![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by AOB on June 24, 2003, at 13:40:22
My son(age 21)is lost in a maze of diagnosis, comorbidity and medications. His survival out in the world is seriously in doubt because of zero motivation to do ANYTHING. He was approved for SSI this year while he was working part time. Now he is unemployed, living in clutter, smoking pot, dropping out of his one college class and not even trying.
In looking for answers, I've come across the drugs Adrafinil, and Provigil. Light bulbs went off when I started reading about the effects these drugs may have on the brain. The description of what the ventral striatum area contols is almost an exact definition of what my son lacks - cognitive flexibility, coherence, vigor, goal oriented behavior and associative learning. Has anyone seen an increase of motivation, drive or setting and attaining goals or sustaining effort on Adrafinil, Provigil or some other meds? My son has been on Cylert, Ritalin, Concerta and Wellbutrin over the years. Most were stopped because of irritability or lack or lessening of response. Most were taken along with other drugs so I am unsure how they really worked. We saw improved neatness, especially in handwriting.
He definitely has a history of some sort of PDD. He matches so many symptoms in the DSM but does not match any diagnosis definitively. The psychologist who treated him for years referred to his symptoms as a bowl of spaghetti. Diagnosis history includes Asperger's, severe NVLD, ADD, bipolar, ODD and depression. Meds seem to lead to only temporary improvement or change. He has been on so many different meds I honestly don't know the difference between symptoms and side efffects.
He has many Asperger's characteristics so how can he be a pathological liar too? How can his early language skills be classic hyperlexic but didn't read until age 7 and has very good comprehension? How can he have ODD but has never been in any real trouble at school or with the police? How can he be bipolar but never really manic? The huge spread between high verbal IQ 125 and low performance IQ 72 result in expectations being too high or too low. The resulting frustration has led to some of his seething anger but does not really explain his temper outbursts. Positve reinforcement doesn't work anymore, he rebuffs and dismisses positive comments.
He got through high school with lots of prodding and case management. Since then he has been unable to successfully complete classes or keep a job, or stay in agency programs. Late in high school Risperdal was added to his mix of meds. Since then he has gained a lot of weight, overeats, sleeps a lot and complains of lack of feelings. I think Risperdal is making things worse - has anyone experienced this also? Currently he has Rxs for Risperdal and Zoloft but I am fairly sure he has stopped taking them. And he skipped his last pschologists appt.
Almost everyone that deals with him finds him very engaging, vunerable and a"good kid." The world has expectations for him to be a MAN and he is far from that goal.
I am looking for some way to reach him before I lose him to depression, drugs and defeat.
Posted by linkadge on June 24, 2003, at 16:04:31
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
It seems that purely serotogenic meds like zoloft, anafranil, etc can lower motivation.
Meds that also lower dopamine can impair motivation, (any of the antispychotics like Risperdal)
Wellbutrin can increase motivation but add irritability due to its ability to selectivly increase dopamine.
You may want to try a dual acting medication such as Effexor, (if you havn't already tried it)It can both improve mood and motivation(serotogenic and norepinephrine)
Some other dual acting ones are Amitryptaline, and Duloxitine (prozac 2, which is coming out soon)
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.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.
Best of Luck
Linkadge
Posted by BrittPark on June 24, 2003, at 17:14:55
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
Your son seems to have a very complex mixture of disorders. It also sounds like he has problems with treatment compliance.
Here's what I'd suggest. First get him seeing a psychiatrist. Psychologists can be helpful but more often than not for the seriously mentally ill they are counterproductive. By law forbidden to prescribe appropriate medications they often make a virtue of what is in fact a disadvantage.
In principle I agree with Linkadge's advice that simplicity in the mix of drugs that can be found that are effective is a goal. However, I think it's a subsidiary goal. The primary concern is to get your son happy and able to move on with his life. Given the broad complex of problems your son has I think it very likely that polypharmacy is going to be necessary to help him significantly.
It seems as if your son needs minimally an activating AD, a psychostimulant, amphetamines, methylphenidate, or provigil, perhaps an antipsychotic and perhaps other drugs to potentiate the main drugs. I'm not a psychiatrist, obviously, so take my advice with a hefty grain of salt. I do very much think that it is important that you find an aggressive psychopharmacologist to start the search for the right combinations of medications sooner rather than later. It's also important to find a way to ensure compliance with his medications.
Best of Luck,
Britt
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.
