Current Therapeutic Medication Schedule: Fill & Download for Free

That “would look like” me; quite attractive and with a few extra pounds. Seriously, though, inattentive ADHD and mild Borderline Personality Disorder is a frustrating combination. I resent being labelled as irresponsible or being told I just don't care about the needs of others, and as much as I want to be completely different, the truth is that I cannot completely change those aspects of myself because a significant part of this hot mess is the wonky chemical soup in my brain.I've been though many years of therapy, including EMDR to address and allow me to recover from the PTSD due to early childhood trauma and a couple of assaults as a young adult. I am still working with a therapist and we're diving into DBT (Dialectical Behavioral Therapy) to help me with the instinctual BPD reactions. It's freaking hard! I don't hold a traditional job because I have crippling anxiety and some medical issues that get in the way of holding a reliable schedule. However, I stay relevant and participatory in life as the Mom of 2 amazing teenage boys who are on the Autism spectrum and considered “high functioning”, as well as being a wife, a friend, a daughter, and part owner of a small but growing business.I also deal with being bipolar with rapid cycling mixed episodes. I keep my appointments with my psychiatrist, I see my therapist regularly, I take my medications, and I advocate for myself and my health by researching my conditions and staying on top of current therapeutic methods for them. My children have grown up watching me as I battled my illnesses, sought diagnosis and care, struggled with balancing medications, and being transparent through the process. My children take their medications (sadly they both inherited issues), and to them it is completely normal to take care of their mental health as equally as their physical health.It is not impossible to lead a life of fulfillment and value with all of this going on, but it is exceptionally more difficult than someone who is neurotypical.

I will assume that you're asking about antidepressant medications. The best antidepressant is, of course, the one that works best for you w/ the fewest side effects. It's important to distinguish here between unipolar & bipolar depression (bipolar = cyclical depression w/ periods of mania/hypomania, or, in some cases, euthymia).In unipolar depression (which is more common), the initial go-to antidepressant is an SSRI (serotonin selective reuptake inhibitor). It doesn't matter much whether there was a precipitant or not to the depression (although clear lack of a precipitant is suggestive of bipolar etiology). If someone has been treated successfully in the past, then it's generally wise to go back to that previously successful treatment. If someone has a family history of depression & some medication worked well for a sibling or parent or child, then that medication is probably a good option.The SSRIs are more similar than not, differing mostly in their half-lives & interactions w/ other medications. Efficacy & side effects are more or less the same. They are all good for anxiety. They all cause sexual problems in many users. Other common side effects are nausea, increased appetite, & sedation (or jitteriness). I usually prefer sertraline (zoloft) or citalopram (celexa & lexapro) as a first choice. There is an SSRI withdrawal syndrome that can happen if you suddenly stop an SSRI you've been taking for more than a few weeks. I avoid paroxetine (paxil) b/c it has a short half life &, as a result, worse problems w/ discontinuation (or a missed dose) than the other SSRIs.If someone is bothered by the potential side effects (particularly the potential for sexual problems) of SSRIs, then bupropion (wellbutrin) may be a good choice. It's mechanism of action is obscure but it is not an SSRI. It tends to be energizing (it's related to amphetamines) & can cause agitation, anxiety, & insomnia. Very often, people have an initial response to the amphetamine effect, then have to go up on the dose later, as that initial effect wears off.In the elderly in particular & in people where initial insomnia is an issue, mirtazapine (remeron) can be a very good choice. It takes a while to get up to a therapeutic dose (it makes you very sleepy) & weight gain is a common side effect. It's not bad for anxiety either. Mirtazapine is a 5HT2, alpha 2 adrenergic, & histamine 1 antagonist).In biplar depression, I would try a mood stabilizer first - lithium or lamotrigine (lamictal). Lithium plasma levels have to be monitored, since it has a narrow therapeutic index, but it's a great medicine for some people & is underutilized. Lamotrigine takes a long time to get up to a therapeutic dose. If someone was already on a mood stabilizer like valproate (depakote) or oxcarbazepine (trileptal) for a previous manic episode, then fluoxetine (prozac) or wellbutrin might be a good choice for a new depressive episode. Using an SSRI or other antidepressant in someone with bipolar disorder, but not on a mood stabilizer, risks drug induced mania.I don't need to remind you that medications won't fix unemployment, incarceration, romantic rejection, trauma, or the whole host of psychosocial afflictions that all of us are subjected to at some point(s) in our lives.It's very important to avoid drugs & alcohol over-use during depression. While this may dull the pain, getting high doesn't help in the long run. Exercise is always good for you. Keeping to a regular schedule & not screwing around w/ your circadian rhythms is also important.A good relationship - someone you care deeply for & who cares deeply for you is the best antidepressant - but we can't put love into a pill.

