Need real advice from users not contracictory BS from doctors. Please Read and help.

[Gasplooge]

SWIM'll be straight SWIMs not feeling to great, just caught pneumonia from his younger brother and SWIM has lurked on these websites but does not know the rules or have an account. Should he say something that warrants takedown could whichever admin point him in the right direction or to answers? I know the SWIM and stuff (Which he is not sure how to use correctly) but what he needs to talk about is medications that have been legally prescribed and are not, for the most part, misused. He'll err on the side of caution and hope you guys understand. SWIM is 24 and overweight from a family with a history of severe drug abuse and mental disorders and ,with his siblings, they suffered abuse and eventual abandonment from their mother. Environmental issues aside, he was diagnosed with Juvenile Bipolar Disorder or ADHD depending on which divorce court ordered therapist wanted to believe. SWIM and his father, ignored it and life got better as life mellowed he was good in school and while not the king the popular kids he was right there among them. Then at 17 SWIM just crashed, dropped out, started drinking, using and just did shitty things. When SWIMs 22nd birthday came around a hospitalization, rehab and real psychiatric help has come to bring back some of his life and now is diagnosed with Sever rapid cycling bipolar (with dysphoric mania and psychotic episodes) Generalized Anxiety Disorder and PTSD. BUT the meds he has been prescribed while not causing problems with abuse just..... Well just look at what SWIM takes to not go crazy.
<DAILY MEDICTION>
-Zyprexa 20mg at bedtime
-403mg intranasal spray Ketamine SOL 15mg/ML (Taken every 3 days)
-1mg of Xanax 4 times daily as needed
-Two 37.2(?)mg Phentermine twice daily
-500mg of Nuvigil in the morning daily
-30mg Restoril also at bedtime
-Trilepdal 150mg daily
-0.1mg Clonidine for BP
Now with the Pneumonia they gave me the codeine 10mg/5ml and 100mg/5ml Guiafenasen (Can't spell) plus Prednisone and an Antibiotic.

For the Record I'm not bragging or seeing a shady Doc, Without naming names I see these doctors who prescribed these and participate in a study (The Ketamine) at NIMH. The exceptions being the Pneumonia meds were given by a local GP who is aware or what I'm taking.

Thank you so much for bearing through this background and here are the questions I can't seem to get the doctors to answer.
1. Ketamine seems to have different effects every time and that "For the most part" referring to misuse was when I have on a few occasions broken down and went IM. In either case I can not seem to get an answer as to the setting and general standard feelings I'm supposed to feel. Consider I have been titrating up from 10mg of K to my ridiculous dose how can I get the most out of the nasal spray? Also on the occasions I have IMed I ended up watching Neflix on my phone in the dark and it was awesome but was that a waste?
2. Ketamine despite being an anesthetic stimulates me. Why?
3. Two powerful Benzos taken in the same day as two stimulants? Shouldn't I be dead or addicted by now?
4. Zyprexa COMPLETELY KILLS all of the "recreational" effects of these meds is that intentional?

SWIM feels like a walking pharmacy and I just want someone to help me understand. It seems I have given up on SWIM but it's 5am and you saw the list I'm not even sure any of this makes sense.


Thanks For your time.

Peace.

 

[Bearlove]

To be honest I wasn't sure where this would be better off as your covering a few points. I have moved over to other drugs as your asking questions on several substances.

The rules of this website can be found here.

The correct way to use 'swim' when referring to yourself is you don't, you simply use the 'I' or 'myself' - 'SWIM' offers you no security or safety and it is not required on this site.

Thanks
Bear

 

[tacodude]

SWIM offers no perfection as well and usually makes things not confusing and harder to understand discouraging people from reading, which is why the use of SWIM is something encouraged to be avoided.

 

[Ozle]

Fucking hell. That's one huge mess of seemingly arbitrarily prescribed meds. I'm guessing a large number of these were initially prescribed by different doctors who never bothered to communicate properly between themselves; and the same for the various diagnoses.

Now I'm certainly not a doctor, but what you've described - a childhood environment involving continuing abuse and abandonment, a history of substance abuse, impulsive behavior, and diagnoses of apparently comorbid anxiety disorders, bipolar (particularly the rapid-cycling kinds), psychosis and PTSD - should typically indicate to a psychiatrist the possibility of reducing a patient's numerous (and often contradictory, as you noted yourself) existing disorders to a single diagnosis of borderline personality disorder or CPTSD (depending on the details of the case). Another thing that would need to be looked at more closely is whether you actually have ADHD, or whether it's your other symptoms that are making it difficult to focus.

As for your meds... Well, frankly I doubt there's any doctor on this planet who could truthfully claim to understand what effect each ingredient in that cocktail is having on you, or how they and their metabolites are interfering with and modifying each others' effects. Poly-drug therapy on this scale is unfortunately rarely much more than guesswork, and generally the aim when dealing with a patient in that situation is to try to reduce the number of drugs they're taking to a more manageable level.

It's practically impossible for a user on a forum to give you properly researched advice about modifying your medication intake. My opinions on all this at first glance: The phentermine sticks out as a particularly odd choice, as does mixing two strong benzos (which is a bad idea to begin with, plus you say you're a recovering alcoholic). I'd always read that ketamine was a bad idea for people with a history of psychosis.

 

[speedballs_over]

Another OP starts out with "SWIM" and eventually writes in the first person. Cracks me up. We all know it's the poster, and SWIM isn't helpful, it's annoying and contrary to how we operate here.

I'll address one med I know very, very well. Phentermine isn't a very useful compound imo / ime. I had unlimited access to it for seven years. Abused the shit out of it, and that led to problems with genuine amphetamine abuse. It'll help you lose weight, I'm guessing that's why it's prescribed. For that typically, it only works to keep weight off if you develop new methods of reducing calorie intake / increase metabolism through diet & exercise. Phentermine is a stop gap while one works on changing habits, then should be discontinued after a month or two. It's psychologically addictive, particularly to some.

That's quite a cocktail of meds. Maybe a second opinion from another psych is in order?

 

[Cotcha Yankinov]

Zyprexa occupies dopamine receptors which are pretty much the quintessential reward receptors that normally other drugs trigger, but with Zyprexa in the way you won't get as much out of the other drugs. It'll also help keep you sane too though, too much dopamine can be very bad.

Trileptal is a good medication but it is a mild enzyme inducer, meaning it will cause other drugs metabolized by the same enzyme (CYP3A4) to be expelled quicker. Normally this is accounted for by altering dosages of the respective meds.