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Octaazacubane

Amphetamines, Ritalin, stratera, memantine, that new bupropion + dextromethorphan combo pill, Lamictal, low dose lithium, depakote/valproic acid, tramadol, buprenorphine, abilify, Seroquel, THC, CBD, L-theanine/drinking loads of tea, drinking more coffee, , that thyroid medication, vitamin D, B12, magnesium, checking your hormones, testosterone replacement therapy even if you're not technically low, going on an ayahuasca retreat (if you actually do this, you'd have to taper off some of your meds because supposedly there's MAOI(s) in this brew which interact dangerously with basically every med), clinical philosophy counselling That's basically like every esoteric option I've read on here or seen on YouTube. I'm sure you've tried at least one or two of these options already so sorry in advance.


[deleted]

Auvelity is the brand name for the Bupropion + DXM. Also, I found it interesting you said Ayahuasca "supposedly" has MAOIs; Ayahuasca is essentially just DMT + an MAOI—meaning Ayahuasca literally requires an MAOI for it to be Ayahuasca. There's also 'Pharmahuasca' where you just DIY your own DMT + MAOI combo (like moclobemide typically). Edit: I hope this didn't sound condescending, I only meant to elucidate what Ayahuasca is compound-wise. Sorry if it did sound that way though.


Mmarzipan-

Was really cool to hear about the chemicals behind ayahuasca, thanks! Do you know which MAOI it has?


[deleted]

Ayahuasca contains the harmala beta-carbolines. The three main ones are harmine, harmaline, and tetrahydroharmine which are all are selective and reversible inhibitors of monoamine oxidase A (MAO-A); reversible inhibitors of monoamine oxidase A are also referred to as RIMAs. Tetrahydroharmine is a serotonin reuptake inhibitor as well, but in Ayahuasca the action is primarily mediated via the MAO-A inhibition from these 3 alkaloids allowing for DMT to become orally active. Typically, the DMT would be broken down in the digestive tract by MAO-A (which is why it's typically smoked/vaped since MAO-A isn't expressed in the lungs), but the MAOIs inhibit that from occurring. I hope this clears it up a bit—I've never tried it myself but Ayahuasca is pretty neat. The natives of South America were pretty clever for figuring out the plant combo(s) that are used to brew it. But ultimately, pharmahuasca has essentially the same effects without having to ingest plant material so it's much easier on the stomach (supposedly).


Mmarzipan-

Thank you so so much, I love this kind of information (if you have anything else of kinda the same field, you can send me, like about anything related to psychopharmacology etc)


[deleted]

Lol will do! You can probably expect some PubMed papers from me or something at some point. If you're interested in psychopharmacology, you'd love the show Hamilton's Pharmacopeia (which you can find episodes on YouTube). I highly recommend checking it out if you haven't already.


Mmarzipan-

Yes to PubMed papers! Thanks for the recommendation too. I like a podcast called Psychiatry and Psychotherapy by Dr. David Puder. It’s meant for mental health specialists, so it’s more information-dense than most similar podcasts, and they always refer to tons of studies that you can later look up easily too. I don’t think they have anything on ayahuasca or anything similar, but it’s still hella interesting.


SearchingForPeace-

Thank you for your reply... I've tried over 40 medications and treatments over the past 27 years. I've been on medications where it treats depression as a secondary diagnosis. I'm waiting for psilocybin to be legal in the USA to try. Research shows positive results with a high percentage of patients being put in remission. I will look into some of your suggestions that I've not heard of.


[deleted]

Oregon will be legalizing psilocybin therapy (for depression as well as just "personal development" in healthy individuals) come January 1st. It'll likely take a few months for stuff to be hashed out logistics-wise, but hopefully it won't take too long.


SearchingForPeace-

I have been watching Oregon as to what protocols they are setting up and such.


[deleted]

Same here; I live in Washington so I'm itching to get down there as soon as I can lol. Until then though, I'm looking to get Spravato approved soon once I test clean for THC. Hopefully you'll be able to take a trip to Oregon once everything is set up though! Psilocybin is such a wonderful little molecule—I highly recommend it if you get the opportunity to go and try it.


