The Biochemical Experiment That Is My Life

[Placo]

In this thread I will talk about my therapies and general experiences with substances, I could also go into detail explaining the various neurotransmitters and receptors and how these influence various mental pathologies.

I'll start by saying that my main problems are depression, anxiety and OCD, a combination that I've read already has a very high suicide rate, so the mere fact that I'm writing this thread at 30 is a victory or at least a good test of endurance, I don't know if I have other disorders but I don't think so.

Here is my current therapy:

40mg paroxetine
30mg mirtazapine
37mg lurasidone
15 drops of diazepam as needed

As a therapy, however, it seems weak on the motivational aspect which is regulated more by dopamine while these drugs have little dopaminergic activity and in fact lurasidone is a partial antagonist of some dopaminergic receptors and therefore I decided on my own initiative to add bupropion which is an NDRI to the therapy, tomorrow I will discuss it with the psychiatrist and see his opinion.

Also as for benzodiazepines I go well beyond 15 drops and use more than one and to calm myself I also help myself with alcohol and nicotine.

With bupropion I usually take 150mg but on days when I'm sleepy I can even take 300mg, I also help myself stimulate myself with caffeine obviously, but I was considering that to stay awake modafinil is more suitable than bupropion, maybe I'll suggest it to the psychiatrist or buy it online, maybe taking both won't hurt since I need both to stay awake on days when I'm sleepy and the activation that bupropion gives.

Having used SSRIs for a long time makes me quite familiar with the effect that excess serotonin has on me, it tends to lift my mood even if it doesn't encourage motivation, in fact some hypothesize that SSRIs can cause amotivational syndrome, the downside however is a greater predisposition to anxiety.

I can also say that a general increase in dopamine in neurotransmission has effects on me, it increases motivation but also paranoia and could also increase OCD, in fact lurasidone fights OCD by antagonizing some dopamine receptors while it is a partial agonist on some serotoninergic receptors, in theory it should have both an anti-obsessive and anti-depressant effect. At 18.5mg the effect seems to be antidepressant even if lately I have gone up to 37mg where it seems that the sedation is starting to take over.

As for norepinephrine I'm a little less sure of the effects it has on me although I hypothesize greater activation and anxiety, I think I mirror the effects it has on the majority of the population.

If you want to add any comments, please do so.

 

[Placo]

I finally went to the appointment, I like this psychiatrist, he is open to my studying drugs and experimentation, others I have dealt with were more skeptical.

He suggested clomipramine, a tricyclic that apparently should affect all three of the main neurotransmitters involved in depression and is also anti-obsessive. At that point I would only have to resolve the anxiety part and I would go on benzodiazepines as I am doing now.

Before at lunch it happened to me that while I was preparing milk the television was on at high volume and at the same time my father was talking to my mother and this caused me a feeling of annoyance, as if I was distracting myself from what I was doing, I think it is a symptom of OCD because I read that in OCD many areas of the brain do not work correctly but the one concerning the processing of sounds remains normal and therefore this predisposes me to be easily distracted I imagine, so OCD also affects the cognitive part apparently.

The most anti-obsessive antipsychotic apparently is risperidone but it gave me depression as a side effect so it solves one problem but exacerbates another, I remember that I took it at the beginning of the year in a period of my life in which I felt easily irritable, I don't know whether to start taking it again in microdoses or increase the dosage of lurasidone.

Much of the anti-obsessive function of lurasidone seems to be in the antagonism of D2 receptors, I need to investigate what role they have.

 

[Placo]

I have gone up to 55.5mg of lurasidone as the OCD still tends to persist a bit, the problem now is the daytime drowsiness that this drug at this dosage gives together with mirtazapine, I am considering whether to ask the psychiatrist or buy modafinil online.

For now I'm fighting it with high doses of caffeine and I also have paroxetine and bupropion which are supposed to help me stay awake.

 

[Placo]

I ordered kratom which can be useful both for living and in case of CTB, in the meantime the therapy with those 4 drugs continues even if I am increasing the dosages a little compared to what was prescribed.

