Frog82 Introduction

[Frog82]

Hi New here been checking out the forums, lots of good info. 

 

Been struggling a bit. Refer to sig. Think I've been put on wrong combination of drugs. Looking to go off quetiapine and mirtazapine in that order. Apprehensive about the quetiapine - was one of the two meds that reduced within a week, leading to second admission. That taper was supposed to have been quetiapine 100-50-25-0 with a month at each level.  Needless to say that the quetiapine 100-50 drop combined with venlafaxine drop 300-225 (75mg per month till 0) saw me admitted for 5 weeks... So they took me off the venlafaxine after much heated discussion. Put the quetiapine back to 100mg ir after trying me on a cocktail of lorazepam, mirtazapine 45mg quetiapine 200ir, 100xr, I could fall asleep for 2.5hrs and wake up wide awake for hours... So on discharge it was mirtazapine 45mg, quetiapine 100mg. Been on that for about 2 months. Saw psychiatrist today who said go quetiapine 100-75-50-25-0 with a week at each level... 

[Altostrata]

Welcome, @Frog82

 

How often do you take diazepam? Please start keeping a diary of when you take it and the dosage. This may be important.

 

Of the drugs you're taking now, quetiapine is the highest risk to health. Here is our topic Tips for tapering off quetiapine (Seroquel)

 

We recommend a much slower tapering schedule, to avoid triggering withdrawal symptoms such as insomnia, headache, night sweats, difficulty concentrating, high blood pressure, tachycardia, surges in anxiety, etc. See Why taper by 10% of my dosage?

 

You may need liquid forms of the drugs to taper. Will this psychiatrist help you?

 

 

[Frog82]

Hi, hadn't really thought to much about it, as required but usually 1 or 2 per week. 

 

Absolutely agree about the quetiapine. I never ever had problems with suicidal ideation until after I left hospital the first time. During that stay was when they reduced venlafaxine from 450mg to 375mg and started me on mirtazapine and quetiapine.. 

 

Very familiar with the "withdrawal symptoms such as insomnia, headache, night sweats, difficulty concentrating, high blood pressure, tachycardia, surges in anxiety" from going on, being on, and going off venlafaxine... 

 

People seem to think that if you're not taking a medication that has caused problems that you are 'right..' problem solved. I was admitted to hospital, ended up in for 5 weeks. I was taken off venlafaxine in hospital in 13 days in psychiatric ward. I was an absolute mess for 3 weeks while going off it. It was the worst 3 weeks of my life. It's not yet been 2 months since I left hospital and my head often feels like it's been put in a blender. 

 

Definitely don't want to be doing that again. You learn a lot with the benefit of hindsight. 

 

A large part of my time since leaving hospital has been devoted to trying to put in place long term supports.

I live in country Western Australia. The hospital I was admitted to was 4hrs drive from home. 

The psychiatrists that I had in hospital are not involved in my ongoing care. The community health psychiatrist was consulting (not permanent) and when I saw him the other day he told me he was moving on to other things (he is in his 70s) and that would be the last time I see him. 

I've an appointment in 3 weeks with a private psychiatrist. Hopefully he will be on board for the long haul. 

I've found a good GP to work with over the long-term who has been very proactive. Unlike my previous GP who had me 450mg of venlafaxine without a psychiatric review...... 

Have found a psychologist who is good but booked for 2.5 months in advance. Am on the list for cancellation appointments, though they are an hour and a half drive away... 

Ive just completed an online course for cbt with moodgym and am working through a ptsd course with mindspot. 

 

 

So all in all I am quite keen to not be on medication that leaves me either suicidal or passively suicidal.. I do have very good supports in place. 

 

I wasn't sure if, but was starting to suspect that I could have similar side effects going of quetiapine and mirtazapine as going off venlafaxine. Hence the doing as much research as possible to try and minimise damage, maximise success. 

 

[Altostrata]

13 hours ago, Frog82 said:

I was taken off venlafaxine in hospital in 13 days in psychiatric ward. I was an absolute mess for 3 weeks while going off it. It was the worst 3 weeks of my life. It's not yet been 2 months since I left hospital and my head often feels like it's been put in a blender. 

 

This sounds like withdrawal syndrome from the venlafaxine. Has taking quetiapine and mirtazapine helped these symptoms? What has their effect been?

 

Very few psychiatrists know anything about tapering psychiatric drugs or withdrawal syndrome. You may be best served by a sympathetic GP.