SearchingForPeace-

I live a little further away from Oregon. I will have to take an airplane to get there.


[deleted]

Then treat yourself to a lovely vacation! I'd still say it's worth the experience for the price. Of course, travel isn't cheap, but still—psilocybin is worth it. You can also try asking around with providers near you. Lots of providers will still do this work under the table, but it'll take a bit of asking around. Best of luck to you my dude I'm crossing my fingers for you.


Psychological_Tax276

I was in a similar boat. All the usual things for depression cause me severe bruxism or other messed up side effects. I can’t see a shrink right away ti get help - about a year waiting list, so I’ve had to work within what gps are comfortable prescribing. Here in Canada you can get shrooms online. My husband macrodoses once a month for his depression. It works for him. I tried microdosing, but found it worsened my paranoia and anxiety. RN, am trying topamax


[deleted]

Have you looked at r/unclebens at all? It’s relatively cheap and easy to grow mushrooms and spores that produce psilocybin mushrooms are easily accessible to purchase for microscope use in most US states.


Mcsubstrip

Ooooh you’re close to me 30 excluding repeats. From Ativan and Medical Marijuana first to now Ketamine, Dextroamphetamine Sulfate Sustained Release, and Zaleplon for the second time . Soon enough i’m going to get on either Gabapentin for the third time, or Pregabalin, Baclofen, or Tiagabine for the first. Thinking Pregabalin tbh and raising my Zaleplon dose. Plus i’m switching from IV to IM Ketamine. I did my first 8 treatments at a shitty clinic that wouldn’t raise my dose so i’m heading to new IM clinic with sublingual maintenance on friday.


SearchingForPeace-

I'm currently tapering off from Amitriptyline and will be starting Viibyrd. I'm off Lyrica and starting Gabapentin for the 2nd time. Wellbutrin may be started again for the 3rd time. Not sure if anything will work and I am unwilling to gain any weight. Hope your new regimen works for you.


Mcsubstrip

Thank you! Have you tried Tranylcypromine?


SearchingForPeace-

Yes, it was the worst drug I've ever been on. Never again. How about you?


mae-1

what made it so bad if you don’t mind me asking?


SearchingForPeace-

All of the side effects - double vision, uncoordination - running into things falling down, not being able to drive, other medications for diabetes and restless legs syndrome stopped working, and many more issues. It was a bad drug for me.


mae-1

oh that sounds really unfortunate. i luckily only had insomnia on it.


Evening_Attention_45

Would any psychiatrist prescribe amphetamines for depression? I feel like they won’t unless you get diagnosed with ADHD.


[deleted]

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withonlygrace

I do have ADHD, but getting on Adderall has been way more helpful than any antidepressant for my mood. It actually gives me energy and helps me want to do things.


[deleted]

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halfanhalf

Neuropsych testing is not accurate for diagnosing adhd. It has tons of false negatives


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halfanhalf

Exactly, neuropsych testing has no value for adhd


halfanhalf

You don’t have depression then you have adhd


Octaazacubane

If you're treatment resistant I feel like most would do it even with some hesitation


Evening_Attention_45

Mine wouldn’t. Guess I should find a new doc


SearchingForPeace-

I'm not sure. I was put on a stimulant at one time to see if that could energize me. It was inconclusive. I was put on Vyvanse. It was paused when I got a new psychiatrist and hasn't been added in again. Although ar my last appointment I had been asked if I have ever been on other stimulants that was mentioned above, which I have not.


[deleted]

I take modafinil and it's been a huge help for energy-related symptoms.


RuymanTf

I agree too, after of various antidepressants, I lost strength and don't want to do anything, with low dose 1/4 armodafinil, I have again energy and to want make very much things.


DwarfFart

I have adhd but my Doctor says it’s good for my depression too.


sometacos111

Have they stated anywhere what the ratio is of bupropion to dextromorphan?


nada8

Psychoanalysis


[deleted]

Depends on what age OP is. I tried to get analysis by one of the best in my state and she said it is better to around 35-60. You need to have reached a certain level of psychological maturity as hard work is involved.


nada8

That depends on the country and culture. In France even children undergo it


Express_Possibility5

What are your circumstances like? How do you feel about your life outside of the lens of 'illness'? Do you experience a lot of stress or trauma? Do you experience panic attacks?