>
> Meds that also lower dopamine can impair motivation, (any of the antispychotics like Risperdal)
>
> Wellbutrin can increase motivation but add irritability due to its ability to selectivly increase dopamine.
>
>
> You may want to try a dual acting medication such as Effexor, (if you havn't already tried it)
>
> It can both improve mood and motivation(serotogenic and norepinephrine)
>
> Some other dual acting ones are Amitryptaline, and Duloxitine (prozac 2, which is coming out soon)
>
>
> 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.
>
> 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.
>
> Best of Luck
>
> Linkadge
>
>
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
Posted by ace on June 25, 2003, at 1:02:54
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
> My son(age 21)is lost in a maze of diagnosis, comorbidity and medications. His survival out in the world is seriously in doubt because of zero motivation to do ANYTHING. He was approved for SSI this year while he was working part time. Now he is unemployed, living in clutter, smoking pot, dropping out of his one college class and not even trying.
I'm sorry to hear about this. It can be a hard age.
> In looking for answers, I've come across the drugs Adrafinil, and Provigil. Light bulbs went off when I started reading about the effects these drugs may have on the brain. The description of what the ventral striatum area contols is almost an exact definition of what my son lacks - cognitive flexibility, coherence, vigor, goal oriented behavior and associative learning. Has anyone seen an increase of motivation, drive or setting and attaining goals or sustaining effort on Adrafinil, Provigil or some other meds? My son has been on Cylert, Ritalin, Concerta and Wellbutrin over the years. Most were stopped because of irritability or lack or lessening of response. Most were taken along with other drugs so I am unsure how they really worked. We saw improved neatness, especially in handwriting.
For motivation I would urge an MAOI. Either that or Ritalin, but you mention you've tried this?
> He definitely has a history of some sort of PDD. He matches so many symptoms in the DSM but does not match any diagnosis definitively. The psychologist who treated him for years referred to his symptoms as a bowl of spaghetti. Diagnosis history includes Asperger's, severe NVLD, ADD, bipolar, ODD and depression. Meds seem to lead to only temporary improvement or change. He has been on so many different meds I honestly don't know the difference between symptoms and side efffects.
I wouldn't worry too much about these 'labels'. I would concentrate on his behaviour and symptoms. Labels serve to get one into big trouble.
> He has many Asperger's characteristics so how can he be a pathological liar too? How can his early language skills be classic hyperlexic but didn't read until age 7 and has very good comprehension? How can he have ODD but has never been in any real trouble at school or with the police? How can he be bipolar but never really manic? The huge spread between high verbal IQ 125 and low performance IQ 72 result in expectations being too high or too low. The resulting frustration has led to some of his seething anger but does not really explain his temper outbursts. Positve reinforcement doesn't work anymore, he rebuffs and dismisses positive comments.
>
> He got through high school with lots of prodding and case management. Since then he has been unable to successfully complete classes or keep a job, or stay in agency programs. Late in high school Risperdal was added to his mix of meds. Since then he has gained a lot of weight, overeats, sleeps a lot and complains of lack of feelings. I think Risperdal is making things worse - has anyone experienced this also? Currently he has Rxs for Risperdal and Zoloft but I am fairly sure he has stopped taking them. And he skipped his last pschologists appt.
>
> Almost everyone that deals with him finds him very engaging, vunerable and a"good kid." The world has expectations for him to be a MAN and he is far from that goal.
>
> I am looking for some way to reach him before I lose him to depression, drugs and defeat.
Sure, I understand. First of all, I would urge him to talk about want he wants in life. Prod him for his goals/ambitions- he would have them I'm sure. Take one step at a time to achieve them. Once started motivation might flow. Secondly, a young man with mental illness smoking a lot of pot is not good. This must stop i think. It is probably what is making him so apathetic- I lived with guys in the past who smoked it all day- they lost all motivation. Thirdly, I would urge new medication- such as an MAOI, Remeron, or Zyprexa- these meds work well for a wide range of disorders.He sounds very talented, and I'm sure there is that spark in him. He just needs to get all the
thwarting influences away- pot, giving in to urges to stay in bed etc etc.Good luck to you.
Ace.
