Confused/Blood sugar out of control; SNRIs out of the question for whatever reason

[blackorca]

I've been staying away from most drugs for years now so I haven't been active in the Bluelight community, but I really need advice and help now.

My psychiatrist has me on Viibyrd (SSRI-like anti-depressant), small doses of Risperdal (anti-psychotic) and Latuda (anti-psychotic), BuSpar (anxiolytic), and as-needed Klonopin. My p-doc has me on Metformin twice daily to control blood sugar levels for diabetes caused by (suspected) Risperdal/Latuda. I have had confusion for approximately a year. It's a mix of anxiety and "not knowing the big picture/what's going on." This makes my job extremely difficult as I get anxious and confused as to what I'm supposed to be doing at that particular time. A co-worker at my last job offered me Tramadol one day and I had no idea what it'd do besides that it was somewhat of an opiate. I tried it, and my confusion and anxiety completely disappears. I was actually able to think clearly and focus on my work. It acts somewhat like amphetamines in that it speeds me up quite a bit at higher doses. I suspect this is because it acts on norepinephrine.

I told my psychiatrist about this experience in hopes he would take it and learn from it and would cross-titrate my anti-depressant to something like an SNRI (that works on serotonin and norepinephrine). I know I have a drug problem, but I honestly don't think asking for a more stimulating anti-depressant that isn't prone to abuse would be such a hassle, but it was. He wanted me to quit the Tramadol and go to NA/AA. He said it's usual of drugs to "help" people, but really they don't. I'm NOT asking for Tramadol, as I don't suffer from chronic pain. I just want the norepinephrine-related effects from Tramadol, which I think I would get from a SNRI. I ended up stopping the Tramadol and having to quit the job I had due to high levels of stress from not being able to do the (simple) work I was being given. He wants to keep cross-titrating me onto Latuda since he claims it messes with blood sugars less than Risperdal, but isn't willing to try a new anti-depressant, even though I'm depressed as hell because I can't do a simple minimum-wage job.

I ended up finding a new job. Until my metformin was adjusted recently, I was waking up with EXTREME confusion in the mornings that would take at least an hour or two to wear off. I literally wouldn't know what was going on. My blood sugar was high as hell. I get a crazy appetite and eat a lot, so it's no wonder. Once they raised my metformin, I was better, but still have lingering confusion throughout the day at work. I literally don't know how to do my job. I'm aware that there's an issue, but I have trouble thinking.

Tonight, I asked around for Tramadol at my new job, and found a co-worker who gave me a dose of Adderall. Within the hour, all the confusion dissipated and I was able to focus and concentrate on my job and actually got done what I was supposed to be doing. I also haven't eaten much in the last 8-12 hours, and my blood sugar is actually within normal levels for once.

I don't know what to do. I don't want to get high; I just want to be able to think with a clear mind. My psychiatrist has told me before he's on the brink of quitting on me. I could keep buying the Adderall and have enough to take daily, but I really want to do everything legally. I feel my psychiatrist isn't addressing my problems. Should I seek a second opinion? I can't shake the notion that something like Effexor or another SNRI would have similar effects on my brain/blood sugar levels that Tramadol/Adderall have, but my current psychiatrist doesn't agree.

Do you think I should seek a second opinion and tell them everything? I don't feel I have anything to hide. Thanks for all the help in advance. It's really hard living life without a full deck, so to speak.

 

[Smoky]

Have you tried Strattera? I used stimulants for a long time, also Heroin. The stimulants helped me focus and take confusion away but were highly addictive. My psychiatrist put me on SNRI's and another time Strattera. It helped me tremendously but my current insurance doesn't cover it.
Traditional SSRI's don't work well for me make me manic like. Everyone is different.

It's good to change meds once at a time, thus he has a point. I don't know though why he is hesitant to try something with norephineprine instead of serotonin. It made all the difference in the world for me. Strattera actually knocked me out though for a week, which isn't usual which does point to adhd.
I've been on the Riperdal. Ate way too much, and had a dream like falling type feeling at night.

BTW: And maybe you know this but Tramadol isn't just an opiate. Be careful. Best of luck. Have you taken the long test for adhd? Maybe another psychiatrist will help you if you are serious about not being on addictive meds

 

[blackorca]

That's the thing, Smoky. I'm NOT asking him to prescribe me something that I could easily abuse. I don't want Tramadol or Adderall, or whatever, even though it helps. My line of thinking is that both affect norepinephrine and they help significantly with confusion-related issues and blood sugar (probably because of their effects on norepinephrine), so why not move from a SSRI to an SNRI, at least to TRY? I've had other doctors simply stop one anti-depressant at the highest dose and start another at a lower dose, but this psychiatrist won't even consider cross-titrating me onto an SNRI or other safe norepinephrine-based agent. It's almost as if he's throwing the whole thing out the window because it has something to do with "illegal drugs." I've just been using the Tramadol/Adderall because 1) It's a lot easier to come by than, say, Strattera, on the black market, and it helps me get through the work day in one piece. I've told him one of my biggest stressors is the inability to do my simple minimum wage job with the confusion, and he brushes it off. I know I'm confused because when I take Tramadol/Adderall, it's literally like a light-switch goes on in my head. I'm able to comprehend what's going on at work, and get the job done in a reasonable time frame.

EDIT: He's only interested in cross-titrating me from Risperdal onto Latuda. He has no desire/interest whatsoever in letting me try Strattera or any other SNRI.

 

[wezface]

Wow you could be my twin. I am in a very similar situation but have recently found what seems to be a miracle solution.

I am on viibryd as well as savella (SNRI for fibromyalgia), trileptal (for nerve pain), tizanidine for muscle spasms and also I just saw a new pain management doctor who put me on Low Dose Naltrexone. I am on 3mg at bedtime. Naltrexone is an opiate antagonist; basically it blocks the opiate receptors. The dose used to treat opiate addiction is around 50mg. But basically by blocking my endocrine receptors, it forces my body to produce more endorphins to compensate.

I have NEVER felt this good. I have been nearly pain free with no opiates for the first time in years. I can think again. I can absorb and retain information and apply it properly again. It's bordering on a miracle for me.
Unfortunately, it is a very progressive treatment and is not well known at all. I recommend doing some research and if you think it's something you'd like to try, take some information to your doctor and ask about the possibility of being on it.

 

[Smoky]

To the poster. That's really unfortunate. Maybe you outta look into a new doc. I had an awesome psychiatrist that was willing to let me try most anything. He treated me like a human being with knowledge and experience (been on many meds ), not just another diagnosis. Pathologizing is overrated…
Wez has some good ideas.
Wez, I have heard of Naltrexone for treatment. Do you really feel pain free? Does it take time to work? That's great. My new internist is a harm reductionist x heroin addict.. Odd coincidence, But he might be open to trying Naltrexone on me… He's been great so far!
I don't have an endocrine, thyroid gland though anymore. I wonder if that would be a problem.