“I quit smoking weed for a month, but I don't think I can do it anymore. Should I cave in? I've had this feeling for days now and it's unbearable”Really?!!Really!!!Is it the physical addiction? Sorry, but, that’s simply not possible.Dr. Ethan Russo is a true cannabis expert -Full Study, free access - Current Therapeutic Cannabis Controversies and Clinical Trial Design IssuesCurrent Therapeutic Cannabis Controversies and Clinical Trial Design IssuesEthan B. RussoPHYTECS, Los Angeles, CA, USA -excerpt follows - The issue of cannabis abuse and dependency remains quite controversial. A cannabis dependency syndrome has been posited (Budney et al., 2004), with an oft quoted figure of 9% of ever cannabis users becoming dependent at some point. In the USA, at least, these figures, which apply to “recreational” usage must be tempered by the fact that greater than 50% of patients admitted to substance abuse treatment programs are there by legal mandate as an alternative to prosecution or incarceration, and not always because of an actual addiction to cannabis. Other authorities opine that cannabis has a DAL lower than that of other legal and illicit agents (Hilts, 1994; Roques, 1998; Nutt et al., 2007). The relative addictive potential of a drug is ascertained by judging its attendant intoxication, reinforcement, tolerance, withdrawal and dependency. DAL requires additional determination of public health and legal data on its degree of abuse and diversion. The advent of the Internet has revolutionized promulgation of drug information to any inquisitive potential consumer.Herbal cannabis is scheduled in international and national categories that generally designate it as addictive or dangerous, having severe abuse potential, and lacking any recognized medical utility. In contrast, Marinol®, a synthetic form of THC has been down-scheduled in countries where it is an approved pharmaceutical, to a category denoting a lesser potential for abuse or lower dependency risk, after documentation showed rare abuse or diversion to the black market (Calhoun et al., 1998). This precedent is one that could potentially be repeated with cannabis-based medicines once their safety and appropriate DAL risk is demonstrated.Intoxication, as noted above, is rarely problematic in long-term usage of nabiximols. The reinforcement properties of a drug are mediated in part by the rapidity of its delivery (Samaha and Robinson, 2005). Nabiximols' onset of effects is 15–40 min, with peak activity in a few hours. This is considerably slower than most drugs of highest abuse potential. Smoked and injected drugs produce greater reinforcement with higher peak serum and brain levels (Samaha and Robinson, 2005). Nabiximols effect onset is intermediate between that of inhalation and that of oral administration. CBD modulates the psychoactivity of THC (Russo, 2006a; Morgan and Curran, 2008; Morgan et al., 2010a,b). Euphoric mood, while desirable to recreational cannabis users, would be a possible risk for abuse in medical users, but has been uncommonly observed with nabiximols (Wade et al., 2006, 2010; Robson, 2011). Given acutely, particularly in cannabis-naïve individuals, THC may produce typical reactions such as tachycardia, hypothermia, orthostatic hypotension, and dry mouth, but these are subject to rapid tachyphylaxis in chronic administration (Jones et al., 1976). The latter side effects have become less prominent with slow titration of nabiximols (Russo et al., 2008), and it has shown no dose tolerance with respect to its therapeutic benefits in MS or treating cancer pain after prolonged usage as long as several years (Wade et al., 2006; Notcutt et al., 2012; Serpell et al., 2013).Information from nabiximols RCTs and safety-extension (SAFEX) studies does not indicate any particular evidence of reinforcement. Euphoric mood is reported in nabiximols clinical trials with under 2% incidence (GW Pharmaceuticals, 2011).Tolerance is quickly established to various manifestations of cannabinoid intoxication: tachycardia, hypothermia, orthostatic hypotension, dry mouth, ocular injection, intraocular pressure decreases, etc. (Jones et al., 1976). In over 15,000 patient-years of experience, no dose tolerance to nabiximols has been observed, however, while therapeutic efficacy is maintained (Wade et al., 2006; Notcutt et al., 2012; Serpell et al., 2013) In SAFEX studies in MS and peripheral neuropathic pain, nabiximols doses have been steady or reduced after months or years of administration (Serpell et al., 2013; Koehler, 2014). Symptomatic pain control is maintained with slow continued improvement in non-progressive disorders.The existence or severity of a cannabis withdrawal syndrome remains under debate (Smith, 2002; Budney et al., 2004). In contrast to reported withdrawal sequelae in recreational users (Solowij et al., 2002), 24 subjects with MS who volunteered to discontinue nabiximols after a year or more suffered no withdrawal symptoms meeting Budney criteria. While symptoms such as pain recurred after some 7–10 days without Sativex, symptom control was rapidly re-attained upon resumption (Wade et al., 2006). Similar safety was noted in a clinical randomized withdrawal trial in spasticity of MS (Notcutt et al., 2012), wherein 36 patients previously improved on Sativex showed no withdrawal symptoms of significance. Additionally, in a study of 136 MS patients taking Sativex for a mean of 334 days, sudden cessation, no withdrawal effects of associated adverse events were reported (Serpell et al., 2013).Sure, you may want to feel better, or, you may crave getting high, but that’s not a physical addiction, (I sometimes crave ice-cream) it’s simply not possible to have physical withdrawal period, and certainly not 6 months later.***for clarity, patients using cannabis for medical purposes, can suffer physical symptoms of course, it’s the condition not being treated by the medicine you’re not using, likely because you can’t afford it.