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PostPosted: Sat Dec 05, 2015 8:50 pm 
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Hey, Lily, I must say you are knowledgeable about psych meds, I am too.

I took Brintellix and found it to be one of the best ones I've taken— I've taken most major market ADs. Similar to Paxil with a bit of Viibyrd and 5-HT7 antagonism akin to Latuda. I'm on Pristiq 50mg and it is is my go-to AD. I get the SSRI effects of about 100mg Effexor XR and noradrenaline effects of 225mg Effexor XR. It is viewed as a patent-extender, sure, but it is a potent AD that requires no dose titration.

I took Brintellix 20mg with Wellbutrin SR 150mg X 2 and had no bad effects. I know there is a cytochrome reaction between the two.

Now, I've found that Pristiq (used to take Effexor too) with a low-medium dose of Remeron is best for treating my depression.

I take:

Subutex 16mg (I know about low-dose theory, but I need 16mg, it helps cravings)
Pristiq 50mg for depression
Aplenzin (hydrobromide Wellbutrin) 348mg for getting out of bed, thinking about discontinuing it as Pristiq 50/Remeron is potent enough)
Remeron 15 - 30mg for sleep/depression (best at 60mg as a primary AD, but low dose with Pristiq is perfect since it doesn't cause weight problems at lower dose for me, occasionally I take 30mg, I get 60 15mg a month, took 60mg nightly in past when I was bad off)
Neurontin 1,200mg X 2 for anxiolysis (works as good as chronic clonazepam 1mg X 2 daily)
Lisinopril 20mg for mild hypertension probably from Pristiq
Omeprazole 40mg for heartburn

Yesterday was last dose of Latuda 20mg which I don't feel I need anymore as my depression is in remission. I have major depression with generalized anxiety disorder, I've tried bipolar meds and other esoteric meds... Name it, I've tried it. I was on EMSAM highest dose of patch with 200mg amitriptyline before and it compares to my Pristiq/Remeron/Wellbutrin combo, I hate having to make such a combo but it is what works best for me.

I've tapered off Topamax 300mg for weight/mood stability, BuSpar 30mg adjunct to Neurontin, trazodone 100mg adjunct to Remeron for sleep, and Latuda 40mg for negative thoughts all taken with above meds since September. I really want to be on Pristiq at maybe 100mg with Remeron at 30mg with Abilify 10mg and nothing else besides my lisinopril/omeprazole, I believe that combo is a depression killer. Abilify should be a last-resort but it is a potent AD for me, better than Latuda and Saphris for me.


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PostPosted: Sun Dec 06, 2015 2:22 pm 
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Welcome, Louisianasportsman!

Whatever disease or disorder we have, it's important that we become our own experts and advocates. Doctors are only human so we need to gain as much knowledge about ourselves as we can.

Glad to have you here! :)

Amy

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PostPosted: Sun Dec 06, 2015 6:50 pm 
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Thanks, Amy!

Yes, I've became my own doctor in a way since I "suggest" things to my psychiastrist to write on a script. I'm so glad I found Suboxone— I took chronic oxycodone 30mg IRs with transdermal fent patches, I felt like I was treating lack of endorphins needed to help conventional ADs work. I had a heroin behaivoral style problem marked by impulsive decisions, major depression, and high anxiety. I focused only on how I feel; with the buprenorphine everyday feels the same, no more noddy highs and moody lows and I can focus on getting on the least number of pills and work on my personality/ family life. Buprenorphine somehow gives me an opiate feel that I need so much right now to cope. Opiates just turn on something in my body that makes me feel comfortable with life and bupe does that too without me being in active addiction. I wish I didn't have to dose so high, I'm jealous of people who only need 4mg or even less. I actually find that 24mg works best but that is too high of a dose for my insurance to cover, unfortunately. My doc won't write concomitantly generic sub at 16mg with Zubsolv to increase the dose for insurance reasons. I'm going to see if insurance would pay for 24mg Zubsolv style.


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PostPosted: Sun Dec 06, 2015 8:47 pm 
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Welcome, Louisianasportsman too!

As Amy said, I think by giving our doctors feedback they also learn more about the meds they prescribe to patients.

You sure have a lot of knowledge and I take my hat off to you. And no one will question your 16 mg's of Sub now that you've put it out there. It takes what it takes and you need that amount. Case closed. I used to be fine on 1 mg and now I'm on 6. Same thing. Maybe one day I'll taper down, just not today.

Glad to have you aboard,

rule

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Dr. Jeffrey Junig, M.D., Ph.D.

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