[Frog82]

I absolutely agree about the venlafaxine withdrawal. 

 

I am unsure about whether the mirtazapine/quetiapine has been helpful or not. 

 

The quetiapine was originally prescribed in hospital to try brake the severe middle insomnia that had developed whilst at highest dose of venlafaxine. That and hospitals are a crappy place to sleep at the best of times, never mind when you have a nurse checking on you every half hour to make sure you are alive.. 

 

The mirtazapine was prescribed to help with sleep and depression, as the second component of Californian rocket fuel.. Under the you have a chemical imbalance, depression runs in your family treatment model. 

 

Falling asleep has never really been a problem. Staying asleep and returning to sleep after waking up has been. To that end this combination at current dose seems for the most part to work. 

 

Though with quetiapine as prn (as required, when things too much) in hospital, I did not find it helpful at all and ended up refusing to take it for this purpose. Lorazepam was effective in those instances. 

 

Sympom wise, I never had problems with suicidal thoughts and self harm until on the venlafaxine, mirtazapine, quetiapine combination. I was going to bed hoping to never wake up. Waking up going, oh crap I haven't died. Rebuilding myself for another day. I couldn't walk past anything without thinking how it could be used to end life.

 

Que hospital stay two. I don't want to die, I want the pain to stop. I want to get better and not have these thoughts. 

 

It's been roughly 2 months since the cocktail became a 2 drug affair. I've felt flat a lot. Especially in the morning. I've lost about 6 or 7kgs. I am not interested in food. Not hungry. Unusual for this combo which has a record of weight gain. Past 2 weeks, passive suicidal, death by accident type thoughts, maybe I should do my will, kinda thing. 

 

I am not working at present. (self employed) Trying to focus on getting well. I walk for about an hour each day. Our dog is quite persistent about that...

 

At this point I have 3 goals for the day. Have a shower. Go for a walk. Talk to someone I don't live with, preferably in person. 

 

I generally haven't been sleeping or napping during the day. 

I am trying to do activities that I used to enjoy. I don't enjoy anything at present. Still generally feel flat or disinterested. I have trouble concentrating or focusing on anything. As I said often feel like my brain has been put in a blender. 

 

About the only time I start to pick up during the day is about 3 or 4hrs before bed, when I know I am going to take medication shortly and fall asleep. 

 

I stopped drinking alcohol after first admission. They were concerned I was alcoholic or at risk of becoming one. Has never been a problem. 

 

Agree about the sympathetic GP, she will actually ring to check how I am going when she knows I am struggling. She contacts the places I've been referred to when concerned about length of time between appointments and treatment. I am glad I've found her to have as part of my treatment. 

 

Not sure if I can get quetiapine as a liquid prescription in Australia unless I diy or through compounding pharmacy. Been reading up a bit. 

 

A couple random thoughts about the venlafaxine. When admitted to hospital the first time they did fasting blood test for levels. Got results back and started reducing venlafaxine straight away. Three days later my blood pressure started to drop. They had been seriously talking about blood pressure meds until it began to drop. 

Second admission they did fasting blood test. Oral dose was 225mg. Blood test showed no venlafaxine and desvenlafaxine outside therapeutic range. The thinking being that body had become used to processing 450mg over a long period of time, that when the dosage had dropped to 225mg (over the space of several months) it was processing it at the same speed as previously and dropping out the therapeutic range daily... 

 

I also had a PGx test done whilst in the second time. It came back with a lot of information on various meds. It also covers a lot about how certain medications interact with certain genes and how some are actually competing for the same receptors and have differing affinitys for them. Aka the champagne fountain analogy. 

 

The other thing that was picked up by the blood work was my cholesterol levels are out of wack. I have high levels of HDL and low levels of LDL but combined I have 'high cholesterol'. 

 

[Frog82]

When I saw the psychiatrist the other day he asked me if I had thought about going on a drug holiday.. Let's be clear I've never taken illicit drugs or those not prescribed to me. The main reason that I wanted to see him and talk about, was that I don't think the combination of drugs is healthy and I want to come off them.

Safely.

Let's be clear I must be in bed not more than half an hour of taking them. They knock me out. I tried to stay up a couple of times after taking them. It was like I was drunk, but worse, trying to get from the dining room to the bedroom. But my biggest problem is the suicidal ideation / passive suicidal thoughts. It's got to stop. The only common denominator is these two drugs, though I suspect it is the quetiapine. The mirtazapine hasn't been adjusted in 6 months. 