I've looked into clomipramine but it doesn't seem like a great idea in my case, I don't know, the fact that it's an antidopamine drug would take away that little bit of motivation that I have and that I look for in bupropion, dopamine is linked to motivation and bupropion works by increasing the levels of dopamine and noradrenaline.

 

[Placo]

In order to avoid falling back into severe depression, I am raising the dosages to significant levels.

Today I took something like 100mg sertraline, 50mg paroxetine, 55.5mg lurasidone, 450mg bupropion and 45mg mirtazapine.

I think I am definitely an esketamine case and maybe even an MAOI or other experimental treatment.

 

[Placo]

The psychiatrist accepted my proposal to try esketamine, the first administration will take place on the 18th, in the meantime I am continuing to keep myself active with above average dosages of the drugs.

 

[Placo]

Things are going better, I'm being treated with esketamine even though I've only had one administration so far, with the dosages of antidepressants I'm maybe a little high but it doesn't matter, the important thing is to feel good, I haven't felt this good for months, but I don't think I'll abandon the forum, maybe I'll just frequent the recovery section.

 

[Placo]

Here I am, trying to move forward and I have to say that compared to months ago I am better but to maintain this decent mood I am using antidepressants at supramaximal or very high doses, I do not feel serious side effects from this, it is certainly better than being depressed and therefore suicidal all the time.

I am also managing to work even if for a few hours.

I must say that this period for me is generally depressive so I think that until the beginning of winter I will have to continue using the drugs at high dosages, I hope that the psychiatrist agrees, when I mentioned it to him he told me to go back to a lower dosage but I fear that at a lower dosage I will then become depressed again.

 

[Placo]

Here I am, it's going well overall even though the combination of antidepressants I'm taking is really massive, I'm going on massive doses of four antidepressants plus a slightly lighter dose of antipsychotic and obviously benzodiazepines and supplements.

Twice a week they also give me Spravato at the mental health center, let's say that it's going well even though this is the most difficult time of year for me.

 

[Placo]

I am continuing the very powerful therapy in this period which is difficult for me because of the low light I imagine and I must say that the suicidality rarely exceeds 20%, I will continue the esketamine even if I recently discovered that I am hypertensive.

 

[Placo]

I'm taking very high doses of antidepressants in the hope that they might do something, as if I were decimated by chronic pain that I try to fight by abusing painkillers, in fact I've also been having physical pain lately and in fact I'm using them too.

 

[Placo]

A friend is helping me with a supplement stack to increase neurotransmitter production and therefore reduce drug dosages, let's see if it works.

 

[Placo]

I must say that I am starting to perceive my mood as artificial, that is, influenced by all the drugs I take. I don't know if I like this, it's a bit like someone who is destroyed by pain without taking painkillers. The same goes for my mood, which without psychotropic drugs would be very low.

 

[ventingfrustrations]

Even though I'm SEVERELY depressed I can still kinda make it through webcomics just to pass the time
If you're looking for suggestions
Gotta go to the second place I've worked that I don't feel actively depressed at it's too bad that it's only part time

 

[56842]

I apologize for interrupting your thread, I hope you can forgive my overstep in light of the concern that is prompting me to post this reply. To preface, I am a firm proponent of patient autonomy and self-advocacy, especially in cases with chronic illness, where a patient, by default, often understands their own body, symptoms, and treatment interactions better than their treatment team. I admire your dedication to knowledge and your commitment to keeping yourself healthy. However I feel it necessary to strongly caution you against self-dosage management. Even with resources like mayo-clinic, or the DSM5, or databases like uptodate, self-treatment without any guidelines has, historically and across the board, proven to be dangerous. I myself have stopped medications of my own volition when I feel there are adverse symptoms or if they are ineffective, but I have also suffered the repercussions of those decisions. Those cases are not as dangerous, I admit, but adjusting dosages of FDA restricted drugs like SSRIs, SNRIs, antipsychotics, mood stabilizers, MAOIs, etc. (especially if any combination of these is being taken in conjunction) is EXTREMELY risky and can have significant adverse effects on your illness. Human neurological biochemistry does not cope well with sudden neurochemical changes from abrupt dosage adjustments like the ones you mention in the thread, in fact this often leads to instances of trauma or can trigger other illnesses. PLEASE consult with a liscenced psychiatric provider immediately after you make any such dosage adjustment, but preferably BEFORE so. I have been on SSRIs, SNRIs, antipsychotics, mood stabilizers, MAOIs, anxiolytics, benzodiazipines, and other adjacent anxiety/sleep aids (like anti-histamines and beta blockers), supplements (like dexthromethorphine), stimulants (like Adderall), and have undergone ketamine, ECT, and TMS treatments so I feel qualified to speak on this. I implore you to at least consider my words before you make a medication adjustment like that again. I wish you a smooth recovery, and again, sorry for disrupting the sanctity of your thread.