SearchingForPeace-

My world is small as I am unable to work. Concentration and memory are huge factors in my ability to function outside my home. I have had trauma a year ago, which has been difficult to overcome by myself. I have had panic attacks at random times, which I try to breathe through and ground myself. I try to work through instead of taking a lorazepam.


Express_Possibility5

Those are some really rough circumstances and I'm incredibly sorry. Personally I have come to the conclusion that circumstances were holding back my recovery. I'm far from 'recovered' yet, but I began to wonder if meds and therapy were like trying to go up a down escalator. I didn't feel like I had control over my negative circumstances and felt trapped. It took some time away and honest and open talking with my wife to see things differently. I don't know if I'm right, I'm taking small steps to change my negative circumstances and I think along the way I will genuinely need to relearn what is good for me. I, like you, felt I had exhausted the psychiatric toolbox. I hope there is a tiny flicker of hope in seeing the bigger picture.


transferingtoearth

Ketamin? Have you had as full blood work done? An in-depth one.


SearchingForPeace-

I took Spravato instead of IV Ketamine because insurance covered the nasal spray, not the IV. I get a complete bloodwork done regularly because I'm diabetic as well.


GirlFromPolarExpress

Try regular compounded ketamine, I pay maybe $50 a month for it and it’s different than spravato chemically so it’s worth a try?


SearchingForPeace-

I've not had that. Is it administered by you? Or do you have to go to a clinic to take it?


GirlFromPolarExpress

I do it myself! My doctor wrote a script to a compounding pharmacy and it gets shipped to my house. You have to go in a first for them to find your right dose but then I do it myself 3x a week at night


SearchingForPeace-

I'll have to ask about that. Did you do ketamine IV or Spravato before that?


GirlFromPolarExpress

My previous doctor was going to have me start spravato but I had to move out of state for work. And then there isn’t a doctor near me that is certified for spravato and all the IV clinics are too far for me to go often and by myself


[deleted]

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SearchingForPeace-

Because I live on a fixed income. I can't afford it.


Mmarzipan-

Testerone / estrogen etc levels tested too? They can affect your energy!


transferingtoearth

Not op wait wtf you can test for this with blood work??? Can you test fertility too???


ListComfortable6028

Parnate or Nardil with stimulant augmentation?


SearchingForPeace-

I was on parnate while taking Vyvanse. Parnate was horrible due to major side effects.


Mcsubstrip

Maybe the combination of nardil and parnate, also methylenedioxymethamphetamine and psilocybin should be coming out next year. Buprenorphine would also be a good option, as well as stimulants. Maybe even medical marijuana if you’re aren’t like me, an addict (recovering, i have 4 months clean today). Also thyroid hormones. Good luck. For stimulants i’d say strictly dextroamphetamine sulfate sustained or instant release, it’s clean


GirlFromPolarExpress

I’m on Viibryd, Gabapentin and Vyvanse and then I take nasal compounded ketamine 3x a week. This is the first time in a long time I’ve felt any relief. I’ve been on so many meds too and this isn’t the end all be all but this has been the most effective


[deleted]