 

It is hard to work out what's what with the multiple meds.

That's why I want to come off them, or at least get it down one.

 

The other pearl of wisdom he shared is that 'I don't think that you have the type of depression that responds well to medication.' If he is right, hopefully, once I go off the medication and healed, I can lead a normal, happy life.. 

 

[Altostrata]

37 minutes ago, Frog82 said:

Falling asleep has never really been a problem. Staying asleep and returning to sleep after waking up has been. To that end this combination at current dose seems for the most part to work. 

 

How long has your sleep been stable? Why do you want to change this?

 

39 minutes ago, Frog82 said:

It's been roughly 2 months since the cocktail became a 2 drug affair. I've felt flat a lot. Especially in the morning. I've lost about 6 or 7kgs. I am not interested in food. Not hungry. Unusual for this combo which has a record of weight gain. Past 2 weeks, passive suicidal, death by accident type thoughts, maybe I should do my will, kinda thing. 

 

39 minutes ago, Frog82 said:

I am trying to do activities that I used to enjoy. I don't enjoy anything at present. Still generally feel flat or disinterested. I have trouble concentrating or focusing on anything. As I said often feel like my brain has been put in a blender. 

 

It's quite common after people have adverse psychiatric drug events, such as your adverse reaction to venlafaxine or severe withdrawal, that they have disorientation, emotional anesthesia, and demotivation. These post-drug symptoms can be dispiriting. Try to separate the withdrawal symptoms and how you feel about withdrawal symptoms. You have control over the latter.

 

Generally, we see these post-drug symptoms very gradually go away over months. Try to be patient and not dwell on how terrible you feel. See The Windows and Waves Pattern of Stabilization , which apply to recovery from drug adverse effects, too.

 

It is possible 100mg quetiapine and 45mg mirtazapine are too strong for you now. If I were you, I'd very gradually lower the quetiapine. It's important to be able to sleep in this recovery period.

 

What circumstances cause you to take a benzo? Please do keep a diary of this. Benzos can cause more problems than they solve -- but this can show up days later.

 

 

 

 

[Frog82]

Sleep has been improving over the last 3 months. It's the best it has been in about 6 years. My sleep had deteriorated so that I had middle insomnia. I was waking up between 1.30am and 2.30am and would be awake for several hours before eventually falling asleep again. I am hoping that the pattern of insomnia that had developed is broken. I don't want my current sleep to change for the worse.

 

I do however need to do something about the passive suicidal thoughts that are there from when I wake, for the first few hours of being awake, then fade as the day progresses. 

 

Ahh, I think I see where you are coming from.

 

The thoughts being more of a legacy of discontinuation of venlafaxine, than from the introduction of the new medications. Hmmm. I guess my attention has been drawn to the quetiapine as I really noticed it when the dose halved. But, the week before that the venlafaxine reduced, I did not notice it.. But, based on the blood tests and some of the changes in symptoms and delays in side effects, its possible that it was more about the venlafaxine. Hmm I will have to think about this. 

 

I've been reading the windows and waves and it's spot on. 

 

Absolutely agree with you lowering the quetiapine and maintaining good sleep. Both the quetiapine and mirtazapine are sedating so hopefully the reduction/removal of one at a time slowly won't be too disruptive. 

 

I will start keeping notes on benzo. I don't give it much thought. That in itself, is a good reason to keep a track of it.

[Altostrata]

It may be that even occasional benzo use can cause sleep problems. Please post your benzo notes here and let us know how you're doing.

[Frog82]

Well I guess it's perhaps time for an update... 

 

Well I had my first private psychiatrist appointment last week... 

 

He seems to think that I have adhd... (all the people who know me have gone No Way that I have it. 

 

Listed 4 treatment options

 

1. Admission for ect or rTMS or major med changes. 

 

2. Add vyvanse (lisdexamfetamine) (apparently not major change) 

 

3. Nothing. Continue Psychotherapy and current meds no changes. 

 

4. Shuffle meds, "minor changes" start brintellix (vortioxetine) 

 

Appointment next week to decide course of treatment. 

 

Feel a bit like an aircraft in a bad tailspin.. About to crash.. 

 

Had a call from my case manager with the health service. They found out that I had an appointment with private psychiatrist and want to offload me from their case list...