Posted by HenryO on June 25, 2003, at 6:05:03
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
I am a bright guy with a very confusingly low motivational level. I was dyslexic, charming smart and totally unengaged in all school work. My parents had me to so many shrinks from 5 to 21 I've lost count. I think my depression began in 1st or 2nd grade. Maybe your son's started much earlier. Nobody has ever been able to understand my lack of motivation least of all me. I did my math home work maybe 10 times in all those years, if you threatened my life. I could almost write a term paper the night before it was due if you gave me a month to do it. I discovered pot and alcohol around 14 or so. I was interested in those two things. I could line up my supplies. I was good at that. It actually did more harm than good but I needed all the relief I could get. Relief from what I’m still not entirely sure, but it was the priority.
I barely and I do mean barely graduated from highschool. I have been to more colleges than anybody I know but have rarely finished a class. Depression has been more or less a constant. I think that the depression was a made much worse by repeated baffling and demoralizing experiences. I hear stories like his and like mine at least once a week. He is struggling under a load of illness and expectations that are sinking him over and over. He is sick, confused and demoralized. That’s my territory.
Some people are just not that well equipped for this world. If you’re missing some crucial parts then all the other good qualities in the world won’t get the job done. I’m smarter than hell in some ways. Showing up day in and day out is not one of them. I would love it to be. I can’t explain it to anybody. I have tried and tried. I don’t think I can explain precisely because it doesn’t make any sense. He is a classic. Help him find AA. My fellowship will welcome him in and help. It is gonna take between two to seven years for him to catch on. Feed him, house him and let him sleep. Just sleep. God, for a dark dark cool comfortable place to sleep undisturbed. Even a closet, but give him some dignity. Oh, to wake without being judged after 19 hours. Then to eat and shower take a look around and go back to sleep with nobody freaking out about it. That is heaven when your depressed. Anything else is terribly painful. Tell him you’ll provide him with that, if he goes to one AA meeting a day. He’ll take that deal.
I would definitely be on the street right now without my parents assistance. Emotional pain is not categorically different from physical pain. I would trade a broken bone or three for my depression at any second. I tell people to think of the pain of a broken heart. It hurts so damn bad, and with depression you get the further insults of it being pointless, subjective and chronic. He has an illness just like the flu or diabetes. You can’t reason with or coerce a sick person to get well. Self knowledge avails us nothing. Have him read this entire post.
Hey, my friend whom I don’t know yet. There are people just like you and me who have found something that works. But don’t take my word for it, check it out for yourself. Come in. Ask for help. Keep coming back. You don’t have to sign anything, say anything or pay anything. The weird thing is, meetings are actually funny. Life won’t transform into some blissful alternate dimension but it will get a lot better. You will even start to like it. That I can promise.
The world has expectations for him to be a MAN and he is far from that goal. Can you hear what he hears? How could you not be frustrated. Imagine what he feels. You never had the power to cure him and you don’t have that power now. Don’t feel badly for not raising a brilliant well adjusted person. I was never going to be like everybody else. There is no such thing as a non-traumatic childhood. I had a shrink tell me once that I was trying to shoot my parents by pointing the gun through my own head. Wrecking my life to get at them. Well maybe, but they continually tried to save my life as well. Talk about ambivalence, I literally thought I was crazy. That is very painful as I’m sure you can see by watching him.
I’ve been on fifty or more of these meds. The stims aren’t gonna do it. Speed feels pretty good though and that’s not always a bad thing. Ritalin, Concerta, Dexedrine, Cylert, Provigil, Straterra, Adrafinil. They prescibed them. I’ve been on them. I'll try anything that might help. Ritalin is the one that makes me feel the best, for awhile. Resperdal knocks down my ability to feel anything and packs on the weight (and that’s depressing). Zoloft and Effexor work for some people for some things but they will hammer anybody’s sexuallity. That is very unpleasant. Prozac helped for a year or two but it only does so much and then it turns to ashes. Lamictal has been the best thing to date. I’m on 200mg. But alone it is useless. He’s got to get outside help. I have turned over a lot of stones in forty years and AA is the only lasting good thing I’ve ever found. Some people swear by different things. Power to them. If it works, do it. There is not any one drug or a cocktail of drugs that are gonna fix him, fast or slow. He like me may never be "normal". Do what you can out of love. And when people lay that "tough love" thing on you tell them to go to hell. You love him so give him all you can.
Posted by AOB on June 25, 2003, at 8:57:08
In reply to Re: Zero Motivation, posted by BrittPark on June 24, 2003, at 17:14:55
> Your son seems to have a very complex mixture of disorders. It also sounds like he has problems with treatment compliance.