 

[Placo]

I apologize for interrupting your thread, I hope you can forgive my overstep in light of the concern that is prompting me to post this reply. To preface, I am a firm proponent of patient autonomy and self-advocacy, especially in cases with chronic illness, where a patient, by default, often understands their own body, symptoms, and treatment interactions better than their treatment team. I admire your dedication to knowledge and your commitment to keeping yourself healthy. However I feel it necessary to strongly caution you against self-dosage management. Even with resources like mayo-clinic, or the DSM5, or databases like uptodate, self-treatment without any guidelines has, historically and across the board, proven to be dangerous. I myself have stopped medications of my own volition when I feel there are adverse symptoms or if they are ineffective, but I have also suffered the repercussions of those decisions. Those cases are not as dangerous, I admit, but adjusting dosages of FDA restricted drugs like SSRIs, SNRIs, antipsychotics, mood stabilizers, MAOIs, etc. (especially if any combination of these is being taken in conjunction) is EXTREMELY risky and can have significant adverse effects on your illness. Human neurological biochemistry does not cope well with sudden neurochemical changes from abrupt dosage adjustments like the ones you mention in the thread, in fact this often leads to instances of trauma or can trigger other illnesses. PLEASE consult with a liscenced psychiatric provider immediately after you make any such dosage adjustment, but preferably BEFORE so. I have been on SSRIs, SNRIs, antipsychotics, mood stabilizers, MAOIs, anxiolytics, benzodiazipines, and other adjacent anxiety/sleep aids (like anti-histamines and beta blockers), supplements (like dexthromethorphine), stimulants (like Adderall), and have undergone ketamine, ECT, and TMS treatments so I feel qualified to speak on this. I implore you to at least consider my words before you make a medication adjustment like that again. I wish you a smooth recovery, and again, sorry for disrupting the sanctity of your thread.

I will try to be careful with the dosages, don't worry, however I see that you have tried many things, almost everything, do you still have any hope or are you now only thinking about CTB?

 

[56842]

I will try to be careful with the dosages, don't worry, however I see that you have tried many things, almost everything, do you still have any hope or are you now only thinking about CTB?

Good to hear, good luck.

Yes and no? I've decided to give it one last shot. I'm giving myself a year. I won't be escalating treatment (like VNS), but I'm committing to reflecting on whether or not I want to live (with meds for relative stability). I'm not worrying about money/career/family/anything else, that would be a problem for "future" me if I decide to keep going. I know I'm capable of standing up no matter how many times I break, because I've done it so many times already, I'm deciding whether or not I want that to be the rest of my life for unknown years to come. I honestly am leaning towards no right now, but I've committed to a year, so I'll wait and see. And my pride won't stand to give it anything less than my best, because I'm not letting a moment's weakness be what gets me when I've been through so much shit and survived.

 

[Placo]

https://en.wikipedia.org/wiki/Biology_of_depression

Things seem very complicated, but I remain quite confident in the monoaminergic theory.

 

[Placo]

I am taking massive doses of antidepressants in the hope that at least these high doses will help me, since the alternative is CTB the risk of these abuses seems like the lesser evil to me.