 

Have an appointment with my GP tomorrow and will try and work out a few things. I think it could be time to ask for my file, to try and work out what the psychiatrists have been up to. Apparently the public psychiatrist sent a letter to the private one outlining future treatments that weren't discussed with me... 

 

Sleep has been pretty crappy the past few days. Nothing to do with benzos, haven't had any for a couple of weeks. 

 

Just generally feel like crap. Feel like what I am on is going to kill me, and what's proposed isn't any better. Well maybe rTMS or ect. I dunno. Just wish it would all just stop. 

 

 

[Frog82]

Was reading another case history and thought I would update mine about some of the symptoms and side effects of being on and coming off venlafaxine. 

 

Historically I always had low blood pressure and heart rate. 

 

Being on venlafaxine I had all of the side effects. Headaches, migraines, night sweats, middle insomnia, difficulty focusing etc. 

 

It wasn't until I was in admitted (acute psychiatric ward) that high blood pressure and heart rate were identified. After being on the medication for 5 years.. 

 

On that admission they also kept on doing ecg's. Finally a Medical Dr came and gave me an ecg. Then explained to me that they had detected some irregularities. 

 

They also did blood tests for venlafaxine levels. They began reducing dose immediately on receiving results. 3 days after dose reduction blood pressure and heart rate went down. They had been talking about medication for blood pressure until that point. 

 

At the second admission, 2 months later, the ecg was ok. Blood pressure and heart rate were back up. Once again talk of medication for blood pressure. On this admission venlafaxine was ceased. Blood pressure and heart rate returned to my historical 'normal' (low).

 

Bear in mind that hospitals can be an incredibly stressful experience. They can also be very healing. It takes a lot of courage to admit that you are not well and need that level of care. The loss of independence, the realisation you no longer trust yourself. Meeting a lot of new people. Having your own routine put aside and adjusting to a new one. Trusting that these strangers have your best interests at heart. 

 

 

[Frog82]

Further update to Dr visit. 

 

They want me to start vortioxetine, with the view to reducing quetiapine and mirtazapine in the near future. 

 

Starting to give serious thought to non drug therapy. Possibly ect or rTMS. I just want to get better, preferably with out medication. 

[Frog82]

So my sleep this past week has gone down hill. Waking up early. No energy to get up. Just enough to roll over and lay there thinking for hours. Have started vortioxetine 5mg, Thursday. Surprised that I am not in hospital, but then nothing has happened to push me over that point. Yet. 

 

At this point I am glad that I am not on venlafaxine. But everything still feels off, scrambled. More glimpses of my old, before antidepressants, self. 

 

No motivation to do anything. I feel that my concerns about being overmedicated aren't really being treated as seriously as they should be. Is it possible that mirtazapine is to high? As opposed to quetiapine being to high? Thinking about asking for a lower dose script of each to make it easier to cut the tablets up to lower the dose more gently. 

 

I don't feel like I am relapsing into a depression, but I don't feel like I am getting well either. More like I am stuck in one place and liking it less and less as time goes on. 

[Frog82]

Time for another update.

 

I ended up with another stay at hospital. 5 weeks

 

I am no longer taking quetiapine. (Ceased while inpatient).

 

Had a course of rTMS

 

Mirtazapine reduced to 30mg during stay.

 

Treating Dr wanted me to start on Zyban and/or Lithium, which I declined.

Did start on low dose of clonidine 50 micrograms, to help me sleep, it didn't, which has now been ceased. Was often withheld due to heart rate being to low.

 

Also completed course in DBT and Intensive CBT group therapy whilst admitted.

 

Ended up being worse by the time I went home. Ended up having to deal with PTSD unexpectedly, core beliefs I couldn't reconcile, increasing isolation from protective factors, covid lockdown/restrictions (living in the country I had managed to avoid them all) and the death of a close friend. Lost confidence in treating Dr. It was time to get out of there....

 

I am now in the process of organising sleep studies to try and get to the bottom of the insomnia.

 

Also awaiting the results for some heart and blood tests. Have been started on perindopril erbumine (blood pressure med).

 

Have just started with new Psychiatrist. Melatonin ceased, mirtazapine reduced further and introduction of lamotrigine as a mood stabiliser.

He suggested starting at 25mg.. after my research I've started on much less and am going ok.  Long term plan is to only be on Lamotrigine or nothing.

 

Am quietly optomistic. Been back home for about 6 weeks. Starting to do more. Starting to feel a bit more like myself. Seasons are changing. Appreciating things. Been a very bumpy road.