Yes, currently he is noncomplant. Usually he begrudgingly takes his meds. When he was younger he would have spurts of not taking meds.
>
> Here's what I'd suggest. First get him seeing a psychiatrist. Psychologists can be helpful but more often than not for the seriously mentally ill they are counterproductive. By law forbidden to prescribe appropriate medications they often make a virtue of what is in fact a disadvantage.
>
He is seeing a psychiatrist - # 8!. Some of those were for assessment only, some assigned during hospitalization, insurance problems led to some changes, total incompetence led to some changes. Now he is seeing a pretty competent one, in a small town so there is not a lot of choice. They BELIEVED him when he says he is OK, they BELIEVED him when he puts on a defiant, tough guy front,angry at everyone. Sure he is angry but he is also afraid and wants to have friends, fit in somewhere in this world more than anything. The current Dr. at least sees through some of that. There is availability of a psychopharmacologist in our area but not where he is living now.> In principle I agree with Linkadge's advice that simplicity in the mix of drugs that can be found that are effective is a goal. However, I think it's a subsidiary goal. The primary concern is to get your son happy and able to move on with his life. Given the broad complex of problems your son has I think it very likely that polypharmacy is going to be necessary to help him significantly.
I read somewhere that it takes an average of 7 years to get meds right. He's been on meds for over 10 years.
>
> It seems as if your son needs minimally an activating AD, a psychostimulant, amphetamines, methylphenidate, or provigil, perhaps an antipsychotic and perhaps other drugs to potentiate the main drugs. I'm not a psychiatrist, obviously, so take my advice with a hefty grain of salt. I do very much think that it is important that you find an aggressive psychopharmacologist to start the search for the right combinations of medications sooner rather than later. It's also important to find a way to ensure compliance with his medications.
>
> Best of Luck,
>
> BrittThanks Britt,
AOB
Posted by AOB on June 25, 2003, at 9:58:52
In reply to Re: Zero Motivation, posted by HenryO on June 25, 2003, at 6:05:03
Thanks for sharing your inside world. I will reread it and think about what you said. I've tried total support and some tough love. He functions better with structure so it is a constant battle. The battle between us and the battle in my head and heart all the time. So many choices, so many opinions. I have tried to follow my "gut" feelings whenever possible because not doing that has led to disaster. Now I am actually exploring diets, brain scans - anything I might have dismissed before as non- traditional. I wish you could tell me what thought or behaviors lead to all the failures at school or work. That might help me understand.
Good luck,
AOB
Posted by HenryO on June 26, 2003, at 4:20:31
In reply to Re: Zero Motivation/Thanks Henry, posted by AOB on June 25, 2003, at 9:58:52
As far as an ADD label goes I subscribe to the notion that I was simply "more easily otherwise attracted." As far as paying attention in school I had to devote my energy to more important matters. Imagine you have some kind of fire in your brain i.e. pain, (that you don't realize is not what everybody else is experiencing) you have to devote a fair portion of your resources just to cope. It is like if you had a nasty burn on your hand, you simply can't concentrate, right. Certainly you would be looking for distractions or anything that made you feel better. Sometimes the only route left open is disassociation partial or otherwise. I was not some comatose basket case, I was a rambunctious, disruptive, bright and confused little person. Who grew into a self destructive sad angry addict. I had no more clue as to my motivations than anybody else who dealt with me. That didn't stop them from comming up with theories though. Ultimately my motivation is beside the point. I don't care what my problem is called or what its origins are. I tell people I caught it off a toilet seat. By which I mean knowing is useless.
The solution, now that is interesting to me.
Diets, brain scans, special schools, drugs, punishment, the loss of things I cherished, I suffered all those. I was unhappy and mystified. It is not like your son is enjoying himself. You have to assume he would act differently, IF HE COULD. AA won't kick him out. Just the opposite. It is full of broken people who know what it means to be utterly not in control of themselves. That is how they get there. They will speak his language. He will go if you promise to let him sleep and not berate him for it. Once he is among his own kind, sooner or later he will start to change for the better. It is called assmosis, you bring the body to meetings and something starts to seep in. I have seen many devistated people get better. He may think your nuts. One meeting a day in exchange for a peaceful place to sleep, some food, and as little judgement as you can manage. You will see a miracle. Go to some AA meetings yourself they are harmless enough. You'll hear a speaker or two describe mysterious nonconformity from the earliest age that blossomed into misery. We come in all stripes and flavors but this is a common enough theme. You might want to explore some Alanon meetings too. They may give you some notion as to the thinking of alcoholic/addicts. We are deeply irrational people. You will never be able to understand (one can't understand insanity) but you'll hear from other people who have dealt with similar loved ones. That will help.
