wellbutrin and not provigil so im not sure.

The medication that cured me was clonazepam. It totally killed my anxiety and thus stopped my dp/dr and brain fog dead in it's tracks. I had dp/dr and brain fog all my life too and i had it really bad at times.

But there is no medication that is going to work for everyone. If there was nobody would have dp/dr. If you have anxiety and agitation id suggest giving a benzodiazepine such as clonazepam or valium a try. It couldnt hurt just to give it a go.


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## fattmik (Jun 15, 2007)

Yea, I just started going through prior posts and realized that my question had been answered in multiple threads. And that it's nearly impossible to get some kind of medical consensus, although it seems that Provigil has been as agitative for many as I find the Wellbutrin (which I came off of today).

I didn't mean to give the impression that I was looking for a one cocktail cure all. But you would figure in the broad spectrum of DP/DR sufferers that some combination would at least have a decent track record, no? I hoped. And I guess you're saying that the mild benzos are helpful for many people.

I am on klonopin, I started it when I began the Wellbutrin trial. It helps with the anxiety, but the emotional blunting remains, and at times, I hate feeling calm and empty more than I hate feeling frustrated and empty.

At times. When I'm not crawling out of my skin.

This is such a crazy way to live.


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## comfortably numb (Mar 6, 2006)

Benzos are helpful for alot of people with dp/dr and brain fog. Clonazepam for some reason seems to be especially helpful. But they don't cure all the symptoms for everybody although they did for me. I guess i got lucky.

For the emotional blunting i really don't know what you could try. A anti-depressant would be a logical choice. A ssri might help or possibly remeron or a tricyclic. Id give one of those a try with the klonopin.

I had good results with amitriptyline which is a tricyclic when i was depressed. I was on this when i first started taking the clonazepam. It works great for major depression and alot of studies have shown it to be better then the ssri's.

But it has side effect's that alot of people don't like. It has pretty bad anti-cholinergic side effect's such as daytime drowsiness, bad dry mouth, weight gain, sweating, overheating and etc. But the upshot is that it tends not to cause sexual dysfunction which is a big plus in my book. Also it's hands down the best sleep aid ive ever tried ever better then seroquel.


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## fattmik (Jun 15, 2007)

Thanks for the idea. Meeting with the psychopharmacologist at the end of the week, so hopefully I can find an antidepressant without too much more trial and error. He did mention the tricyclics as a possibility last time, and I am wary of the sexual side effects of the SSRI's, so maybe it's a good fit.

I'm half cursing myself for rolling the dice once again with the medicine, cause it's such a crapshoot and expensive and clearly no solution. I came into it looking for that 20 percent push - the ignition to lift me out of this entrenched DP funk - and I'm working hard to stick to that expectation. The process of placing bets on these drugs can make me a little chemically greedy.

I'm just glad that I found this resource for the time being. Thanks again.


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## mark75 (Oct 23, 2006)

For me personally - Provigil cuts through the 'brain fog' like nothing I have found to this point at least.

I have high amounts of anxiety, but the Provigil has never felt like it excacerbated it. For a long time I took Wellbutrin, and although it helped me a tad with depression I felt jittery and unconfortable on it.

The pleasant alertness of provigil contrasts greatly with my experiences of increased anxiety with anti-depressants....but all of our brains are different =)

I haven't taken it with an SSRI (referencing original question about this) - but I have taken it at the same time as wellbutrin and lamictal.

I take 100mg right now per day.

I am prescribed for 200mg, but I am trying to see if i can get a benefit from the lower dose to save money. Not as potent as 200mg, but still helps.

Hope this helps a bit
cheers


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## fattmik (Jun 15, 2007)

Thanks for the tip. I'm currently on 75mg of nortriptyline, a tricyclic antidepressant, that has helped with the coinciding (or possibly instigating) depression. Still emotionally blunted, for the most part, still have difficulty thinking fluidly, though I'm trying to notice and track the minor emotional and cognitive movements more.

I talked to the psychopharmacologist about Provigil today, and I mentioned your success. I've had some chest pain so far with the nortriptyline, so I have go through second round of cardiac tests to ensure that my heart's in good shape before adding another stimulating med...but I'm hopeful. He said that Dr. Simeon, who I saw for a consultation a few months back, included Provigil in her general recommendation of drugs to try.

Either way, always glad to hear of someone's good experience, and I hope you continue to feel better.


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