Posted by AOB on June 24, 2003, at 18:52:50
In reply to Re: Zero Motivation, posted by linkadge on June 24, 2003, at 16:04:31
> It seems that purely serotogenic meds like zoloft, anafranil, etc can lower motivation.
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> Meds that also lower dopamine can impair motivation, (any of the antispychotics like Risperdal)
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> Wellbutrin can increase motivation but add irritability due to its ability to selectivly increase dopamine.
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> You may want to try a dual acting medication such as Effexor, (if you havn't already tried it)
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> It can both improve mood and motivation(serotogenic and norepinephrine)
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> Some other dual acting ones are Amitryptaline, and Duloxitine (prozac 2, which is coming out soon)
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> I know these kind of cases, and the absolute *worst thing* you can do is overmedicate. Try as hard as possible to find as few agents to do the trick. Even if this means substituting instead of layering on.
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> The reason I say this is because, too many meds can destroy the a persons sense of confidence and independance. It also gives the patient the idea that it is somebody else's responsibility to make them feel better (when infact the doctor and patient have to work hard together) You may want to find a psychiatrist that is slightly more attuned, and less liberal.
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> Best of Luck
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> Linkadge
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>
Thanks for the advice. I know a little bit about the drug effects but its the combinations that really confuse me. The problem is - we have already done the damage you describe. He thinks it is too late for him to be helped. He wants easy answers, always has. AND has ALWAYS been unmotivated.The lack of drive is not just a meds issue. He was born without drive, risperidone and Zoloft just make it worse. Getting him to work with OT and PT, roll over or walk took great effort and creativity. His therapists had never seen any child quite so disnterested in mobility. But now he is not an adorable infant, he's a miserable young man, living off SSI and doing nothing.He was born before there was anything out on autistic spectrum or NVLD. Everyone gave a diagnosis or prognosis based on the part of the problem they were working on. He was so bright, sweet and articulate PDD never was mentioned. It became clear in hindsight only.
He was on Effexor for four months but was making bad decisions lost his job and became suicidal. He seemed really desperate to change and wanting help. A week on Zoloft and he shut down.
The psychiatrist that sees him now has just continued the meds since the last hospitalization. He moved away to a small town and there is not a lot of choice. I believe he is seeing one of the best Drs. available. Both the therapist and psychiatrist are good but they have only seen him function at a fairly low level. They have never seen the potential I and others saw previously. I need to reach him - help him to have hope.
Thanks,
AOB
poster:AOB
thread:236674
URL: http://www.dr-bob.org/babble/20030624/msgs/236748.html