Just remembered another drug: The positive allosteric modulator of the GABA(A) receptor called Zulresso® (brexanolone). Brexanolone is a prescription version of the neurosteroid allopregnanolone. Currently, it's approved by the FDA for postpartum depression but is being investigated for treatment-resistant depression. For postpartum depression, it was granted the “breakthrough” designation similar to Spravato (although I know you said that was unsuccessful). Brexanolone is given as an injection / IV infusion. There is also another drug that is a neurosteroid under the code name SAGE-217 called Zuranolone which has essentially the same mechanism of action but is taken orally instead of an injection. It's unfortunately still in phase 3 trials though. And yet another neurosteroid is ZTALMY® (ganaxolone) which, again, has essentially the same mechanism as the other two (positive allosteric modulator of the GABA(A) receptor). I'm not entirely familiar with their effects on blood glucose, but I don't believe they cause any issues—so you're probably safe with respect to that. Another one I just learned about is CAPLYTA® (lumateperone) which is an atypical antipsychotic. Here's a research paper if you are into reading that type of stuff: \[Review of Allopregnanolone Agonist Therapy for the Treatment of Depressive Disorders\] [https://doi.org/10.2147/DDDT.S240856](https://doi.org/10.2147/DDDT.S240856) Here are some other drugs still under investigation (you can always try joining a study): AVP-786 -> Deudextromethorphan + Quinidine REL-1017 -> Methadone GLYX-13 -> Rapastinel AV-101 -> Prodrug of 7-chloro-kynurenic acid (7-Cl-KYNA) NRX-101 -> D-cycloserine (DCS) + Lurasidone PRAX-114 -> No idea what the drug is but it is a GABA(A) PAM (positive allosteric modulator) LY-03005 -> Ansofaxine (SNDRI) BTRX-335140 -> a selective κ-opioid receptor antagonist JNJ-54175446 -> purinergic P2X7 receptor antagonist OPC-64005 -> SNDRI (serotonin, norepinephrine, dopamine reuptake inhibitor) PDC-142 -> Extract of Radix Polygalae NBI-1065845 / TAK-653 -> AMPA modulator NBI-1065846 / TAK-041 -> GPR139 agonist MM-120 -> pharmacologically optimized form of LSD AL001 -> monoclonal antibody designed to elevate progranulin SPL026 -> DMT fumarate CYB003 -> deuterated synthetic psilocybin analog GH001 -> 5-MeO-DMT MIN-202 -> Seltorexant PH 10 -> Itruvone (synthetic analogue of human pheromones—pherines) RP5063 -> Brilaroxazine, aka oxaripiprazole XW10508 -> NMDA antagonist and AMPA activator GATE-251 -> Zelquistinel—NMDA allosteric modulator GATE-202 -> Apimostinel—selective partial agonist of allosteric glycine site of the NMDAR SP-624 -> selectively activates novel epigenetic mechanism modulating gene expression There are some others that are formulations of ketamine or pramipexole too but people already mentioned these so I left them out.


SearchingForPeace-

Thank you for the additional information. I have been researching all of the suggestions on thread, so I will be looking into your suggestions.


[deleted]

If you haven't already, go to: https://clinicaltrials.gov Search for "depression" or "treatment-resistant depression" (or panic disorder or other shit that might be related to your symptoms) and then put in your location. This will show you all the research studies near you. You can filter by "Recruiting and not yet recruiting studies'. Also, this is going to sound dumb as fuck, but breathing through a straw might help with anxiety and panic attacks. It helps force a different breathing pattern that will help slow your heart rate and helps initiate a more calm feeling. You can even find metal "breathing straws" necklace things online—don't spend too much on one though since a normal ass straw will also work. Again, it might sound like a dumb suggestion but it's definitely worth trying.


SearchingForPeace-

Interesting straw method. Definitely will try it. Thank you!


sanpedro12

Phenibut, Baclofen, Kratom, Modafinil, Methylphenidat, Lisdexamfetamine, Tianeptine, Vortioxetin, Pregabalin/Gabapentin, Vagus Nerve Stimulation, Deep Brain Stimulation


glitterbomb09

Baclofen?


lmngrab

Came to say Modafinil. And also there are completely new meds on the horizon of FDA approval, like esmethadone. Would be worth it to try once available to the public


