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Help me create the optimal (theoretically) combination of antidepressants/anti-GAD-medications.

Båtmannen

Bluelighter
Joined
Jan 18, 2015
Messages
267
Hello,

I'm 28 years old, and have been on antidepressants since I was 18. I've tried all sorts of medications except MAOI:s. I'm diagnosed with high functioning autism (or Aspergers), MDD, GAD, OCD and I think one more I've forgotten. Today I would be diagnosed with schizophrenia like symptoms due to my psychosis, but it's probably due to amphetamin use, although I've hold up for several weeks while ingesting 15 mg abilify per day and it's still there, but much weaker.

Today I'm on;:
300 mg Bupropion (which I have no intention of stopping)
67,5 (sic) mg of Mirtazapine (which works but together with methadone I don't have the discipline to keep the weight off; I'm at 253 lbs now)
15 mg of Abilify but I don't use it as I should because I want to use street amphetamine and Abilify is exceptionally good at blocking the D-receptors, but I plan on quitting, and will officially be on 15 mg:s, but iwll really take about up to 5 mg per dag (like 2,5 mg, as this seems to be the better range for depression - probably because at this amount it works as a weak agonist att D-receptors, while already occupying 70 % of D2, and I suppose 15 mg would occupy 90 % (the level of D-occupancy(/occupation?) seems to be following an inverse x^2-graph, hency my supposing about 15 mg)
4 mg trihexyphenidyl which I really don't need but use in higher amounts because of its ability to induce sleep)
100 mg of Methadone per day (this I will increase, and try to switch to Levomethadone due to it having higher affinity for the MOR-receptor, and because - if I remember correctly - it's also a 5-HT and NE reuptake inhibitor
Melatonine, 4 mg per day that I rarely take

Now, I'm trying to get Agomelatine added, and Mirtazapine removed. I fear they won't do this because I had very slightly too high ASAT-levels, but I will try. If I suceeed With changing to Agomelatine instead of Mirtazapine,, then I have no serotonergic effect of my antidepressant medications - should I try completely without something that is serotonergic? Other than Vortioxetine, it has never worked for me anyway. Not even MDMA (tried different sorts of Exctacy as well as pure MDMA) makes me euphoric.

Well, aripiprazole is a partial agonist of the most important receptor - 5-ht1a, although it also affects 5-ht2c in the same way, but much weaker, and probably won't be affected at all by 2,5 mgs.

I'm thinkinf of asking for Vortioxetine if they say no to Agomelatine, should I try and get in on top of what I already have, or discontinue Mirtazapine? The problem is....I want a girl friend, and your **** has to be working, and methadone makes this very problematic, but when on mirtazapine and bupropion it's manageable. No matter, I will just use exogenous testosterone to fix this.


What do you suggest/propose I ask for? And am I thinking correctly regarding what I've written?


best regards and I'm very thankful for all serious answers, even if you're not sure (hell - the combined world's research and doctors and pharmacologists can't solve problems like mine fully, so why should I or you? But please...try)
 

Phobos

Bluelighter
Joined
Oct 5, 2010
Messages
1,487
Hi there man, glad to see you posting again.
Are you still using amphetamine? If yes, how much?

The first thing I notice is that you weigh 253lbs and you seem to imply that you are overweight, so you need to be very careful about taking testosterone shots, and how you take them.
Fat converts testosterone to estrogen through aromatase, so you might suffer from elevated estrogen if you go on TRT.
You should be able to manage that with aromatase inhibitors and frequent, smaller injections though.
 

madness00

Moderator: NMI, MH, CD
Staff member
Joined
Aug 8, 2018
Messages
4,868
Location
New England
Thanks S.J.P.

And just to reiterate the rules of MH, please don't advise anyone to start or stop a medication. Simple explain what has worked for you in the past.

No one broke this rule, yet, just a forewarning.
 

Båtmannen

Bluelighter
Joined
Jan 18, 2015
Messages
267
Hi there man, glad to see you posting again.
Are you still using amphetamine? If yes, how much?

The first thing I notice is that you weigh 253lbs and you seem to imply that you are overweight, so you need to be very careful about taking testosterone shots, and how you take them.
Fat converts testosterone to estrogen through aromatase, so you might suffer from elevated estrogen if you go on TRT.
You should be able to manage that with aromatase inhibitors and frequent, smaller injections though.
hi and thanks.
My amphetamine use is lower, because I don't use 1 gram per shot anymore. I don't have any veins left..
.. so no kick. Now I want to quit... Just not strong enough. I told myself this is the last time I buy. I have a reason: I get my Metadonet home with me during weekends if I piss clean. And then I can come only 4 times a week etc. If I shoot my methadone... I don't think I will need other drugs. I have an artery I shoot in often. Burns like hell but no permanent problems. I must have a terrible oral BA because I got an high from taking 35 mg IV than 100 mg orally.
 

Båtmannen

Bluelighter
Joined
Jan 18, 2015
Messages
267
Thanks S.J.P.

