repairs in progress

i have seen an assessment dude from the psychiatry services here recently and said dude has recommended a pretty major medication shift. the main sleep medication i have is quietiapine, or Seroquel as its brand name. it's actually an antipsychotic (i am not psychotic) so it has some pretty gnarly side effects, but it works well as a sedative and is also one of the only well-studied treatments for BPD. i was fairly certain that because of this i'd be stuck with the shit for life. it's a pain in that it fucks up your metabolism and appetite - apparently almost everyone on these drugs gains weight, which is one of the things that's been really getting to me. i track and restrict calories but the amount that i lose weight on instead of plateau has gone way down, from 1500 losing me a good amount of weight per month to still weighing the same on 1350, so it's hard to actually get the weight off.

so assessment psychiatrist dude tells me apparently there's a new drug called aripiprazole or Abilify that i'd never heard of. says you add it on to pre-existing antidepressant regimes instead of replacing them, but he reckons it can replace the quetiapine. and it doesn't cause weight gain - in fact it's apparently associated with weight loss in depressives. fucking a. i agreed, and dude wrote to my GP (who is currently in charge of my psych meds until i can see a real psychiatrist, in the predicted waiting time of six to eight months, natch) recommending a regime change. he also pointed out that tramadol is a pretty crap breakthrough pain med for someone accustomed to 100mls of bloody methadone as their everyday pain control, but didn't suggest a replacement, so i have to go inquire therein about everything. hopefully i can see the GP either tomorrow or Tuesday and start that shit ASAP, although i did find that quetiapine can fuck you up if you stop taking it suddenly. mine ran out when i forgot to request the repeat scrip once and i was throwing up everything i ate for like five or six days. i think i'll probably need to taper off of it this time.

dunno how i'll do with sleep on just melatonin, but insomniac is better than fatarse.



Anonymous said...

Good news I suppose. Maybe soon we can have the vibrant Lepht we all enjoy. Or at least some iteration of that.

But please look after yourself and keep that mind busy. Meds only help so much.

The true Faust said...

I'm glad to know you're being progressive. That's awesome, and I hope it helps. That being said I concur with the general attitude in comments on previous recent posts: please take it easy, so that you can feel better soon.

Dan Campbell said...

The summary of this posting, on the bright side, is

There's hope for our hero.

Sorry there's such a long wait for needed treatment & medicine, Lepht. I hope that such inhumane circumstances, will fade away in this century.

Lepht said...

urgh yeah the waiting list is pretty insane, but at least there actually *is* a local psychiatric service. i was amazed to find a treatment centre in this little village, and so far more general area services have been alright at arranging appointments there, or at the GP (and once at my ma's house, go figure.)

don't worry about the nasty anon commenter, yeah? i think it is the girl who tried to get me committed ages ago; it's a shame. i really did love her so much as a best friend, but she couldn't hack it when i got ill - she thought of it as "me not listening to her" and she was always convinced that people on painkillers needed to STOP THEM DRUGS RIGHT NAO, preferably with inpatient rehab clinics. i last heard from her several years ago. she sent me an email "cutting me out" of her life, as she did with another friend. i did write a letter back saying i didn't want not to be friends, and delivered it to her and talked for a while, but that conversation ended with me saying it was OK for her to call me whenever she was ready since she didn't seem comfortable with my idea of coming round, and that was the last i heard. kinda sad story, especially if she's now trying to pass judgment (she never really saw the relationship with me and MD, especially as he started caring for me long after she stopped contact, so she'd have to be basing her nasty comments on hearsay, mostly.) i did hear from a mutual friend that she thought i was buying dodgy morphine or heroin or something off the streets, so that explains the "get into rehab" messages.

damn... some people can change a lot, you know? at least i have my dog and the rest of you guys.


Anonymous said...

In her own twisted way she was trying to help. I think that is what all your friends are doing. Trying to help in their won way.

I don't think anyone truly holds contempt towards you Lepht, maybe tough love, but ultimately everyone sees a broken person and they want to help.

I suppose you remind everyone of how human we all really are. No one is perfect and we just want to get through this crappy world.

Anonymous said...

Kinda surprised to read Abilify was presented to you as a new drug. We've (I'm a psych nurse, from Europe) been administering it for a while now, whereas Seroquel is pretty recent over here and always raises a few eyebrows whenever a doc prescribes it (seeing as it's marketed as a drug for pretty much everything, from mood disorders to OCD to psychotic states). Abilify is known for being a "light" antipsychotic with little adverse effects (especially weight-wise) and usually our drug of choice for bpds and sub-syndromic psychosis.
(Been following you for a while now and I just had to give you my humble expertise, hope it helps)
Take care.

Lepht said...

interesting. i gotta say Seroquel has definitely got more side-effects than beneficial effects, at least in my experience. i'll be quite glad to at least be able to try something else. and yeah, i was kinda weirded out that an antipsychotic was being given as treatment for a PD and insomnia both at once... i guess i'll find out.


Mattiew said...

If controlling your weight is a issue for you, you might be interested to look into the paleo/primal "diet".

Long story short : hunter gatherer based diet.

Plenty of meat, lots of veggies, a bit of fruits with moderation (sugar/glucose wasn't available as it is today), with a few nuts once in a while.

I've been on this for years and lost 30 pounds while eating a ton of eggs and steak cooked in bacon fat for breakfasts.

One of the best primer i could find, enjoy :) :

Anonymous said...

Your Talks on youtube were the first time I saw somebody who really put his ideology in the line of fire, not caring about their physical body.

I respect that, espescially because I couldn´t do it myself to be honest and I hope that you will recover from your problems in the future

You have people thinking about you all over the world, keep that in Mind if you think nobody cares about you.

a guy from the south of Germany

nobrains said...

I did the seroquel/abilify combo a few years ago. lost weight actually, migraines got worse, slept a lot. girlfriend at the time was put on some weird bipolar med (she doesn't even have bp, the doc was trying to find an alternative to increasing her dosage) on top of her roxies/pain control, which caused her to break everything in the apartment. eventually we both got off of our respective meds.

hopefully it works for you. apparently I have some unknown species of drug resistant MDD. these days I practice zen meditation. seems to help.

Anonymous said...

You should look into medical marijuana. Cannabis Indica is a great alternative for opioid dependency. It works for nerve pain (which oxycodon did not for me) and really helps with both depression and insomnia. It won't screw with you're metabolism either. And you can use edibles and nobody is the wiser. One little square of medical chocolate every 4 hours could replace all of your meds. Might be worth a shot.

Anonymous said...

Glad to hear you are getting different meds and a different GP. Have you reconsidered taking Bitcoin for future projects in mind? Just watched your presentation and read up on your status i think its awesome what you are doing and you should definitely keep being curious. :)

Anonymous said...

I can recommend an additional pain medication. I've chronic pain from nerve damage and I could get rid of opioids altogether.
In addition to my on demand pain medication I take Lyrica, a anti epic drug lowering pain and anxiety levels quite effectively. It also lowers opioid dependency withdrawal symptoms.
For me it works without adverse effects (except for 1-2 days when changing the dose, which feels like some of the anti depressants I've taken in the past).
The damaged skin is treated with capsaicin (Qutenza) every three months providing 2-3 months additional pain relief.
The treatment seems to have a small permanent effect. I only need 50% of the initial Meditation and pain levels are mostly ignorable.
Find a pain specialist if you haven't yet visited one. That changed my life.

Best wishes from northern Germany

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[pls no ask about the vodka. debate is always welcome. remember, Tramadol fucks you up]