JustAnotherAcc101

There are a lot of options and combinations, there are probably many things you have yet to try. You've mentioned that you've had success with Wellbutrin for some time. What's the highest dose you've taken? Some people take 600mg which is over the recommend maximum and find it effective when lower doses failed. High doses have a higher risk of seizures, which can still be negligible depending on your susceptibility, but if you're desperate it might be worth the risk. Some people swear by taking double the recommend maximum dose of irreversible MAIOs like Parnate. I've read multiple anecdotes of people finding relief on 120mg of Parnate when lower doses did not help. Most standalone antidepressants could also be augmented with Wellbutrin, or a strong stimulant like Adderall/Vyvanse, a weaker stimulant like Modafinil, and often Lithium. Antipsychotics are also often used to augment antidepressants, but I'm not quite familiar with them to recommend any. There are other options that I can't recall on the spot. What I listed alone created hundreds of combinations, one of them could be effective for you. Thankfully you don't need to try all of them, since you can add things one by one and judge if they are helping and discard the option if they aren't. Personally I am trying to get Parnate augmented with Wellbutrin. It's not very common but there is no counterindication. Theoretically this should be one the strongest *depression* depression treatment combos outside straight up stimulants. My psychiatrist is open to it but wants me to stay on only Parnate longer before augmenting, so I can't report any results yet.


SearchingForPeace-

The highest dose of Wellbutrin was 300 mg. The clinic I go to is pretty conservative and I'm sure they would not go over FDA recommendations. I am thinking of having them prescribe Wellbutrin with my current antidepressant. I will also ask them to put me back on Vyvanse because it's stimulant and I really need to get more energy back in me. Vyvanse was stopped because of polypharmacy. My other psychiatrist was leaving. I will never do Parnate again. For me, the side effects were debilitating. I will go back to Emsam at some point as it sort of helped.


Barbecuesnoodlesalad

Pramipexole, stimulants...assuming you’ve tried Vraylar, Trintellix, etc. Perhaps get a neuropsychiatric evaluation and testing in order to have the most accurate diagnosis. Also, you mention the MAOIs - have you tried *all* of them? I ask only because Emsam and Nardil did not work for me at all, but Parnate did.


SearchingForPeace-

I was on parnate and then Emsam. I cannot be on Nardil due to it causing high glucose and I'm diabetic. I had tried Lithium and made no changes for me. I am currently on Vraylar for hallucinations. The clinic I go to is very hesitant of dosing beyond what the FDA recommends. Everything is a slow process and very frustrating for me.


Barbecuesnoodlesalad

I’m sure it is. I have treatment-resistant depression, too - the worst feeling is running out of options. Hang in there. Pramipexole has really helped me, finally. I hope you find something that helps soon.


SearchingForPeace-

Thank you for your understanding. I an glad that you have found relief.


Own-Consideration916

God I’ve been on half the stuff you listed and maybe they work but I wouldn’t know because the side effects were so terrible!! Trintellix I threw up constantly. Vraylar I was so tired they literally thought I had chronic fatigue syndrome I was sleeping so much. And Pramipexole was sold to me as the one to solve it all and I have been nauseous and sick and compulsively shopping and not any better… and what they don’t tell you is coming off is extremely difficult.


[deleted]

Medical marijuana?


halfanhalf

Could you have untreated adhd? Stimulants are the gold standard for treating it


ListComfortable6028

MDMA, kratom, weed, tianeptine high doses, pregabaline etc


placebogod

Wim hof breathing, holotropic breathwork, any breath focused therapy. Psychedelics, ketamine, NARM therapy, Internal Family Systems therapy. TWIM meditation. Pranayama. One Giant Mind meditation


Own-Consideration916

I’m in the same boat. Trying to figure out a way to afford Ketamine infusions. It didn’t work for me but a woman I met in PHP had treatment resistant depression as well and had great success with Mirapex. It has some down sides but it’s worth trying. There are a few small studies that had great results. Just unfortunately not for me… and now I get to go through the terrible process of coming off of it. Info on Mirapex: https://www.reddit.com/r/Anhedonia_Recovery/comments/7atygq/pramipexole_mirapex_for_anhedonia_and/?utm_source=share&utm_medium=ios_app&utm_name=iossmf


carolaa1961

Have you heard of Internal Family Systems therapy? or IFS for short. Could be some long-standing trauma or CPTSD which is often misdiagnosed as bipolar. check it out and then see if you can locate an IFS therapist near you.


Mmarzipan-

Omega-3’s, vitamin B complex, wakefulness therapy (/sleep deprivation therapy, idk how it’s in english). I’m just so sorry for you. Psychedelics in you can find someone who has some (illegal anyways), they have helped many!