Posted by HenryO on June 26, 2003, at 4:37:06
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
I can't believe this discussion has not been kicked over to Psycho-Social-Babble that is where it belongs.
I am sitting here thinking about zero motivation, it seems to be the same thing as totally giving up. Hopelessness. What's the use. The same thing will just happen again. It's heart breaking. Heartbroken. Completely demoralized. My life is ruined so why not go all in and destroy it completely. I know what that's like.
Posted by Ame Sans Vie on June 26, 2003, at 8:29:02
In reply to Re: Zero Motivation, posted by HenryO on June 26, 2003, at 4:37:06
The low dopamine thing was already mentioned on here, and I have to say it certainly has played the largest role in sapping my motivation. I am able to say this because just a couple months ago I was just like your son (I'm male, 20 years old, completely unmotivated but very bright--however, unlike your son (AFAIK), agoraphobic). I researched meds endlessly until I stumbled across Mirapex--an anti-Parkinsonian drug that is a dopamine agonist. There are many of these types of drugs available (Permax, Symmetrel, etc.) but only Mirapex and Requip, relatively new medications, are more specific for the D-3 receptors than the others. I would urge you to run a search on Google for "Mirapex Prozac" to find a study that compares the effects of these two drugs in treating depression. Mirapex is lacking all the side effects of the antidepressants (the only side effect I have is mild sleepiness occasionally, and when first beginning the medication it's common to experience some nausea). It is believed that the D-3 receptor stimulation is responsible for its marked antidepressant qualities (relief of anhedonia, amotivation, anergia, melancholy, and even improvement in sex drive). Mirapex (in combination with Klonopin for my agoraphobia/socal anxiety has been a true lifesaver for me, and I strongly urge you to read up on it (and Requip, for that matter), print out some information, and have your son present it to his doctor.
Best of luck to you and your son, and I'd really like to hear any future updates!
Posted by ace on June 26, 2003, at 22:28:02
In reply to Re: Zero Motivation -- Mirapex is the cure, posted by Ame Sans Vie on June 26, 2003, at 8:29:02
I think I read one of your posts before on this- you really seemed happy! Unfortunately I don't think us Aussies can get it- stoopid governement! But I'll check again. Did it help for depression OCD or any other probs? Once again, congrats on the great find!Ace.
Posted by Ame Sans Vie on June 27, 2003, at 0:21:30
In reply to Re: Zero Motivation -- Mirapex is the cure » Ame Sans Vie, posted by ace on June 26, 2003, at 22:28:02
Hi Ace, thanks for the congrats. :-) Actually, Mirapex *is* available in Australia, under the brand name "Sifrol".
I don't have any symptoms of OCD, but as for depression, it ABSOLUTELY helped. Better than anything I've ever taken, and I'm somewhere up in the 50's as far as the number of drugs I've tried. I'll see if I can find anything on Mirapex and OCD, or, more specifically, dopamine and OCD.
Posted by Ame Sans Vie on June 27, 2003, at 0:26:36
In reply to Re: Zero Motivation -- Mirapex is the cure » Ame Sans Vie, posted by ace on June 26, 2003, at 22:28:02
Sorry to say, I just ran a quick search on OCD and dopamine, and it appears the consensus is that raising dopamine alone would be detrimental to OCD patients. However, it was also mentioned that it is postulated that those with OCD have low dopamine in relation to serotonin and norepinephrine. So it's possible that a moderate-dose SSRI in combination with Mirapex (which eliminates the sexual side effects of SSRIs) could be beneficial... or perhaps even adding Mirapex on to your precious Nardil? :-)
Posted by ace on June 27, 2003, at 2:25:29
In reply to Re: Zero Motivation -- Mirapex is the cure » Ame Sans Vie » ace, posted by Ame Sans Vie on June 27, 2003, at 0:26:36
> Sorry to say, I just ran a quick search on OCD and dopamine, and it appears the consensus is that raising dopamine alone would be detrimental to OCD patients. However, it was also mentioned that it is postulated that those with OCD have low dopamine in relation to serotonin and norepinephrine. So it's possible that a moderate-dose SSRI in combination with Mirapex (which eliminates the sexual side effects of SSRIs) could be beneficial... or perhaps even adding Mirapex on to your precious Nardil? :-)
Hey Ame Sans Vie!,Thanks so much for your research! Fully Appreciated! I'm definately going to check out about Mirapex tonight. With the dopamine thing- I actually believe people with OCD have different imbalances ie OCD has a different chemical cause in each sufferer. So Mirapex could be spot on. Either that or Zyprexa.