[Frog82]

Next update I guess...

 

What a few months..

 

Where do I start..

 

Hmm sleep studies. Confirmed sleep problems.. Short version, not enough REM sleep and middle insomnia. 1st part of sleep ok, 2nd part broken by stopping breathing and waking.. oxygen desaturation in low 90's.. sleep, stop breathing, wake repeat....

 

Heart and blood tests.. nothing to worry about.

 

Got to 25mg of Lamotrigine.. developed rashes. Ceased.

 

One of my favourite Aunts Died.

 

After about 2 months of no change (improvement) in mental state, mirtazapine was ceased and I started on Nortriptyline 25mg increased to 50mg after 2 weeks. Drastic decrease in sleep. Big decrease in intrusive/suicidal thoughts/ideation. Itchiness, rashes, agitated irritable, everything annoying me. Even less sleep. Hands and arms aching, muscles feeling really tense. Pins and needles. Drastic increase in physical pain threshold - could put sharp knife/sewing needle in skin and it felt like a mug or cup resting there.. (no cutting or drug use I assure you). Difficulty focusing. Restless. No appetite. ect... 

 

Soo after taking the Nortriptyline for 3.5 weeks, they (case manager/psychiatrist) said stop taking the Nortriptyline on the phone and saw me 5 or 6 days later...

 

About a day-day and a half later some of the symptoms began to ease.. Itchiness, rashes, agitated irritable, hands and arms aching, muscles feeling really tense, pins and needles, all started to reduce in intensity.

 

How about we give you a medication holiday and we will see how you go for the next month?

 

Yay.

 

I had only been asking since March to come off the Quetiapine and Mirtazapine because I had a strong suspicion that they were at the cause of the intrusive thoughts and suicidal thoughts/ideation...

 

Well at least I had the self control to not do anything to alter my living/life status..

 

I wonder if I had been listened to, if everything since March could have been avoided..??

 

So now i am on the least amount of "stuff" in years, the ondansetron is to help with the constant feeling of nausea and try and pick up my appetite, the temazepam only after 3 or 4 days of trying to get my sleep back to normal and reaching that point of not coping. Get a little catch up sleep then go as long as I can before taking again (at least 3 or 4 days) until my sleep is back to normal. 

 

My blood pressure seems to have come down to a point that i might be able to stop the perindopril. it would seem that my body has been fighting all the drugs and now they aren't present my blood pressure has come down.....

 

So we will see how the next month goes...

[ChessieCat]

Thank you for updating your topic.

[Frog82]

 Hi thanks for reading.

I was starting to think I was the only one reading it

I still find the exercise helpful though, posting experiences and updates. It helps to see where I've been and what's been tried, in the one place. I am fortunate to have had good insight and some great help and support in real life.

I had read your story some time back. Life can be quite the rollercoaster at times. Congratulations on getting off the Pristiq safely.

[Frog82]

Time for another update.

 

Still on medication holiday. Still not right, but heading slowly in the right direction...

I haven't taken ondansetron or temazepam in the past month possibly 2 months now.

Appetite still not good but improving slowly. I've gone down several belt sizes in the past few months (at least 3 sizes).

Sleep is improving slowly still. I have some nights that I sleep very poorly yet others that are bordering on a normal nights sleep. I've gone from an average of about 4-4.5 hrs uninterrupted to about 6-6.5 hrs uninterrupted.

Concentration is still all over the place, taking a bit more interest in life.

I tire out very quickly and easily. I have lost my physical strength and stamina in the past 12 months of not working. I am in the process of engaging an exercise physiologist to come up with a plan to get my physical strength and stamina back up. Which will hopefully also improve my appetite and sleep further. Which should also help get other aspects of life back on track. Past few days I've woken between 3.30 and 4.30 am and ended up just getting up and taking the dog for a walk.. back home before sunrise though.. sadly I just haven't the strength or stamina to stay out that bit longer to watch the sunrise.  

Last time I saw my case manager and psychiatrist they began talking about discharging me back into the care of my GP soon.

Feeling a bit tired and off today. Crikey how many times can you read the same line over and over.. or retype what you were writing..

Take care people, have an awesome day.

[Frog82]

Hello again.

 

Another update I guess....

 

Still not better, but not "worse".

 

Been going back over things trying to work out why things aren't right/better/fixed.