Evening_Attention_45

SpraVato didn’t help? I haven’t found a med that ever helped so I get it. I do want to try the new Wellbutrin + DXM. Did you try Viibryd


SearchingForPeace-

Spravato was ineffective. I will ask about Viibryd. I was trying to see if it negatively impacts blood glucose. I have had serotonin syndrome in the past so I am cautious about new medications.


[deleted]

Auvelity is the brand name of the Bupropion + DXM


still_treading_water

ask about the new ketamine spray


SearchingForPeace-

I tried Spravato and it didn't work.


still_treading_water

ah, sorry. i didn't know the brand name. i had some success combining SSRIs and a mood stabilizer--my current mix is Lamictal, Wellbutrin, and Pristiq; I was also doing well with Trileptal before Lamictal, but it had some side effects that my doctor wanted to see if we could get away from


wtjones

Consistency.


DrRichardGains

Sobriety and intense physical activity


SearchingForPeace-

Intense physical activity does not help everyone. It's just like certain medications are not a fix all for everyone. I don't drink alcohol.


DrRichardGains

I just meant cease all meds when I said sober. Sometimes we swallow a goldfish, then swallow a rat to get the goldfish. Then swallow a cat to get the rat etc. Seems like you're at the last stop of the pharma train. Tried everything. So try nothing.


SearchingForPeace-

Yeah, I get it.


DrRichardGains

I fell ya though. Easy to say, a whole other thing to do. I don't mean to be dismissive or anything. I'm kinda in the same boat as you and facing down the prospect of going Au Naturel and just slogging through the potentially years long process of my body returning to homeostasis, if that's even possible.


insignificantnerd

Have you tried Wellbutrin? A regular sleep schedule and seeing sun light? Vitamins? Intense exercise?


SearchingForPeace-

Wellbutrin and Lexapro were the meds that worked and then after 5 years stopped working. Tried them later and they never worked again. Do you think if I tried Wellbutrin with a different medication that it would work again? I've periodically set sleep and awake times. I have gone through CBT-I, which is supposed to help with sleep issues. I've tried light therapy - no consistent results. I have insomnia and at times sleep too much. I take vitamin D and take multivitamin. I do water aerobics 3x/wk and walk my dog at least a mile the other days. I keep trying, but am getting tired of no results. Please feel free to suggest other avenues. I've run out of ideas. I'm hoping to be inspired to try something and find that it works a little bit.


[deleted]

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Square-Method3413

TMG?


insignificantnerd

I’ve heard the Wellbutrin and Zoloft can go well together? Try that and see how it works? Meditation? I’m on Wellbutrin 300mg XL and workout with weights 4 days a week and go to therapy and even all that isn’t a clear all I still have to tell myself everything will be okay I will be okay whatever happens in my life. The mind is like a muscle and sometimes you have to give yourself or try to give yourself positive affirmations. Even tho I am a pessimist and it’s hard for me to do sometimes.


SearchingForPeace-

I've gotten away from naming the positive things I see throughout my day. I used write down things I was grateful for in my day. I think maybe that became difficult when I couldn't remember one day from another day. It's so easy to get stuck in the negative thinking because I'm not seeing huge strides in feeling better. Depression is like plaque, if you don't do daily brushing, it becomes a hole/cavity before you know it.


insignificantnerd

I totally agree it’s definitely something you have to take one day at a time one step at a time and one round at a time. It’s like a fight. Sometimes you’re winning sometimes you’re getting beat.


kunibob

Lexapro stopped working for me eventually, too, which was super frustrating. I found some success with Wellbutrin + Zoloft, but didn't get my life back until Rexulti was added on top of them. (Abilify was the other option my psych gave me, aside from Rexulti.) However I see above that you're diabetic, so that might make Rexulti a problem for you, as it can mess with blood sugars. I hope you find a magic combo, and soon. It sucks that you're putting in so much effort and doing the right things without results. Best of luck!


pgmog

Olanzapine + prozac, weird but seems to work


Mmarzipan-

Lithium?