Dropping Nardil is not an option....even with my less than functional you know what! Maybe Mirapex or Zyprexa would reverse this effect?Anyhow, thanks again- I remeber seeing your post and you saying 'I wish everyone could try this Mirapex' You said you had a smile on your face- that post was so great and it's wonderful to hear it's helped you- really helps us all to hear about wonderful responses and happy people!
All the best to you, keep me posted on how you're doing Mirapex lover!
Ace, Nardil lover, 90mg.
Posted by Ame Sans Vie on June 27, 2003, at 7:58:49
In reply to Re: Zero Motivation -- Mirapex is the cure » Ame Sans Vie, posted by ace on June 27, 2003, at 2:25:29
I'm really glad you've decided to look further into it! We really need someone to go ahead and be the "guinea pig" to see how it works with an MAOI, lol (I know they're not dangerous together; I just want to see how they synergize).
As far as the sexual dysfunction from Nardil, I can all but guarantee you that it will be eradicated once you reach a high-enough dose of Sifron (i.e. 2-5mg per day). Zyprexa would more than likely make this problem even worse... I think I'd personally want to consider the Sifron first, lol.
Posted by McPac on June 29, 2003, at 1:36:35
In reply to Re: Zero Motivation -- Mirapex is the cure » ace, posted by Ame Sans Vie on June 27, 2003, at 7:58:49
I too was wondering how an OCD'er would fare on Mirapex? I'm always very weary of ANYTHING making my ocd worse.
Posted by beppe3 on July 1, 2003, at 0:45:44
In reply to Zero Motivation, posted by AOB on June 24, 2003, at 13:40:22
Sorry to hear about you and your son's struggle. From my personal battle with depression and alcohole-drug dependance I have found the 12 step program to be the 1 thing that has kept me functioning through my battles.
I was first diagnosed with depression after my hsopitalization for an eating disorder over 15 years ago. Over the years I have tried different medications, a variety of therapy, compolete denial of having a problem to using drugs and alcohol to self medicate my ups and downs.Point being after 15 years of trial an error I recently was forced into AA and it has been my saving grace. I don't like going to meetings half the time, but afterwards I alwyas hear something I need to hear. The program holds me accountable for my actions and it is giving me the tools to get back on my feet and off of SSI.
I strongly suggest you get a list of AA meetings in your area and try to get your son to go sit in and just listen and that you go to an alanon meeting and get support for yourself and receive the tools you'll need to help you and your son.
Once again, I'm speaking from experience.
Good luck and have faith!
Posted by AOB on July 2, 2003, at 10:40:35
In reply to Re: Zero Motivation » AOB, posted by beppe3 on July 1, 2003, at 0:45:44
Thanks for your insights into your and my son's problems. I have thought of AA but he is not interested. He has attended a few meetings with a friend(acquaintance, he has no friends)and really liked the desserts after the meeting. I guess what I am saying is that he is not "there" yet. I will keep trying to encourage him to go back to a meeting. He starting using pot as a way to fit in and look cool to people he was hanging out with. He found it was an escape even though very temporary. I am afraid he is the type to get hooked quickly though. He is living across the country from me and I have little influence in his day to day life. He has admitted than I have very good insight into what makes him "tick" and usually he respects my opinion begrudgingly.
I think he needs to be on the right medications to be receptive to AA, counseling, behavior modification or whatever.
Stimulants have helped in school or job performance in the past. He is NOT a good candidate for a controlled substance however. I have been researching Provigil, Strattera, Mirapex, and I am confused to say the least. I am looking for a site that give more details than is given on the Medline site about the theory of how a drug works.
We found accidentally that he improves on fish oils/Omega-3. He went thru a period of eating sardines everyday. His mood improved considerably. Then I read about the benefits of Omega-3s. He stopped his sardine obsession but took fish oil pills until the side effect of diarrhea stopped that. Now he won't touch them.
Has anyone had luck with Omega-3 without side effects?
AOB
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