 

Trying to order my thoughts trying to work out where to start/skip back to.

 

A psychiatrist I saw in person once and on skype once, who over saw my referral to a private clinic as inpatient said/suggested that I have ADD/ADHD.

We dismissed the idea and when I was discharged I never went back and saw him.

Our thoughts and all previous diagnosis being that I have Depression, anxiety and PTSD. That and the dose/combination of Mirtazapine and Quetiapine were causing/exasperating the problems.

 

However. Upon talking with a long time family friend who was recently diagnosed as ADD "inattentive" my wife and I have noted a lot of similarities to aspects of my life and behaviour. We are starting to suspect that it has been a comorbid condition (along with depression/anxiety/PTSD), masked by a combination of upbringing, medication and coping strategies (some positive, some negative).

 

I grew up in a household where positive behaviour was highly rewarded and negative behaviour brought discipline.

I didn't/don't come across as hyperactive, but for a lot of my life I suffered with bad allergies. The only effective medications I've found are polarimine and phenergan. Both of which are supposedly sedating... but for me, at the dose on the packet enabled me to function. I eventually ended up having to take them 11 months of the year and had to alternate between the two once one or the other became ineffective. 

Later on in life I did a course of immunology treatment which has negated the need for antihistamines down to maybe 6 per year.

 

Playing quietly and reading were strongly encouraged. Anytime that I had to sit quietly i.e. at school/courses I would be swing my legs, rocking my chair, doodling on whatever I could, that wouldn't get me into trouble, reading ahead. When questions were asked my hand was always the first up. I wouldn't interrupt the teacher because that would be wrong. Virtually all my school assignments were done the night before they were due, and I never did homework. If they couldn't teach it to me at school during school time I wouldn't do it.

 

Hate all ball sports.

 

I am always thinking (daydreaming) or I will hyper focus on things and ignore everything else. I've kinda gotten though life because of my trade and work choices. There was always drawings, procedures, lists, work orders. Boring work generally went to others and I was always involved in the specialty stuff and could hyper focus on it and was left alone to get it done. When given "boring or repetitive" tasks I would either try to turn it into a challenge or stuff around/take repeated breaks. I was always listening to music. Pretty much work until I was physically exhausted.  Always punctual for work, but frequently lose track of time otherwise. Usually hunger or exhaustion would be my time cues. I am usually really good at anticipating and planning for work tasks ahead of time. Either for later that day or the next. Other areas of my life have a complete lack of planning. Usually when going away I will pack my bag night before or morning of travel. I usually take more than is required.

I delegated bill paying and shopping to my wife years ago. I dislike being around people and waiting in lines. When it came to invoicing, whilst running my business I would do it, but it was frequently put to the bottom of the list and I would have to do it myself because my notes were insufficient to enable someone else to do it, but I would know everything about it. Damn it how many times do I have to use the delete key. :)

 

As a younger adult, I was always careful of my alcohol intake due to parental example.

 

I still am careful, but I can certainly admit to using alcohol and codeine medications to mitigate the side effects of the high dose of venlafaxine I was on. Since all the stuff that has gone on these past few years, alcohol, caffine and most dairy have largely been removed from my diet.  

 

While I have a pretty good driving record my wife is always chastising me to pay attention. Stop looking at the water main. Stop looking in the Paddock.. Often when I go quiet and my wife asks me whats going on or what am I thinking about I will tell her no less than 6-10 things that are going through my mind.

 

Ugh so much going through my mind to try and get out. There is probably more but I cant get it out right now.

 

So medication wise I am only on Perindopril for blood pressure and the occasional diazepam or temazepam to help with sleep/anxiety.

I am still seeing my psychologist every month - 6 weeks.

I have also been able to reincorporate fitness into my routine and have been going to the gym once or twice a day usually for an hour or two.

I still have not returned to work and still battle insomnia, depression, the inability to focus and concetrate. I tend to wake around 3.30-4am at present. Appetite is still generally poor, usually consisting of cooked breakfast mid to later morning 7.30am-11.30am and dinner around 6pm minimal if any snacking. Bed time between 8-10pm.

 

My wife wants me to reengage with a psychiatrist and see whether diagnosis and treatment will help me on the journey to get better. 

 

I recall that the Psychiatrist who reckoned I have ADD/ADHD wanted to start me on Vyvanse... So trying to get my thoughts out of my head. Curious if anyone has thoughts/suggestions/comments/experience. Thanks in advance.