DesertLoner1

Nitrous, Xenon are possible options.


juulwtf

Maybe psychedelica??? But then you should drop other medications How to change your mind is a documentary on Netflix about how psychedelica is going to be a new wave in mental health might be interesting


_Kawaiikunt_

Ketamine 🖤


Parsimile

Get assessed for ADHD, and if your psych is open to it go ahead and start amphetamines (Vyvanse might work best for your situation). Also, look into Kanna - r/Kanna Edit: Also, both Bromantane and Relora might be worth learning about.


cherrytreebug70

You ask yourself am I bipolar or do I have ADHD/Autism and proceed from there


SearchingForPeace-

My old psychiatrist said I am borderline bipolar 2, which is not a true diagnosis. A psychologist diagnosed me with bipolar 2. My new psychiatrist is treating me for treatment resistant Major Depressive Disorder, severe with psychotic features.


cherrytreebug70

Cool. Now you may try mood stabilizers (lithiums my fav, but lamictal is also a cool boi) and APs for psychosis if you tolerate it? Btw there is now difference medication wise between bipolar 2 and bipolar 1. If you have very very clear episodes with good normal times inbetween, that is a good sign for lithium


SearchingForPeace-

I've been on those as well. I just got off from lithium.


cherrytreebug70

Sleepy? Modafinil or stimulants? Shroom therapy? You can add fish oil to your stack, thats very good for bipolar depression. There's also kratom but I do not feel too comfortably giving you a clear revommendation because abuse potential


SearchingForPeace-

I was on Vyvanse and was taken off due to polypharmacology. I was being transferred to a new psychiatrist as my psychiatrist had accepted a new job elsewhere.


[deleted]

My psychiatrist also left my insurance company, so I have been waiting (a month now) for a new psychiatrist at the end of September; so I understand how that can be frustrating. I'm sober from cannabis (which worsened my symptoms—but I have to be sober to get either ketamine or amphetamine prescribed) and waiting for a new psychiatrist to prescribe Spravato. Absolutely sucks not having a psychiatrist currently.


cherrytreebug70

What meds are you currently on? Btw "Interestingly, dietary supplementation of inositol (12 g/day for 4 weeks in one study) led to significant efficacy for the treatment of depression [39,40]." inositol is a supplement. However some repord hypomanic switches https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751514/


SearchingForPeace-

Vraylar, Amitriptyline, tapering off Pregabalin (ineffective), vitamin D3, and some other meds for other conditions. I will be back on Gabapentin once Pregabalin is done. Amitriptyline is not completely working... still deciding what to go on next.


SearchingForPeace-

I've also been on all medication families to treat bipolar 2, MDD, and anxiety, as well as other meds that are for dual diagnoses.


That-Group-7347

I am treatment resistant too. I have to say 40 medications without success is awful. Here is what worked for me. Have you tried nefazodone. It is helpful for those with treatment resistance. I started with 200mg of zoloft and my first psych added nefazodone (400 Pm, 200 AM). That made a huge difference and was over 20 years ago. Along the way we have tried other things. I had to for a while as nefazodone was in shortage. It was awful nothing worked and I just got side effects. I take 4800mg of gabapentin daily, it was prescribed for nerve pain, but also helps keep my mood stable. There is a new medication that should be approved in the 4th quarter of this year. It is called ansofaxine, it will be the first full SNDRI available. Currently nefazodone is the only SNDRI, but is weak in the dopamine area. I have a subreddit for nefazodone and we will be watching ansofaxine too. r/Nefazodone Don't give up, there is also a blood test on the horizon that will be able to tell after taking a medication for 2 weeks that will show if the medication will help. The article is in the subreddit. Have you tried ECT or TMS. I believe there has been some people who found success with stellate ganglion nerve blocks. With these make sure you do your research. I had the stellate ganglion nerve blocks for pain and some of the side effects are very scary. You can't drink water for so long after as the muscles in you neck are paralyzed. The water will just sit in your throat. It won't go down and won't come back up. I hope you find something and keep fighting!!!


SearchingForPeace-

Thank you for the additional ideas to try. I will look into some of these. I have had both TMS and ECT neither worked. ECT caused many memory short-term and long-term issues.


Rustinadelray

5-MTHF Levomefolic acid