And just to reiterate the rules of MH, please don't advise anyone to start or stop a medication. Simple explain what has worked for you in the past.

No one broke this rule, yet, just a forewarning.
But people can tell me what theoretically would be the best combination of antidepressants, yes?
 

Phobos

Bluelighter
Joined
Oct 5, 2010
Messages
1,487
hi and thanks.
My amphetamine use is lower, because I don't use 1 gram per shot anymore. I don't have any veins left..
.. so no kick. Now I want to quit... Just not strong enough. I told myself this is the last time I buy. I have a reason: I get my Metadonet home with me during weekends if I piss clean. And then I can come only 4 times a week etc. If I shoot my methadone... I don't think I will need other drugs. I have an artery I shoot in often. Burns like hell but no permanent problems. I must have a terrible oral BA because I got an high from taking 35 mg IV than 100 mg orally.
Dude... You have to stop any injecting now.
You have no veins left and you can only use an artery.... That's scary.
There is no point in telling you anything else, that has to be your priority.
No medication can make you feel better until you start loving yourself enough to stop doing artery shots.
 

Mycophile

Bluelighter
Joined
Mar 3, 2014
Messages
3,592
Hello,

I'm 28 years old, and have been on antidepressants since I was 18. I've tried all sorts of medications except MAOI:s. I'm diagnosed with high functioning autism (or Aspergers), MDD, GAD, OCD and I think one more I've forgotten. Today I would be diagnosed with schizophrenia like symptoms due to my psychosis, but it's probably due to amphetamin use, although I've hold up for several weeks while ingesting 15 mg abilify per day and it's still there, but much weaker.

Today I'm on;:
300 mg Bupropion (which I have no intention of stopping)
67,5 (sic) mg of Mirtazapine (which works but together with methadone I don't have the discipline to keep the weight off; I'm at 253 lbs now)
15 mg of Abilify but I don't use it as I should because I want to use street amphetamine and Abilify is exceptionally good at blocking the D-receptors, but I plan on quitting, and will officially be on 15 mg:s, but iwll really take about up to 5 mg per dag (like 2,5 mg, as this seems to be the better range for depression - probably because at this amount it works as a weak agonist att D-receptors, while already occupying 70 % of D2, and I suppose 15 mg would occupy 90 % (the level of D-occupancy(/occupation?) seems to be following an inverse x^2-graph, hency my supposing about 15 mg)
4 mg trihexyphenidyl which I really don't need but use in higher amounts because of its ability to induce sleep)
100 mg of Methadone per day (this I will increase, and try to switch to Levomethadone due to it having higher affinity for the MOR-receptor, and because - if I remember correctly - it's also a 5-HT and NE reuptake inhibitor
Melatonine, 4 mg per day that I rarely take

Now, I'm trying to get Agomelatine added, and Mirtazapine removed. I fear they won't do this because I had very slightly too high ASAT-levels, but I will try. If I suceeed With changing to Agomelatine instead of Mirtazapine,, then I have no serotonergic effect of my antidepressant medications - should I try completely without something that is serotonergic? Other than Vortioxetine, it has never worked for me anyway. Not even MDMA (tried different sorts of Exctacy as well as pure MDMA) makes me euphoric.

Well, aripiprazole is a partial agonist of the most important receptor - 5-ht1a, although it also affects 5-ht2c in the same way, but much weaker, and probably won't be affected at all by 2,5 mgs.

I'm thinkinf of asking for Vortioxetine if they say no to Agomelatine, should I try and get in on top of what I already have, or discontinue Mirtazapine? The problem is....I want a girl friend, and your **** has to be working, and methadone makes this very problematic, but when on mirtazapine and bupropion it's manageable. No matter, I will just use exogenous testosterone to fix this.


What do you suggest/propose I ask for? And am I thinking correctly regarding what I've written?


best regards and I'm very thankful for all serious answers, even if you're not sure (hell - the combined world's research and doctors and pharmacologists can't solve problems like mine fully, so why should I or you? But please...try)
Hey. I'm sorry to hear that you are having a hard time, and sorry that I don't really have any good advice.

However, you did mention a medication that I have heard some good things about, which is Vortioxetine, and I had a few questions about it.

Have you ever taken Vortioxetine, and if so, how has it helped you, and what does it usually help people with?

I have generalized anxiety disorder, OCD, some depression and Non-Verbal Learning Disability, which some people say might be on the autism spectrum much like your Aspergers, though if that is true it's not as severe I don't think as Aspergers.

I am on Klonopin and Lexapro, but i don't feel the Lexapro does much for me, and I do get some side effects from Klonopin like fatigue, and I think someone mentioned Vortioxetine to me when I asked about medications that might help with anxiety that aren't benzos, and if I remember correctly someone said it is probably the best SSRI for anxiety out there.

Do you feel that is the case?

Would you recommend it for someone with the kind of mental health issues I'm describing?

Anyone else who knows more about Vortioxetine also please feel free to answer.

Thanks.
 
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